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.
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From the weekend circuit, Dr. Anthony Fauci on whether we have turned the corner on the pandemic in the United States. "Well, you know, I'm sorry, but I have to disagree with that. Because if you look at the thing that you just mentioned this statistics, Andrea, the disturbing, you know, we're plateauing at around 40,000 cases a day, and the deaths are around 1000. As we enter and you know, we we turn the corner after the Labor Day weekend, I'm hoping that we do not see a surge in cases as we've seen following the Fourth of July, and Memorial Day, but when you have a baseline of infections that are 40,000 per day, and you have threats of increased test positivity in certain regions of the country, such as the Dakotas and Montana and places like that What we don't want to see is going into the full season when people will be spending more time indoors. And that's not good for respiratory borne virus. You don't want to start off already with a baseline that's so high. So the thing that we've all been talking about, I've been stressing this over the last few weeks to a month or more, to try as best as possible to get that level down. So that when you go into a more precarious situation, like the fall in the winter, you won't have a situation where you really are at a disadvantage right from the very beginning."
Source:
Commentary: We're now a week out from Labor Day. Recalling that the incubation time for COVID-19 is 7-14 days, we'll start to see the impact of Labor Day weekend over the next week or so in case counts.
Here's the concern worrying many: testing is declining instead of rising, leading to higher positivity rates. That means we're missing more actual cases of the disease.
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Dr. Fauci on when things return to normal. "I mean, if you're talking about normality being, being able to go into a theater, or go into a restaurant in its full capacity and not having to wear a mask all the time, as long as you have active infection in the community will, you're going to have to do the things that we've been talking about all along, wearing a mask, keeping physical distance, avoiding crowds, trying to do things outdoors much more than indoors. Once we get a very low level of infection, one that's easily controllable. Then we could start talking about what we just mentioned, normal living, going to a theater, going to a restaurant not having to wear a mask.
When we get a vaccine, let's say available at the end of the year, there will be millions and 10s of millions of doses available. It won't be until we get into 2021, that you'll have hundreds of millions of doses and just the logistics constraints in vaccinating large numbers of people. It's going to take months to get enough people vaccinated to have an umbrella of immunity over the community so that you don't have to worry about easy transmission. And that's what I mean, it's not going to be an overnight event where you have a vaccine, and then all of a sudden everything is okay. It's gonna take several months to get the population of this country vaccinated. And protected from infection.
I would be surprised if we had a vaccine like measles, which is a 97 to 98% effective vaccine where the only thing you need to do is vaccinate the population, and you've taken measles off the table. I don't think that that's going to happen. I would accept a 70 to 75% effective vaccine, which means you still have to have a component of public health measures."
Source:
Commentary: For those that think we'll just go back to what life was like before March 2020, no. There's no going back. There's only adaptation and change, and what the world looks like even in 2-3 years isn't certain at this point. All we know is that we will be living with this disease as we've been living with so many others, and our reality will need to continue to adapt. The sooner we accept that there is no going back, the faster we can move forward.
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Dr. Michael Osterholm on what's next. "You know, looking forward where we're at right now, I, Tony and I are completely on the same page. Number one is, we're now level off at about 40,000 cases a day, which you think about that that's 8000 more when the house was on fire back in March. And we will with the colleges and universities openings with the spillover that's occurring with people experience even more pandemic fatigue, wanting to be in indoor air spaces with other people. As we get into the fall. We're going to see these numbers grow substantially, the vaccine does become available. It won't be in any meaningful way until the beginning of next year. And then it's still going to take us months to vaccinate the population of just this country. And so I agree we really have another 12 to 14 months have a really hard road ahead of us. And that's what I'm concerned about today. I don't I don't go back and, you know, replay February and March I play right now, what is our national plan? We don't have one. We have 50 state plans that in many cases are so different, so divided and not based on necessarily good science. So yeah, we got a long road ahead."
Source:
Commentary: Plan accordingly. 12-14 months of continued tough times, combined with the winter months. Be sure to take care of yourself, including mentally and emotionally. Find something inside your own mind that makes you happy, whether it's writing, playing music, exploring virtual reality - it doesn't matter as long as you can be happy inside yourself.
One of the most neglected parts of the overall pandemic, combined with the other situations happening in the world, is that our collective mental health has suffered tremendously. Depression, anxiety, anger - everything is at all-time highs. Do your best to set aside time to clean yourself of those emotions; staying in an angry state all the time produces cortisol, which is incredibly draining on your body. It's keeping you in a near-permanent fight or flight state, and that leads to nothing good.
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Dr. Scott Gottlieb on the vaccine. "This this clinical trials and event based trial mean that they have to wait until enough people in the clinical trial actually developed COVID disease to get a readout from the trial and whether or not the vaccine is actually preventing people from getting signs and symptoms of COVID. The initial market entry of this vaccine, if you will, it's not going to be like a traditional approval of a vaccine, where it's sort of a binary event and a vaccine gets licensed for broad community what is likely to be as offered under an emergency use authorization to a very narrow population initially, perhaps frontline healthcare workers and first responders, maybe people above a certain age who like who are more likely to have a bad outcome from COVID. Then after the FDA gets more experienced with the vaccine, and after the original data set from these clinical trials continues to mature, then the FDA is going to slowly walk down that approval, meaning Let it be available to successively larger groups of people while they collect very rigorous evidence in the post market. So this is likely to be a very staged market entry. I think that's what people should expect. But for most people, they will not have access to a vaccine until 2021. I think maybe the first quarter of 2021, probably the first half of 2021. And that's assuming that these vaccines are demonstrated to be safe in effect with nice large trials. I think the people who will get it this year are going to be people select populations, who are either high risk of contracting the virus and perhaps spreading it or at high risk of having a bad outcome to it.
I think we're gonna be using this vaccine, at least initially, almost in a therapeutic sense, we're not going to use it like we use a traditional vaccine when you broadly vaccinated population to try to prevent the virus from spreading across the population. What we're going to be doing is targeting the vaccine to select select groups of people who are very high risk of a bad outcome from COVID, to try to reduce their risk, but it's not going to be used to achieve broad based immunity, at least in 2020, perhaps in 2021. And I think it's likely that if the FDA is able to get top line data from from the trial that Dr. Barlow was talking about, at the end of October, it's going to take them a number of weeks to even turn around and initial authorization, they're gonna want to bring that before an advisory committee. They're gonna want to scrub that data set very hard. So this isn't something you just turn around in a couple of days. So you know, it Hopefully we'll see some availability in 2020. I'm optimistic that we will have these trials are successful, but we very limited availability."
Source:
Commentary: Nearly everyone agrees that large scale vaccination, assuming we get a working vaccine with high efficacy, will be a 2021 event. Prepare accordingly. In the business I work in, events and conferences have had to pivot, to greater or lesser degrees of success, and that pivot is looking like it's going to be the case for some time.
Is that what any of us want to hear? No. Is it reality? Yes.
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Finally, a fun and informative interview with Dr. Fauci on Tiffany Haddish's show.
Source:
Commentary: It's worth the watch. It really is. I won't spoil any more than that.
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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.
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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.