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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Do not use other people's cars without a mask and ventilation. "We used a Sioutas personal cascade impactor sampler (PCIS) to screen for SARS-CoV-2 in a car driven by a COVID-19 patient. SARS-CoV-2 was detectable at all PCIS stages by PCR and was cultured from the section of the sampler collecting particles in the 0.25 to 0.50 □μm size range.
The PCIS is a cascade impactor, and the manner that virus particles are collected (impaction onto filters) and the presence of a constant air-flow stream (drying out the virus) should, if anything, have reduced virus viability. The air flow in the impactor increases in velocity as it passes through stages A to E, imperiling virions collected at stage D to a greater extent than virions collected at earlier stages. Yet despite these potential adverse conditions, we isolated viable virus from stage D of the impactor. Taken together, our data highlight the potential risk of SARS-CoV-2 transmission by minimally symptomatic persons in the closed space inside of a car (with closed windows and air conditioning running), and suggest that a substantial component of that risk is via aerosolized virus."
Source: https://www.medrxiv.org/content/10.1101/2021.01.12.21249603v1.full.pdf
Commentary: If you must use someone else's car, do so only with the best mask possible and the windows down - Uber, taxi, friend's car, whatever. This study (warning, it's a pre-print) found viable virus in the air TWO HOURS after an infected driver drove the vehicle.
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COVID-19 and lift expectancy. "COVID-19 may shorten Americans' life expectancy at birth of by a median of 1.13 years, to 77.48 years—the largest single-year dip in at least 40 years and the lowest estimated lifespan since 2003, according to projections from a study published yesterday in the Proceedings of the National Academy of Sciences.
The researchers, from the University of Southern California (USC) and Princeton University, also projected a decline in life expectancy at age 65 of 0.87 years. They caution that their projections are only best estimates and not definitive.
The decline is especially steep for black Americans, who could expect to die 2.10 years sooner, at 72.78 years, and for Latinos, who could see their lives shortened by 3.05 years, to 78.77. The researchers projected a much smaller decline for whites, at 0.68 years, for a life expectancy of 77.84 years. In contrast, the 1918-19 flu pandemic was estimated to have lowered life expectancy by 7 to 12 years.
As a result, the gap in life expectancy between black and white Americans could widen by 40%, from 3.6 to more than 5 years, a prediction that backs mounting evidence of COVID-19's disproportionate effect on disadvantaged populations. Blacks have consistently had a lower life expectancy than whites, but they had made larger relative gains in life expectancy than whites over the past 20 years."
Source: https://www.cidrap.umn.edu/news-perspective/2021/01/covid-may-cut-us-life-expectancy-especially-blacks-latinos
Commentary: COVID-19 affects minorities disproportionately, owing to things like access to care. Help keep all your friends, but especially those who are minorities, safe by being vigilant about mask usage. If possible, provide higher quality PPE (N95/FFP2/KN95) to folks you know who are minorities and might not have access to it.
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COVID-19 kills in crowded ICUs. "COVID-19 patients admitted to intensive care units (ICUs) at US Department of Veterans Affairs (VA) hospitals during peak coronavirus patient surges were twice as likely to die than those treated during low-demand periods, an observational study published today in JAMA Network Open suggests.
VA researchers studied 8,516 COVID-19 patients, 94.1% of them men, admitted to ICUs at 88 veterans hospitals from Mar 1 to Aug 31, 2020, with 30 days of follow-up.
Compared with COVID-19 patients treated in the ICU during times of low ICU demand (≤25%), those treated during times of 25% to 50% demand had an adjusted hazard ratio (aHR) of 0.99. But the aHR jumped to 1.19 when ICU demand was 50% to 75% and to 1.94 when demand was greater than 75%.
The death rate did not increase with increasing ICU demand in patients treated in the noncritical setting. The overall all-cause death rate varied over time, ranging from a high of 25.0% in April to a low of 12.5% in July.
Patient load was defined as the number of COVID-19 patients in the ICU compared with the typical ICU bed counts at each hospital, while ICU demand was defined as the mean number of coronavirus patients in the ICU during the patient's stay divided by the upper limit of COVID-19 patients in that unit. COVID-19 ICU loads ranged from 1% to more than 100%, at which point hospitals increased critical care bed capacity by repurposing other facility areas as ICUs."
Source: https://www.cidrap.umn.edu/news-perspective/2021/01/crowded-icus-tied-higher-risk-covid-19-death
Commentary: So death rate doubles when ICU demand exceeds 75%. In the United States, almost half of the states have ICU demand at or above 75%; Alabama right now is at 94%, the highest in the nation, followed by California. Crowded ICUs mean reduced standards of care out of sheer necessity. Encourage legislators where you live to tie precautionary measures to ICU demand; once demand exceeds 50%, start rolling out more lockdown measures.
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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.
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. 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.