Lunchtime pandemic reading.
Standard disclaimer: this is a roundup of informative pieces I've read that interest me on the severity of the crisis and how to manage it. I am not a qualified medical expert in ANY sense; at best I am reasonably well-read laity. ALWAYS prioritize advice from a qualified healthcare provider who knows your specific medical situation over advice from people on the Internet.
This is also available as an email newsletter at https://lunchtimepandemic.substack.com if you prefer the update in your inbox.
You are welcome to share this.
---
Commentary: I have seen more than a few uninformed tweets recently about fears of "flurona" and some folks mistakenly believing that influenza and coronaviruses can combine. They are radically different viruses; influenza is in the phylum *negarnaviricota* while coronaviruses are in the phylum *pisuviricota*. To give you a sense of how huge a difference that is, it's the difference between humans being in the *chordata* phylum and octopus in the *mollusca* phylum. It's virtually impossible for us to breed with an octopus, and it's virtually impossible for influenza viruses to combine with coronaviruses.
The "flurona" more refers to people at risk of catching both diseases at the same time. However, high-quality masks and vaccines defeat both diseases.
---
Long COVID could become chronic. "“Long COVID”, where symptoms of COVID-19 persist for months after an initial infection, could be emerging as a chronic disease in Finland, Minister of Family Affairs and Social Services Krista Kiuru said on Friday.
Speaking at a news conference, she referred to a Finnish expert panel’s summary of more than 4,000 international studies which showed one in two adults and around 2% of children may experience prolonged symptoms connected to COVID-19.
“There is a threat that Finland will see the emergence of the largest, or one of the largest, new groups of chronic diseases, and that not only too many adults will suffer from a long-term COVID-19, but at worst also children,” Kiuru said.
The Finnish institute of health and welfare considers an illness chronic when it has a major impact on public health and the national economy through lowered working capacity and strains on healthcare.
The summary published by the Ministry of Social Affairs and Health said long COVID was more likely when the initial infection had required hospitalisation, but it might also occur after a mild or asymptomatic infection.
“The virus has been shown to enter the brain through the nose and its effects are also seen on magnetic resonance imaging,” Risto Roine, professor of neurology and chairman of the expert panel, told the same news conference.
“Around 20% see long-term cognitive impairment,” Roine added, warning that the incidence of neurological diseases such as Alzheimer’s or Parkinson’s could increase sharply following a COVID-19 infection."
Source: https://www.reuters.com/article/us-health-coronavirus-finland-long-covid-idUSKBN2JH14W
Commentary: Yet another reason why "just let everyone get Omicron" is a poor policy choice. COVID-19 will inevitably leave us with a massive population of chronically-ill, potentially permanently ill people. Let's not make that population any larger than it has to be.
---
Omicron causing 150% increases in hospitalizations. " In early-hit cities, hospitals are seeing more patients testing positive for Covid-19 than at any time last year. Because of the sheer infectiousness of the Omicron variant, many who arrive at the hospital for other ailments test positive for the coronavirus. Some doctors have also said that patients who do have Covid as a primary diagnosis are faring better than during previous waves.
Even so, the number of Covid-19 patients who need intensive care or mechanical ventilation is approaching levels not seen since last winter. And the sheer number of patients is overwhelming to hospitals, where staffing shortages are putting healthcare workers under immense strain.
Healthcare workers were already quitting their jobs in record numbers before the Omicron wave. Now, many more are out sick with the hugely transmissible variant. With fewer staff members available to care for them, even a smaller number of patients can overwhelm emergency departments and intensive care units."
Source: https://www.nytimes.com/interactive/2022/01/09/us/omicron-cities-cases-hospitals.html
Commentary: Keep yourself safe. Get fully vaccinated and boosted.
---
Pfizer update coming. "Pfizer CEO Albert Bourla on Monday said a vaccine that targets the omicron variant of Covid will be ready in March, and the company’s already begun manufacturing the doses.
“This vaccine will be ready in March,” Bourla told CNBC’s “Squawk Box.” “We [are] already starting manufacturing some of these quantities at risk.”
Bourla said the vaccine will also target the other variants that are circulating. He said it is still not clear whether or not an omicron vaccine is needed or how it would be used, but Pfizer will have some doses ready since some countries want it ready as soon as possible.
“The hope is that we will achieve something that will have way, way better protection particularly against infections, because the protection against the hospitalizations and the severe disease — it is reasonable right now, with the current vaccines as long as you are having let’s say the third dose,” Bourla said."
Source: https://www.cnbc.com/2022/01/10/covid-vaccine-pfizer-ceo-says-omicron-vaccine-will-be-ready-in-march.html
Commentary: The fact that the current crop of vaccines, now based on a strain from two years ago, continue to work is nothing short of amazing. These new updates will add substantial protection.
