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 a qualified healthcare provider who knows your specific medical situation over advice from people on the Internet.
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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Not COVID news, but a HUGE advancement in understanding multiple sclerosis: it's HIGHLY correlated with Epstein-Barr virus (aka mononucleoisis) and may be triggered by it. "Now researchers have found strong evidence that it’s an infection, specifically the Epstein-Barr virus, best known for causing mononucleosis. In a large cohort of military service members followed over many years, infection with Epstein-Barr increased the likelihood of developing multiple sclerosis, or MS, by more than 32-fold, a team of scientists led by Harvard University’s Neuroepidemiology Research Group reported in the journal Science on Thursday."
Source: https://www.statnews.com/2022/01/13/strong-new-evidence-suggests-virus-triggers-multiple-sclerosis/
Commentary: This could potentially be life changing for people; if we develop vaccines for EBV, we could potentially wipe out MS in a generation.
This does raise a COVID-related question: what will the long-term effectives of SARS-CoV-2 be in us? We won't know for years, but all the more reason to get vaccinated now.
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Foolish. "The Centers for Disease Control and Prevention's COVID-19 guidance will be optional for many cruise ships starting Saturday.
Why it matters: The CDC's framework for cruise lines was extended to Jan. 15 in October after cases spiked. Its expiration comes two weeks after the CDC issued a warning to avoid cruise travel for both vaccinated and unvaccinated people.
State of play: The vast majority of cruise ships currently have reported enough coronavirus cases to meet the threshold for a CDC investigation.
After Saturday, the CDC will transition to a voluntary risk mitigation program for cruise lines operating in U.S. waters.
"This transition will continue strong measures to detect, mitigate, and control the spread of COVID, and it will align with other travel orders including the global contract tracing and global testing orders," the CDC said in an October statement announcing the voluntary program.
The CDC has notified industry members about the program and expects cruise lines to decide whether to participate or not in the coming week, USA Today reports."
Source: https://www.axios.com/covid-cruise-ships-cdc-guidance-3cf245f9-9b29-4710-b3f5-e4866db2abcb.html
Commentary: Moving to voluntary enforcement of COVID-19 testing and screening will only encourage more spread. Not that I was a huge fan of cruising before the pandemic, but you would have to pay me substantial sums of money to set foot on a cruise ship now.
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Long COVID sufferers have a loss of some immune response. "A proportion of patients surviving acute coronavirus disease 2019 (COVID-19) infection develop post-acute COVID syndrome (long COVID (LC)) lasting longer than 12 weeks. Here, we studied individuals with LC compared to age- and gender-matched recovered individuals without LC, unexposed donors and individuals infected with other coronaviruses. Patients with LC had highly activated innate immune cells, lacked naive T and B cells and showed elevated expression of type I IFN (IFN-β) and type III IFN (IFN-λ1) that remained persistently high at 8 months after infection. Using a log-linear classification model, we defined an optimal set of analytes that had the strongest association with LC among the 28 analytes measured. Combinations of the inflammatory mediators IFN-β, PTX3, IFN-γ, IFN-λ2/3 and IL-6 associated with LC with 78.5–81.6% accuracy. This work defines immunological parameters associated with LC and suggests future opportunities for prevention and treatment.
In summary, our data indicate an ongoing, sustained inflammatory response following even mild-to-moderate acute COVID-19, which is not found following prevalent coronavirus infection. The drivers of this activation require further investigation, but possibilities include persistence of antigen, autoimmunity driven by antigenic cross-reactivity or a reflection of damage repair. These observations describe an abnormal immune profile in patients with COVID-19 at extended time points after infection and provide clear support for the existence of a syndrome of LC. Our observations provide an important foundation for understanding the pathophysiology of this syndrome and potential therapeutic avenues for intervention."
Source: https://www.nature.com/articles/s41590-021-01113-x?s=09
Commentary: This finding is not causal in nature in the sense that COVID-19 is disrupting T-cell function in otherwise healthy people. Instead, it's saying that there's a percentage of the population - and it's unclear what percentage it is - that has a dysfunction in their T-cell functions, making them vulnerable to Long COVID. What that means in turn is that unless you know you have this immune marker, there's no way to determine whether you will be more susceptible to Long COVID or not - again, more reason to get vaccinated.
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Stop saying Omicron is "mild". "These dismissals of the variant as trifling—desirable, even—represent “a very dangerous attitude,” Akiko Iwasaki, an immunologist at Yale, told me. At the core of the problem sits the word mild itself, a slippery and pernicious term that “doesn’t mean what people think it means,” Neil Lewis, a behavioral scientist at Cornell, told me. Less severe forms of COVID-19 can certainly be experienced by individual people, especially if they’re vaccinated. And there are true reasons to think that Omicron, particle for particle, might be less toothy than Delta. But Omicron’s unfettered spread has sowed a situation that is not mild at all. And right now, the notion of mildness is making the pandemic worse for everyone.
Much of our Omicron problem can be traced back to a false binary: That the variant is less of a danger too often gets misconstrued as the variant is not a danger at all. Severity works in degrees, which is indeed what we’re seeing. Per capita, Omicron seems less likely than Delta to hospitalize or kill the people it infects. In South Africa, one of the first countries to be hit by the variant, cases have already crested at a record-shattering peak, but hospitalizations, admissions to intensive-care units, and deaths remain far below the heights of prior waves; infections also appear to be decoupling from severe disease in parts of continental Europe. Even in the United States, where the pandemic is as bad as it’s ever been, early data are pointing to a blunting in the propensity of Omicron cases to turn severe."
Source: https://www.theatlantic.com/science/archive/2022/01/omicron-mild-severity-immunity/621238/
Commentary: "Mild" COVID is like a "minor accident" with your car. It still causes damage, it's just that your car doesn't need a tow or isn't totaled. Given a choice between no car accident and a "mild" car accident, which would you choose?
No car accident = wearing a mask, getting fully vaccinated, and not hanging out in places with other people.
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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, including boosters. 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 available. If it's available, choose Moderna as your first choice for both vaccine and booster, Pfizer as your second choice. However, remember than any vaccine is better than no vaccine.
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.