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.
--
Honestly, I had hoped to not be doing this newsletter any more because the need would have gone away. It looks like it'll continue for quite some time, so thank you for being here.
--
The more you get, the worse you get it according to a new pre-print paper. "We find that 80% of secondary transmissions can be traced back to 14% of SARS-CoV-2 infections, indicating substantial transmission heterogeneities. Regression analysis suggests a marked gradient of transmission risk scales positively with the duration of exposure and the closeness of social interactions, after adjusted for demographic and clinical factors. Population-level physical distancing measures confine transmission to families and households; while case isolation and contact quarantine reduce transmission in all settings. Adjusted for interventions, the reconstructed infectiousness profile of a typical SARS-CoV-2 infection peaks just before symptom presentation, with ~50% of transmission occurring in the pre-symptomatic phase. Modelling results indicate that achieving SARS-CoV-2 control would require the synergistic efforts of case isolation, contact quarantine, and population-level physical distancing measures, owing to the particular transmission kinetics of this virus."
Source: https://www.medrxiv.org/content/10.1101/2020.08.09.20171132v1
Commentary: Two important takeaways: the greater your exposure to the virus, the more likely you'll have a sever case. Wear a mask - even if you do get COVID-19, it may help reduce the severity. Second, 50% of transmission occurs before symptoms. Wear a mask, and avoid people who aren't wearing masks.
The conclusion about dosage was also echoed by UCSF.
Source: https://www.ucsf.edu/news/2020/07/418181/one-more-reason-wear-mask-youll-get-less-sick-covid-19
--
Excess deaths exceed 200,000. "Across the United States, at least 200,000 more people have died than usual since March, according to a New York Times analysis of estimates from the Centers for Disease Control and Prevention. This is about 60,000 higher than the number of deaths that have been directly linked to the coronavirus.
As the pandemic has moved south and west from its epicenter in New York City, so have the unusual patterns in deaths from all causes. That suggests that the official death counts may be substantially underestimating the overall effects of the virus, as people die from the virus as well as by other causes linked to the pandemic.
When the coronavirus first took hold in the United States in March, the bulk of deaths above normal levels, or “excess deaths,” were in the Northeast, as New York and New Jersey saw huge surges.
The Northeast still makes up nearly half of all excess deaths in the country, though numbers in the region have drastically declined since the peak in April.
But as the number of hot spots expanded, so has the number of excess deaths across other parts of the country. Many of the recent coronavirus cases and deaths in the South and the West may have been driven largely by reopenings and relaxed social distancing restrictions."
Source: https://www.nytimes.com/interactive/2020/08/12/us/covid-deaths-us.html
Commentary: This number is low. The CDC's mortality statistics lag by as much as 8 weeks during normal times, so this analysis is on the lower end. In the end, whether or not a death was coded as a COVID-19 death by direct infection or because someone was afraid to go seek care and died of an otherwise preventable condition doesn't matter. The death would not have occurred without the pandemic, making it a relatively robust measure of the overall impact. Certainly, for families affected, the reason for the death is largely irrelevant if a loved one is gone.
--
Who's blocking the middle seat? Hawaiian Air, JetBlue, Delta. If you must fly, fly those.
Source:
Commentary: You can debate whether positioning matters, but airlines that block the middle seat have an inarguable advantage: there are just fewer people on the plane, which reduces the probability that someone is infected.
--
Unventilated bathrooms are bad. In an examination with a CO2 meter, CO2 (a proxy for contaminated, exhaled air) spikes within 10 minutes of someone entering, and remains high for up to 25 minutes after they leave.
Source:
Commentary: The one thing a CO2 meter won't tell you is if someone is wearing a mask or not. They'll still exhale the same amount of CO2, but particles and aerosols will be lower. That said, avoid public bathrooms of any kind as long as you can.
--
$12 trillion price tag. ""IMF estimates the pandemic costs the global economy $375 billion a month, and predicts a cumulative loss to the global economy over 2 years of over $12 trillion”, says @drtedros . "The world has already spent trillions dealing with the short-term consequences of the pandemic."
Source:
Commentary: And the longer it takes to get under control, the more it costs. COVID-19 isn't an either/or, where either you lockdown or you open the economy. It's both; the economy can't function if 20% of the population is impaired and 1% of it dies.
--
Winter is coming, part 2. Dr. Richard Neher of NeherLab: "What happens to #COVID19 when winter returns to the Northern Hemisphere is still uncertain, but here are some things we know:
- people will spend more time indoors
- indoor air will be drier and less ventilated
- endemic CoVs have pronounced seasonality.
So far:
- Europe and Northern US saw big #SARSCoV2 winter/spring outbreaks. Social distancing (and maybe spring) helped contain them followed by fairly quiet summer
- Southern US had a broad peak in summer
- South America has large outbreaks in their winter.
- This is consistent with the pattern of the 2009 H1N1 pandemic (given it started 4 months later).
To me, this suggests controlling #SARSCoV2 in the Northern Hemisphere will become a lot harder over the next six months and things might spiral out of control quickly.
We understand much better now what settings account for most transmission, so we can hopefully contain #SARSCoV2 without drastic restrictions --- but it probably won't be as easy as in summer. We need to act early and should head into winter with as few cases as possible."
Source:
Commentary: Winter is coming, and it bodes ill. Be prepared with supplies, with all the precautions you've been taking all along.
--
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.
--
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
--
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.