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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The EU is seeing a massive, true second wave.
Source: https://ourworldindata.org/coronavirus-data-explorer?zoomToSelection=true&country=USA~BRA~IND~EuropeanUnion®ion=World&casesMetric=true&interval=smoothed&smoothing=7&pickerMetric=location&pickerSort=asc
Commentary: While the EU successfully subdued the outbreak in April and May, since August it's been accelerating there. On a population-scaled basis, the Czech Republic, Belgium, the Netherlands, and France are leading infection sites.
The key people forget is that the virus doesn't get tired, bored, or distracted. It never lapses in judgement. It ignores opinions, beliefs, and political ideologies. It just does what a virus does: replicates and infects. It will give us no quarter, and thus we cannot give it any quarter or let down our guard. The moment we do, it begins to win again.
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The J&J vaccine is on hold. "The study of Johnson & Johnson’s Covid-19 vaccine has been paused due to an unexplained illness in a study participant.
A document sent to outside researchers running the 60,000-patient clinical trial states that a “pausing rule” has been met, that the online system used to enroll patients in the study has been closed, and that the data and safety monitoring board — an independent committee that watches over the safety of patients in the clinical trial — would be convened. The document was obtained by STAT.
Contacted by STAT, J&J confirmed the study pause, saying it was due to “an unexplained illness in a study participant.” The company declined to provide further details.
Though clinical trial pauses are not uncommon — and in some cases last only a few days — they are generating outsized attention in the race to test vaccines against SARS-CoV-2, the virus that causes Covid-19.
Given the size of Johnson & Johnson’s trial, it’s not surprising that study pauses could occur, and another could happen if this one resolves, a source familiar with the study said.
“If we do a study of 60,000 people, that is a small village,” the source said. “In a small village there are a lot of medical events that happen.”"
Source: https://www.statnews.com/2020/10/12/johnson-johnson-covid-19-vaccine-study-paused-due-to-unexplained-illness-in-participant/
Commentary: Pauses in clinical trials for adverse events are a GOOD thing. It means we're testing for safety, testing for outliers, testing for the unexpected, and we're not just rubber stamping brand new medicines. You want pausing of trials, investigation, and analysis.
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A study of reinfection. "We present, to our knowledge, the first North American case of reinfection with SARS-CoV-2. A 25-year-old man, who was a resident of Washoe County in the US state of Nevada, had laboratory-confirmed SARS-CoV-2 infection in April, 2020, followed by secondary infection within a period of around 6 weeks, in June, 2020. The second infection was symptomatically more severe than the first. Genomic analysis showed the two viral agents were genetically distinct. The patient's immune reaction in vitro was not assessed and, thus, conclusions cannot be made about the duration or degree of immunity.
Reinfection with SARS-CoV-2 has been reported in at least four individuals worldwide. Thus, previous exposure to SARS-CoV-2 does not necessarily translate to guaranteed total immunity. The implications of reinfections could be relevant for vaccine development and application. From a public health perspective, all individuals—whether previously diagnosed or not—must take identical precautions to prevent infection with SARS-CoV-2. Further work is needed to assess immune reactions in vitro after reinfection."
Source: https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30764-7/fulltext
Commentary: The key to remember here is that reinfection is possible. That also means re-spreading is possible. Whether or not you've had COVID-19, act as though you never have and take all precautions to protect yourself and others.
Wear a mask at all times outside your home.
Wash your hands.
Watch your distance.
Walk out of indoor spaces as quickly as possible.
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First reinfection death. "An elderly woman in the Netherlands has died after getting COVID-19 a second time, researchers reported on Monday. It’s the first time a death has been reported from reinfection with coronavirus.
The patient was an 89-year-old woman who was being treated for Waldenström’s macroglobulinemia, a rare type of white blood cell cancer which is treatable but incurable. The findings were published in the Oxford University Press.
The researchers said the woman arrived at the emergency department earlier this year while suffering from a fever and severe cough. She tested positive for coronavirus and remained hospitalized for 5 days, after which her symptoms subsided completely, except for persisting fatigue.
Nearly 2 months later, just two days after starting a new round of chemotherapy, she developed a fever, cough, and dyspnea. When she was admitted to hospital, her oxygen saturation was 90 percent with a respiratory rate of 40 breaths per minute. She again tested positive for coronavirus while tests for antibodies were negative at days 4 and 6.
“At day 8, the condition of the patient deteriorated. She died two weeks later,” the researchers said.
The team had access to test samples from both infections and confirmed that the genetic makeup of each virus was different to a degree which cannot be explained through in-vivo evolution. This supports the finding that the woman was suffering from a reinfection with coronavirus.
To date, researchers have confirmed only 23 cases of reinfection, but in all prior cases the patient recovered."
Source: https://bnonews.com/index.php/2020/10/dutch-researchers-report-first-death-from-covid-19-reinfection/
Source: https://academic.oup.com/cid/advance-article-pdf/doi/10.1093/cid/ciaa1538/33863695/ciaa1538.pdf
Commentary: This is a case where the patient was clearly immunocompromised, so even though she survived the first case, she did not survive the second.
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SARS-COV-2 was here long before many were aware. "The Wall Street Journal interviewed disease detectives and reviewed hundreds of pages of new research to piece together how the coronavirus infiltrated the wealthiest nation on earth. The latest genetic, epidemiological and computational research suggests it was spreading inside the country before anyone started looking.
Jan. 2, 2020. Retrospective testing in Ohio found that five women and a man who had developed Covid-like symptoms in early January had antibodies for the virus, qualifying as "probable" infections. They lived at opposite corners of the state, up to 200 miles apart. Though the findings aren't conclusive, modeling experts say they are consistent with the speed of the pandemic's later spread.
February 6, 2020: A 57-year-old woman died in Santa Clara County, Calif. Later tests found she had the coronavirus, making her the first known U.S. Covid-19 death. It’s still not known how she caught the virus."
Source: https://www.wsj.com/graphics/when-did-covid-hit-earliest-death/
Commentary: You and I have been following this for a long, long time, from the very first pandemic 'newsletter' post on Facebook on January 27. That it was spreading before anyone was aware is no surprise. What has continued to surprise and dismay is how few people take it seriously, and how many people have been killed or permanently disabled since the warnings in early January.
Honestly, I was hoping that this newsletter would have been obsolete by now. Instead, it's looking like a long-running publication.
Source: https://www.facebook.com/cspenn/posts/10163265767440122
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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. Always 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, 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. Participate in your local political process. For Americans, go to Vote.org and register/verify your vote.
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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.