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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Aerosol. Airborne. "Skeptics of the notion that the coronavirus spreads through the air — including many expert advisers to the World Health Organization — have held out for one missing piece of evidence: proof that floating respiratory droplets called aerosols contain live virus, and not just fragments of genetic material.
Now a team of virologists and aerosol scientists has produced exactly that: confirmation of infectious virus in the air.
“This is what people have been clamoring for,” said Linsey Marr, an expert in airborne spread of viruses who was not involved in the work. “It’s unambiguous evidence that there is infectious virus in aerosols.”
A research team at the University of Florida succeeded in isolating live virus from aerosols collected at a distance of seven to 16 feet from patients hospitalized with Covid-19 — farther than the six feet recommended in social distancing guidelines.
The findings, posted online last week, have not yet been vetted by peer review, but have already caused something of a stir among scientists. “If this isn’t a smoking gun, then I don’t know what is,” Dr. Marr tweeted last week."
Source: https://www.nytimes.com/2020/08/11/health/coronavirus-aerosols-indoors.html
Commentary: This finding confirms what we've known for some time: COVID-19 spreads through the air. That means that 6 feet/2 meters of distance is NOT enough in enclosed air spaces, and masks must be mandatory at all times outside your home. Growing the virus right out of the air also means common sense measures outdoors too - don't sit right next to someone else if you're outdoor dining, and certainly do not walk/run/bike in the airstream behind someone.
Watch your distance (and keep it large). Wash your hands. Wear a mask.
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Minorities underrepresented in COVID-19 clinical trials. "As we strive to overcome the social and structural causes of health care disparities, we must recognize the underrepresentation of minority groups in Covid-19 clinical trials. Although the Food and Drug Administration hailed remdesivir as the standard of care for Covid-19 and is actively distributing supplies throughout the United States, data supporting the drug’s efficacy and safety in minority groups are limited. Data on race and ethnicity were not provided for the 53 patients treated with remdesivir under the “compassionate use” program.2 Though we acknowledge that these early results were obtained from a limited data set, Black Americans accounted for only about 20% of the 1063 patients in the placebo-controlled Adaptive Covid-19 Treatment Trial (ACTT-1) funded by the National Institute of Allergy and Infectious Diseases (NIAID)3 and 11% of the 397 patients randomly assigned to 5 or 10 days of remdesivir in the Gilead-funded study (GS-U.S.-540-5773).4 The proportions of Latinx and Native American patients were provided only for ACTT-1 and were 23% and 0.7%, respectively.3
Covid-19 Cases and Deaths, According to Black or White Race and Latinx Ethnicity.
Both trials included sites throughout the United States where Black, Latinx, and Native Americans are overrepresented among people with Covid-19 and related deaths, but these groups were substantially underrepresented in the study samples. Indeed, despite widespread underreporting of patients’ race or ethnicity, we know that Black, Latinx, and Native Americans are dying from Covid-19 at rates disproportionate to their representation in the population in multiple U.S. regions. The modest benefit seen in time to clinical improvement with remdesivir may not be generalizable to minority populations, given the differences in disease severity and outcomes."
Source: https://www.nejm.org/doi/full/10.1056/NEJMp2021971
Commentary: A call to action to all clinical researchers everywhere to ensure that clinical trials are representative of the population. The virus doesn't care who you are or what you look like - just that you're a host. If we want to tame the virus, we must ensure everyone is equally treated and protected - otherwise you'll have reservoirs of the virus that leak out and make containing the virus all but impossible.
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Assaulting a retail worker is a felony. "Assaulting a worker who is enforcing face mask policies can now be prosecuted as aggravated battery in Illinois – a felony charge.
Gov. J.B. Pritzker signed a law Friday that expands the definition of aggravated battery to include attacks against a retail worker who is conveying public health guidance, such as requiring patrons to wear face coverings or promoting social distancing.
"It's clear there is still an even greater need to get people to wear masks – especially to protect front line workers, whether they’re at the front of a store asking you to put on your mask or whether they’re responding to 911 calls to save those in distress," Pritzker said in a statement.
A simple battery charge is considered a misdemeanor and can result in up to a year in prison and fines up to $2,500. An aggravated battery charge, on the other hand, is a felony that can result in a sentence of up to five years in prison – or up to 10 years depending on factors such as the individual's criminal history – and fines up to $25,000."
Source: https://www.usatoday.com/story/news/nation/2020/08/11/illinois-coronavirus-assaulting-worker-enforcing-face-masks-felony/3342856001/
Commentary: A necessary change, and hopefully one adopted by many other states. Sad that it's come to this, but do what is needed to protect public health during a global pandemic.
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A call for readiness for natural disasters. "Irrespective of the nature of the disaster, whether a slowly occurring process or an emergency, all disasters cause displacement, food crises, and diseases for people and livestock. Even in non-pandemic times and high-income countries, disasters overwhelm national response systems. However, the outcomes of disasters, amid the COVID-19 pandemic, will be compounded the most in low-income and fragile countries. Disasters represent situations similar to mass gatherings. The COVID-19 lockdowns in southeast Asia, Africa, and Latin America resulted in mass gatherings of stranded workers who risked both starvation and transmission of COVID-19.
Congregate shelters and large-scale population movements—hallmarks of a natural disaster response—can determine the rate of COVID-19 transmission and challenge the physical distancing requirements of lockdowns. In a natural disaster scenario, evacuees susceptible to COVID-19 will mix with asymptomatic carriers of the virus, and the prevalence of other air-borne, water-borne, and vector-borne diseases might add to comorbidities. Facilities for handwashing and hygiene are severely disrupted during and in the aftermath of natural disasters due to breakage and lack or contamination of water and sanitation systems, if they exist in the first instance. In regions where open defecation is prevalent, which can range from 6% to 75% of the population, potential faecal–oral transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and exacerbation of the spread of endemic diseases should be a concern. Additional challenges include cholera and other diarrhoeal infections, intestinal helminths that cause anaemia, and soil-transmitted infections particularly among people who walk barefoot. Even environmental sampling techniques such as sewage sampling for SARS-CoV-2 surveillance would be challenging where open defecation is most common. Contact tracing would seem impossible when so many people are on the move and intermingling."
Source: https://www.thelancet.com/journals/lanplh/article/PIIS2542-5196(20)30175-3/fulltext
Commentary: With hurricane season in full swing in many parts of the world and more severe climate events happening in general, planning disaster response is even more essential in pandemic times.
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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.
2. 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.
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; 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.
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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.