Lunchtime Pandemic Reading, 11-June-2021

Delta's on the move

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.

You are welcome to share this.

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The Delta variant is on the move. "The reproduction rate in England of Covid-19 has risen to between 1.2 and 1.4, UK government estimates show, confirming that coronavirus is spreading again in the country.

That rate has increased from last week’s value that was estimated at between 1.0 and 1.2, the figures published on Friday revealed. Infections in the UK have risen 13 per cent in the week to June 5, a report released earlier, as the dominant Delta variant, first detected in India, spreads.

The value of between 1.2 and 1.4 suggests, for every 10 people infected with the virus, they will pass it on to between 12 and 14 others.

According to the data, the virus is growing between 3 and 6 per cent a day in England.

The R rate is highest in the north west of England, estimated to be between 1.3 and 1.5.

A figure above 1 implies the virus is spreading exponentially; below 1 means it is slowing.

More than 110,000 people across the UK were infected with Covid-19 in the week to June 5, according to the Office for National Statistics.

The number of Covid-19 infections increased fastest in England and Scotland, where the newly-dominant Delta variant, first identified in India, is spreading rapidly.

One in 560 people had the virus in England in the week to June 5, a deterioration from one in 640 people the week before.

In Scotland, one in 540 people were infected compared to one in 680 people a week earlier.

The prevalence of infections also rose slightly in Northern Ireland over the same period — from one in 800 to one in 700 people.

Across the UK, there were 111,400 people infected with the virus, up from 98,500 in the week to May 29.

In Wales, the spread of infections decreased slightly from one in 1,050 people to one in 1,300."

Source: https://www.ft.com/content/5e4dd187-a899-46cf-811c-796d1be2e42c

Commentary: The Delta variant can still be stopped and slowed by our existing vaccines, but it will present a significant challenge to the unvaccinated. It's more contagious and now appears more harmful as well. Anyone who is eligible to get vaccinated, do what you can to convince them to get it done.

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A good read on vaccine hesitancy. "Anti-vaxxers aren’t anti-vaxxers because they’re stupid. Some are in it for the money (the prominent ones, at least); others for ideological or religious reasons, or due to deep mistrust of medical institutions. People want to believe they’re just dumb, but that’s not correct.

If we have any hope of reaching those who are skeptical of vaccines (not all are hardened anti-vaxxers), we have to actually understand what & who we’re dealing with. In most cases, it’s not a knowledge deficit or a lack of intelligence; it’s complex, interwoven belief systems.

It’s super easy to just say anti-vaxxers are dumb, largely because that’s what we want to believe. But when you do that, you’re actually falling prey to the very same cognitive biases (eg, confirmation bias) that anti-vaxxers fall prey to. But you’re not stupid, right?

There exists a multi-million dollar anti-vaccine propaganda industry that targets people’s beliefs, fears & vulnerabilities. The most recent product of this industry is RFK’s new film targeting African Americans by exploiting their very justified distrust of medical institutions.

As this author noted, some Black people felt that blindly accepting the assurances of the medical community that has historically discriminated against them would be the ignorant thing to do. It’s a very valid point.

Black people have understandable concerns about vaccines due to a history of racism.

https://theconversation.com/anti-vaxxers-are-weaponising-the-vaccine-hesitancy-of-black-communities-153836

More broadly, there’s no evidence that anti-vaxxers are lacking in information or are any less educated than the general public. In fact, many of them spend a huge amount of time consuming information online — just not usually good information.

There’s evidence that vaccine skepticism in some people may be driven by differences in information processing and skewed risk perceptions, particularly related to low-frequency, high impact events.

We also know that negative emotions like fear and anxiety narrow your attention, and that fear of an immediate threat (even one that's not real) creates a sort of tunnel vision that can limit a person’s ability to think critically.

Most experts on this subject, myself included, warn against calling vaccine skeptics dumb, because not only is it inaccurate, but it also risks further hardening their beliefs and turning skeptics into staunch anti-vaxxers.

The growth of the anti-vaccine movement (in online communities, it’s grown by 10 million people since 2019) is what happens when skepticism & distrust are misunderstood and when our only response to these people is to repeat facts they’ve already rejected. We need to do better.

