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.
You are welcome to share this.
---
A bit of commentary to start. No one in the USA CDC is lying to you when it comes to mask mandates being reinstated. I've seen that commentary from some politicians and pundits, that the USA CDC lied when they said fully vaccinated people didn't have to wear them any more. The virus changed. We know more now. Guidance changed as a result.
If the virus hadn't changed but the guidance had, then you might have grounds for argument, but the new variants are getting better at attacking us.
Could you imagine a baseball player getting angry at the coach for not telling them the opposing team had a stellar batter just join the team? "Coach lied! He said we wouldn't have to go this far in the outfield!" No, the other team changed. You have to change with it if you want to stand a chance of winning the game.
If anything, I think the CDC isn't playing safe enough. Their internal recommendation last week was for universal masking, but they came out saying masking in areas of high spread. The virus doesn't need a ton of at-bat chances. Play it safe. Wear a mask any place indoors that isn't your home.
---
An excellent tool, recently updated for the Delta variant, to help determine risks of COVID-19. Before you travel, or even engage in daily activities, give it a try. It supports multiple nations.
Source: https://www.microcovid.org/
Commentary: Tools like this help make very complex decisions easier. I'm to be speaking at an event in the fall in Cleveland, Ohio, and this tool helped me to make some requests for the event; if they can't accommodate, I'll need to build other countermeasures in.
---
COVID-19 increases stroke and heart disease risks after infection. "COVID-19, caused by SARS-CoV-2, has led to a global health crisis. More than 190 million people have tested positive for SARS-CoV-2 worldwide, with more than 4 million deaths due to COVID-19 (WHO epidemiological update: July 20, 2021).1 Although initially the main concern focused on the risk of pneumonia progressing to acute respiratory distress syndrome with high mortality,2 there are increasing reports of cardiovascular manifestations and thrombotic complications following COVID-19.3 The prognosis is worse in patients with COVID-19 who have these complications, highlighting an acute need to determine the magnitude of cardiovascular complications and identify populations at risk.4
We identified only one study that used the self-controlled case series method to calculate the incidence rate ratio of acute myocardial infarction and ischaemic stroke following COVID-19 and found increased risks of both acute myocardial infarction and ischaemic stroke in the first 2 weeks following COVID-19. Furthermore, two studies were identified that used the retrospective cohort study and retrospective case-control method to determine the risk of ischaemic stroke following COVID-19. A retrospective cohort study compared patients with COVID-19 with patients with influenza. The odds of stroke following COVID-19 was greater than the odds following influenza. A small (n=41) retrospective case-control study found patients with COVID-19 being associated with increased odds of acute ischaemic stroke. Current evidence focusing on the association between COVID-19 and cardiovascular complications is based on small studies, and includes mainly hospitalised patients (ie, those with severe disease), therefore presenting a high risk of bias.
The evidence indicates that acute cardiovascular complications might represent an essential clinical manifestation of COVID-19 and the long-term effects might be a challenge for the future. These findings could change clinical practice and warrant a prioritisation of preventive and diagnostic strategies, which can affect treatment and, therefore, reduce the burden of morbidity and mortality in this patient group."
Source: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)00896-5/fulltext
Commentary: What we are starting to see play out is a legion of health issues that follow in the wake of COVID-19 - cognitive impairment, heart and lung issues, erectile dysfunction, etc. Vaccination right now is the only way to prevent these issues at a large scale that's sustainable; we can't ask everyone to wear masks for the remainder of their lives and expect compliance.
What this means for everyone is that our healthcare systems will see increased burdens in the months and years to come as we see the long-tail effects of COVID-19. It may well have created an entire generation of people with disabilities, which will be a burden on healthcare systems everywhere. In nations lacking universal healthcare, it will likely create an entire population of significantly disabled people, further straining social infrastructure.
---
COVID-19 is a long war. "n May, when the CDC said fully vaccinated people could ditch masks and social distancing, it seemed to signal a return to normalcy. But epidemiologists cautioned at the time that the move wasn’t likely to be permanent, and shouldn’t be interpreted as the end of Covid-19 as a daily concern. Colder weather or a right hook in the virus’s evolution could bring restrictions right back.
