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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It's just after halftime and our MVP who was out the first half of the game is finally in play and scoring big. Our team is behind, but we're catching up. Pop quiz, sports fans: is this the time to simply bench the defense?
The answer is heck no. We need a strong defense now as we put more points on the board. Any self-respecting sports fan would be screaming at the TV right now if a coach simply benched their defense and only let the offense play.
Wearing masks, watching distance, staying out of indoor spaces that aren't our homes, avoiding gatherings - that's our defense. The vaccines? That's our offense. And we need both to win. Worldwide, cases are declining. Our vaccine production and distribution is ramping up. But our opponent has not one, but a bench full of MVPs also getting into the game - the new strains. Benching our defense now would be a crushing defeat no matter how good our MVPs are at offense.
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Some severe COVID-19 patients experience damage to the eyes. "This paper reports a series of patients with severe COVID-19 presenting with abnormal MRI findings of the globe. This study showed that 7% of patients with severe COVID-19 presented with one or several nodules of the posterior pole of the globe. This rate is in line with the prevalence of 5.5% of ocular manifestations among COVID-19 patients reported in a recent meta-analysis(3). Patients affected by severe COVID-19 were reported to be more at-risk to develop ocular manifestations (4,11,12).
Nodules were mostly bilateral and were located in the macular region in all cases, in association with extra-macular nodules in 22% of the cases. These nodules were not visible in the 3 patients who underwent ophthalmological examination. This might be due to a lack of sensitivity of the clinical examination, which was difficult to perform in patients with severe COVID-19 or to the delay between the completion of the MRI examination and the ophthalmological examination.
This paper reports a series of patients with severe COVID-19 presenting with abnormal MRI findings of the globe. Screening of these patients might be suitable to provide appropriate treatment and improve the management of potentially severe ophthalmological manifestations."
Source: https://pubs.rsna.org/doi/10.1148/radiol.2021204394
Commentary: COVID-19 is the punishment that keeps on punishing. Part of the reason it has such severe effects all throughout the body is that it attaches to our cells differently than many other viruses. By using the ACE2 receptor, it can invade many more organs than other respiratory viruses, and once inside the body, it can travel to many different places. The only defense is to keep it out or to vaccinate against it.
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The danger of moralization. "We investigated whether the moralization of health-based C19 efforts (i.e., to reduce C19 deaths and illnesses, or eliminate the virus) would generate asymmetries in the evaluation of human costs. We hypothesized that because the health impacts of C19 remain an urgent, visible, and quantifiable threat, efforts to reduce that harm would become moralized as moral mandates (Rozin, 1999; Skitka & Houston, 2001). As such, the harmful by-products inherent in combating C19's health effects would be accepted as more tolerable than identical harm resulting from efforts unrelated to C19's health effects. Predictions were overwhelmingly supported. In Study 1 participants exhibited asymmetries in their tolerance for health, social, and human rights costs; identical costs (e.g., number of deaths, online harassment, or police abuse of power) arising from health-related C19 strategies were more readily accepted than those arising from either non-health-based strategies (e.g., economic), or from other unrelated efforts. Moreover, these effects were mediated by moral outrage, supporting that elimination efforts have become moralized.
Study 2 furnished additional evidence for the moralization of C19 health-targeted efforts. Indeed, participants in NZ evaluated a research proposal as less accurate, less methodologically sound, and less valuable to society when it posited the hypothesis that the suffering resulting from continuing an elimination approach in NZ outweighed that from abandoning the approach (compared to one forwarding the reverse hypothesis). Yet, both proposals contained the same amount of empirically validated information. Moreover, Study 2 participants evaluated the researchers as less competent and were less trustful they would honor participants' donation wishes when the researchers merely posited the empirical possibility the elimination approach led to increased suffering. These patterns are congruent with extant work on sacred values (Tetlock, 2003), whereby merely opening cherished beliefs up to scrutiny evokes moral outrage and motivates individuals to further demonstrate their moral commitments. In a similar vein, Study 2 participants who read the research proposal questioning the elimination strategy espoused heightened moral commitments to an elimination approach. Altogether, these patterns support that efforts to control or eliminate C19 have become moralized, leading individuals to overlook potential collateral costs from such efforts."
