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.
---
Happy Groundhog Day to the Groundhog year that is COVID-19. If you're unfamiliar with the reference, it's a 1993 movie in which the protagonist repeats the same day for approximately 33 years.
---
Alarming in-vitro results on E484K. "We generated 'pseudo' viruses bearing the Spike protein of SARS-CoV-2 that had all 8 B.1.1.7 mutations + E484K. We mixed virus with sera from vaccinated individuals (Pfizer) Overall, E484K substantially increases the amount of serum antibody needed to prevent infection of cells."
Source:
Commentary: Many of the new strains - B.1.1.7, B.1.351 - don't have a noticeable change in immune response, just transmissibility. But the P.1 and P.2 lineages with the E484K mutation have shown immune response diminishment in tests. This new test demonstrates in a lab setting that the diminishment is quantifiable.
The concerning scenario is a mutation that picks up the B.1.1.7/B.1.351 transmissibility combined with the P.1 reduction in immune effectiveness. Should a strain like that emerge, we will have a much harder time controlling the pandemic. How likely is that? If the B.1.1.7 strain becomes prevalent in a nation that poorly controls the pandemic - say, the United States - and a haphazard vaccination program is in play, then the E484K mutation could occur within a B.1.1.7 lineage strain, giving the virus two survival advantages instead of one.
---
Creating a misinformation vaccine? "However, rather than only “vaccinating” people against individual examples of misinformation, we instead focus on the more general ways in which people are misled – manipulation techniques such as the use of excessively emotional language, the construction of conspiracy theories, and the false testimony of fake experts.
To do so, we developed a series of online games in which players learn how misinformation works from the inside by being encouraged to create their own fake news: Bad News (about misinformation in general), Harmony Square (about political misinformation) and Go Viral!, which is specifically about misinformation around COVID-19.
Research has shown that a powerful way to induce resistance to persuasion is to make people aware of their own vulnerabilities. In our games, players are forewarned about the dangers of fake news and encouraged to actively generate their own antibodies through gradual exposure to weakened examples of misinformation in a simulated social media environment.
When we assessed the success of these projects, we found that playing a misinformation game reduces the perceived reliability of misinformation (even if participants had never seen the misinformation before); increases people’s confidence in their ability to assess the reliability of misinformation on their feed; and reduces their self-reported willingness to share misinformation with other people in their network. We also found that similar inoculation effects are conferred across cultures and languages."
Source: https://theconversation.com/covid-19-misinformation-scientists-create-a-psychological-vaccine-to-protect-against-fake-news-153024
Commentary: The game is a fun romp as you create chaos and disorder in a simulation. It's worth a play!
Play the game here: https://www.goviralgame.com/en
---
The Oxford/AstraZeneca vaccine shows single-dose efficacy at 76% after 3 months. "17,177 baseline seronegative trial participants were eligible for inclusion in the efficacy analysis, 8948 in the UK, 6753 in Brazil and 1476 in South Africa, with 619 documented NAAT +ve infections of which 332 met the primary endpoint of symptomatic infection >14 days post dose 2.The primary analysis of overall vaccine efficacy >14 days after the second dose including LD/SD and SD/SD groups, based on the prespecified criteria was 66.7% (57.4%, 74.0%). There were no hospitalisations in the ChAdOx1 nCoV-19 group after the initial 21 day exclusion period, and 15 in the control group.Vaccine efficacy after a single standard dose of vaccine from day 22 to day 90 post vaccination was 76% (59%, 86%), and modelled analysis indicated that protection did not wane during this initial 3 month period. Similarly, antibody levels were maintained during this period with minimal waning by day 90 day (GMR 0.66, 95% CI 0.59, 0.74).In the SD/SD group, after the second dose, efficacy was higher with a longer prime-boost interval: VE 82.4% 95%CI 62.7%, 91.7% at 12+ weeks, compared with VE 54.9%, 95%CI 32.7%, 69.7% at <6 weeks. These observations are supported by immunogenicity data which showed binding antibody responses more than 2-fold higher after an interval of 12 or more weeks compared with and interval of less than 6 weeks GMR 2.19 (2.12, 2.26) in those who were 18-55 years of age.
Interpretation: ChAdOx1 nCoV-19 vaccination programmes aimed at vaccinating a large proportion of the population with a single dose, with a second dose given after a 3 month period is an effective strategy for reducing disease, and may be the optimal for rollout of a pandemic vaccine when supplies are limited in the short term."
Source: https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3777268
Commentary: Like the J&J vaccine, the Oxford/AstraZeneca vaccine shows good efficacy - 76% at preventing disease - but critically, stopped 100% of hospitalization or deaths within 21 days. And like the J&J vaccine, the Oxford/AstraZeneca vaccine requires only basic refrigeration and a single dose, which means we have another tool in the toolkit for blunting the impact of the pandemic.
---
Who's spreading the disease most? People 20-49, at least in the United States. "As of October 2020, individuals aged 20-49 were the only groups sustaining COVID-19 transmission with reproduction numbers well above 1 in the US.
Following initial declines, numbers of COVID-19 cases started to rise again halfway through 2020 in the United States and Europe. In September the team published Report 32 as a pre-print, using age-specific mobility data from across the United states and linking these to age-specific COVID-19 mortality. Their findings pointed out that targeting interventions to adults aged 20-49 could facilitate safe reopening of schools and kindergartens.
The peer reviewed publication in Science today by the Imperial College COVID-19 Response team includes new data up to October 2020. The updated analysis of aggregated age-specific mobility data from more than 10 million individuals in the US, shows that 65 of 100 COVID-19 infections still originated from individuals aged 20-49 in the US.
Across the US as a whole, the mobility trends indicate substantial initial declines in venue visits (such as visit by an individual to locations like supermarkets and restaurants) followed by a subsequent rebound for all age groups. In contrast with the large fluctuations in the share of age groups among reported COVID-19 cases, the study describes the share of age groups among the observed COVID-19 deaths remarkably constant."
Source: https://www.imperial.ac.uk/news/213954/us-covid-resurgence-driven-younger-adults/
Commentary: This isn't terribly surprising news. One of the key topics of discussion after the pandemic is over will be to determine how to improve public health messaging to achieve greater compliance, at least in nations with substantial compliance issues like the United States.
---
The source of the claim that Groundhog Day covers 33 years: https://whatculture.com/film/just-how-many-days-does-bill-murray-really-spend-stuck-reliving-groundhog-day
---
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 or better mask if you can obtain 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. How to properly fit a mask:
---
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
---
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.