Still, Americans seem shocked by the recent turn of events. Last week, the Centers for Disease Control and Prevention advised everyone — even those who’ve gotten Covid-19 shots — to go back to indoor masking, a decision driven by new data showing the hyper-contagious Delta variant colonizes the nose and throat of some vaccinated people just as well as the unvaccinated, meaning they may just as easily spread this new version of the virus, while stilling being protected against the worst manifestations of the disease.
The prospect of contending with a prolonged outbreak phase — and adjusting again to a constantly evolving roster of restrictions — has brought back another feature of pandemic living in America: anger.
This time it’s not just the mostly Republican anti-masking refrain rearing its defiant head (though fights over school mask mandates have returned with a vengeance). Coast to coast, and across the political spectrum, contempt for unvaccinated people is rising. “It’s the unvaccinated folks that are letting us down,” Alabama Governor Kay Ivey, a Republican, said on July 22, as her state, with one of the lowest vaccination rates in the country, reeled from a 530% rise in Covid-19 hospitalizations in just three weeks.
Among the vaccinated, there’s a sense that the freedoms they gained by getting the shots — travel, eating out, concerts, sports, school, seeing friends — are now being jeopardized by those who are still holding out.
Epidemiological researchers like Emory University’s Jennie Lavine have turned to models to try to project when SARS-CoV-2 might transition from pandemic pathogen to endemic. In a paper published in Science, Lavine and her co-authors predicted that this transition might take anywhere from a few years to a few decades, depending on how quickly the pathogen spreads and how widely vaccines are adopted."
Source: https://www.statnews.com/2021/08/02/belated-realization-that-covid-will-be-a-long-war-sparks-anger-denial/
Commentary: It's beyond living memory for me and anyone I know, but did people back in the 1930s and 1940s expect the Second World War to be over in a year?
---
Don't lie. "Two travelers trying to enter Toronto from the USA were each fined nearly $20,000 after providing false information related to proof of vaccination and pre-departure coronavirus tests, according to Canadian officials.
The travelers tried to enter during the week of July 18, the Public Health Agency of Canada said in a news release. They provided false information and were found noncompliant with the requirement to stay at a government-authorized accommodation and test upon arrival, according to the release.
They each received four fines totaling $19,720, officials said.
Travel restrictions for vaccinated Americans wanting to enter Canada are set to ease in August, but the country continues to enforce strict requirements for entry.
Canadian citizens, permanent residents of Canada, people registered under the Indian Act and protected persons can enter Canada but must show a negative coronavirus test. Most travelers must quarantine 14 days upon arrival. Dual Canadian citizens can enter with a valid passport or special authorization. "
Source: https://www.usatoday.com/story/travel/destinations/2021/07/31/canada-travelers-fined-20-k-falsifying-covid-vaccination-credentials/5442379001/
Commentary: They're lucky they weren't fined to the fullest extent of the law; they could have been fined up to US$750,000 each.
---
Deer are a reserve. "On Wednesday, the US Department of Agriculture released some rather disturbing news: a survey of wild deer populations has found that large numbers of the animals seem to have been exposed to SARS-CoV-2, the virus that causes COVID-19. The finding indicates that there's a very large population of wild animals in North America that could serve as a reservoir for the virus, even if we were to get its circulation within the human population under control.
Why check deer in the first place? The USDA's Animal and Plant Health Inspection Service is studying a variety of species "to identify species that may serve as reservoirs or hosts for the virus, as well as understand the origin of the virus, and predict its impacts on wildlife and the risks of cross-species transmission." This is the same group that identified the spread of the virus to a wild mink in 2020.
Using a captive deer population, the USDA had already determined that deer can be infected by the virus, although the animals display no symptoms. So although direct interactions between deer and humans are relatively limited, checking the wild populations made sense. The USDA checked populations in a total of 32 counties in four different states, obtaining blood samples to look for antibodies specific to SARS-CoV-2."
Source: https://arstechnica.com/science/2021/07/over-half-the-deer-in-michigan-seem-to-have-been-exposed-to-sars-cov-2/
Commentary: Like mink, cats, and other animals who can catch COVID-19, these deer are acting as a disease reservoir. Knowing they can be infected means we have to keep an eye on these animal populations and where they interact with humans, make sure preventative measures are in place. For example, if you hunt deer, make sure you're fully vaccinated, because hauling an infected deer around can still transmit infection to some degree.
---
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 other people, 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 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. Get your personal finances in order now. Cut all unnecessary costs.
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:
---
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
---
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.
---
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.