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.
---
Increasing evidence the USA CDC is handing out flawed information that unnecessarily increases risks.
"Holy cow.
Despite all the evidence, @CDCgov is still promoting an exceptionally dangerous practice of leaving isolation at 5 days without a negative test.
>70% of boosted people are still highly infectious at 5 days
WHY CDC are you standing by this when ALL the data says NO."
"My friend has now tested positive for 7 consecutive days. 💡Did you know—70% of people will continue to test #COVID19 positive on day 5? This is why CDC’s 5-day exit rule without any testing is ludicrous. CDC consulted with experts who told them it’s stupid—CDC did it anyway.🤦🏻♂️"
Source:
Source:
Commentary: The guidance from the CDC has become increasingly unreliable all year; the new "community levels" are based on hospitalization data, not how much virus is available in your community. Increasingly, USA citizens are being asked to take responsibility for their safety with poor data, leaving them exposed to Long COVID risks.
---
Wastewater data indicates USA is on the rise again.
Source: https://biobot.io/data/
Commentary: Far more effective than testing at this point, wastewater data shows us what's likely happening in terms of virus presence in our communities. Use this data instead of CDC data to judge the relative safety of your community in the USA, and for those not in the USA, look for wastewater data provided by your governments.
The reason wastewater data is more reliable? With lots of home testing now, that data no longer reaches government agencies for reporting, which may mean our testing is no longer a reliable indicator of risk. Wastewater, however, is immune to this data issue.
---
The FDA debate about new updates to the vaccines is revealing and informative.
Source: https://www.statnews.com/2022/04/06/tracking-fda-advisory-panel-meeting-covid-19-vaccines-boosters/
Commentary: The reason we haven't seen a major update to the vaccines is because the manufacturers haven't all agreed on what strain to target for updates. This makes logical sense; you don't want one vaccine targeting Delta and another targeting Omicron BA.2. The amount of confusion about which vaccine to get would be exponentially worse than it is now.
---
Boosters reduce viral load of breakthroughs. "Infectious viral load (VL) expelled as droplets and aerosols by infected individuals partly determines SARS-CoV-2 transmission. RNA VL measured by qRT-PCR is only a weak proxy for infectiousness. Studies on the kinetics of infectious VL are important to understand the mechanisms behind the different transmissibility of SARS-CoV-2 variants and the effect of vaccination on transmission, which allows to guide public health measures. In this study we quantified infectious VL in SARS-CoV-2 infected individuals during the first 5 symptomatic days by in vitro culturability assay in unvaccinated or vaccinated individuals infected with pre-variant of concern (pre-VOC) SARS-CoV-2, Delta, or Omicron. Unvaccinated individuals infected with pre-VOC SARS-CoV-2 had lower infectious VL compared to Delta-infected unvaccinated individuals. Full vaccination (defined as >2weeks after reception of 2nd dose during primary vaccination series) significantly reduced infectious VL for Delta breakthrough cases compared to unvaccinated individuals. For Omicron breakthrough cases, reduced infectious VL was only observed in boosted but not in fully vaccinated individuals compared to unvaccinated subjects. In addition, infectious VL was lower in fully vaccinated Omicron- compared to fully vaccinated Delta-infected individuals, suggesting that other mechanisms than increased infectious VL contribute to the high infectiousness of SARS-CoV-2 Omicron. Our findings indicate that vaccines may lower transmission risk and therefore have a public health benefit beyond the individual protection from severe disease."
Source: https://www.nature.com/articles/s41591-022-01816-0
Commentary: Current vaccines and boosters lower infectiousness and viral load by 5x. That's a big, big amount. Stay on track with your booster schedule and get them whenever you're eligible.
---
SARS-CoV-2 evolves at a remarkable rate. "My main point was really how fast evolution has been proceeding. We see that SARS-CoV-2 variants have (1) displaced existing genetic diversity and (2) accumulated amino acid changes in the relevant domain much faster than seen in the fastest seasonal flu subtype H3N2. 2/13"
Source: https://bedford.io/talks/sars-cov-2-continuing-evolution-vrbpac/#/
Commentary: It's astonishing how fast COVID has mutated in 2 years. We're at Omicron with 2 subvariants. That's more or less 17 major changes to SARS-CoV-2 in 2 years. For context, imagine the original iPhone in 2007 had been issued at the same time. You'd be at iPhone 17 now (iPhones are only up to version 13 at the time of writing).
What this means for us is that we have to continue relying on non-pharmaceutical interventions - masks and good ventilation - to minimize risks from new variants. Vaccines alone are not enough to bring this pandemic to an end.
---
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, or you know, a global war breaks out.
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.