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.
You are welcome to share this.
--
From the WHO briefing: "Q about dexamethasone. "It is exceptionally important that this drug is used under medical supervision. This is not for prophylaxis, this is not for mild cases”, says @DrMikeRyan. “It can rescue patients who are in very serious condition."
Source:
Commentary: Kai Kupferschmidt's additional commentary is right on the money. People assume that if something works for a severe case, it should work for everything else. That's not true. The only people who should be administering dexamethasone are doctors. Don't try to go obtain it on your own.
--
How do we stop the pandemic? "We estimated that combined isolation and tracing strategies would reduce transmission more than mass testing or self-isolation alone: mean transmission reduction of 2% for mass random testing of 5% of the population each week, 29% for self-isolation alone of symptomatic cases within the household, 35% for self-isolation alone outside the household, 37% for self-isolation plus household quarantine, 64% for self-isolation and household quarantine with the addition of manual contact tracing of all contacts, 57% with the addition of manual tracing of acquaintances only, and 47% with the addition of app-based tracing only. If limits were placed on gatherings outside of home, school, or work, then manual contact tracing of acquaintances alone could have an effect on transmission reduction similar to that of detailed contact tracing. In a scenario where 1000 new symptomatic cases that met the definition to trigger contact tracing occurred per day, we estimated that, in most contact tracing strategies, 15,000–41,000 contacts would be newly quarantined each day."
Source: https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30457-6/fulltext
Commentary: Testing alone can't stop the pandemic. Test, trace, isolate, and treat is how leading countries are stopping the pandemic and shutting it down - and it's something that can't be a one-and-done effort. New Zealand, which was clear of COVID, had 2 new cases crop up in testing - but they got ahead of it and isolated, keeping the fires put out. Advocate to your elected officials that it's essential we not let up on testing or tracing until a vaccine is available.
--
Alcohol patterns may be causing harm. "In the UK, which went into lockdown on March 22, data from the Office for National Statistics show that sales in alcohol stores in March had increased in month-on-month volume by 31·4%. Alcohol consumption patterns have also altered, according to a survey by the charity Alcohol Change UK. Reassuringly, more than a third of the 1555 people surveyed who reported drinking alcohol before lockdown stated that they had stopped drinking or reduced how often they drank in the 2 weeks after lockdown commenced. However, around a fifth responded that they had been drinking more frequently in the same period. And while about half of drinkers said they were consuming about the same amount on a typical drinking day, 15% said they had been drinking more per session since lockdown began. Of particular concern was that almost one in five of those who drank alcohol on a daily basis had further increased the amount they drink since lockdown. While these preliminary data must be treated with caution, they hint at the emergence of a subgroup of drinkers at risk of establishing potentially dangerous patterns of alcohol consumption during lockdown."
Source: https://www.thelancet.com/journals/langas/article/PIIS2468-1253(20)30159-X/fulltext
Commentary: That behaviors have changed is no surprise; what will be the next emergency to deal with will be all of the mental health challenges during and after the pandemic. We already see this in the data; we saw a huge spike in searches for domestic violence hotline in mid-March and search levels remain elevated even now. If you or someone you know is struggling in any capacity, whether alcohol, drugs, or other destructive behaviors, don't wait to get them help. There are so many options including telehealth and telephone options to get assistance to those who need it. Don't wait.
--
We are running out of remdesivir. "The US government's current supply of remdesivir, the only drug known to work against Covid-19, will run out at the end of the month, Dr. Robert Kadlec, a US Department of Health and Human Services official, told CNN.
The government's last shipment of the drug will go out the week of June 29. Gilead Sciences, the company that makes the drug, is ramping up to make more, but it's unclear how much will be available this summer."
Source: https://amp.cnn.com/cnn/2020/06/07/health/remdesivir-donation-runs-out-coronavirus/index.html
Commentary: This is poorly timed with the most recent set of outbreaks. That's why it's so important to keep new cases low. The United States has not used the time during lockdown to catch up on supply chain issues and inventory, and it's going to bite us hard with the resurgence of COVID-19 from opening too soon.
--
COVID-19 might be the practice run. "Spillovers of animal pathogens into the human world—the source of flu and HIV and the virus behind Covid-19—happen on no predictable timeline. That means another pandemic could be on its way at any moment. Robert Redfield, director of the US Centers for Disease Control and Prevention, seemed to acknowledge as much when he told the House of Representatives at a hearing on June 4: “You think we weren’t prepared for this, wait until we have a real global threat for our health security.”"
Source: https://www.wired.com/story/covid-19-is-bad-but-it-may-not-be-the-big-one/
Commentary: The reality is that COVID-19 is much less bad than it could have been. The fatality rate is likely to stabilize around 1%, more or less, which is still cold comfort to anyone who's lost a loved one. The number of people afflicted with permanent or long-term injury will be between 5-20%, mostly in lung and respiratory damage. That's not nearly as bad as the fatality rate from diseases like SARS and MERS. Now imagine something with the transmissibility of COVID, the long incubation times, etc. but with the fatality rate of MERS. That's the pandemic we should be planning for now - because we don't know when it will happen, just that it probably will.
Take the lessons you've learned yourself during this pandemic and adjust how you live, too. Toilet paper? No one saw that coming. Now you should know. Meat and frozen vegetables, bread, flour - we now have rich data on how people are like to behave.
--
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/
--
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
--
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.