---
5 days of isolation is not enough. "Since December 3, 2021, the National Institute of Infectious Diseases (NIID) and the Disease Control and Prevention Center within the National Center for Global Health and Medicine (NCGM/DCC) have jointly initiated an investigation on Omicron cases in collaboration with several medical facilities in Japan. Here, we examined the duration of infectious virus shedding in Omicron cases identified early in this investigation. A total of 83 respiratory specimens from 21 cases (19 vaccinees and 2 unvaccinated cases; 4 asymptomatic and 17 mild cases) were subjected to SARS-CoV-2 RNA quantification using quantitative reverse transcriptase polymerase chain reaction and virus isolation tests. The date of specimen collection for diagnosis or symptom onset was defined as day 0. The amount of viral RNA was highest on 3-6 days after diagnosis or 3-6 days after symptom onset, and then gradually decreased over time, with a marked decrease after 10 days since diagnosis or symptom onset (Figure). The positive virus isolation results showed a similar trend as the viral RNA amount, and no infectious virus in the respiratory samples was detected after 10 days since diagnosis or symptom onset (Table). These findings suggest that vaccinated Omicron cases are unlikely to shed infectious virus 10 days after diagnosis or symptom onset."
Source: https://www.niid.go.jp/niid/en/2019-ncov-e/10884-covid19-66-en.html
Commentary: Infectivity in many cases continues well after 5 days; the only way to ensure that someone is not contagious is through testing- and a lot of it.
---
A reminder of the simple daily habits we should all be taking.
1. Wear the best mask available to you when you'll be around people you don't live with, even after you've been vaccinated. Respirators are back in stock at online retailers, too. Wear an N95/FFP2/KN95 that's NIOSH-approved or better mask if you can obtain it. If you can't get an N95 mask, wear a surgical mask with a cloth mask over it.
2. Verify your mask's NIOSH certification here: https://www.cdc.gov/niosh/npptl/usernotices/counterfeitResp.html
3. Get vaccinated as soon as you're able to, and fulfill the full vaccine regimen, including boosters. Remember that you are not vaccinated until everyone you live with is vaccinated. If you received an adenovirus vaccine (J&J/AstraZeneca), consider getting an mRNA single shot booster (Pfizer/Moderna) if available. If it's available, choose Moderna as your first choice for both vaccine and booster, Pfizer as your second choice. However, remember than any vaccine is better than no vaccine.
4. Wash/sanitize your hands every time you are in or out of your home.
5. Stay out of indoor spaces that aren't your home and away from people you don't live with as much as practical. Minimize your contact with others and avoid indoor places as much as you can; indoor spaces spread the disease through aerosols and distance is less effective at mitigating your risks.
6. Aim to have 3-6 months of living expenses on hand in case the pandemic gives another crazy plot twist to the economy.
7. Replenish your supplies as you use them. Avoid reducing your stores to pre-pandemic levels in case an outbreak causes unexpected supply chain disruptions.
8. Ventilate your home as frequently as weather and circumstances permit, except when you share close airspaces with other residences (like a window less than a meter away from a neighboring window).
9. Masks must fit properly to work. Here's how to properly fit a mask:
10. If you think you may have been exposed to COVID-19, purchase a rapid antigen test. This will detect COVID-19 only when you're contagious, so follow the directions clearly. https://amzn.to/3fLAoor
---
Common misinformation debunked!
There is no basis in fact that COVID-19 vaccines can shed or otherwise harm people around you.
Source: https://www.reuters.com/article/factcheck-covid19vaccine-reproductivepro-idUSL1N2MG256
There is no mercury or other heavy metals in the Pfizer mRNA vaccine.
Source: https://www.technologyreview.com/2020/12/09/1013538/what-are-the-ingredients-of-pfizers-covid-19-vaccine/
There is no basis in fact that COVID-19 vaccines pose additional risks to pregnant women.
Source: https://www.nejm.org/doi/full/10.1056/NEJMoa2104983
There is no genomic evidence at all that COVID-19 arrived before 2020 in the United States and therefore no hidden herd immunity:
Source:
There is no evidence SARS-CoV-2 was engineered, nor that it escaped a lab somewhere.
Source: https://www.washingtonpost.com/world/2020/01/29/experts-debunk-fringe-theory-linking-chinas-coronavirus-weapons-research/
Source: https://www.nature.com/articles/s41591-020-0820-9
Source: https://www.nationalgeographic.com/science/2020/05/anthony-fauci-no-scientific-evidence-the-coronavirus-was-made-in-a-chinese-lab-cvd/
Source: https://www.smh.com.au/national/are-we-ignoring-the-hard-truths-about-the-most-likely-cause-of-covid-19-20210601-p57x4r.html
There is no evidence a flu shot increases your COVID-19 risk.
Source: https://www.factcheck.org/2020/04/no-evidence-that-flu-shot-increases-risk-of-covid-19/
Source: https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciaa626/5842161
---
Disclosures and Disclaimers
I declare no competing interests on anything I share related to COVID-19. I am employed by and am a co-owner in TrustInsights.ai, an analytics and management consulting firm. I have no clients and no business interests in anything related to COVID-19, nor do I financially benefit in any way from sharing information about COVID-19.
---
A common request I'm asked is who I follow. Here's a public Twitter list of many of the sources I read.
https://twitter.com/i/lists/1260956929205112834
This list is biased by design. It is limited to authors who predominantly post in the English language. It is heavily biased towards individual researchers and away from institutions. It is biased towards those who publish or share research, data, papers, etc. I have made an attempt to follow researchers from different countries, and also to make the list reasonably gender-balanced, because multiple, diverse perspectives on research data are essential.
This is also available as an email newsletter at https://lunchtimepandemic.substack.com if you prefer the update in your inbox.