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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FDA clears 3rd dose for immunocompromised people. "The Food and Drug Administration on Thursday authorized the administration of an additional dose of one of the messenger RNA Covid-19 vaccines for people who have certain immunocompromising conditions amid growing evidence that they do not get adequate protection from the normal two-dose regimen of the Pfizer-BioNTech or Moderna vaccines.
The decision was formally an amendment to the emergency authorization under which the mRNA vaccines are already being used. It does not apply to the one-dose Johnson and Johnson vaccine, which has been used far less in this country than the mRNA products. It is unclear how many immunocompromised Americans would have received the J&J vaccine.
“Today’s action allows doctors to boost immunity in certain immunocompromised individuals who need extra protection from Covid-19,” Acting FDA Commissioner Janet Woodcock said in a statement released shortly before midnight. “As we’ve previously stated, other individuals who are fully vaccinated are adequately protected and do not need an additional dose of COVID-19 vaccine at this time.”
Patient groups and the physicians who treat them have been advocating for immunocompromised people — for instance, solid organ transplant recipients who take immunosuppressant drugs — to be given an additional dose, especially in the face of the spread of the more transmissible Delta variant. Several countries — France, Germany, Britain, and Israel among them — are or will soon be giving third doses to immunocompromised people.
The amended emergency use authorizations say the third doses of vaccine should be given at least 28 days after the second shot in the series. The Pfizer vaccine, which can be given to people 12 years of age and older, is administered in two doses, 21 days apart. The Moderna vaccine, which can be given to people 18 and older, is given in two doses 28 days apart."
Source: https://www.statnews.com/2021/08/12/fda-authorizes-additional-dose-of-covid-19-vaccine-for-the-immunocompromised/
Commentary: This makes logical sense; immunocompromised people would not have developed a robust immune response and thus Delta can still cause them substantial harm.
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Tennessee is out of ICU beds. "BREAKING FROM TENNESSEE: "There are no beds. In Middle Tennessee right now it is impossible to find an empty, staffed ICU, ER, or med/surg bed," says chief medical officer for Sumner Regional Medical Center in Gallatin. #COVID19"
Source:
Commentary: The key takeaway here is that if you're in an area with substantial spread, you are at risk. Not directly, but if you have a heart attack or get into a car accident or anything requiring urgent care, you may not be able to get help in a timely fashion. That means you'll want to reduce as many risks in your life as possible right now, be mindful of your health, and keep an eye on hospital utilization in your region.
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4,700 needless deaths in the USA in July. "The success of COVID-19 vaccination campaigns in many states demonstrates the real-world feasibility, and impact, of achieving high vaccination coverage. By the end of July, the five highest-performing states — Vermont, Connecticut, Massachusetts, Maine, and Rhode Island — had fully vaccinated an average of 74 percent of adults and lowered rates of COVID-related hospitalizations and deaths compared with other states. In contrast, the two states with the greatest burdens of cases, hospitalizations, and deaths currently — Florida and Texas — had fully vaccinated only 59.3 percent and 55.6 percent of their adult residents, respectively.
We calculated the number of deaths, hospitalizations, and cases that could have been averted if Florida and Texas had reached vaccination coverage of 74 percent. We found that by doing so, together the two states could have averted more than 70,000 hospitalizations and 4,700 deaths by the end of July.
The highly infectious Delta variant, which is driving the current surge, makes the situation even more dire. As of Aug. 11, the seven-day average of new daily cases had exceeded 118,000 across the U.S., higher than the peak the summer before. Outbreaks are predominantly affecting states that have relatively low vaccination coverage, with nearly a third of recent cases occurring in Florida and Texas.
Florida recorded the nation’s highest daily death toll — 141 (averaged over seven days ending Aug. 10, 2021). Texas followed, with 63 deaths.
Our previous analyses have demonstrated that the U.S. vaccination campaign against COVID-19 prevented nearly 1.25 million hospitalizations and 280,000 deaths nationwide by the end of June. Our current analysis found that fully vaccinating 74 percent of adults in Florida by the end of July would have reduced hospitalizations by nearly 39,000, from 144,782 to 106,113, and deaths by an estimated 2,806, from 19,489 to 16,683 (table). In Texas, increasing vaccination rates would have reduced hospitalizations by more than 32,000, from 163,058 to 130,755, and deaths by more than 1,900, from 29,435 to 27,525, according to our estimates (Table 1)."
Source: https://www.commonwealthfund.org/blog/2021/increasing-covid-19-vaccination-rates-florida-and-texas-could-have-saved-4700-lives
Commentary: This does not take into account those who have been injured with long COVID. That will play out over months and years for a substantial percentage of the hospitalizations. But nearly all of those deaths would have been prevented if people had gotten vaccinated instead of believing garbage they read on Facebook or other nonsensical reasons for not getting vaccinated (excepting those who have a legitimate medical condition preventing vaccination).
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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 people you don't live with, 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. Verify your mask's NIOSH certification here: https://www.cdc.gov/niosh/npptl/usernotices/counterfeitResp.html
3. 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. If you received an adenovirus vaccine (J&J/AstraZeneca), consider getting an mRNA single shot booster (Pfizer/Moderna) if permitted.
4. Wash/sanitize your hands every time you are in or out of your home.
5. Stay out of indoor spaces that aren't your home and away from people you don't live with 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.
6. Aim to have 3-6 months of living expenses on hand in case the pandemic gives another crazy plot twist to the economy.
7. Replenish your supplies as you use them. Avoid reducing your stores to pre-pandemic levels in case an outbreak causes unexpected supply chain disruptions.
8. 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).
9. Masks must fit properly to work. Here's how to properly fit a mask:
10. If you think you may have been exposed to COVID-19, purchase a rapid antigen test. This will detect COVID-19 only when you're contagious, so follow the directions clearly. https://amzn.to/3fLAoor
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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.