Source: https://www.sciencedirect.com/science/article/pii/S0022103120304248
Commentary: Moralizing public health messages is shown to be ineffective at helping them spread, because once you contradict someone's core values, they are non-receptive to the message. This is an important part of scientific and public health communications for the future - how to communicate in ways that the audience is receptive to, without crossing into moral boundaries where a political point of view inevitably polarizes public health responses, such as wearing masks.
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50,000 cases of COVID-19 in 2020 could be traced back to a single individual at Mardi Gras. "Mardi Gras in New Orleans is normally a rowdy affair. But today’s celebrations will be more muted, and for good reason. By “Fat Tuesday” last year there were just 16 official cases of covid-19 in America. But, according to a new working paper led by a scientist of Scripps Research Institute in California, the festivities were a superspreader event. About 50,000 cases can probably be traced back to a single individual in attendance. The authors combined genomic information with travel data from smartphones and flights to show how the virus was then spread across America’s South. They argue that their research, a cautionary tale about how chains of infection run rampant, should inform decision-making about new, potentially more infectious variants. New Orleans seems to have learned from last year. Parades have been cancelled and bars shut in parts of the city popular with revellers."
Source: https://espresso.economist.com/adf2e0a8e2b1a07ccc72645ad04f52ff
Commentary: I hope people stay home this year. There's a great walkthrough of the houses decorated for Mardi Gras in lieu of the floats, called Yardi Gras this year. Here's one such walking tour which you can watch from the comfort of your home.
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Saliva tests and COVID-19. "It’s widely known that the COVID-19 nasopharyngeal test is invasive. (It involves having a swab inserted into your nose and twirled around for several seconds.) But like it or not, it’s currently the standard test for detecting SARS-CoV-2, the virus that causes COVID-19.
But there’s another type of COVID-19 test that’s a lot simpler—one that requires gathering just a little bit of saliva. But because researchers are still learning about the potential of saliva testing, the technique is being used only in select authorized laboratories.
Still, encouraging news about this method came in January, when Yale School of Medicine researchers released a study showing that high levels of the SARS-CoV-2 virus in a person’s saliva could be a predictor of who will be more likely to develop severe disease, be hospitalized, or die from COVID-19. This information could help doctors determine which patients should be treated early with medicines such as monoclonal antibodies, which can decrease the viral load and work best in the early stages of the disease. (The study was published on a preprint server that still needs to undergo peer review.)
“We discovered that the saliva viral load is a much better correlate of disease outcome than the nasopharyngeal viral load,” says Akiko Iwasaki, PhD, lead author of the study, and an immunologist at Yale School of Medicine.
The premise behind this testing is fairly straightforward. The standard test, called the nasopharyngeal (NP) swab, only looks as far as the nasal passages. But if the virus is found in the saliva, it means that it’s more likely to have infiltrated the lungs, where COVID-19 causes the most serious damage, says Iwasaki. That’s because cilia (hair-like projections) in the respiratory tract regularly move mucus up to the throat where it mixes with saliva, or it can move during a cough."
Source: https://www.yalemedicine.org/news/saliva-test-covid-19-severity
Commentary: This is a vitally important development in COVID-19 testing because it opens the way towards more flexible, easier to administer tests. If people need only spit in a little container instead of stick a swab up their nose, they might be more willing to get tested. And if tests made for home use can leverage this technology, it could dramatically change how we test for COVID-19.
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A reminder of the simple daily habits we should all be taking.
1. Always wear the best mask available to you when out of your home and you'll be around other people. 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.
3. Wash/sanitize your hands every time you are in or out of your home for any reason.
4. 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.
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 mercury or other heavy metals in the Pfizer mRNA vaccine. https://www.technologyreview.com/2020/12/09/1013538/what-are-the-ingredients-of-pfizers-covid-19-vaccine/
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.
This is also available as an email newsletter at https://lunchtimepandemic.substack.com if you prefer the update in your inbox.