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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This is what a rapid antigen test looks like. "For anyone wondering what a best-in-class rapid antigen test looks like. This is the Abbott Labs PanBio rapid antigen test.
If you lift up the plastic top (which is cheap) it is a simply paper strip (that white part with the red line)....
These are exceptionally cheap w/ very good accuracy to detect people when they are carrying infectious virus
Extremely easy to use
Simple design
I suggest a model where you reuse the plastic shell (like contact lenses) and just change the paper strip. Simple.
It is really unfortunate though that this particular test is NOT sold in the US. It is sold outside of the United States.
Nevertheless - this is to show that THESE TESTS EXIST.
The US Government should be making them in the 10's of millions daily.
Instead, Americans are dying
To use these... take self nasal swab - just front of nose (like you're picking it - not painful). Then put swab in a tube with a liquid. Then put 2 drops of the liquid in the circle on the test... liquid flows across (lateral flow) and a line forms if pos - like a pregnancy test."
Source:
Commentary: I am hopeful for Americans that when the new administration takes office in January, tools like this can be given emergency authorization and mass produced under the Defense Production Act. A tool that you could mail to every American household and have people self-administer would go a very long way towards identifying clusters and epicenters of disease. Used at the population level, the test doesn't have to be 100% accurate - just seeing a series of positives in an area tells you that area has a problem.
Right now, we don't know - and thus we cannot formulate responses except mass lockdowns or "letting things happen", both of which are unsustainable strategies.
For countries where this is not available, contact your elected representatives and urge them to make these tests available at scale.
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Positive news from experts on vaccines. "The drug maker Pfizer said on Wednesday that its coronavirus vaccine was 95 percent effective and had no serious side effects β the first set of complete results from a late-stage vaccine trial as Covid-19 cases skyrocket around the globe.
The data showed that the vaccine prevented mild and severe forms of Covid-19, the company said. And it was 94 percent effective in older adults, who are more vulnerable to developing severe Covid-19 and who do not respond strongly to some types of vaccines.
Pfizer, which developed the vaccine with its partner BioNTech, said the companies planned to apply to the Food and Drug Administration for emergency authorization βwithin days,β raising hopes that a working vaccine could soon become a reality.
The trial results β less than a year after researchers began working on the vaccine β shattered all speed records for vaccine development, a process that usually takes years.
βThe study results mark an important step in this historic eight-month journey to bring forward a vaccine capable of helping to end this devastating pandemic,β Dr. Albert Bourla, Pfizerβs chief executive, said in a statement.
If the F.D.A. authorizes the two-dose vaccine, Pfizer has said that it could have up to 50 million doses available by the end of the year, and up to 1.3 billion by the end of next year.
However, only about half of its supply will go to the United States this year, or enough for about 12.5 million people β a sliver of the American population of 330 million. Americans will receive the vaccine for free, under a $1.95 billion deal the federal government reached with Pfizer for 100 million doses."
Source: https://www.nytimes.com/2020/11/18/health/pfizer-covid-vaccine.html
Commentary: Shared by Dr. Akiko Iwasaki of Yale's Virology Lab, we are seeing credible experts examining the results of vaccine trials and finding them solid. One of the greatest concerns we've had is whether the vaccines are effective and/or safe. While I'm reluctant to listen to manufacturers themselves and US government officials under the current administration, credible experts like Dr. Iwasaki endorsing the vaccines goes a very long way.
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Severe COVID-19 causes increased gut permeability. "A disruption of the crosstalk between gut microbiota and the lung (gut-lung axis) has been implicated as a driver of severity during respiratory-related diseases. Lung injury causes systemic inflammation, which disrupts gut barrier integrity, increasing the permeability to gut microbes and their products. This exacerbates inflammation, resulting in positive feedback. To test the possibility that a disrupted gut contributes to Coronavirus disease 2019 (COVID-19) severity, we used a systems biology approach to analyze plasma from COVID-19 patients with varying disease severity and controls. Severe COVID-19 is associated with a dramatic increase in tight junction permeability and translocation of bacterial and fungal products into blood. This intestinal disruption and microbial translocation correlate strongly with increased systemic inflammation and complement activation, lower gut metabolic function, and higher mortality. Our study highlights a previously unappreciated factor with significant clinical implications, disruption in gut barrier integrity, as a force that contributes to COVID-19 severity."
