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.
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Happy St. Patrick's Day. Please celebrate responsibly and away from people you don't live with.
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Long COVID is a burgeoning health crisis. "Researchers have now established that long Covid is a debilitating condition with full-body symptoms that can range from monthslong fevers to respiratory problems. The National Institutes of Health recently announced an initiative to study it. Many sufferers are unable to return to work or care for themselves or their loved ones and will likely require long-term medical attention.
The misconceptions around long Covid are due in part to the mistaken belief that it is rare. But it’s not. Approximately 30 percent of Covid patients in a new but small study from the University of Washington reported that symptoms persisted months after their infection. If confirmed on a bigger scale, this suggests that long Covid could be one of the largest mass disabling events in modern history.
There could be millions of Americans experiencing long Covid, and many may need health care and workplace accommodations. Patients report long waiting lists at the few medical centers with programs to specifically treat people with long Covid.
Long Covid is one of the most devastating outcomes of the pandemic, and will likely put a strain on our society and economy for years to come. There is little to indicate that global health systems are prepared for it. In response to this lack of recognition, long Covid patient advocacy is emerging as a health movement that will be increasingly hard for governments to ignore.
Even so, these early studies have provided a peek into what Covid-19 recoveries can look like. In a non-peer-reviewed online survey conducted by our Patient-Led Research Collaborative of 3,762 long Covid patients in 56 countries, respondents said they continued to experience an average of 14 symptoms after six months.
Eighty-eight percent of people reported cognitive issues like memory loss that in many cases impaired their ability to work, have conversations with others, maintain medication schedules or drive. There was no statistically significant difference in the prevalence of these symptoms and their impact across age groups."
Source: https://www.nytimes.com/2021/03/17/opinion/long-covid.html
Commentary: The reality is that we simply don't know what the long-term impacts of a new disease are. We do know that hundreds of millions of people have contracted it, and a substantial number of them have had lingering effects. Only time will reveal just what the impact of COVID-19 will be on our population as a whole, but we should plan for its impact to be substantial and costly.
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Should pregnant people get vaccinated? In a word, yes. "As COVID-19 vaccines are distributed, uncertainty exists for individuals who are trying to get pregnant or pregnant. At the University of Massachusetts Medical School – Baystate, a group of experts (the Shared Decision-Making: COVID Vaccination in Pregnancy working group), created a decision aid to help individuals who are pregnant, lactating, or planning on becoming pregnant decide whether or not to receive an mRNA COVID-19 vaccine. These decision aids, currently available in 10 languages, will be updated on this post as more information."
Source: https://foamcast.org/COVIDvacpregnancy/
Commentary: COVID-19 is more dangerous to pregnant people. Share this decision guide if you know someone who is pregnant and not sure about getting vaccinated.
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Vaccination also highlighting inequalities. "In the first 2.5 months of the U.S. vaccination program, high social vulnerability counties had lower COVID-19 vaccination coverage than did low social vulnerability counties. Although vaccination coverage estimates by county-level social vulnerability varied widely among states, disparities in vaccination coverage were observed in the majority of states.
Continued monitoring of vaccination coverage by social vulnerability metrics is critical for developing tailored, local vaccine administration and outreach efforts to reduce COVID-19 vaccination inequities."
Source: https://www.cdc.gov/mmwr/volumes/70/wr/mm7012e1.htm?s_cid=mm7012e1_w
Commentary: Be sure to continue urging your government officials, wherever you live, to push for equitable access to vaccines. Highlight when you see inequities in your own communities.
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Brazil is in serious trouble. "The Bulletin shows that, at the moment, of the 27 federative units, 24 states and the Federal District have occupancy rates for ICU Covid-19 beds for adults in the Unified Health System (SUS) equal to or greater than 80%, 15 of which with rates equal to or greater than 90%. In relation to capital cities, 25 of the 27 have these rates equal to or higher than 80%, 19 of which are higher than 90%."
Source: https://agencia.fiocruz.br/observatorio-covid-19-aponta-maior-colapso-sanitario-e-hospitalar-da-historia-do-brasil
Commentary: The Brazilian healthcare system is where the United States was in the autumn. As the Southern Hemisphere heads into its winter season, COVID-19 with its new variants is making a massive resurgence.
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A silver lining: more people studying public health. "The Covid-19 pandemic has tested the public health and medical workforces like never before. And yet people in those fields say they see emerging signs that the crisis will inspire the next generation of doctors, nurses, and public health professionals to join the ranks.
Public health schools, for example, saw a 23% jump in applicants for master’s and doctoral programs from fall 2019 to fall 2020, and are reporting an even bigger increase so far in this application cycle, according to the Association of Schools and Programs of Public Health.
One reason is what Laura Magaña, the CEO of the association, called “the Fauci effect,” after the now-famous U.S. health official Anthony Fauci.
One reason public health programs are drawing more people, officials say, is because young people committed to social justice now view the field as an avenue for addressing racial inequities, given the disparate toll of the pandemic on people of color in the United States. Brown University’s public health school, for example, last week said applications for its MPH program had jumped 116% from this point last year, and were up 187% among Black candidates and 137% among Latino candidates.
The pandemic is also shifting what people want to focus on. Caroline Basil, an MPH student at Claremont, had been planning to work with college students and young adults after getting her degree. Now, after seeing the impact of Covid-19 on older people, she intends to specialize in the health of the aging population. Some of her peers, she said, have been more drawn to policy because of the pandemic.
“Public health went from a backstage position to really being front and center,” she said. “It’s been really cool to see what epidemiologists do, and how important data science is, and how science and policy work together.”"
Source: https://www.statnews.com/2021/03/17/driven-by-pandemic-applicants-flood-public-health-schools/
Commentary: The pandemic will yield some interesting side effects, just as any war has. Some good will come of it, and this is one of those things.
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A reminder of the simple daily habits we should all be taking.
1. Always wear the best mask available to you when out of your home and you'll be around other people. 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. Get vaccinated as soon as you're able to.
3. Wash/sanitize your hands every time you are in or out of your home for any reason.
4. Stay home as much as possible. Minimize your contact with others and maintain physical distance of at LEAST 6 feet / 2 meters, preferably more. Avoid indoor places as much as you can; indoor spaces spread the disease through aerosols and distance is less effective at mitigating your risks.
5. Get your personal finances in order now. Cut all unnecessary costs.
6. Replenish your supplies as you use them. Avoid reducing your stores to pre-pandemic levels in case an outbreak causes unexpected supply chain disruptions.
7. 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).
8. Masks must fit properly to work. Here's how to properly fit a mask:
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Common misinformation debunked!
There is no mercury or other heavy metals in the Pfizer mRNA vaccine. https://www.technologyreview.com/2020/12/09/1013538/what-are-the-ingredients-of-pfizers-covid-19-vaccine/
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.
This is also available as an email newsletter at https://lunchtimepandemic.substack.com if you prefer the update in your inbox.