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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A hint at pan-coronavirus immunity. "Almost 20 years before SARS-CoV-2, a related and even more lethal coronavirus sowed panic, killing nearly 10% of the 8000 people who became infected. But the 2003 outbreak of severe acute respiratory syndrome (SARS) may have left some survivors with a gift. Former SARS patients who have been vaccinated against COVID-19 appear able to fend off all variants of SARS-CoV-2 in circulation, as well as ones that may soon emerge, a new study suggests. Their formidable antibodies may even protect against coronaviruses in other species that have yet to make the jump into humans—and may hold clues to how to make a so-called pancoronavirus vaccine that could forestall future outbreaks.
A team led by emerging disease specialist Linfa Wang from Duke-NUS Medical School in Singapore identified eight SARS survivors who recently received two shots of a messenger RNA COVID-19 vaccine. In the test tube, antibodies sieved from their blood potently “neutralized” an early strain of SARS-CoV-2 as well as SARS-CoV, the virus that caused SARS, Wang and colleagues report today in The New England Journal of Medicine. The team further found these neutralizing antibodies worked well against the Alpha, Beta, and Delta variants of SARS-CoV-2 and stymied five related coronaviruses found in bats and pangolins that potentially could infect humans.
This study’s demonstration of broad spectrum immunity against sarbecoviruses—a subset of coronaviruses that includes the causes of SARS and COVID-19—is “amazing and very good news,” says Priyamvada Acharya, a structural biologist at Duke University who works on pancoronavirus vaccine research and was not involved in the new study. “This paper provides a proof of principle that a pansarbecovirus vaccine is possible.” It also marks an important step toward a long-term hope—a vaccine that works against all coronaviruses—several researchers trying to develop this dreamed of protection say."
Source: https://www.sciencemag.org/news/2021/08/covid-19-vaccines-may-trigger-superimmunity-people-who-had-sars-long-ago
Source: https://www.nejm.org/doi/full/10.1056/NEJMoa2108453
Commentary: If we've detected a way to essentially block the entire family of coronaviruses, that would be an amazing blessing. This study hints at that possibility; if we can derive a vaccine that recognizes both SARS-CoV (SARS) and SARS-CoV-2 (COVID-19), we might have a solution to stopping all kinds of mutations.
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Much confusion about 3rd boosters. "The Biden administration’s decision to start authorizing third doses of Covid-19 vaccine in September is being met with bafflement, concern, and even anger from a number of immunologists, vaccinologists, and people steeped in the normal way such decisions are made.
Many flat-out challenged the need for booster doses at this time. Others questioned the morality of administering third shots to Americans when most people on the planet haven’t received one. And some worried that a decision had been made before the Food and Drug Administration had ruled on the need for a booster or a key vaccine advisory committee had evaluated the data — typically the way vaccine policy is set.
The government’s top public health officials on Wednesday pointed to data showing that the mRNA vaccines developed by Pfizer-BioNTech and Moderna are no longer protecting as well against mild and moderate Covid-19 infections as evidence that “could” signal a decline in protection against serious disease.
But “could is not a very strong word … especially to make a policy decision on,” Norman Baylor, president and CEO of Biologics Consulting and a former head of the FDA’s Office of Vaccines, told STAT.
To many experts, including Baylor, the sequencing of the decisions being made is also out of whack. While U.S. health officials said booster shots could start being offered the week of Sept. 20, the Food and Drug Administration has not even ruled yet on Pfizer’s application for approval of a third shot; it was filed only Monday. Moderna hasn’t yet asked the agency to authorize a third shot at all."
Source: https://www.statnews.com/2021/08/18/u-s-decision-on-covid-19-booster-shots-baffles-and-upsets-some-scientists/
Commentary: Third boosters also create even more of a divide between vaccinated and unvaccinated in the sense that as SARS-CoV-2 continues to mutate, we will have two long-term populations, those with long-haul and those without. Our efforts should be on vaccinating everyone. That's the only way to truly stay ahead of the virus.
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Delta spreads faster before symptoms. "People infected with the Delta variant of SARS-CoV-2 are more likely to spread the virus before developing symptoms than are people infected with earlier versions, suggests a detailed analysis of an outbreak in Guangdong, China1.
“It is just tougher to stop,” says Benjamin Cowling, an epidemiologist at the University of Hong Kong and a co-author of the study, which was posted on a preprint server on 13 August.
Cowling and his colleagues analysed exhaustive test data from 101 people in Guangdong who were infected with Delta between May and June this year, and data from those individuals’ close contacts. They found that, on average, people began having symptoms 5.8 days after infection with Delta — 1.8 days after they first tested positive for viral RNA. That left almost two days for individuals to shed viral RNA before they showed any sign of COVID-19.
An earlier study2 and an unpublished analysis by Cowling and others estimate that before Delta emerged, individuals infected with SARS-CoV-2 took an average of 6.3 days to develop symptoms and 5.5 days to test positive for viral RNA, leaving a narrower window of 0.8 days for oblivious viral shedding.
In the latest work, the researchers also found that those infected with Delta had higher concentrations of viral particles, or viral load, in their bodies than did people infected with the original version of SARS-CoV-2. “Somehow the virus is appearing quicker and in higher amounts,” says Cowling.
As a result, 74% of infections with Delta took place during the presymptomatic phase — a higher proportion than for previous variants. This high rate “helps explain how this variant has been able to outpace both the wild-type virus and other variants to become the dominant strain worldwide”, says Barnaby Young, an infectious-disease clinician at the National Centre for Infectious Diseases in Singapore."
Source: https://www.nature.com/articles/d41586-021-02259-2
Source: https://www.medrxiv.org/content/10.1101/2021.08.12.21261991v1
Commentary: How do you stop an enemy you can't see and detect until it's too late? You can't. The only way to prevent spread is to mask up and be fully vaccinated. Fully vaccinated folks shed less virus across all variants, and masks protect us further.
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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. 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 permitted.
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.
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.