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.
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In the USA, mask mandates overruled by a federal judge. "Passengers on airplanes, trains and other public transportation in the U.S. don’t have to wear masks anymore, after a federal judge struck down the mandate.
The U.S. Transportation Security Administration and the Centers for Disease Control and Prevention said orders requiring masks on public transportation would no longer be enforced, although both agencies recommended their continued use.
U.S. District Judge Kathryn Kimball Mizelle in Tampa, Florida, vacated the mask requirement nationwide Monday and directed the CDC to reverse the policy put in place in February 2021. The ruling was handed down in a lawsuit filed last year by the Health Freedom Defense Fund, a nonprofit group that says it focuses on “bodily autonomy” as a human right.
“Today’s court decision means CDC’s public transportation masking order is not in effect at this time,” an administration official said in a statement. “Therefore, TSA will not enforce its Security Directives and Emergency Amendment requiring mask use on public transportation and transportation hubs at this time.”
United Airlines Holdings Inc. and Alaska Air Group Inc. reacted swiftly to the TSA decision, dropping mask requirements for passengers on their flights shortly after the TSA announcement.
“As of today, masks are optional in airports and onboard aircraft,” Alaska Airlines said in a statement on its website."
Source: https://news.bloomberglaw.com/coronavirus/mask-mandate-for-planes-trains-overturned-by-florida-judge
Commentary:
There's an ironic twist to these changes. By saying the TSA and CDC will no longer enforce mask mandates, their enforcement of which masks to wear also comes to an end. For a select few folks who have very strong filtration gear - like the P100 respirator I wear - airlines were saying you couldn't wear those, you had to wear a lesser mask that airline staff could recognize and improve. An N95 mask lets in about 5% of particles below 0.3 microns in size - plenty enough to reduce your risk of getting COVID. My P100? It lets in 0.03%, which means I can be in a high-risk environment for longer periods of time, or be totally safe in low-risk environments.
So while I think in general lifting the mask mandate is a bad thing, the silver lining is that if you want to wear a full-face powered air respirator, now you can and no one can say anything about it or make you change to less effective PPE.
And remember, masks optional does NOT mean you are forbidden to wear a mask, so mask up.
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COVID breathalyzer goes into production. "The Food and Drug Administration granted emergency use authorization to the first coronavirus test that can detect the coronavirus in a breath sample, within a few minutes and with a high degree of accuracy, the agency said Thursday.
“Today’s authorization is yet another example of the rapid innovation occurring with diagnostic tests for Covid-19,” Jeff Shuren, the director of the F.D.A.’s Center for Devices and Radiological Health, said in a statement.
The InspectIR Covid-19 Breathalyzer, which is about the size of a piece of carry-on luggage, can produce results in less than three minutes and can be used in doctor’s offices, hospitals and mobile testing sites by trained operators. A single machine can analyze about 160 samples per day.
Yvonne Maldonado, an infectious disease specialist at Stanford University School of Medicine who is working on another Breathalyzer test, said that having more options to test will only help the transition to the endemic phase of the pandemic.
“If you think back from the original P.C.R., those were pretty horrible,” Ms. Maldonado said. “They were very uncomfortable and seemed to last forever — the easier we can make it, the better off we are.”
The device was tested in a study made up of 2,409 individuals both with and without symptoms of the virus. In the study, the test identified 91 percent of positive samples correctly and 99 percent of negative samples correctly."
Source: https://www.nytimes.com/2022/04/15/us/the-fda-authorizes-the-first-covid-19-breath-test.html
Commentary: Advances like these are critical to our ongoing containment. For live events, rapid antigen tests still create a lot of waiting as tests take 15-20 minutes to develop. That's fine on an individual level but cumbersome to put thousands of people in holding areas before an event. Three minutes is far more manageable.
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Dr. Angela Rasmussen details how she will avoid getting COVID while traveling. "Lots of anecdotes about people getting COVID at in-person conferences. I went to one last week in Boston and next week am going to one in Portugal. Both require negative testing for international travel.
Here’s how I plan to not get COVID.
1. Vaccination. I’ve had 4 doses of COVID vaccine. 1 J&J in the US, 3 Pfizers in Canada (issues with international transfer of my vaccine records so I had to get fully vaccinated here for my Canadian vaccine SMART card). Last dose January 2022. #VaccinesWork
2. But there’s still a lot of omicron around and it is antigenically different enough that it can still cause breakthroughs so I’ll use additional precautions.
3. That means wearing a KN95 or N95 respirator in public places most of the time when I am not eating, drinking, or giving my talk. Especially important at the airport, in taxis, on trains, etc.
