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.
This is also available as an email newsletter at https://lunchtimepandemic.substack.com if you prefer the update in your inbox.
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How quickly does COVID-19 spread? "The transmission mode of severe acute respiratory syndrome coronavirus 2 is primarily known as droplet transmission. However, a recent argument has emerged about the possibility of airborne transmission. On June 17, there was a coronavirus disease 2019 (COVID-19) outbreak in Korea associated with long distance droplet transmission.
The epidemiological investigation was implemented based on personal interviews and data collection on closed-circuit television images, and cell phone location data. The epidemic investigation support system developed by the Korea Disease Control and Prevention Agency was used for contact tracing. At the restaurant considered the site of exposure, air flow direction and velocity, distances between cases, and movement of visitors were investigated.
A total of 3 cases were identified in this outbreak, and maximum air flow velocity of 1.2 m/s was measured between the infector and infectee in a restaurant equipped with ceiling-type air conditioners. The index case was infected at a 6.5 m away from the infector and 5 minutes exposure without any direct or indirect contact.
Droplet transmission can occur at a distance greater than 2 m if there is direct air flow from an infected person. Therefore, updated guidelines involving prevention, contact tracing, and quarantine for COVID-19 are required for control of this highly contagious disease."
Source: https://jkms.org/DOIx.php?id=10.3346/jkms.2020.35.e415
Commentary: How quickly does COVID-19 spread? In as little as 5 minutes, 20 feet away. That's how fast. Wear a mask.
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Super-spreader events have always been a problem. "It likely took just one of the 175 people gathered in February at a Biogen conference at the Boston Marriott Long Wharf hotel to ignite a COVID-19 wildfire. Within a week, attendees began falling ill. More than 99 would ultimately test positive. By then, many of them had hopped aboard planes to head home or even attend other conferences. And the spread only exploded from there.
Between 205,000 and 300,000 COVID-19 cases across the nation and around the world can likely be traced back to the two-day Boston conference, according to Jacob Lemieux, the lead author of a new study published Thursday in the journal Science. The study estimates some 71,540 of the cases with a genetic link to the Biogen conference were discovered in Florida, more than 1,000 miles from the waterfront lobby and banquet rooms in Boston that served as the perfect incubator for an eager virus to multiply.
In all, the study estimates the Biogen conference is responsible for roughly 1.6 percent of all cases in the United States since the start of the pandemic."
Source: https://www.bostonglobe.com/2020/12/10/nation/biogen-conference-boston-likely-linked-330000-covid-19-cases-worldwide-researchers-say/
Commentary: What's interesting about COVID-19 is that it's not a linear disease. It explodes exponentially when it spreads, which makes any kind of large gathering extremely unsafe. I am still astonished at news every single day of a company or group gathering indoors, in close proximity. That's just asking for an outbreak.
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Truth suppression. "Early in the pandemic, we couldn't help but notice the horrifying death rates among older people with covid-19. As time went on, and case counts grew, enough young people got sick that the deaths started to add up. It took many more cases for the numbers of young adults to be noticeable—the rates of severe illness among younger adults are far lower—but it eventually occurred. No one physician in the United States has documented this more unwaveringly than Dr. Cleavon Gilman. Dr. Gilman was told not to return to work at Yuma Regional Medical Center in Arizona late last month in a story made public yesterday. Why? Because Dr. Gilman tweeted his concerns about capacity in his hospital and others in the region. There were no intensive care beds left in Yuma, and even the other hospitals in the state were too full to accept transfers via ambulance or medical flight. Gilman wanted everyone to know that covid-19 was so out of control in the region, that the hospitals couldn't keep up. Now, the hospital has determined that he can't come to work, simply for spreading the truth.
Healthcare workers speaking out on these issues is more important than most people realize. Information on hospital capacity is sometimes available to the public, but not always. And with the Centers for Disease Control and Prevention being shut out of that reporting since the summer, less information has been available as of late. Meanwhile, it's difficult for the public to understand just how bad things are in hospitals because healthcare providers are not allowed to post pictures or videos online of hospital conditions, owing to privacy concerns for patients. This means that all-too-often, the public can't see what is happening inside of our hospital facilities. If they did, maybe it would hit home as to how serious this disease is and how "on the edge" the entire healthcare system is now. In a world in which HIPAA laws protect patients, but cloister the public from the hard truths, whistleblowers like Dr. Gilman are extraordinarily important. They give voice to thousands of doctors, nurses, and other healthcare professionals who do not feel free to speak on these issues. Telling the truth should not be a risky decision. Healthcare workers educate the public without violating patient privacy should be celebrated and supported."
Source: https://brief19.com/#policy
Commentary: Suppressing the truth does not change it. Disease is unlike humanity; it does not care what our opinions are, it does not respect our boundaries, it does not play favorites. It certainly has no concern for things like politics. Disease just spreads. The sooner we recognize that transparency and openness are the best agents to get a handle on disease and fight it, the sooner we can bring the pandemic to an end. Pretending a disease isn't as bad as it is or doesn't exist at all just makes you an easier target.
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Sanofi hits an obstacle. "One of the world’s leading vaccine manufacturers has suffered a major setback in its work to produce a Covid-19 vaccine. The problem will push the timeline for deployment of Sanofi Pasteur’s vaccine — if it is approved — from the first half of 2021 into the second half of the year, the company said Friday.
The news is not just disappointing for Sanofi and its development partner, GlaxoSmithKline, which is providing an adjuvant used in the vaccine. The companies have contracts with multiple countries, including the United States and Britain, as well as the European Union.
The problem relates to inadequate results in older adults in Sanofi’s Phase 1/2 trial, which the company traced back to an inadequate formulation of their vaccine, Su-Peing Ng, global medical head for Sanofi Vaccines, told STAT in an interview.
In effect, participants in the trial received too little vaccine. While the too-small dose generated adequate levels of neutralizing antibodies in adults aged 18 to 49 in the trial, adults 60 and older generated lower levels of neutralizing antibodies than are seen in the blood of people who have recovered from Covid-19 infection, Ng said."
Source: https://www.statnews.com/2020/12/11/sanofi-suffers-major-setback-in-development-of-a-covid-19-vaccine/
Commentary: Failures like this are reassuring in their own way, that companies are taking the necessary steps to test and finding things going wrong. What would be worrisome would be if these companies all got through their final vaccine candidates with no hitches or stumbles; that would indicate to me that corners were cut, steps skipped, and potential safety issues overlooked. You want people finding mistakes and fixing them
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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 or injected. If you come in physical contact with others, wash your clothing upon returning home.
2. Always wear a mask when out of your home and if going to a high-risk area, wear goggles. Respirators are back in stock at online retailers, too. When going indoors to a place that isn't your home, wear the best protective mask available to you.
3. Stay home as much as possible. Minimize your contact with others and maintain physical distance of at LEAST 6 feet / 2 meters, preferably more. Avoid indoor places as much as you can; indoor spaces spread the disease through aerosols and distance is less effective at mitigating your risks.
4. Get your personal finances in order now. Cut all unnecessary costs.
5. Replenish your supplies as you use them. Avoid reducing your stores to pre-pandemic levels in case an outbreak causes unexpected supply chain disruptions.
6. 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).
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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.
This is also available as an email newsletter at https://lunchtimepandemic.substack.com if you prefer the update in your inbox.