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kottke.org posts about Ed Yong

Meet the Long-Haulers, Whose Covid-19 Symptoms Last For Months

posted by Jason Kottke   Aug 20, 2020

In the Atlantic, Ed Yong checks back in with the long-haulers, people who are still experiencing Covid-19 symptoms months after their initial infection. (Read his previous article from early June.)

Lauren Nichols has been sick with COVID-19 since March 10, shortly before Tom Hanks announced his diagnosis and the NBA temporarily canceled its season. She has lived through one month of hand tremors, three of fever, and four of night sweats. When we spoke on day 150, she was on her fifth month of gastrointestinal problems and severe morning nausea. She still has extreme fatigue, bulging veins, excessive bruising, an erratic heartbeat, short-term memory loss, gynecological problems, sensitivity to light and sounds, and brain fog. Even writing an email can be hard, she told me, “because the words I think I’m writing are not the words coming out.” She wakes up gasping for air twice a month. It still hurts to inhale.

As Yong says in a thread about the article: “The pandemic is going to create a large wave of chronically disabled people.” Once again for the people in the back: this is not just the flu. The flu does not incapacitate otherwise healthy people like this. I know at least two long-haulers personally and am astounded on a daily basis by how casually some Americans continue to regard Covid-19.

More than 90 percent of long-haulers whom Putrino has worked with also have “post-exertional malaise,” in which even mild bouts of physical or mental exertion can trigger a severe physiological crash. “We’re talking about walking up a flight of stairs and being out of commission for two days,” Putrino said. This is the defining symptom of myalgic encephalomyelitis, or chronic fatigue syndrome. For decades, people with ME/CFS have endured the same gendered gaslighting that long-haulers are now experiencing. They’re painfully familiar with both medical neglect and a perplexing portfolio of symptoms.

You can read Seabiscuit author Laura Hillenbrand’s excellent article on her chronic fatigue syndrome diagnosis and how difficult it is for people with chronic conditions like this to get the right diagnosis and to get family and friends to believe what’s going on.

Also, Yong should win all the awards this year for his pandemic coverage. It has been simply outstanding.

For Some, the Effects of Covid-19 Last for Months

posted by Jason Kottke   Jun 04, 2020

The Atlantic’s Ed Yong interviewed several people who, like thousands of others around the world, have been experiencing symptoms of Covid-19 for months now, indicating that the disease is chronic for some. Thousands Who Got COVID-19 in March Are Still Sick:

I interviewed nine of them for this story, all of whom share commonalities. Most have never been admitted to an ICU or gone on a ventilator, so their cases technically count as “mild.” But their lives have nonetheless been flattened by relentless and rolling waves of symptoms that make it hard to concentrate, exercise, or perform simple physical tasks. Most are young. Most were previously fit and healthy. “It is mild relative to dying in a hospital, but this virus has ruined my life,” LeClerc said. “Even reading a book is challenging and exhausting. What small joys other people are experiencing in lockdown-yoga, bread baking-are beyond the realms of possibility for me.”

One of those who has been sick for months is Paul Garner, a professor of infectious diseases:

It “has been like nothing else on Earth,” said Paul Garner, who has previously endured dengue fever and malaria, and is currently on day 77 of COVID-19. Garner, an infectious-diseases professor at the Liverpool School of Tropical Medicine, leads a renowned organization that reviews scientific evidence on preventing and treating infections. He tested negative on day 63. He had waited to get a COVID-19 test partly to preserve them for health-care workers, and partly because, at one point, he thought he was going to die. “I knew I had the disease; it couldn’t have been anything else,” he told me. I asked him why he thought his symptoms had persisted. “I honestly don’t know,” he said. “I don’t understand what’s happening in my body.”

Garner wrote about his experience for BMJ.

The illness went on and on. The symptoms changed, it was like an advent calendar, every day there was a surprise, something new. A muggy head; acutely painful calf; upset stomach; tinnitus; pins and needles; aching all over; breathlessness; dizziness; arthritis in my hands; weird sensation in the skin with synthetic materials. Gentle exercise or walking made me worse — I would feel absolutely dreadful the next day. I started talking to others. I found a marathon runner who had tried 8 km in her second week, which caused her to collapse with rigors and sleep for 24 hours. I spoke to others experiencing weird symptoms, which were often discounted by those around them as anxiety, making them doubt themselves.

