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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Kaiser Family Foundation highlights critical risks of reopening schools too soon. "There are many factors that state and local officials, as well as individual schools or school systems, are likely to consider as they decide when and how to reopen in the upcoming school year. One set of issues involves the myriad of practical considerations needed to keep students, teachers and others who work at schools safe, particularly those who may be at higher risk of severe illness if they become infected with coronavirus. Doing so is challenging, however, given the concentration of students and teachers in relatively tight spaces, limited budgets to cover additional expenses for personal protective equipment (PPE) and physical space reconfiguration, along with the difficulty in enforcing social distancing and safe habits among school-age children. For these reasons, there is a concern that transmission will occur in schools, potentially placing students and teachers at risk. Our prior analysis shows one in four teachers are at-risk of becoming seriously ill if they contract COVID19. So far, the effects of opening schools in other countries has been mixed.
Another concern is that children may become infected at school and carry the virus back to their homes, potentially infecting others in their household. It is still unclear how frequently children transmit the virus to others. While experts believe children are not the main source of infection in communities, transmission from children does occur. Evidence so far indicates that children are at a lower risk of infection, present with milder symptoms, and are much less likely to die from the infection compared to older adults, but they still could present a risk to others in their household, especially in households with people at higher risk, such as older adults and others with pre-existing conditions. To better understand how big this group might be, we used data by state on family composition to analyze the number of older adults with at least one school-age child at home.
Our analysis finds about 6% of people age 65 or older, or about 3.3 million people, lived in a household with a school-age child (ages 5-18) in 2018 (Figure 1). Looking the other way, 4.1 million school-age children, about 7% of those between the ages of 5 and 18, live in a household with someone 65 or over.
While nearly half of older adults living with a school-age child are White, older people of color are significantly more likely to live with a school-age child compared to their White counterparts. Nearly one in five (19%) Asian and Native Hawaiian or Other Pacific Islander older adults live with a school-age child, as do 17% of Hispanic older adults, 13% of American Indian or Alaska Native older adults, and over one in ten (11%) Black older adults. In contrast, 4% of older White adults lives with a school-age child. COVID19 already has disproportionately affected people of color, and if schools become a source of infection, older people of color would be at increased risk of exposure through school- age children."
Source: https://www.kff.org/coronavirus-covid-19/issue-brief/millions-of-seniors-live-in-households-with-school-age-children/
Commentary: As we've seen in other aspects of the pandemic, people of color will bear an unfairly larger burden as schools reopen, too.
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Over 70,000. "The US has for the first time recorded more than 70,000 new coronavirus infections in a single day, led by Texas and Florida which each tallied more than 10,000 cases.
The one-day record of 71,229 cases reported on Thursday was accompanied by an alarming rise in coronavirus-related fatalities. The 977 deaths recorded over the past 24 hours by the Covid Tracking Project was up from 855 on Wednesday and at a level not consistently seen since the tail-end of the earlier outbreak in the US north-east two months ago.
Both Florida, with 156 deaths, and Texas, with 129, reported single-day records, helping push the number of fatalities in southern states over 500 for the first time.
The continued spread of the outbreak in the American south and west has come despite moves by several states to reimpose strict social distancing measures. Anthony Fauci, the US’s leading infectious disease expert, called the uptick “quite disturbing”."
Source: https://www.ft.com/content/4d73cdf8-fa68-40f0-be99-29ae54135669
Commentary: We are now seeing deaths begin to catch up from cases. This should be absolutely no surprise to anyone who's been following along; all the commentary about the "falling death rate" is likely to be muted from here on out.
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Additional support for the use of dexamethasone in critically ill patients. "In patients hospitalized with Covid-19, the use of dexamethasone resulted in lower 28-day mortality among those who were receiving either invasive mechanical ventilation or oxygen alone at randomization but not among those receiving no respiratory support."
Source: https://www.nejm.org/doi/full/10.1056/NEJMoa2021436?query=featured_coronavirus
Commentary: A reminder that dexamethasone is applicable only to the critically ill. If you haven't been intubated/on supplementary oxygen, it won't do you any good.
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Some sobering pieces from the WHO briefing, via Kai Kupferschmidt.
“Up to 132 million more people may go hungry in 2020, in addition to the 690 million who went hungry last year”, says @drtedros . Almost 10 million children could be forced out of school forever by the end of this year, he says.
Source:
"We all owe health workers an enormous debt – not just because they have cared for the sick. But because they have risked their own lives in the line of duty”, says @drtedros . Points out that about 10% of all #covid19 cases in the world are among health care workers.
Source:
“When you get into a particular setting, a very overcrowded situation in an indoor environment then effectively all bets are off because so many of the modes of transmission come into play: the aerosol route, the airborne route, the fomite or contamination route”,says @DrMikeRyan
Source:
Commentary: The pandemic's other effects will be system shocks in every other area; plus, with 10% of COVID cases being healthcare workers, any of them dying from the disease permanently damages our ability to respond to this and future pandemics.
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Georgia is on the brink. "There's increasing risk that Georgia could become a new epicenter of epidemic spread. There's a window of opportunity for the State of Georgia, with its outbreak largely concentrated in one region for now, to get control of its infection and mitigate risk of a broader epidemic."
Source:
Commentary: When your governor overrides mask mandates to say that citizens do not need to obey them, the consequences will be quite clear. Someone put it quite eloquently in an opinion piece - the virus doesn't sleep, doesn't rest, doesn't get tired, doesn't care who you are or what you believe. It does what it does - infects and kills.
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Scientists are filling in the blanks left by CDC and HHS.
Source:
Commentary: Glad to see this data, but shameful that we have to resort to scraping data ourselves because the federal government is willfully suppressing it.
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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 or injected.
2. Wear gloves and a mask when out of your home. Consider wearing a face shield if you can't breathe at all through a mask. Respirators are back in stock at online retailers, too.
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. Replenish your supplies as you use them. Avoid reducing your stores to pre-pandemic levels in case an outbreak causes unexpected supply chain disruptions.
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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.