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 a qualified healthcare provider who knows your specific medical situation over advice from people on the Internet.
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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USA friends, in case you missed it yesterday, you can request 4 free COVID-19 test kits at home for free from the US Government. This is per residential mailing address.
Source: https://www.covidtests.gov/
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If this doesn't convince some people to get vaccinated, nothing will. "COVID-19 infection may have extrapulmunary manifestations such as blood hypercoagulability that may cause thrombosis in both arterial and venous system. Deep dorsal penile vein thrombosis is very rare, and the most common reason is coagulation disorders. The common observed symptom is penile pain especially during erection and it is diagnosed by ultrasound evaluation of the vein. It is necessary to distinguish deep dorsal penile vein thrombosis from superficial dorsal penile vein thrombosis as it needs anti-coagulant treatment. In present study, we describe a unique case of the deep dorsal penile vein thrombosis following COVID-19 infection."
Source: https://onlinelibrary.wiley.com/doi/10.1002/ccr3.5117
Commentary: To decode the medical jargon, this patient experienced a serious blood clot in the penis due to COVID-19's ability to wreak havoc on the circulatory system. It took the patient 2 months of blood thinner treatment to restore normal function.
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France steps up. "PARIS -- France’s parliament approved a law Sunday that will exclude unvaccinated people from all restaurants, sports arenas and other venues, the central measure of government efforts to protect hospitals amid record numbers of infections driven by the highly contagious omicron variant.
The National Assembly adopted the law by a vote of 215-58. Centrist President Emmanuel Macron had hoped to push the bill through faster, but it was slightly delayed by resistance from lawmakers both on the right and left and hundreds of proposed amendments."
Up to now, a COVID-19 pass has been required in France to go to restaurants, movie theaters, museums and many sites throughout the country, but unvaccinated people have been allowed in if they show a recent negative test or proof of recent recovery.
The new law requires full vaccination for such venues, including tourist sites, many trains and all domestic flights, and applies to everyone 16 and over. Some exceptions could be made for those who recently recovered from COVID-19. The law also imposes tougher fines for fake passes and allows ID checks to avoid fraud."
Source: https://abcnews.go.com/Health/wireStory/vaccine-cafe-french-virus-law-82297435
Commentary: Good job, France.
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Omicron reinfection risk 16x higher than Delta. "The estimated rate for all reinfections including those with a lower viral load was 20.8 per 100,000 participant days at risk (95% confidence interval: 19.5 to 22.2) over the entire at-risk period. This is an increase from our previously published findings up to 1 December 2021, where we estimated the rate for all reinfections was 12.7 per 100,000 participant days at risk (95% confidence interval: 11.6 to 13.9) over the entire at-risk period. This increase is likely driven by the Omicron variant of COVID-19.
Viral load is approximated by Cycle threshold (Ct ) values, which are lower with a high viral load. The estimated rate for reinfections with a high viral load (strong positive test where the Ct value was less than 30) was 14.4 per 100,000 participant days at risk (95% confidence interval: 13.3 to 15.6) over the entire at-risk period. Participant days at risk and Ct values are further defined in our Glossary. This is an increase from our previously published findings up to 1 December 2021, where we estimated the rate for reinfections with a high viral load was 7.2 per 100,000 participant days at risk (95% confidence interval: 6.4 to 8.1) over the entire at-risk period. This increase is likely driven by the Omicron variant of COVID-19.
Before 17 May 2021, infections were likely to be compatible with Alpha or other variants. From 17 May to 19 December 2021, substantial numbers of infections compatible with the Delta variant were observed in the survey. From 20 December 2021 onwards, substantial numbers of infections compatible with the Omicron variant were observed in the survey. We looked at the difference between initial infections and reinfections in terms of viral load, classifying each by the time period the reinfection occurred in.
People with a high viral load (low Ct value) in their first episode tend to have a low viral load (higher Ct value) in the second episode. Some people with low viral load (high Ct values) in the first episode have a high viral load (low Ct values) in the second, perhaps suggesting a weaker immune response to the first infection. Others have a lower viral load (high Ct values) at both episodes. This could be because of monthly follow ups occurring when participants are nearing the end of infection in both episodes.
The likelihood of people reinfected with COVID-19 and reporting symptoms varies by variant. Before 17 May 2021 (Alpha-dominant period), the likelihood of an individual having symptoms in their second infection was lower compared with their first infection. From 17 May to 19 December 2021 (Delta-dominant period), people were more likely to have symptoms of COVID-19 in their second infection than in their first infection. From 20 December 2021 onwards (Omicron-dominant period), people were just as likely to have symptoms of COVID-19 in their second infection as their first infection."
Source: https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/conditionsanddiseases/bulletins/coronaviruscovid19infectionsurveycharacteristicsofpeopletestingpositiveforcovid19uk/19january2022#reinfections-with-covid-19-uk
Commentary: Omicron is a different player in the game. It's why we still need to mask up.
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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, including boosters. 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 available. If it's available, choose Moderna as your first choice for both vaccine and booster, Pfizer as your second choice. However, remember than any vaccine is better than no vaccine.
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.