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.
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PSA for Americans: Vote if you haven't already done so. Is it safe to vote in person? If you wear a mask, keep your distance, minimize your time indoors, and sanitize your hands before and after voting, absolutely. It's no more dangerous than going to the grocery store. Wear the best mask available to you.
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Dr. Scott Gottlieb: "Things are getting worse around the country. I think Thanksgiving is really going to be an inflection point, I think December is probably going to be our toughest month. But when you look at what's happening in states right now, you're seeing a accelerating spread. We're right at the beginning of what looks like exponential growth in a lot of states, the Midwest, the Great Lakes region, even states like Texas, where you see 6000 cases, Illinois, 8000 cases, Florida 5000 cases, Wisconsin 5000 cases reported Friday, these are very worrisome trends. There are about 23 states right now that are accelerating the spread. Right now there's the positivity rate is above 10% in 15 states, and all the states have an are above one, which means that they're an expanding epidemic right now. So this is very worrisome as we head into the winter.
I think the facts are going to overtake any political dialogue very quickly. I think as we get into the next two or three weeks, it's going to be unmistakable. What's happening around the country. And we're going to have to start taking tough steps, I don't think we're going to lock down like Europe is right now and Europe has a very dense epidemic.
I don't think the political support is here for that (lockdowns) even at a state level, I think you're going to see targeted mitigation states take local actions, but we're going to have to start taking more aggressive actions. Probably my view is the inflection point is going to be Thanksgiving, you can see cases build over the next three weeks."
Source:
Commentary: Exponential growth is not the phrase you want to hear around disease. It's a concept we struggle with mathematically, because it's so hard to imagine. 1 doubling to 2 doesn't seem like a big deal, but 512 doubling to 1024 is. In a very short period of time, exponential growth can overwhelm nearly anything. If I start by giving you a penny, and double it every day, how many days will it take before you're a millionaire?
The answer: 28 days. That's it. That's the power of exponential growth and why we have to do everything we possibly can to stop the spread of COVID-19 all around the world.
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Dr. Fauci: "Whenever we looked around at what other countries have done, and even individual situations in our own country. There's no doubt that masking and as I made the title of our paper in JAMA I would and other low tech type in interventions, if you've, if you put masking with keeping distances and avoiding congregate set, adding in crowds and trying to do thing outdoors more than indoors, it makes a difference. It really, really does. Would you know, I mean, we don't want to shut down completely. I mean, that's almost radioactive. Now when you say that, because of the situation, I'm not wanting to hurt the economy, well, if you don't want to shut down, at least do the fundamental basic things, which are really the flagship of which is wearing a mask. And that's the reason why we've got to do what we can have this very inconsistent wearing that you see, we see some states that absolutely refuse to wear a mask. And as we've said, on our broadcast in previous times, how would it almost becomes a political statement? We've got to get away from that.
I mean, that's the thing that we have to sort of shake each other by the collar and say, take a look at what's going on. Look at the data, it speaks for itself, we're in a very difficult situation. And countries that have done it the other way, have done it and been successful. So let's put aside these extraordinary excuses for not doing it. When we're dealing with a situation, that's not trivial. You know, we have 225,000 deaths, the modeling tells us we're going to get 100 or more thousand as we get into the winter."
Source:
Commentary: An extra hundred thousand deaths. What we're seeing around the world is a test of the beliefs in science, nation by nation. Those nations who put data, facts, and science at the forefront have controlled their infections far more successfully than those who have not. If you want this pandemic to end sooner rather than later, elect leaders who believe in data, facts, and science.
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Herd immunity driven by bots? "For months, debates about so-called herd immunity have occurred internationally. The idea behind this herd immunity strategy is to shield vulnerable populations while allowing COVID-19 transmission to go uncontrolled among less vulnerable populations. This strategy has been dismissed by many scientists for several ethical and practical reasons, such as the large size of vulnerable populations in countries like the US, and a lack of full understanding of longer-term impacts of SARS-CoV-2 on lower-risk groups. However, the conversation has increased in support, partially due to the embrace of the concept by a senior advisor to President Trump, Dr. Scott Atlas, who has called for the US to attempt the strategy. Support for the strategy has been outlined by a small group of public health scientists in the Great Barrington Declaration.