Source: https://www.medrxiv.org/content/10.1101/2020.11.13.20231209v1
Commentary: As always, a warning that this is a preprint, and has not been peer reviewed yet. The reports of patients with substantial gastrointestinal distress as part of their COVID-19 symptoms is well-catalogued, but this research shows that SARS-CoV-2 directly attacks the gut as well. The net effect of increased gut permeability is more bacteria and fungi leaking into the bloodstream, causing substantly complications, infections, and severe illness.
Long-haul COVID patients have also reported that their GI symptoms have not abated even after "recovery", which is problematic.
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COVID-19 leaves long-lasting organ damage in SEVENTY PERCENT of young, healthy patients. "Young, low risk patients with ongoing symptoms of covid-19 had signs of damage to multiple organs four months after initially being infected, a preprint study has suggested.1
Initial data from 201 patients suggest that almost 70% had impairments in one or more organs four months after their initial symptoms of SARS-CoV-2 infection.
The results emerged as the NHS announced plans to establish a network of more than 40 long covid specialist clinics across England this month to help patients with long term symptoms of infection.
The prospective Coverscan study examined the impact of long covid (persistent symptoms three months post infection) across multiple organs in low risk people who are relatively young and had no major underlying health problems. Assessment was done using results from magnetic resonance image scans, blood tests, and online questionnaires.
The research has not yet been peer reviewed and could not establish a causal link between organ impairment and infection. But the authors said the results had βimplications not only for [the] burden of long covid but also public health approaches which have assumed low risk in young people with no comorbidities.β
The study enrolled participants at two UK sites in Oxford and London between April and August 2020. Two hundred and one individuals (mean age 44 (standard deviation 11.0) years) completed assessments after SARS-CoV-2 infection a median of 140 days after initial symptoms.
Two thirds (66%) of participants had impairment in one or more organ systems and there was evidence of multiorgan impairment in a quarter (25%) of individuals, with varying degrees of overlap across multiple organs.
Multiorgan impairment was significantly associated with risk of prior covid-19 hospitalisation (P<0.05). Measures of inflammation in the kidneys and pancreas, and ectopic fat in the pancreas and liver, were also higher in hospitalised individuals (P<0.05)."
Source: https://www.bmj.com/content/371/bmj.m4470
Commentary: Long-lasting organ damage in healthy, young, low-risk people is a serious concern. COVID-19 is creating large populations of people with chronic illness that may take months or years to fully recover. Take the disease seriously. Urge your friends to do the same.
Wear a mask, always, outside your home.
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Some positive news to bring a smile. Who's a leader in vaccine research? Dolly Parton. "Country star Dolly Parton has said she feels "very honoured and proud" to have given money to research into one of the most promising Covid-19 vaccines.
In April she announced she was giving $1m (Β£750,000) to Vanderbilt University Medical Center in Nashville.
That was one of the trial sites for the Moderna vaccine, which is nearly 95% effective according to early data.
Speaking on BBC One's The One Show on Tuesday, Parton said she was "so excited" to hear the news.
"I'm sure many millions of dollars from many people went into that," she told co-presenters Alex Jones and Jermaine Jenas.
"But I just felt so proud to have been part of that little seed money that will hopefully grow into something great and help to heal this world."
A Vanderbilt spokesperson said Parton's "generous" gift was helping "several promising research initiatives".
A portion of the singer's money went towards funding an early stage trial of the Moderna vaccine.
The Dolly Parton Covid-19 Research Fund was listed among the funders in a preliminary report into the Moderna vaccine that was published in the New England Journal of Medicine."
Source: https://www.bbc.com/news/entertainment-arts-54974987
Commentary: It's always nice to see people leveraging their wealth and power for good causes, and even better when they're genuinely decent human beings on top of 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. Always wear a mask when out of your home and if going to a high risk area, wear goggles. 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, 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.
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.
6. Participate in your local political process. For Americans, go to Vote.org and register/verify your vote.
7. Ventilate your home as frequently as weather and circumstances permit.
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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.
This is also available as an email newsletter at https://lunchtimepandemic.substack.com if you prefer the update in your inbox.