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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Pfizer vaccine more effective than initially thought. "A new COVID vaccine efficacy study from Israel has concluded that Pfizer/BioNTech's jab is up to 85% effective after the first dose.
The research, conducted by the Sheba Medical Centre, the country's largest hospital, has been published in the Lancet medical journal.
The hospital assessed the effectiveness of the first dose of the Pfizer/BioNTech vaccine among 7,000 of its healthcare employees.
The workers each received their first dose in January and the research team observed an 85% reduction of clinical (symptomatic) COVID-19 between 15 and 28 days after the jab.
But critically, they also observed efficacy in asymptomatic patients.
The study found that all infections, including asymptomatic, were reduced by 75% after the first dose.
Professor Eyal Leshem, an infectious disease expert and director of Sheba's Institute for Travel and Tropical Medicine, told Sky News: "This is first real-world evidence of effectiveness that shows up after the first dose of the vaccine."
Source: https://news.sky.com/story/covid-19-pfizer-vaccine-is-up-to-85-effective-after-first-dose-new-israeli-study-finds-12222164
Source: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)00448-7/fulltext
Commentary: This is wonderful news - let's hope the same holds true for the Moderna vaccine. If that's the case, we might be able to speed up the number of people vaccinated overall by delaying the second dose longer.
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Pfizer also asks for cold storage changes. "Pfizer Inc and BioNTech SE have asked the U.S. health regulator to relax requirements for their COVID-19 vaccine to be stored at ultra-low temperatures, potentially allowing it to be kept in pharmacy freezers, they said on Friday.
Approval by the Food and Drug Administration (FDA) could send a strong signal to other regulators around the world that may ease distribution of the shot in lower-income countries.
The companies have submitted new temperature data to the FDA to support an update to the current label that would allow vials to be stored at -25 to -15 degrees Celsius (-13°F to 5°F) for a total of two weeks.
The current label requires the vaccine to be stored at temperatures between -80ºC and -60ºC (-112ºF to -76ºF), meaning it has to be shipped in specially designed containers.
The shot’s cold-storage requirements set off a scramble among U.S. states at the beginning of the rollout for dry ice, in which it can be stored temporarily when there are no specialized freezers available, for instance in rural areas.
Pfizer/BioNTech’s vaccine, along with Moderna Inc’s two-dose shot, has already won U.S. emergency-use authorization and is being widely distributed as part of the country’s mass vaccination efforts.
The update from the drugmakers comes as two studies from Israel found that the vaccine greatly reduced virus transmission, and the shot was backed by two of the South African government’s top advisers.
The new data also will be submitted to global regulatory agencies within the next few weeks, the two companies said.
A BioNTech spokeswoman declined to provide more details on the timing and which agencies would be contacted.
“The data submitted may facilitate the handling of our vaccine in pharmacies and provide vaccination centres an even greater flexibility,” BioNTech Chief Executive Ugur Sahin said."
Source: https://www.reuters.com/article/us-health-coronavirus-pfizer/pfizer-seeks-u-s-approval-to-ease-handling-of-covid-19-vaccine-idUSKBN2AJ1CJ
Commentary: Moderna's vaccine also requires only -25C as well, which means that if Pfizer receives approval to change their storage requirements, both vaccines could be stored together, simplifying logistics, rather than having the Pfizer one be in ultra-cold storage. They erred on the side of caution (I don't blame them!) and now that the real world has proven the vaccine is more stable than initially thought, this would be a welcome change for getting more vaccine into more people.
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Schools and B.1.1.7 don't mix. "Two schools and eight daycare institutions in the central Jutland city of Kolding will remain closed until Friday 26 following coronavirus outbreaks that experts claim underline the devastating potential of the British variant of COVID-19.
At the last count the two schools had a total of 69 infections among staff and students, while up to 20 have been infected at the daycare institutions.
Speaking to DR, Viggo Andreasen, an associate professor at Roskilde University who is swiftly becoming the nation’s favourite mathematical epidemiologist, questions whether there is “something going on with the infection of [the British variant] B117 among children that we have not seen with the old coronavirus”.
“If we see more examples like this, then we must ask ourselves whether it is too risky to open the schools to the little ones,” he continued.
“This means there is a good risk that infection chains will run for quite some time before we discover them. There are probably also some parents who have become infected.”
Professor Allan Randrup Thomsen, a virologist connected to the University of Copenhagen who advises the government, questions whether there can be a partial reopening of society on March 1.
“Based on what has happened in Kolding, we can see that there is a great potential for infection with the British variant – even under the restrictions we have now.
“When the British variant takes over, there will be a marked increase in the number of infected and hospitalised in April.”"
Source: https://cphpost.dk/?p=122479
Commentary: This is bad news for any schools. The B.1.1.7 strain already spreads rapidly, and if school kids are more susceptible to it, then schools should not reopen.
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The long haul affects 30% of COVID-19 patients. "In this cohort of individuals with COVID-19 who were followed up for as long as 9 months after illness, approximately 30% reported persistent symptoms. A unique aspect of our cohort is the high proportion of outpatients with mild disease. Persistent symptoms were reported by one-third of outpatients in our study, consistent with a previously reported study,4 in which 36% of outpatients had not returned to baseline health by 14 to 21 days following infection. However, this has not been previously described 9 months after infection.
Consistent with existing literature, fatigue was the most commonly reported symptom.2-4 This occurred in 14% of individuals in this study, lower than the 53% to 71%2-4 reported in cohorts of hospitalized patients, likely reflecting the lower acuity of illness in our cohort. Furthermore, impairment in HRQoL has previously been reported among hospitalized patients who have recovered from COVID-19; we found 29% of outpatients reported worsened HRQoL.5
Notably, 14 participants, including 9 nonhospitalized individuals, reported negative impacts on ADLs after infection. With 57.8 million cases worldwide, even a small incidence of long-term debility could have enormous health and economic consequences.6"
Source: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2776560
Commentary: The last point is the key. We don't know what the real long-term effects of COVID-19 are. We won't know for years to come. But the fact that we see 30% of patients having some kind of long-term effect isn't a good thing at all. Best to get people vaccinated and protected as quickly as possible.
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A reminder of the simple daily habits we should all be taking.
1. Always wear the best mask available to you when out of your home and you'll be around other people. 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.
3. Wash/sanitize your hands every time you are in or out of your home for any reason.
4. 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.
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 mercury or other heavy metals in the Pfizer mRNA vaccine. https://www.technologyreview.com/2020/12/09/1013538/what-are-the-ingredients-of-pfizers-covid-19-vaccine/
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.