On the other side of the debate, prominent scientists like Dr. Fauci have called herd immunity through natural infection “dangerous” and “nonsense”. Infectious disease experts speculate this strategy could result in two million unnecessary deaths. Another group of scientists have recently published a correspondence in the Lancet, as well as an accompanying John Snow Memorandum, as an alternative to the Great Barrington Declaration.
Approximately half of the profiles pushing the case for herd immunity are artificial accounts. These bot or bot-like accounts are generally characterized as engaging in abnormally high levels of retweets and low content diversity.
The high level of bot-like behavior attributed to support for the Great Barrington Declaration on social media indicates the conversation is manipulated and inorganic in comparison to the scientific consensus-based conversation opposing herd immunity theories. A consequence of high frequency of inorganic activity is the creation of a majority illusion (when certain members within a social network give the appearance that an idea or opinion is more popular than it is)."
Source: https://fas.org/blogs/fas/2020/10/social-media-conversations-in-support-of-herd-immunity-are-driven-by-bots/
Commentary: This is an excellent analysis, and could be crucial evidence should nations ever choose to hold social networks accountable for their users. A bot network dissuading citizens from listening to science-based evidence is no different than a biological warfare weapon, and that's a weapon of mass destruction under most international treaties.
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Undercounts in the US. "As rapid coronavirus tests are becoming more widely available, delivering results in minutes for patients in doctor's offices, nursing homes, schools and even the White House, officials warn of a significant undercount, blurring the virus's spread nationally and in communities where such tests are more commonly used.
Public health officials say that antigen tests, which are faster than polymerase chain reaction (P.C.R.) tests but less able to detect low levels of the virus, are an important tool for limiting the spread of the coronavirus. But they caution that with inconsistent public reporting, the case undercount may worsen as more “point-of-care” antigen tests, as well as D.I.Y. and home test kits, come on the market.
“We want to be sure that we’re not now saying, ‘there’s no disease,’ when there is lots of disease. All that’s happened is that the science with which we identify it has evolved,” said Janet Hamilton, the executive director of the Council of State and Territorial Epidemiologists, the group that helps the Centers for Disease Control and Prevention define cases of the coronavirus.
Public health experts say that more coronavirus rapid testing will lead to more undercounting of coronavirus cases, even in states that attempt to count them publicly. What’s going on?
Despite C.D.C. guidance to report cases based on P.C.R. and antigen testing, Washington, D.C. and seven states don’t publicly share case counts for those with antigen positive tests, including California, New Jersey and Texas.
Another six states keep these tallies separate from their total case counts, and most of these report them less frequently.
The differences among states are due in part to each state’s comfort level with the rapid tests, which aren’t “confirmatory” like P.C.R. tests because they can miss low levels of the virus. Yet most states treat antigen positive cases or “probable” cases the same as “confirmed” cases, by following up with interviews and contact tracing. And a growing number of states, including New Mexico, Oregon and Utah, include individuals with positive antigen tests in their total confirmed case counts."
Source: https://www.nytimes.com/interactive/2020/11/01/us/antigen-testing.html
Commentary: This is part of why excess deaths are so high compared to official COVID-19 numbers. We're missing a lot of data - and that in turn means it's harder to forecast and project things like hospital capacity. Only a coordinated national response and agreement on which metrics to measure will solve this.
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COVID-19 deaths in El Paso have necessitated the construction of 4 mobile morgues.
Source:
Commentary: Expect to see many more stories like this over the next 2 months.
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A reminder of the simple daily habits we should all be taking.
1. Wash/sanitize your hands every time you are in or out of your home for any reason. Consider also spraying the bottoms of your shoes with a general disinfectant (alcohol/bleach/peroxide) when you return home. Remember that cleaners are NEVER to be ingested or injected.
2. Always wear a mask when out of your home and if going to a high risk area, wear goggles. Respirators are back in stock at online retailers, too.
3. 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.
4. Get your personal finances in order now. Cut all unnecessary costs.
5. Replenish your supplies as you use them. Avoid reducing your stores to pre-pandemic levels in case an outbreak causes unexpected supply chain disruptions.
6. Participate in your local political process. For Americans, go to Vote.org and register/verify your vote.
7. Ventilate your home as frequently as weather and circumstances permit.
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Common misinformation debunked!
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.