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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When asked what they thought was safe to do, here's what 27 epidemiologists, immunologists, and infectious disease experts said. "With Covid-19 cases and hospitalizations spiking around the country, dreams of a summer like those many us had in mind just a short time ago have faded.
The fully vaccinated have been told to resume wearing masks indoors. Companies and institutions are leveling vaccine mandates. And some municipalities are requiring people to show proof of vaccination to get into restaurants, bars, and gyms.
Confusion abounds about what is safe to do. (For the unvaccinated, there’s no confusion about what’s most important to do: Get immunized.)
To try to cut through the fog, STAT contacted three dozen epidemiologists, immunologists, and other infectious disease experts around the country to see how they are navigating the risk of Covid in these uncertain times. Twenty-eight responded.
STAT didn’t ask these experts to explain how they would advise others. Rather, we asked them to answer 10 questions — saying yes, no or only if masked — about their own willingness to engage in various activities, assuming they were vaccinated.
Their answers suggest that, with the highly transmissible Delta variant spreading, caution prevails. Those who know viruses best aren’t buying many movie tickets, and most aren’t eating indoors in restaurants.
Of the questions, only one earned a unanimous response: “Would you send your unvaccinated child to school without a mask?”
“Lord, no,” Paul Offit, a pediatric infectious disease specialist at Children’s Hospital of Philadelphia, replied. “NO!!! As a parent and a pediatrician, that is a terrible idea,” wrote Andrew Pavia, chief of pediatric infectious diseases at the University of Utah.
None of 27 people who answered this question expressed a willingness to send an unvaccinated child to school without a mask. Carlos del Rio, a professor of epidemiology and global health at the Rollins School of Public Health at Emory University, said he’d withdraw an unvaccinated child from a school if it didn’t have a mask mandate.
Children under the age of 12 cannot yet be vaccinated as none of the vaccines has been authorized for use in this age group.
The other school-related question — “Would you send your vaccinated teen to school without a mask?” — drew almost as fervent a response, with 24 of 26 saying no.
Michael Osterholm, director of the University of Minnesota’s Center for Infectious Disease Research and Policy, said he not only wouldn’t allow a vaccinated teen to go to school without a mask, he’d demand the teen wear an N-95 respirator. Cloth face coverings aren’t enough to combat Delta, he insisted."
Source: https://www.statnews.com/2021/08/17/whats-safe-to-do-during-summers-covid-surge-stat-asked-public-health-experts-about-their-own-plans/
Commentary: It's pretty clear that people who actually know how diseases work wouldn't send unvaccinated kids to school without a mask - and an N95 one at that.
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Third shot coming in the USA. "U.S. experts are expected to recommend Covid-19 vaccine boosters for all Americans, regardless of age, eight months after they received their second dose of the shot, to ensure lasting protection against the coronavirus as the delta variant spreads across the country.
Federal health officials have been actively looking at whether extra shots for the vaccinated would be needed as early as this fall, reviewing case numbers in the U.S. as well as the situation in other countries such as Israel, where preliminary studies suggest the vaccine’s protection against serious illness dropped among those vaccinated in January.
An announcement on the U.S. booster recommendation was expected as soon as this week, according to two people familiar with the matter.
Third doses would only begin to be administered widely once the Food and Drug Administration formally approves the vaccines. That action is expected for the Pfizer shot in the coming weeks and for Moderna some time later.
Officials were continuing to collect information as well about the J&J vaccine, which was only approved in the U.S. in late February, to determine when to recommend boosters, one of the officials said."
Source: https://www.statnews.com/2021/08/17/u-s-expected-to-recommend-covid-19-vaccine-booster-shots-for-all/
Commentary: The key number to remember there is 8 months after your second shot.
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We are losing visibility in the USA. "Two months ago, we highlighted the fact that states were reducing their data reporting frequency, minimizing the availability and quality of public data about COVID-19. Believing the pandemic was settling down, states closed their COVID-19 online dashboards or dramatically reduced reporting with little public attention. But the highly contagious Delta variant and diminishing vaccination coverage led to uncontrolled spread, high rates of hospitalizations in unvaccinated populations, and increased cases and deaths across the country — ushering in a new phase of the pandemic, worse than the winter peak in many locations.
As has been the case throughout the pandemic, decision makers at all levels need more public data, not less, to properly assess the state of the outbreak, forecast future conditions, and plan response efforts accordingly. Obscuring the reality of this phase of COVID-19 is dangerous, and could lead to deadly outcomes.
For some perspective, when we released our first blog on state reporting cadences in June, there were about 100,000 new cases in the United States. Twenty-one states had stopped reporting COVID-19 data on the weekends, and only three states were reporting less frequently. Cases have increased 9-fold to over 900,000 new cases last week, and states continue to reduce their reporting cadences. As of today, 36 states do not update their dashboards with all data streams every day, and 11 states report fewer than five days a week. Six states report certain data only once a week, and Nebraska has even shut down its state dashboard.1
At present, we are losing the granularity that our current rate of transmission demands. The lack of data erodes public trust in the government institutions that strive to keep us safe, and reduces the ability to analyze data and devise the most strategic public health response. The motto of the United States Department of Health and Human Services is: “Improving the health, safety, and well-being of America.” Most state health departments operate under a similar motto or creed. Reducing the public’s access to real-time data during an unprecedented crisis serves neither health, safety, nor well-being of anyone and certainly doesn’t reflect the core values that are at the center of our public health systems."
Source: https://coronavirus.jhu.edu/pandemic-data-initiative/news/state-data-reporting-reduction-continues-amidst-covid-19-resurgence
Commentary: If you live in the USA, urge your elected officials to mandate DAILY data updates on COVID-19 until the pandemic is over. Anything less is a disservice to your citizens.
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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 people you don't live with, 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. Verify your mask's NIOSH certification here: https://www.cdc.gov/niosh/npptl/usernotices/counterfeitResp.html
3. 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.
4. Wash/sanitize your hands every time you are in or out of your home.
5. Stay out of indoor spaces that aren't your home and away from people you don't live with 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.
6. Aim to have 3-6 months of living expenses on hand in case the pandemic gives another crazy plot twist to the economy.
7. Replenish your supplies as you use them. Avoid reducing your stores to pre-pandemic levels in case an outbreak causes unexpected supply chain disruptions.
8. 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).
9. Masks must fit properly to work. Here's how to properly fit a mask:
10. If you think you may have been exposed to COVID-19, purchase a rapid antigen test. This will detect COVID-19 only when you're contagious, so follow the directions clearly. https://amzn.to/3fLAoor
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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.