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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There will be no newsletter on Friday, 16 July 2021.
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Herd immunity is not 70% with Delta in the mix. "Still see 70% quoted as level of vaccination required for 'herd immunity'. Important to note it's now likely to be much higher. The standard (albeit rough) calculation for herd immunity threshold is (1/E) x (1-1/R) where E is vaccine effectiveness in reducing transmission... 1/
In scenario where R is 6 (plausible for Delta in susceptible populations without any restrictions), and vaccination reduces infection/infectiousness such that onwards transmission reduced by 85%, above calc suggests would need to vaccinate (1-1/6)/0.85 = 98% of population. 2/
If transmission reduction is less than this (which is likely the case for some vaccines against Delta), or R higher, then herd immunity wouldn't be achievable through current vaccines alone. This leads to three possibilities... 3/
If herd immunity through vaccination alone not possible, need to either: A) keep some control measures in place indefinitely, B) prepare for exit wave as measures relaxed, C) update what are already very good vaccines to be even more effective. 4/
For avoidance of doubt – above calculations are for *otherwise fully susceptible population* (i.e. estimating effect of vaccination alone). In populations where there have been large epidemics, this accumulated immunity will reduce level of vaccination required to get R below 1."
Source:
Commentary: 70% was against the original SARS-CoV-2 virus, the wildtype - not D614G, not Alpha, and certainly not Delta. The reality is that we were globally unlikely to achieve herd immunity even before the variants. We will not with the current vaccines, vaccine hesitancy, and the new variants.
In other words, plan to keep your mask on for the foreseeable future for optimum safety. Good news is that it'll also help keep you safe from other airborne pathogens and allergens.
Remember to use the best mask available to you. Many of the higher-quality masks like N95/FFP2/KN95 are now back in stock at many retailers. Stock up a little, or consider getting one of the heavy masks like the one I wear that's reusable. Example: https://amzn.to/3rewfxv
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If you or someone you know is pregnant and unvaccinated, and are concerned about the health effects of vaccines on pregnancy, the UK has updated guidelines. Short version: get vaccinated. "COVID-19 vaccines can be given at any time in pregnancy.
• In low-risk situations some women may choose to delay vaccination until 12 weeks of
gestation, aiming for vaccination as soon as possible thereafter.
• If there is a higher chance of contracting infection, or a woman is at a higher risk of severe illness from COVID-19, the vaccine should be offered at the earliest opportunity, including in the first trimester.
• Breastfeeding women can receive a COVID-19 vaccine; there is no need to stop breastfeeding to have the vaccine.
• Women planning a pregnancy or fertility treatment can also receive a COVID-19 vaccine and do not need to delay conception"
Source: https://www.rcog.org.uk/globalassets/documents/guidelines/2021-06-30-coronavirus-covid-19-vaccination-in-pregnancy.pdf
Commentary: Get vaccinated. The risks are extremely low from the vaccine and extremely high from COVID-19.
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Both infection and vaccines will create long-lasting protection. "Ending the COVID-19 pandemic will require long-lived immunity to SARS-CoV-2. Here, we evaluate 254 COVID-19 patients longitudinally up to 8 months and find durable broad-based immune responses. SARS-CoV-2 spike binding and neutralizing antibodies exhibit a bi-phasic decay with an extended half-life of >200 days suggesting the generation of longer-lived plasma cells. SARS-CoV-2 infection also boosts antibody titers to SARS-CoV-1 and common betacoronaviruses. In addition, spike-specific IgG+ memory B cells persist, which bodes well for a rapid antibody response upon virus re-exposure or vaccination. Virus-specific CD4+ and CD8+ T cells are polyfunctional and maintained with an estimated half-life of 200 days. Interestingly, CD4+ T cell responses equally target several SARS-CoV-2 proteins, whereas the CD8+ T cell responses preferentially target the nucleoprotein, highlighting the potential importance of including the nucleoprotein in future vaccines. Taken together, these results suggest that broad and effective immunity may persist long-term in recovered COVID-19 patients."
Source: https://www.cell.com/cell-reports-medicine/fulltext/S2666-3791(21)00203-2
Commentary: This study may help quell some concerns about durability of vaccines, as long as we don't get even more powerful variants. Essentially, once our bodies know what to look for, they're pretty good at stopping SARS-CoV-2.
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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 other people, 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. 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.
3. Wash/sanitize your hands every time you are in or out of your home.
4. Stay out of indoor spaces that aren't your home 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.
5. Get your personal finances in order now. Cut all unnecessary costs.
6. Replenish your supplies as you use them. Avoid reducing your stores to pre-pandemic levels in case an outbreak causes unexpected supply chain disruptions.
7. 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).
8. Masks must fit properly to work. Here's how to properly fit a mask:
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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.