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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When do COVID-19 vaccines protect you? A helpful calendar from Dr. Ian Myles:
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Commentary: In short, you don't have confirmed immune responses until a week after the last booster.
And to reiterate: just because you've been vaccinated doesn't mean rip off the mask and go party. We don't have clinical studies yet on the vaccine's ability to stop transmission - meaning you may not get sick but you might still transmit it to others - and with the potential for adaptation/mutation, just stick to the habits you've already built.
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Children are not protected inherently from COVID-19. "A new research letter out today in JAMA Pediatrics looks at trends in pediatric hospitalizations for covid-19 in 2020. The data came from researchers at the University of Minnesota which tracked hospitalizations in 22 US states. (Only the states that collected hospitalizations by age could be included in the analysis. This paper assessed overall hospitalizations for adults, and those for patients under 19 years of age from May to November 2020.
Out of over 300,000 hospitalizations for covid-19, 5,364 of them were for children. Over the course of the study, overall hospitalization of children increased from a rate of 2 per 100,000 children in the state population to 17 per 100,000 children, an impressive jump. There was variation seen between states, and for two of the states in May there were no pediatric hospitalizations specifically recorded as being related to covid-19. By the end of the study period, though, every state had pediatric covid-19 hospitalizations, and the 20 states who had previously reported them in May showed increases in pediatric covid-19 admissions ranging from 42 percent to 5,067 percent.
By now, it doesn't matter what state you live in; children are suffering from this disease across the United States, though fortunately at rates far lower than adults and with far fewer serious outcomes.
Pediatricians are accustomed to counseling families on managing viral symptoms at home, but covid-19 has started pushing children into hospital beds. It has forced families to reconsider visits to pediatric offices, and continually and increasingly threatened the health and safety of our children in a variety of ways. Uncontrolled spread has meant school closures, as well as complications like MIS-C, a post-covid-19 inflammatory syndrome. Is this data finally enough for us to realize how much our youth are affected by this deadly virus? At a minimum it should raise our concerns, especially as we learn more about the B.1.1.7. variant, which many believe is causing an increase in infections among children. Regardless, say it with me now: children are not immune to covid-19."
Source: https://brief19.com/2021/01/11/brief
Commentary: The latest data from the UK shows that B.1.1.7 isn't more infectious in children specific, just more infectious in general, averaging 35% more infectious across all age groups.
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The peace dividend of COVID-19. "CAMBRIDGE, Mass.--(BUSINESS WIRE)--Jan. 11, 2021-- Moderna, Inc. (Nasdaq: MRNA), a biotechnology company pioneering messenger RNA (mRNA) therapeutics and vaccines, today announced that it is expanding its pipeline of innovative vaccines with three new development programs based on the clinical success of its infectious disease vaccine portfolio to date. This announcement reflects the Company’s commitment to accelerating its infectious disease portfolio based on Moderna’s experience with its COVID-19 vaccine. The development programs announced today are mRNA vaccine candidates against seasonal flu, HIV and the Nipah virus. Moderna also announced an expansion of its respiratory syncytial virus (RSV) vaccine program into older adults.
“The uniquely challenging year of 2020 for all of society proved to be an extraordinary proof-of-concept period for Moderna,” said Stéphane Bancel, Moderna’s chief executive officer. “Even as we have shown that our mRNA-based vaccine can prevent COVID-19, this has encouraged us to pursue more-ambitious development programs within our prophylactic vaccines modality. Today we are announcing three new vaccine programs addressing seasonal flu, HIV and the Nipah virus, some of which have eluded traditional vaccine efforts, and all of which we believe can be addressed with our mRNA technology. Beyond vaccines, we are extending our mRNA development work to a total of 24 programs across five therapeutic areas.”"
Source: https://investors.modernatx.com/news-releases/news-release-details/moderna-provides-business-update-and-announces-three-new
Commentary: Our race to build a vaccine is paying dividends. Moderna is looking at applying its technology to HIV, flu, and Nipah, as well as RSV. Imagine the implications of a vaccine for HIV based on mRNA technology. Imagine flu shots that worked well for that year, because the time to produce them was cut from months to days.
COVID-19 has unquestionably been terrible, but if the 2 million lives lost to date result in hundreds of millions of lives saved from new technologies, then their sacrifices and losses weren't for nothing.
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Ireland seeing a massive spike. "The incidence of the more infectious variant of the coronavirus first discovered in England has risen further in Ireland in recent days and accounted for almost half of the most recent sample of positive tests, Prime Minister Micheál Martin said.
Ireland’s 14-day infection rate has risen 10-fold in the last three weeks to 1,291 cases per 100,000, fueled by the new variant and the reopening of shops, restaurants and relaxing of a ban on household visits ahead of Christmas.
Martin said he was told by Ireland’s chief medical officer that the new variant accounted for 45% of the most recent 92 samples than underwent additional testing, compared with 25% of those tested in the week to Jan. 3 and 9% two weeks earlier."
Source: https://www.reuters.com/article/us-health-coronavirus-ireland/incidence-of-faster-spreading-covid-19-has-risen-more-in-ireland-pm-idUSKBN29G13Q
Commentary: This could be other nations if sequencing doesn't ramp up. Petition your legislators to invest heavily in genomic sequencing to detect the disease and enact isolation procedures sooner rather than later. When the disease is 35% more transmissible, it means that some countermeasures become less effective. Masks, properly worn and fitted, do work. But improperly worn masks may offer less protection because fewer virus particles need to enter your body to infect you.
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What to do when there's vaccine leftover? "Yesterday a friend of mine got his first COVID vaccine dose because he happened to be at a CVS buying Hot Pockets near the pharmacy's closing hours, and they had leftover shots that had to be adminstered.
I'm happy for him, but y'all—what!?"
"When there're 6 doses/vial, but 4 ppl to be vaccinated, what happens to other 2 doses? Ideally it goes to person w/ priority. But not always possible to find at moment when needed. Do you throw away 2 (REALLY BAD), reschedule until you can find 6 (BAD), or just vaccinate SOMEONE?"
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Commentary: Vaccinate someone. Anyone. If you happen to be in line for Hot Pockets and you have a chance at the vaccine, get it, and buy yourself an extra box of Hot Pockets to celebrate.
For those living near places where the vaccine is in distribution at retail, call your local pharmacy/distribution point and ask to be put on a "will call" list if they have one. You might get the call at the end of a day when a couple of appointments have canceled and can jump the line for your vaccination.
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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 the best mask available to you when out of your home and you'll be around other people. Respirators are back in stock at online retailers, too.
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 mercury or other heavy metals in the Pfizer mRNA vaccine. https://www.technologyreview.com/2020/12/09/1013538/what-are-the-ingredients-of-pfizers-covid-19-vaccine/
There is no genomic evidence at all that COVID-19 arrived before 2020 in the United States and therefore no hidden herd immunity:
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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.