4. On plane, I’ll turn up the fan at my seat. Airplanes in flight have great HEPA filtration, so increasing airflow at my seat will reduce my exposure risk. I do sometimes eat/drink in flight & on this trip I lucked out with an upgrade, but will only remove mask briefly for that.
5. When going to cafes/bars/restaurants/places to eat or drink I will look at capacity, crowding, and outdoor dining options. Will avoid crowded or packed indoor spaces. When outdoor isn’t an option, I’ll look for larger indoor spaces with lots of open windows/ventilation.
6. Won’t use the hotel gym and will instead work out by going for a run or just walking around Lisbon (which I normally do anyway when visiting new cities). Bonus: provides more opportunities to check out outdoor bars/cafes/restaurants.
7. This is a clinical microbiology conference so there’s a requirement for vaccination and/or testing. That will further help reduce exposure risk, as vaccinated people are less likely to get infected with omicron and less likely to transmit onwards. Note I said LESS likely.
8. My default greeting will not be hugging people. I’ll shake hands but will also regularly sanitize and wash them because that’s good hygiene practice anyway.
Travel and in-person meetings are not without risk. I might still get COVID despite my precautions. But this is not a choice solely between lockdowns and let ‘er rip. I can take steps to greatly *reduce* my risk, to protect myself and others around me as much as possible.
This doesn’t have to be as hard as some make it out to be. Risk reduction is additive and by layering on as many precautions as possible, I can significantly reduce the likelihood of exposure and infection. I will do that as I resume getting back out into the world.
I'm going to add three things here based on some feedback:
1. I will use rapid tests periodically during the trip, including those required for travel (I'm connecting through the US, which requires it), but my other precautions are not contingent on the results.
In other words, I'll take those precautions regardless. The rapid tests will help me determine if I need to isolate, which I would immediately do if I test positive. I'll also immediately do that if I develop symptoms even if I'm negative on a rapid test.
2. I feel comfortable travelling in part because I know my own risk level (and my spouse, who is coming with) & we don't live with anyone at high risk (elderly, immunocompromised, etc). YMMV but it's important to assess risk of your household, not just what you can tolerate.
3. We have a plan for what to do if we test positive. Our medical plan covers travel & sometimes we purchase supplementary medical insurance in case we get sick or have an accident. This is generally pretty affordable and it's wise whenever you travel for any reason.
We always ensure we have adequate coverage in case of any kind of medical emergency. And the credit card I used to book the tickets covers unexpected non-medical expenses related to medical emergencies while travelling, like flight changes & extra hotel costs.
COVID or not, it's *always* a good idea to make sure you are covered in case of an emergency while travelling abroad. If we test positive while abroad, we'll rely on this coverage to ensure we isolate properly, without endangering others & in line with public health requirements.
Because SARS-CoV-2 is an infectious virus, that means that your actions can impact & cause harm to others. So the key to travelling during the pandemic is to make sure you have lots of options. Choose the options that keep both yourself & those around you as safe as possible."
Source:
Commentary: I'll be following these precautions to the letter when I travel as well.
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Dr. Saskia Popescu on the travel mandates:
"You’re likely seeing a lot of “ffs” from public health folks at the news that TSA is dropping mask mandates on airplanes, trains, and public transportation. Here are some thoughts (while screaming into the void):
(1/n)
Cases are rising in the U.S. and with so many public health measures relaxing, we’ll likely see increasing case counts. This data also reflects an underreported # bc home antigen tests aren’t report. (2/n)
Public transportation is hard to enforce infection prevention measures in - from masking to ensuring adequate ventilation. Even on airplanes (great ventilation/filtration), masks are critical - lots of ppl + enclosed space + prolonged period of time. (3/n)
Protecting the safety of those who use public transportation is critical and frankly, deciding it’s not worth it is a really privileged stance to take. (4/n)
For air travel - removing masking requirements is a great way to ensure you’re spreading COVID (and any other respiratory infection in circulation) among a lot of people going to a lot of different regions. (5/n)
We may want to be done with COVID, but forcing our way through it is myopic & frankly ridiculous. People are still getting sick, going to hospitals, & dying. We need primary prevention, like masks +vaccines. Personally, I’ll continue to wear a mask on airplanes & pubtranspo (6/6) "
Source:
Commentary: One critical part of the ruling is that it applies to all public transit in the USA, not just airplanes. It endangers people unnecessarily on mass transit like trains and buses. Mask up any time you're around others with the best mask available - and as I said previously above, now you can wear pretty much whatever you want, so bust out the big respirators. They're much more comfortable than N95 masks.
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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. If it's available, choose Moderna as your first choice for both vaccine and booster, Pfizer as your second choice. However, remember than any vaccine is better than no vaccine.
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, or you know, a global war breaks out.
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.