We still have no idea what the long-term effects of this disease are going to be. But it is definitely not the flu. And I remain unwilling to risk myself or my family getting it.

The Changing Profile of Covid-19’s Presenting Symptoms

posted by Jason Kottke   Apr 29, 2020

As Ed Yong notes in his helpful overview of the pandemic, this is such a huge and quickly moving event that it’s difficult to know what’s happening. Lately, I’ve been seeking information on Covid-19’s presenting symptoms after seeing a bunch of anecdotal data from various sources.

In the early days of the epidemic (January, February, and into March), people were told by the CDC and other public health officials to watch out for three specific symptoms: fever, a dry cough, and shortness of breath. In many areas, testing was restricted to people who exhibited only those symptoms. Slowly, as more data is gathered, the profile of the presenting symptoms has started to shift. From a New York magazine piece by David Wallace-Wells on Monday:

While the CDC does list fever as the top symptom of COVID-19, so confidently that for weeks patients were turned away from testing sites if they didn’t have an elevated temperature, according to the Journal of the American Medical Association, as many as 70 percent of patients sick enough to be admitted to New York State’s largest hospital system did not have a fever.

Over the past few months, Boston’s Brigham and Women’s Hospital has been compiling and revising, in real time, treatment guidelines for COVID-19 which have become a trusted clearinghouse of best-practices information for doctors throughout the country. According to those guidelines, as few as 44 percent of coronavirus patients presented with a fever (though, in their meta-analysis, the uncertainty is quite high, with a range of 44 to 94 percent). Cough is more common, according to Brigham and Women’s, with between 68 percent and 83 percent of patients presenting with some cough — though that means as many as three in ten sick enough to be hospitalized won’t be coughing. As for shortness of breath, the Brigham and Women’s estimate runs as low as 11 percent. The high end is only 40 percent, which would still mean that more patients hospitalized for COVID-19 do not have shortness of breath than do. At the low end of that range, shortness of breath would be roughly as common among COVID-19 patients as confusion (9 percent), headache (8 to 14 percent), and nausea and diarrhea (3 to 17 percent).

Recently, as noted by the Washington Post, the CDC has changed their list of Covid-19 symptoms to watch out for. They now list two main symptoms (cough & shortness of breath) and several additional symptoms (fever, chills, repeated shaking with chills, muscle pain, headache, sore throat, new loss of taste or smell). They also note that “this list is not all inclusive”. Compare that with their list from mid-February.

In addition, there’s evidence that children might have different symptoms (including stomach issues or diarrhea), doctors are reporting seeing “COVID toes” on some patients, and you might want to look at earlier data from these three studies about symptoms observed in Wuhan and greater China.

The reason I’m interested in this shift in presenting symptoms is that on the last day or two of my trip to Asia, I got sick — and I’ve been wondering if it was Covid-19.

Here’s the timeline: starting on Jan 21, I was in Saigon, Vietnam for two weeks, then in Singapore for 4 days, and then Doha, Qatar for 48 hours. The day I landed in Doha, Feb 9, I started to feel a little off, and definitely felt sick the next day. I had a sore throat, headache, and congestion (stuffy nose) for the first few days. There was also some fatigue/tiredness but I was jetlagged too so… All the symptoms were mild and it felt like a normal cold to me. Here’s how I wrote about it in my travelogue:

I got sick on the last day of the trip, which turned into a full-blown cold when I got home. I dutifully wore my mask on the plane and in telling friends & family about how I was feeling, I felt obliged to text “***NOT*** coronavirus, completely different symptoms!!”

I flew back to the US on Feb 11 (I wore a mask the entire time in the Doha airport, on the plane, and even in the Boston airport, which no one else was doing). I lost my sense of taste and smell for about 2 days, which was a little unnerving but has happened to me with past colds. At no point did I have even the tiniest bit of fever or shortness of breath. The illness did drag on though — I felt run-down for a few weeks and a very slight cough that developed about a week and a half after I got sick lingered for weeks.

According to guidance from the WHO, CDC, and public health officials at the time, none of my initial symptoms were a match for Covid-19. I thought about getting a test or going to the doctor, but in the US in mid-February, and especially in Vermont, there were no tests available for someone with a mild cold and no fever. But looking at the CDC’s current list of symptoms — which include headache, sore throat, and new loss of taste or smell — and considering that I’d been in Vietnam and Singapore when cases were reported in both places, it seems plausible to me that my illness could have been a mild case of Covid-19. Hopefully it wasn’t, but I’ll be getting an antibody test once they are (hopefully) more widely available, even though the results won’t be super reliable.

