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 a qualified healthcare provider who knows your specific medical situation over advice from people on the Internet.
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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Commentary: It's a week before Christmas and for many in the world, especially the northern hemisphere, holiday travel is about to get underway. Here's what you need to do for safe holidays. Omicron is now widespread in many nations.
1. Get boosted if you can. Boosters can have strong immune effects as early as 7 days, and protection increases.
2. If you are not vaccinated or at greater than normal risk, DO NOT TRAVEL for the holidays. Likewise, if you are planning to visit people who are unvaccinated or at great risk, do not visit them.
3. Wear the best mask available to you at all times when you're around others you don't live with. An N95/FFP2/KN94 is the minimum level of protection you should be wearing.
4. Minimize time indoors at places you don't live, especially crowded places like restaurants. If you must dine out, get takeout instead.
5. If not available freely where you are, consider purchasing rapid antigen tests and using them 3 days after you travel.
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Omicron isn't proven to be milder. "The Omicron coronavirus variant could be just as severe as the Delta strain, according to early findings from researchers at Imperial College London, in a study which also highlighted the elevated risk of reinfection posed by the new variant and the need for booster shots to combat it.
“The study finds no evidence of Omicron having lower severity than Delta, judged by either the proportion of people testing positive who report symptoms, or by the proportion of cases seeking hospital care after infection,” said the research team, led by Professor Neil Ferguson, an infectious disease modeller and government science adviser.
However, they cautioned that hospitalisation data “remains very limited at this time”. The study said data suggested “at most limited changes in severity compared with Delta”.
The early findings could dash the hopes of some experts that a change in the virulence of the new variant would ease the pressure on health systems despite Omicron’s high levels of infectiousness. "
Source: https://www.ft.com/content/48931667-cbb5-481d-acef-b2263bb74f80#post-9edf18ad-fb67-4ea1-b59e-11aa65d4060e
Commentary: The key thing to remember here is risk. There are two levels of risk - personal and collective. If you are fully vaccinated and boosted and you're wearing a mask in places other than your home, your personal risk levels are VERY LOW. You are safer than you've ever been.
We have collective risk from people filling up hospitals and such. That's the major risk to people who have not done what needs to be done to protect themselves, and there is some spillover risk to the rest of us if you need, for example, an ICU bed and you can't get one.
However, in terms of managing worry, if you're doing the 5 things I outlined above, then your personal risk is very low and shouldn't infringe heavily on your ability to enjoy the holidays with equally protected friends and family.
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Omicron's faster growth rate means faster hospitalization. "⚠️FASTER HOSPITALIZATION WITH #Omicron—Latest data on hospital admissions in London (🇬🇧Omicron epicenter) shows Omicron wave is sending patients to hospitals sooner in 6 days than versus Delta (9-10 days). And the model suggests similar severity, not “milder”.🧵
2) Let’s look at the other 10 day model for new #Omicron — it seems it’s a poor fit to the actual hospitalization data. It’s visible on both the log scale and natural scale that it’s not a good fit. ImageImage
3) Now let’s for a moment test whether #Omicron is “milder” - half as severe as Delta, but just sent people to hospital faster, but not as often. Does it fit the data well? Not exactly… the latest few days doesn’t jive with that “milder” model. Image
4) to be clear, the above model is based on total hospitalizations. But we know from South Africa that their hospitalization surging and a bit faster than normal. And separately, most ~90% of the patients that tested positive for #COVID19 were admitted for COVID not other stuff. ImageImage
5) also check out the crazy DOUBLING TIMES for probable #Omicron (SGTF is a shortcut PCR signal for likely Omicron)— its now just **1.5 days** for doubling in many parts of England!! Image
6) SHOW MORE PROOF? Denmark 🇩🇰 hospitalization is showing similar **faster hospitalization** phenomenon — notice how hospitalizations rise much faster with #Omicron… much shorter delay to hospital admissions than Delta. 👀
7) People keep forgetting that #DeltaVariant was found to be ~4x **more severe** than the original 2020 strain of #SARSCoV2. There’s several studies that found 3-4x. Thus anyone saying Omicron is “milder” don’t realize even if true (doubtful)— it’s back to Wuhan 1.0 if 4x milder.
8) “Omicron is just as severe as Delta” according to newest UK 🇬🇧 study…. this is consistent with the data I presented atop. "
Source:
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Commentary: Faster hospitalization means more strain on the healthcare system - and with fewer resources. 100 people visiting the hospital over 10 weeks is a lot more manageable than 100 people visiting the hospital over 10 hours.
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More on spread. "The extremely rapid rate of spread of Omicron clearly visible since the beginning of December will now be acutely felt in many geographies as local epidemics amplify to the point of eclipsing Delta circulation. 1/12
Continuing previous methods, if we partition case counts from @OurWorldInData using sequence data from @GISAID and apply a modeling approach from @marlinfiggins we get rapid rises in Omicron cases in South Africa, Denmark, Germany, the UK and the US. 2/12 Image
This corresponds to rates epidemic doubling of between 2.3 days in the UK and 3.3 days in Germany. 3/12 Image
However, this approach of using sequence data is necessarily lagged by timeline for genomic sequencing. We can get a more recent picture by looking instead at PCR testing results that distinguish between probable Delta cases and probable Omicron cases via SGTF. 4/12
London as expected from travel connections appears to be ahead of the rest of the UK and much of the rest of Europe and the US with 72% of specimens from Dec 13 as probable Omicron in a remarkable rise. 5/12
With Omicron comprising the majority of SARS-CoV-2 in London, we can now expect its continued spread to manifest as skyrocketing case loads. Figure from coronavirus.data.gov.uk/details/cases. 6/12 Image
The UK has a systematic effort to track and record SGTF that's lacking in the US. We do have particular local efforts to track this however. Close to home, we have @UWVirology and @seattleflustudy tracking probable Omicron via S gene presence/absence. 7/12
In combining datasets, we can see rapid logistic growth of probable Omicron tests in King County. 8/12 Image
Partitioning King County cases by these proportions shows a rapid exponential rise in Omicron cases in King County with a 2.2 day doubling. 9/12 Image
There is potential worry that tests performed by @UWVirology and @seattleflustudy won't be fully representative of the county, but pace of doubling fits what we've seen elsewhere and with spread this fast a slight difference in prevalence will only push things slightly. 10/12
If we do a very simple 10-day projection of this rate of growth we get ~2100 daily Omicron cases in King County on Dec 22. This is ~3.5 times the Delta peak in King County in August and this is only 1 week away. 11/12 Image
I expect case loads to climb suddenly and rapidly in a large number of well connected cities over the next week. This will take many by surprise but was baked in as soon as we knew Omicron Rt. 12/12"
Source:
Commentary: The good news, to the extent there is any, is that because Omicron is a faster-spreading disease, the wave it will create will be over sooner - but that wave will have dire consequences for the healthcare system. Plan accordingly.
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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, including boosters. 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 available.
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.