Lunchtime pandemic reading.
Standard disclaimer: this is a roundup of informative pieces I've read that interest me on the severity of the crises and how to manage them. 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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New COVID boosters are on the way. The FDA authorized and CDC recommended updated Pfizer and Moderna Covid-19 booster shots targeting the XBB.1.5 variant for everyone 6 months and older, with a couple caveats around timing for those recently infected or boosted. The shots are urged especially for high risk groups like those over 65, with health conditions, pregnant, or immune-compromised. Peak protection should last a few months before waning. While not all experts agree with vaccinating low risk groups, shots will be free or covered by insurance for most Americans. The goal is to provide updated vaccines that help prevent serious illness and death from Covid-19. (Summarized by AI)
Source: https://www.theguardian.com/world/2023/sep/16/new-covid-vaccine-booster-shot-faq
Commentary: There are a lot of questions about timing of the boosters; some doctors say you should get it later in October so that your immunity is primed for the holidays. I have a simpler benchmark: if you are diligently masking, you have a lot more flexibility and can probably wait until the holidays. If you are not masking, then you are at higher risk of transmission as well as complications, so you may want to err on the side of earlier. Masking diligently means that you're much less likely to catch COVID and other respiratory diseases, so it affords you more time and flexibility.
And it is perfectly safe to get COVID + flu at the same time. My local pharmacy says the new boosters will be available in about a week.
A new paper in Nature details the impact of long COVID.
Among people not hospitalized for COVID-19, the risk of death was not significant beyond 6 months after infection, but the risk of hospitalization remained elevated until 19 months after infection.
In people hospitalized for COVID-19, the risks of death and hospitalization remained significantly elevated through the 2 years of follow-up.
At 2 years after infection, risks remained elevated for 31% and 65% of the examined sequelae in the nonhospitalized and hospitalized groups, respectively. Several gastrointestinal, musculoskeletal, and neurologic sequelae had longer-lasting risk horizons.
Cumulatively at 2 years after infection, postacute sequelae contributed 80.4 and 642.8 disability-adjusted life years (DALYs) per 1,000 persons in the nonhospitalized and hospitalized groups, respectively.
While most disability-adjusted life years occurred in the first year after infection, a substantial proportion (25% in nonhospitalized and 21% in hospitalized) occurred in the second year.
The decline in risks and disability-adjusted life years was less pronounced among those hospitalized versus nonhospitalized, highlighting the difficult recovery for those with more severe initial infections.
The findings demonstrate the substantial cumulative burden of postacute sequelae of COVID-19 and the need to address long-term care needs, especially for those hospitalized. Reducing hospitalizations may help stem long-term consequences.
The authors cite other evidence that reinfection can add additional risks of sequelae on top of the primary infection.
They conclude that reducing reinfections is important to stem long-term consequences.
(Summarized by AI)
Source: https://www.nature.com/articles/s41591-023-02521-2
Commentary: This is a really, really important paper. A lot of people are treating COVID like the flu - that is, getting it once a year isn't a big deal. That's simply untrue, and this massive longitudinal study is evidence of that. COVID continues to damage the body for YEARS after people have had it; 1/3 of non-hospitalized people have problems 2 years after their initial COVID infection.
A new piece in STAT News discusses frustration with the NIH's RECOVER initiative for researching and treating long COVID, over 2 years after its launch. Critics say most of the $1 billion in funding went to observational research rather than urgently needed clinical trials. The few trials underway are testing treatments like Paxlovid, sleep drugs, and therapies for autonomic issues, but these are unlikely to address underlying biological causes. Experts worry flawed trial designs may miss impacts. There are concerns RECOVER disregarded patient input and existing research on similar chronic conditions. With limited trials not starting until 2023 and funding waning, scientists say answers may come faster from private research. Overall, the article portrays the NIH effort as a wasted opportunity that has left millions of long COVID patients without meaningful treatment options.
(Summarized by AI)
Source: https://www.statnews.com/2023/08/09/long-covid-nih-trials/
Commentary: This is the follow-on piece to the previous article. Long COVID is a serious problem and we do not have serious interventions to treat it. Thus, the only sure-fire way to deal with Long COVID is to not catch it in the first place. Stop treating COVID like the flu as something you just have to accept catching, and take the appropriate, known, proven precautions to keep yourself safe.
A reminder of the simple daily habits we should all be taking.
Wear the best mask available to you when you'll be around people you don't live with, even after you've been vaccinated. P100 respirators are back in stock at online retailers, too and start around US$40 for a reusable respirator. 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.
Verify your mask's NIOSH certification here: https://www.cdc.gov/niosh/npptl/usernotices/counterfeitResp.html
Get vaccinated as soon as you're eligible to, and fulfill the full vaccine regimen, including boosters. Remember that you are not vaccinated until everyone you live with is vaccinated. There are new vaccines available now in addition to the boosters we already know that may be more efficacious and tolerated better, so talk to your healthcare provider about which vaccine or booster is the best choice for you.
Check COVID dashboards to see how prevalent it is in your region. A couple of useful dashboards:
In areas of above-average prevalence, 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 disease through aerosols and distance is less effective at mitigating your risks.
Aim to have 3-6 months of living expenses on hand in case the pandemics give another crazy plot twist to the economy, or you know, a global war breaks out.
Replenish your supplies as you use them. Avoid reducing your stores to pre-pandemic levels in case an outbreak causes unexpected supply chain disruptions.
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).
Masks must fit properly to work. Here's how to properly fit a mask:
If you think you may have been exposed to COVID, purchase several rapid antigen tests and/or acquire them from your healthcare provider or government. This will detect COVID only when you're contagious, so follow the directions clearly. https://amzn.to/3fLAoor
Remember, you are not clear until you take 2 tests that are negative, 24 hours apart.
Common misinformation debunked!
There is no basis in fact that COVID 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 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 arrived before 2020 in the United States and therefore no hidden herd immunity:
Source:
https://twitter.com/trvrb/status/1249414291297464321
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 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
Disclosures and Disclaimers
I declare no competing interests on anything I share related to COVID or other communicable diseases. 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 or other communicable diseases, nor do I financially benefit in any way from sharing information about COVID or other communicable diseases.
I am not a qualified healthcare provider and I do not provide medical advice. Only take medical advice from your qualified healthcare provider who knows your specific details and can provide customized recommendations for you.
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
if you prefer the update in your inbox.