Update: More on the changing profile of Covid-19 symptoms from a sample size of more than 30,000 tests.

Covid-19 presenting symptoms

Fever is waaay down on the list.

While not as common as other symptoms, loss of smell was the most highly correlated with testing positive, as shown with odds ratios below, after adjusting for age and gender. Those with loss of smell were more likely to test positive for COVID-19 than those with a high fever.

Seeing this makes me think more than ever that I had it. I had three of the top five symptoms, plus an eventual cough (the most common symptom) and a loss of smell & taste (the most highly correlated symptom). The timing of the onset of my symptoms (my first day in Qatar) indicates that I probably got infected on my last day in Vietnam, in transit from Vietnam to Singapore (1 2-hr plane ride, 2 airports, 1 taxi, 1 train ride), or on my first day in Singapore. But I went to so many busy places during that time that it’s impossible to know where I might have gotten infected (or who I then went on to unwittingly infect).

Update: A few weeks ago, I noticed some horizontal lines on several of my toenails, a phenomenon I’d never seen before. When I finally googled it, I discovered they’re called Beau’s lines and they can show up when the body has been stressed by illness or disease. Hmm. From the Wikipedia page:

Some other reasons for these lines include trauma, coronary occlusion, hypocalcaemia, and skin disease. They may be a sign of systemic disease, or may also be caused by an illness of the body, as well as drugs used in chemotherapy, or malnutrition. Beau’s lines can also be seen one to two months after the onset of fever in children with Kawasaki disease.

From the Mayo Clinic:

Conditions associated with Beau’s lines include uncontrolled diabetes and peripheral vascular disease, as well as illnesses associated with a high fever, such as scarlet fever, measles, mumps and pneumonia.

From the estimated growth of my nails, it seems as though whatever disruption that caused the Beau’s lines happened 5-6 months ago, which lines up with my early February illness that I believe was Covid-19. Covid-19 can definitely affect the vascular systems of infected persons. Kawasaki disease is a vascular disease and a similar syndrome in children resulting from SARS-CoV-2 exposure is currently under investigation. And here’s a paper from December 1971 that tracked the development of Beau’s lines in several people who were ill during the 1968 flu pandemic (an H3N2 strain of the influenza A virus) — coronaviruses and influenza viruses are different but this is still an indicator that viruses can result in Beau’s lines. “Covid toe” has been observed in many Covid-19 patients. Harvard dermatologist and epidemiologist Dr. Esther Freeman reports that people may be experiencing hair loss due to Covid-19.

I couldn’t find any scientific literature about the possible correlation of Covid-19 and Beau’s lines, but I did find some suggestive anecdotal information. I found several people on Twitter who noticed lines in their nails (both fingers and toes) and who also have confirmed or suspected cases of Covid-19. And if you go to Google’s search bar and type “Beau’s lines c”, 3 of the 10 autocomplete suggestions are related to Covid-19, which indicates that people are searching for it (but not enough to register on Google Trends).

But I am definitely intrigued. Are dermatologists and podiatrists seeing Beau’s lines on patients who have previously tested positive for Covid-19? Have people who have tested positive noticed them? Email me at jason@kottke.org if you have any info about this; I’d love to get to the bottom of this.

Super-Pandemics Last All Summer Long

posted by Jason Kottke   Apr 15, 2020

The Atlantic’s Ed Yong has written his second long article about the Covid-19 pandemic about what happens next and what a roadmap to dealing with the next phase of the crisis might look like.

As I wrote last month, the only viable endgame is to play whack-a-mole with the coronavirus, suppressing it until a vaccine can be produced. With luck, that will take 18 to 24 months. During that time, new outbreaks will probably arise. Much about that period is unclear, but the dozens of experts whom I have interviewed agree that life as most people knew it cannot fully return. “I think people haven’t understood that this isn’t about the next couple of weeks,” said Michael Osterholm, an infectious-disease epidemiologist at the University of Minnesota. “This is about the next two years.”

The pandemic is not a hurricane or a wildfire. It is not comparable to Pearl Harbor or 9/11. Such disasters are confined in time and space. The SARS-CoV-2 virus will linger through the year and across the world. “Everyone wants to know when this will end,” said Devi Sridhar, a public-health expert at the University of Edinburgh. “That’s not the right question. The right question is: How do we continue?”

