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.
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Debunking. There is no genomic evidence at all that COVID-19 arrived before 2020 in the United States.
Source:
There is no hidden herd immunity, period. Avoid sharing this and other coronavirus conspiracy theories that have no factual basis.
Also worth debunking: no evidence SARS-CoV-2 was engineered, either.
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
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A new study in NEJM highlights the danger of COVID-19 establishing itself. "Young children and females were less likely to test positive for SARS-CoV-2 than adolescents or adults and males. Whether the lower incidence of positive results in these two groups resulted from less exposure to the virus or from biologic resistance is not known. In other studies, investigators have found that infected children and females were less likely to have severe disease than adults and males, respectively. The haplotype composition of the viruses from persons who were identified through population screening was different from that of viruses infecting persons who tested positive in the early phase of targeted testing, so we conclude that the haplotypes of the virus that were propagating in the general population came from a different source (as compared with those infecting high-risk persons in the early phase of targeted testing), perhaps brought into Iceland by persons arriving from countries that had not yet been designated as high-risk areas."
Source: https://www.nejm.org/doi/full/10.1056/NEJMoa2006100
The good news: kids were less likely to test positive. Iceland's testing has been one of the most aggressive per capita in the world, allowing them to quickly gain control of their outbreak. The fact that early infections came from a different source means that the asymptomatic transmission was probably a problem for them as well. This disease evades detection like crazy, which means that declaring victory too soon will give the virus exactly what it needs to make a powerful resurgence.
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Mental health is suffering during the pandemic due to school closures. In a new study in The Lancet, 26% of participants were unable to access mental health services. "For children and adolescents with mental health needs, such closures mean a lack of access to the resources they usually have through schools. In a survey by the mental health charity YoungMinds, which included 2111 participants up to age 25 years with a mental illness history in the UK, 83% said the pandemic had made their conditions worse. 26% said they were unable to access mental health support; peer support groups and face-to-face services have been cancelled, and support by phone or online can be challenging for some young people. Social distancing measures can result in social isolation in an abusive home, with abuse likely exacerbated during this time of economic uncertainty and stress. Jianli County in Hubei province, China, has seen reports of domestic violence to the police more than triple during the lockdown in February, from 47 last year to 162 this year. Increased rates of child abuse, neglect, and exploitation have also been reported during previous public health emergencies, such as the Ebola outbreak in west Africa from 2014 to 2016."
Source: https://www.thelancet.com/journals/lanchi/article/PIIS2352-4642(20)30109-7/fulltext
As best as we can, we must provide monitoring, services, and escape for persons at risk of depression, abuse, and other challenges. We're not going back to the world the way it was before 2020 until a vaccine is generally available and deployed.
What can you do? Keep checking in, and encourage those who have loved ones at higher risk to interact as much as they are comfortable. It can be challenging; video interactions aren't as good as in-person, but they're better than nothing.
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Ending lockdowns will be a dangerous case of trial and error, according to Science Magazine. "The number to watch in the next phase may no longer be the actual number of cases per day, but what epidemiologists call the effective reproduction number, or R, which denotes how many people the average infected person infects in turn. If R is above 1, the outbreak grows; below 1 it shrinks. The goal of the current lockdowns is to push R well below 1. Once the pandemic is tamed, countries can try to loosen restrictions while keeping R hovering around 1, when each infected person on average infects one other person, keeping the number of new cases steady. To regulate R, “Governments will have to realize that there are basically three control knobs on the dashboard,” says Gabriel Leung, a modeler at the University of Hong Kong: isolating patients and tracing their contacts, border restrictions, and social distancing."
Source: https://www.sciencemag.org/news/2020/04/ending-coronavirus-lockdowns-will-be-dangerous-process-trial-and-error
Here's the challenge for developing nations with poor healthcare infrastructure, like the United States: contact tracing and testing requires... well, lots of testing. In the absence of the tools and manpower to do testing and tracing, a government really only has social distancing and border closures to rely on.
When all you have is a hammer, everything's a nail.
Already, we're seeing the hints of what's to come, with the Western States Pact and the Northeast States Working Group established - it would be no surprise at all to see these states eventually need to enact border restrictions and mandatory quarantines from states with less aggressive COVID-19 containment.
"Visitors from District 10 must self quarantine upon arrival in District 13. Travel from District 11 is prohibited at this time." is not an inconceivable outcome.
Source: https://www.cnbc.com/2020/04/13/new-york-new-jersey-and-other-northeastern-states-form-coronavirus-working-group-to-decide-when-to-ease-restrictions.html
Source: https://www.gov.ca.gov/2020/04/13/california-oregon-washington-announce-western-states-pact/
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A reminder of the simple daily habits we should all be taking.
1. Wash/sanitize your hands often, and 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.
2. Wear gloves and appropriate protective equipment if you have it when out of your home in any enclosed airspace (stores, etc.).
3. Stay home. Just stay home.
4. Get your personal finances in order now. Cut all unnecessary costs.
5. Donate any PPE you can. https://getusppe.org/give/