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 qualified healthcare experts over some person on Facebook.
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Viral load shown to be similar in patients with or without symptoms. "So these asymptomatic infections may not be so benign in the people who have them. Can they transmit the infection to others? The viral load of asymptomatic compared with symptomatic has consistently been shown to be similar in multiple studies"
Source:
Commentary: Viral load is how much of the virus is in you, which obviously correlates with how contagious you are. For those saying that asymptomatic COVID-19 people aren't something to worry about... that's incorrect. Wear a mask at all times outside your home where you'll be closer than 20 feet to the nearest person.
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22% of people would avoid seeing medical help if they incurred COVID-19 symptoms due to healthcare costs. "New research conducted by the analytics firm Gallup and the nonprofit organization West Health has found 1 in 7 people in the U.S. would avoid seeking treatment for the key symptoms of COVID-19 because of concerns over cost.
While only 5% of people whose annual household income was over $100,000 would avoid seeking medical care if they had a dry cough or fever, this figure jumped to 22% for people whose annual household income was below $40,000.
Likewise, for those who suspected they had COVID-19 and had an annual household income of $100,000 or more, only 3% would avoid seeking treatment due to cost. The figure for those whose household income was under $40,000 was 14%."
Source: https://www.medicalnewstoday.com/articles/covid-19-cost-of-care-puts-off-1-in-7-people-from-seeking-treatment
Commentary: This is obviously problematic for tracing the pandemic and extinguishing it. Lobby your elected representatives wherever you are to make any and all COVID-19 testing completely free of any cost to the patient. It's the only way we'll get good testing numbers.
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And lobby your elected representatives, at least in the US, to use the funding made available. "Only $10.8 million, or 0.5%, of the $2 billion Congress set aside to help providers pay for COVID-19 testing for uninsured patients has been approved to be paid during the first two weeks of the program's operation, according to the most recent government data. While other HHS grant funds are essentially prospective payments, the uninsured reimbursement program is dependent on providers submitting claims. Several sources that work with providers said the Health Resources and Services Administration has been processing claims promptly, but slow distribution could be caused by coding issues, a lack of awareness about the program, and early technical issues with the HRSA portal. (Cohrs, 6/8)"
Source: https://khn.org/morning-breakout/only-0-5-of-money-allocated-by-congress-to-pay-for-testing-for-uninsured-has-been-approved/
Commentary: the fact that money was made available for testing people without health insurance and less than 1% of it has been used is an appalling failure on the part of the US government. The way the federal government is behaving, the US has essentially surrendered to the pandemic. Could you imagine the US rolling up to the beaches of Normandy, not offloading any troops, and then surrendering to the Axis powers? No. But that's what we've effectively done by not ramping up testing, contact tracing, or providing a unified national response with all the resources the country has to bear.
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Data from the USS Theodore Roosevelt's COVID-19 outbreak. "Among a convenience sample of 382 young adult U.S. service members aboard an aircraft carrier experiencing a COVID-19 outbreak, 60% had reactive antibodies, and 59% of those also had neutralizing antibodies at the time of specimen collection. One-fifth of infected participants reported no symptoms. Preventive measures, such as using face coverings and observing social distancing, reduced risk for infection.
Young, healthy adults with COVID-19 might have mild or no symptoms; therefore, symptom-based surveillance might not detect all infections. Use of face coverings and other preventive measures could mitigate transmission. The presence of neutralizing antibodies among the majority is a promising indicator of at least short-term immunity."
Source: https://www.cdc.gov/mmwr/volumes/69/wr/mm6923e4.htm
Commentary: This underscores the importance of universal testing. Relying on symptoms will not show mild or asymptomatic cases. As we see numbers spiking all around the United States and other nations, testing hasn't substantially increased in turn. Expect more outbreaks.
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Social networking data is being used to identify COVID-19 mobility. "What does your data say about how people in the U.S. are complying with physical distancing recommendations?
We’ve seen a pretty clear correlation between accelerated timelines to reopen in specific areas and changes in case count. If you look at Alabama, Wisconsin, Iowa, Nebraska, Minnesota, Ohio — all places where they changed social distancing orders at earlier stages — you now see a turnaround in the case rate. Where you had falling case rates at the beginning of May, you now have rising case rates.
In Alabama, where most of the counties were flat or declining at the end of April, practically the entire state is now on the increase. In rural areas, where there’s no ICU system, people are flocking to cities like Montgomery. Those hospitals are now in dire condition. Wisconsin is also a concern right now. Most of the southern part of the state has been rebounding pretty significantly.
At the same time there’s good news: New York and New Jersey — where mobility patterns increased much more slowly — have gotten things under control."
Source: https://www.statnews.com/2020/06/10/covid19-data-mobility-network-tech/
Commentary: Unsurprising that places which opened too soon are seeing outbreaks. Where possible, stay home. That guidance remains unchanged. The pandemic isn't even close to being over yet.
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A reminder of the simple daily habits we should all be taking.
1. Wash/sanitize your hands every time you are in or out of your home for any reason. Consider also spraying the bottoms of your shoes with a general disinfectant (alcohol/bleach/peroxide) when you return home. Remember that cleaners are never to be ingested.
2. Wear gloves and a mask when out of your home. Consider wearing a face shield.
3. Stay home as much as possible. Minimize your contact with others and maintain physical distance of at LEAST 6 feet / 2 meters. Avoid indoor places as much as you can.
4. Get your personal finances in order now. Cut all unnecessary costs.
5. Donate any PPE you can. https://getusppe.org/give/
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Common misinformation debunked!
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/
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
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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.