You Should Be Wearing a Face Mask

posted by Jason Kottke   Mar 30, 2020

Wear A Mask

Have you been wearing a face mask when going out in public recently? There’s been a lot of debate recently about whether they are effective in keeping people safe from COVID-19 infection, and it’s been really challenging to find good information. After reading several things over the past few days, I have concluded that wearing a mask in public is a helpful step I can take to help keep myself and others safe, with the important caveat that healthcare workers need access to masks before the rest of us (see below). In particular, I found this extensive review of the medical and scientific literature on mask & respirator use helpful, including why research on mask efficacy is so hard to do and speculation on why the CDC and WHO generally don’t recommend wearing them.

I was able to find one study like this outside of the health care setting. Some people with swine flu travelled on a plane from New York to China, and many fellow passengers got infected. Some researchers looked at whether passengers who wore masks throughout the flight stayed healthier. The answer was very much yes. They were able to track down 9 people who got sick on the flight and 32 who didn’t. 0% of the sick passengers wore masks, compared to 47% of the healthy passengers. Another way to look at that is that 0% of mask-wearers got sick, but 35% of non-wearers did. This was a significant difference, and of obvious applicability to the current question.

See also this review of relevant scientific literature, this NY Times piece, this Washington Post opinion piece by Jeremy Howard (who is on a Twitter mission to get everyone to wear masks):

When historians tally up the many missteps policymakers have made in response to the coronavirus pandemic, the senseless and unscientific push for the general public to avoid wearing masks should be near the top.

The evidence not only fails to support the push, it also contradicts it. It can take a while for official recommendations to catch up with scientific thinking. In this case, such delays might be deadly and economically disastrous. It’s time to make masks a key part of our fight to contain, then defeat, this pandemic. Masks effective at “flattening the curve” can be made at home with nothing more than a T-shirt and a pair of scissors. We should all wear masks — store-bought or homemade — whenever we’re out in public.

At the height of the HIV crisis, authorities did not tell people to put away condoms. As fatalities from car crashes mounted, no one recommended avoiding seat belts. Yet in a global respiratory pandemic, people who should know better are discouraging Americans from using respiratory protection.

I have to admit that I have not been wearing a mask out in public — I’ve been to the grocery store only three times in the past two weeks, I go at off-hours, and it’s rural Vermont, so there’s not actually that many people about (e.g. compared to Manhattan). But I’m going to start wearing one in crowded places (like the grocery store) because doing so could a) safeguard others against my possible infection (because asymptomatic people can still be contagious), b) make it less likely for me to get infected, and c) provide a visible signal to others in my community to normalize mask wearing. As we’ve seen in epidemic simulations, relatively small measures can have outsize effects in limiting later infections & deaths, and face masks, even if a tiny bit effective, can have a real impact.

Crucially, the available research and mask advocates stress the importance of wearing masks properly and responsibly. Here are some guidelines I compiled about responsible mask usage:

So that’s what I’ve personally concluded from all my reading. I hope wearing masks can help keep us a little safer during all of this.

Update: From Ferris Jabr at Wired, It’s Time to Face Facts, America: Masks Work.

It is unequivocally true that masks must be prioritized for health care workers in any country suffering from a shortage of personal protective equipment. But the conflicting claims and guidelines regarding their use raise three questions of the utmost urgency: Do masks work? Should everyone wear them? And if there aren’t enough medical-grade masks for the general public, is it possible to make a viable substitute at home? Decades of scientific research, lessons from past pandemics, and common sense suggest the answer to all of these questions is yes.

Update: The Atlantic’s Ed Yong weighs in on masks:

In Asia, masks aren’t just shields. They’re also symbols. They’re an affirmation of civic-mindedness and conscientiousness, and such symbols might be important in other parts of the world too. If widely used, masks could signal that society is taking the pandemic threat seriously. They might reduce the stigma foisted on sick people, who would no longer feel ashamed or singled out for wearing one. They could offer reassurance to people who don’t have the privilege of isolating themselves at home, and must continue to work in public spaces. “My staff have also mentioned that having a mask reminds them not to touch their face or put a pen in their mouth,” Bourouiba noted.

He also writes about something I’ve been wondering about: is the virus airborne, what does that even mean, when will we know for sure, and how should that affect our behavior in the meantime?

