Lunchtime Pandemic Reading, 18-June-2021

Delta, delta, delta

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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Delta causing breakthrough infections in Canada. "Outbreaks of the delta variant at the Foothills Medical Centre in Calgary are sparking concern as some with both doses of the vaccine are still getting affected with the variant.

"We're scared, very concerned," said Wayne Stopa, a registered nurse and a vice-president with United Nurses of Alberta (UNA) Local 115.

"A lot of us have had the double vaccines already … and to find out people are still getting affected with the delta variants is quite concerning to all the staff."

The delta variant, otherwise known as B.1.617.2, has battered the U.K. and prompted calls for a delayed reopening.

At the Foothills hospital, 16 patients on two units — as well as six health-care workers — have tested positive for the delta variant.

Six of the patients and five of the health-care workers received two doses of the vaccine, while seven patients and one health-care worker had a single dose. All of those infected were vaccinated with an mRNA vaccine.

Alberta Health Services said it's important to remember that even after immunization, it is still possible to contract COVID-19.

However, people are less likely to experience severe illness or require hospitalization with either one or two doses, said spokesperson Kerry Williamson.

"For example, in the case of these two outbreaks, only one of the 22 people have required ICU care," Williamson said in an email. "The majority of both patients and healthcare workers have experienced mild symptoms."

Williamson said the vaccines are about 73 per cent effective against the B.1.1.7 variant after one dose, and 91 per cent after two doses.

They are about 33 per cent effective against the delta variant after the first dose, he said, and rise to more than 80 per cent effective after the second dose."

Source: https://www.cbc.ca/amp/1.6063802

Commentary: It's really important to note that the vaccines do not show much effectiveness if you received a partial dose - i.e. only 1 of 2 shots. And against Delta, the odds of contracting COVID-19 are 1 in 5 versus 1 in 16 against other strains.

If you live in an area with low vaccination rates locally, dust off your masks and start using them indoors if you haven't already. As Delta becomes the dominant strain in many places, it puts people at risk again.

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COVID-19 causes neurological damage, regardless of severity. "There is strong evidence for brain-related pathologies in COVID-19, some of which could be a consequence of viral neurotropism. The vast majority of brain imaging studies so far have focused on qualitative, gross pathology of moderate to severe cases, often carried out on hospitalised patients. It remains unknown however whether the impact of COVID-19 can be detected in milder cases, in a quantitative and automated manner, and whether this can reveal a possible mechanism for the spread of the disease. UK Biobank scanned over 40,000 participants before the start of the COVID-19 pandemic, making it possible to invite back in 2021 hundreds of previously-imaged participants for a second imaging visit. Here, we studied the effects of the disease in the brain using multimodal data from 782 participants from the UK Biobank COVID-19 re-imaging study, with 394 participants having tested positive for SARS-CoV-2 infection between their two scans. We used structural and functional brain scans from before and after infection, to compare longitudinal brain changes between these 394 COVID-19 patients and 388 controls who were matched for age, sex, ethnicity and interval between scans. We identified significant effects of COVID-19 in the brain with a loss of grey matter in the left parahippocampal gyrus, the left lateral orbitofrontal cortex and the left insula. When looking over the entire cortical surface, these results extended to the anterior cingulate cortex, supramarginal gyrus and temporal pole. We further compared COVID-19 patients who had been hospitalised (n=15) with those who had not (n=379), and while results were not significant, we found comparatively similar findings to the COVID-19 vs control group comparison, with, in addition, a greater loss of grey matter in the cingulate cortex, central nucleus of the amygdala and hippocampal cornu ammonis (all |Z|>3). Our findings thus consistently relate to loss of grey matter in limbic cortical areas directly linked to the primary olfactory and gustatory system. Unlike in post hoc disease studies, the availability of pre-infection imaging data helps avoid the danger of pre-existing risk factors or clinical conditions being mis-interpreted as disease effects. Since a possible entry point of the virus to the central nervous system might be via the olfactory mucosa and the olfactory bulb, these brain imaging results might be the in vivo hallmark of the spread of the disease (or the virus itself) via olfactory and gustatory pathways."

Source: https://www.medrxiv.org/content/10.1101/2021.06.11.21258690v1

Commentary: These findings indicate the potential for COVID-19 to cause neurological issues, even in less severe cases. The only way to be 100% safe is to avoid getting it, so get vaccinated and be cautious in your interactions with the outside world. Definitely treat it as dangerous for anyone unvaccinated, such as children under 12 years old.

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Delta is spreading 2x as fast as original COVID and causing more severe outcomes. "More than 90% of Covid cases in the UK are now down to the coronavirus Delta variant first discovered in India, data has revealed, as the total number of confirmed cases passed 42,000.

Also known as B.1.617.2, the Delta variant has been linked to a rise in Covid cases in the UK in the past weeks. It is believed to spread more easily than the Alpha variant, B.1.1.7, that was first detected in Kent, and is somewhat more resistant to Covid vaccines, particularly after just one dose. It may be also associated with a greater risk of hospitalisation.

Now, Public Health England (PHE) has said that more than 90% of new Covid cases in the UK involve the Delta variant. Indeed the most recent data suggests the figure could be as high as 96% of new cases in England.

The PHE report further revealed that cases of the virus are doubling between every 4.5 and 11.5 days, depending on the region of England, and that it has about a 60% increased risk of household transmission compared with the Alpha variant. Confirmed cases in the UK to date have risen by 29,892 to 42,323."

Source: https://www.theguardian.com/world/2021/jun/11/delta-variant-is-linked-to-90-of-covid-cases-in-uk

Commentary: Delta is a significant risk to anyone unvaccinated. Here's what I'm doing:

1. Keep wearing masks anywhere indoors. Period.

2. Because I have an unvaccinated kid in the house, treat the entire house as unvaccinated in our interactions with the outside world.

3. Resume most 2020 protocols. Avoid unnecessary trips to indoor places with other people, stay away from large groups, etc.

It's still safe for fully vaccinated people to gather as of right now, as long as you KNOW everyone's fully vaccinated. If you don't KNOW beyond a shadow of doubt, wear a mask. For example, I'll be visiting my folks next month. We're all vaccinated, so I have no qualms with that gathering. We still won't be going out to eat or to any place indoors, and we'll wear masks and stuff for the trip there and back any time we're out of the car (like rest areas, which are germ bombs anyway).

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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 other people, 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. Get vaccinated as soon as you're able to, and fulfill the full vaccine regimen. Remember that you are not vaccinated until everyone you live with is vaccinated. If you received an adenovirus vaccine (J&J/AstraZeneca), consider gettings an mRNA single shot booster (Pfizer/Moderna).

3. Wash/sanitize your hands every time you are in or out of your home.

4. Stay home 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.

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 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.