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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Big news from the UK. "A cheap and widely available drug can help save the lives of patients seriously ill with coronavirus. The low-dose steroid treatment dexamethasone is a major breakthrough in the fight against the deadly virus, UK experts say. The drug is part of the world's biggest trial testing existing treatments to see if they also work for coronavirus.
It cut the risk of death by a third for patients on ventilators. For those on oxygen, it cut deaths by a fifth. Had the drug had been used to treat patients in the UK from the start of the pandemic, up to 5,000 lives could have been saved, researchers say. And it could be of huge benefit in poorer countries with high numbers of Covid-19 patients."
Source: https://www.recoverytrial.net/files/recovery_dexamethasone_statement_160620_final.pdf
https://www.bbc.com/news/health-53061281
Commentary: While NHS hasn't released the clinical data or paper yet, the results from this trial are very encouraging, doubly so because dexamethasone is an inexpensive generic drug. If further studies confirm benefit, this could do quite a bit to reduce the impact of COVID-19. Of note, there was no benefit to people not on ventilators or other respiratory distress, so there's no need to go run out and buy any.
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1 in 5 people around the world have an underlying condition that puts them in the high risk category should they contract COVID-19. "We estimated that 1·7 billion (UI 1·0–2·4) people, comprising 22% (UI 15–28) of the global population, have at least one underlying condition that puts them at increased risk of severe COVID-19 if infected (ranging from <5% of those younger than 20 years to >66% of those aged 70 years or older). We estimated that 349 million (186–787) people (4% [3–9] of the global population) are at high risk of severe COVID-19 and would require hospital admission if infected (ranging from <1% of those younger than 20 years to approximately 20% of those aged 70 years or older). We estimated 6% (3–12) of males to be at high risk compared with 3% (2–7) of females. The share of the population at increased risk was highest in countries with older populations, African countries with high HIV/AIDS prevalence, and small island nations with high diabetes prevalence. Estimates of the number of individuals at increased risk were most sensitive to the prevalence of chronic kidney disease, diabetes, cardiovascular disease, and chronic respiratory disease."
Source: https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(20)30264-3/fulltext
Commentary: This study has deadly implications, especially for nations without good healthcare infrastructure. As a reminder, this pandemic has only just begun. Approximately 0.1% of the world has been infected with COVID-19 - 8 million people out of more than 7 billion. We still have a long way to go, and as we're seeing in Brazil, Russia, and India, an outbreak can run away very quickly.
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Not only is hydroxychloroquine ineffective against COVID-19, it reduces the effectiveness of remdesivir. "Based on a recently completed non-clinical laboratory study, the FDA is revising the fact sheet for health care providers that accompanies the drug to state that co-administration of remdesivir and chloroquine phosphate or hydroxychloroquine sulfate is not recommended as it may result in reduced antiviral activity of remdesivir. The agency is not aware of instances of this reduced activity occurring in the clinical setting but is continuing to evaluate all data related to remdesivir."
Source: https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-warns-newly-discovered-potential-drug-interaction-may-reduce
Commentary: At this point, HCQ should be removed from the COVID-19 discussion entirely. Let it go back to work doing what it was engineered to do.
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What does opening up too soon look like? Hospitalization increases in Texas and Arizona.
Source:
Commentary: The number to watch is hospitalizations. Case counts can increase as testing increases - and that's a good thing, current political commentary aside. We want more testing everywhere. Hospitalizations - we don't want more of those.
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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.
2. Wear gloves and a mask when out of your home. Consider wearing a face shield.
3. Stay home as much as possible. Minimize your contact with others and maintain physical distance of at LEAST 6 feet / 2 meters. Avoid indoor places as much as you can.
4. Get your personal finances in order now. Cut all unnecessary costs.
5. Donate any PPE you can. https://getusppe.org/give/
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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.