These particles might not even have been infectious. “I think we’ll find that like many other viruses, [SARS-CoV-2] isn’t especially stable under outdoor conditions like sunlight or warm temperatures,” Santarpia said. “Don’t congregate in groups outside, but going for a walk, or sitting on your porch on a sunny day, are still great ideas.”

You could tie yourself in knots gaming out the various scenarios that might pose a risk outdoors, but Marr recommends a simple technique. “When I go out now, I imagine that everyone is smoking, and I pick my path to get the least exposure to that smoke,” she told me. If that’s the case, I asked her, is it irrational to hold your breath when another person walks past you and you don’t have enough space to move away? “It’s not irrational; I do that myself,” she said. “I don’t know if it makes a difference, but in theory it could. It’s like when you walk through a cigarette plume.”

And from the WHO, here’s a video on how to wear a mask properly.

Update: One of the reasons I started to wear a mask when I go out in public was to “provide a visible signal to others in my community to normalize mask wearing”. Maciej Cegłowski’s post touches on this and other reasons to wear a mask that don’t directly have to do with avoiding infection.

A mask is a visible public signal to strangers that you are trying to protect their health. No other intervention does this. It would be great if we had a soap that turned our hands gold for an hour, so everyone could admire our superb hand-washing technique. But all of the behaviors that benefit public health are invisible, with the exception of mask wearing.

If I see you with a mask on, it shows me you care about my health, and vice versa. This dramatically changes what it feels like to be in a public space. Other people no longer feel like an anonymous threat; they are now your teammates in a common struggle.

Can America Turn Our COVID-19 Failure into Some Sort of Success?

posted by Jason Kottke   Mar 25, 2020

From Ed Yong at the Atlantic, a great article on the current state of the pandemic in the United States, what will happen over the next few months, how it will end, and what the aftermath will be.

With little room to surge during a crisis, America’s health-care system operates on the assumption that unaffected states can help beleaguered ones in an emergency. That ethic works for localized disasters such as hurricanes or wildfires, but not for a pandemic that is now in all 50 states. Cooperation has given way to competition; some worried hospitals have bought out large quantities of supplies, in the way that panicked consumers have bought out toilet paper.

Partly, that’s because the White House is a ghost town of scientific expertise. A pandemic-preparedness office that was part of the National Security Council was dissolved in 2018. On January 28, Luciana Borio, who was part of that team, urged the government to “act now to prevent an American epidemic,” and specifically to work with the private sector to develop fast, easy diagnostic tests. But with the office shuttered, those warnings were published in The Wall Street Journal, rather than spoken into the president’s ear. Instead of springing into action, America sat idle.

Rudderless, blindsided, lethargic, and uncoordinated, America has mishandled the COVID-19 crisis to a substantially worse degree than what every health expert I’ve spoken with had feared. “Much worse,” said Ron Klain, who coordinated the U.S. response to the West African Ebola outbreak in 2014. “Beyond any expectations we had,” said Lauren Sauer, who works on disaster preparedness at Johns Hopkins Medicine. “As an American, I’m horrified,” said Seth Berkley, who heads Gavi, the Vaccine Alliance. “The U.S. may end up with the worst outbreak in the industrialized world.”

If you’ve been reading obsessively about the pandemic, there’s not a lot new in here, but Yong lays the whole situation out very clearly and succinctly (he easily could have gone twice as long). The section on potential after effects was especially interesting:

Pandemics can also catalyze social change. People, businesses, and institutions have been remarkably quick to adopt or call for practices that they might once have dragged their heels on, including working from home, conference-calling to accommodate people with disabilities, proper sick leave, and flexible child-care arrangements. “This is the first time in my lifetime that I’ve heard someone say, ‘Oh, if you’re sick, stay home,’” says Adia Benton, an anthropologist at Northwestern University. Perhaps the nation will learn that preparedness isn’t just about masks, vaccines, and tests, but also about fair labor policies and a stable and equal health-care system. Perhaps it will appreciate that health-care workers and public-health specialists compose America’s social immune system, and that this system has been suppressed.

Aspects of America’s identity may need rethinking after COVID-19. Many of the country’s values have seemed to work against it during the pandemic. Its individualism, exceptionalism, and tendency to equate doing whatever you want with an act of resistance meant that when it came time to save lives and stay indoors, some people flocked to bars and clubs. Having internalized years of anti-terrorism messaging following 9/11, Americans resolved to not live in fear. But SARS-CoV-2 has no interest in their terror, only their cells.