And I should add that I totally get the anger towards the anti-vaccine crowd, and I share in it. But save that anger for the leaders and the funders of the movement, and don’t conflate the victims of propaganda with the creators of it. "

Source:

Commentary: The anti-vaccine movement is a classic ringleader movement. I hope we reach a point where these people can be held accountable for willfully spreading harmful information, ideally through mechanisms like civil or even criminal lawsuits. The ringleaders certainly have conned enough money out of other people to pay it.

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Teen suicide attempts are up, especially among girls. "During 2020, the proportion of mental health–related emergency department (ED) visits among adolescents aged 12–17 years increased 31% compared with that during 2019.

In May 2020, during the COVID-19 pandemic, ED visits for suspected suicide attempts began to increase among adolescents aged 12–17 years, especially girls. During February 21–March 20, 2021, suspected suicide attempt ED visits were 50.6% higher among girls aged 12–17 years than during the same period in 2019; among boys aged 12–17 years, suspected suicide attempt ED visits increased 3.7%.

Suicide prevention requires a comprehensive approach that is adapted during times of infrastructure disruption, involves multisectoral partnerships and implements evidence-based strategies to address the range of factors influencing suicide risk.

Some researchers have cautioned about a potential increase in suicides during the COVID-19 pandemic on account of increases in suicide risk factors; however, this study was not designed to identify the risk factors leading to increases in suspected suicide attempts (10). Young persons might represent a group at high risk because they might have been particularly affected by mitigation measures, such as physical distancing (including a lack of connectedness to schools, teachers, and peers); barriers to mental health treatment; increases in substance use; and anxiety about family health and economic problems, which are all risk factors for suicide. In addition, average ED visit rates for mental health concerns and suspected child abuse and neglect, risk factors for suicide attempts, also increased in 2020 compared with 2019 (5), potentially contributing to increases in suspected suicide attempts. Conversely, by spending more time at home together with young persons, adults might have become more aware of suicidal thoughts and behaviors, and thus been more likely to take their children to the ED."

Source: https://www.cdc.gov/mmwr/volumes/70/wr/mm7024e1.htm?s_cid=mm7024e1_w

Commentary: The latter point is an interesting one; for a lot of people, being at home for extended periods of time might have raised visibility of issues. Nonetheless, be sure you're checking in on those people you care about. The pandemic has created and will leave us with longstanding issues of all kinds, physical and mental health alike.

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Among cancer patients, vaccines still work most of the time. "As COVID-19 adversely affects patients with cancer, prophylactic strategies are critically needed. Using a validated antibody assay against SARS-CoV-2 spike protein, we determined a high seroconversion rate (94%) in 200 patients with cancer in New York City that had received full dosing with one of the FDA-approved COVID-19 vaccines. Comparing to solid tumors (98%), a significantly lower rate of seroconversion was observed in patients with hematological malignancies (85%), particularly recipients following highly immunosuppressive therapies such as anti-CD20 therapies (70%) and stem cell transplantation (73%). Patients receiving immune checkpoint inhibitor therapy (97%) or hormonal therapies (100%) demonstrated high seroconversion post-vaccination. Patients with prior COVID-19 infection demonstrated higher anti-spike IgG titers post-vaccination. Relatively lower IgG titers were observed following vaccination with the adenoviral than mRNA-based vaccines. These data demonstrate generally high immunogenicity of COVID-19 vaccination in oncology patients and identify immunosuppressed cohorts that need novel vaccination or passive immunization strategies."

Source: https://www.cell.com/cancer-cell/fulltext/S1535-6108(21)00285-3

Commentary: This is excellent news for folks who have cancer (or have had it in the past) - be sure to get one of the Pfizer or Moderna vaccines if you are in that group.

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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 other people, 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. Get vaccinated as soon as you're able to, and fulfill the full vaccine regimen. Remember that you are not vaccinated until everyone you live with is vaccinated.

3. Wash/sanitize your hands every time you are in or out of your home.

4. Stay home 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.

5. Get your personal finances in order now. Cut all unnecessary costs.

6. Replenish your supplies as you use them. Avoid reducing your stores to pre-pandemic levels in case an outbreak causes unexpected supply chain disruptions.

7. 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).

8. Masks must fit properly to work. Here's how to properly fit a mask:

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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

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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.

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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.