I really hope that Betteridge’s law is wrong about that headline I wrote.

Ed Yong on fixing the gender imbalance in his stories

posted by Jason Kottke   Feb 07, 2018

Science writer Ed Yong noticed that the stories he was writing quoted sources that were disproportionately male. Using a spreadsheet to track who he contacted for stories and a few extra minutes per piece, Yong set about changing that gender imbalance.

Skeptics might argue that I needn’t bother, as my work was just reflecting the present state of science. But I don’t buy that journalism should act simply as society’s mirror. Yes, it tells us about the world as it is, but it also pushes us toward a world that could be. It is about speaking truth to power, giving voice to the voiceless. And it is a profession that actively benefits from seeking out fresh perspectives and voices, instead of simply asking the same small cadre of well-trod names for their opinions.

Another popular critique is that I should simply focus on finding the most qualified people for any given story, regardless of gender. This point seems superficially sound, but falls apart at the gentlest scrutiny. How exactly does one judge “most qualified”? Am I to list all the scientists in a given field and arrange them by number of publications, awards, or h-index, and then work my way down the list in descending order? Am I to assume that these metrics somehow exist in a social vacuum and are not themselves also influenced by the very gender biases that I am trying to resist? It would be crushingly naïve to do so.

Journalism and science both work better with the inclusion and participation of a diverse set of voices bent on the pursuit of truth.

Update: NY Times’ columnist David Leonhardt conducted his own experiment and discovered I’m Not Quoting Enough Women.

Blue Planet II, another massively entertaining Attenborough/BBC nature documentary

posted by Jason Kottke   Jan 18, 2018

Blue Planet II, the latest BBC nature documentary narrated by David Attenborough, is finally set to air in the US this Saturday on BBC America, AMC, and other networks. Here’s a five-minute preview…if this doesn’t pique your interest, you might actually be dead:

In a review of the program at The Atlantic, Ed Yong makes a bold declaration:

Blue Planet II is the greatest nature series that the BBC has ever produced.

Coming on the heels of Planet Earth II, which I thought was the best thing I watched last year, that’s really saying something. Here’s Yong on the difference between the two:

Who can forget the marine iguanas of Planet Earth II, escaping from the jaws of hungry racer snakes? But in chasing drama, some of the shows became thinner and messier. Many episodes of Planet Earth II felt like glorious visual listicles — selections of (admittedly awesome) set pieces woven together by the flimsiest of narrative gossamer.

By contrast, the threads that hold Blue Planet II together are thick and tightly woven. Each episode flows. For example, the second episode, on the deep ocean, achieves narrative depth through actual depth, sinking deeper and deeper so that each new spectacle is anchored in space. Where previous series felt like they sacrificed the storytelling craft and educational density for technical wizardry and emotional punch, Blue Planet II finally marries all of that together.

Blue Planet II was watched by more people in the UK than Planet Earth II and has seemingly influenced the UK government’s stance on pollution:

Cutting plastic pollution is the focus of a series of proposals being considered by the UK environment secretary, Michael Gove, who has said he was “haunted” by images of the damage done to the world’s oceans shown in David Attenborough’s Blue Planet II TV series.

The government is due to announce a 25-year plan to improve the UK’s environmental record in the new year. Gove is understood to be planning to introduce refundable deposits on plastic drinks bottles, alongside other measures.

I got a sneak peek at the first few episodes of Blue Planet II, and it certainly is a great program. I watched it with my kids and they were riveted the entire time. After the fourth or fifth episode, my son said, “I think I like this better than Planet Earth II.” I’m not quite sure it’s peak Attenborough — I’m still partial to Planet Earth II — but it’s still a must-see and I’m certainly not going to argue with Ed Yong and my son about it.

Watch time lapse videos of bacteria evolving drug resistance

posted by Jason Kottke   Sep 09, 2016

Researchers at Harvard have come up with a novel way of studying how bacteria evolve to become drug resistant. They set up a large petri dish about the same shape as a football field with no antibiotics in the end zones and increasingly higher doses of antibiotics toward the center. They placed some bacteria in both end zones and filmed the results as the bacteria worked its way toward the center of the field, evolving drug resistance as it went. Ed Yong explains:

What you’re seeing in the movie is a vivid depiction of a very real problem. Disease-causing bacteria and other microbes are increasingly evolving to resist our drugs; by 2050, these impervious infections could potentially kill ten million people a year. The problem of drug-resistant infections is terrifying but also abstract; by their nature, microbes are invisible to the naked eye, and the process by which they defy our drugs is even harder to visualise.

But now you can: just watch that video again. You’re seeing evolution in action. You’re watching living things facing down new challenges, dying, competing, thriving, invading, and adapting — all in a two-minute movie.

Watch the video…it’s wild. What’s most interesting — or scary as hell — is that once the drug resistance gets going, it builds up a pretty good momentum. There’s a pause at the first boundary as the evolutionary process blindly hammers away at the problem, but after the bacteria “learn” drug resistance, the further barriers are breached much more quickly, even before the previous zones are fully populated.

How it happened: the discovery of bacteria in the 1670s

posted by Jason Kottke   Aug 09, 2016

Antonie van Leeuwenhoek ran a draper’s shop and was a local politician in Delft, Netherlands in the mid-17th century. During this time, he developed an interest in making lenses and hit upon a technique for making lenses with extremely high magnifications for the time, 270x and perhaps even 500x normal magnification. These lenses allowed him to discover that there were tiny organisms living in his mouth.

Ed Yong, Joss Fong, and Julia Belluz discuss van Leeuwenhoek’s achievement and microorganisms in general in the video above and in an interview.

It is undeniable that antibiotics have been a tremendous health good, maybe one of the greatest health goods of all time. They have brought so many infectious diseases to heel and saved so many lives.

But it’s also clear that they have negative effects on our microbiome. So they are indiscriminate weapons. They kill the microbes that we depend upon and that are good for us as well as the ones that are causing disease and causing us harm. They’re like nukes, rather than precision weapons.

So we’re in a difficult situation now, where on the one hand we’re running out of antibiotics, and the rise of antibiotic-resistant bacteria is a huge public health threat. But at the same time we’re aware of the need to preserve the microbiome.

Yong just came out with a book on microbes called I Contain Multitudes. (Perhaps Whitman was speaking literally?)

I Contain Multitudes

posted by Jason Kottke   Jul 07, 2016

I Contain Multitudes

Crackerjack science writer Ed Yong is coming out with his very first book in a month’s time. It’s called I Contain Multitudes (good title!) and is about “astonishing partnerships between animals and microbes”.

Every animal, whether human, squid, or wasp, is home to millions of bacteria and other microbes. Ed Yong, whose humor is as evident as his erudition, prompts us to look at ourselves and our animal companions in a new light-less as individuals and more as the interconnected, interdependent multitudes we assuredly are.

The microbes in our bodies are part of our immune systems and protect us from disease. In the deep oceans, mysterious creatures without mouths or guts depend on microbes for all their energy. Bacteria provide squid with invisibility cloaks, help beetles to bring down forests, and allow worms to cause diseases that afflict millions of people.

I will read anything described as “like a David Attenborough series shot through a really good microscope”.

Update: Bill Gates liked I Contain Multitudes so much he sat down for a chat with Yong to discuss the particulars.

We are also utterly inseparable from them. Yong illustrates that we are at least as much microbe as human. We literally have more microbial cells living inside our bodies than human cells. And even the cells we label “human” are part microbe. With the exception of red blood cells and sperm, all our cells are powered by mitochondria, which are likely the descendants of ancient bacteria that became integrated into the type of cells that subsequently gave rise to all complex life.

New antibiotic discovered: teixobactin

posted by Jason Kottke   Jan 08, 2015

Scientists have discovered the first promising new antibiotic in 25 years. And even better, says Ed Yong, is that the antibiotic in question is “resistant to resistance”.

A team of scientists led by Kim Lewis from Northeastern University have identified a new antibiotic called teixobactin, which kills some kinds of bacteria by preventing them from building their outer coats. They used it to successfully treat antibiotic-resistant infections in mice. And more importantly, when they tried to deliberately evolve strains of bacteria that resist the drug, they failed. Teixobactin appears resistant to resistance.

Bacteria will eventually develop ways of beating teixobactin — remember Orgel — but the team are optimistic that it will take decades rather than years for this to happen. That buys us time.

…and also that the process by which teixobactin was discovered is the real breakthrough:

Teixobactin isn’t even the most promising part of its own story. That honour falls on the iChip-the tool that the team used to discover the compound. Teixobactin is a fish; the iChip is the rod. Having the rod guarantees that we’ll get more fish-and we desperately need more.