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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Delta confirmed spreading via vaccinated people. "A preliminary study has shown that in the case of a breakthrough infection, the Delta variant is able to grow in the noses of vaccinated people to the same degree as if they were not vaccinated at all. The virus that grows is just as infectious as that in unvaccinated people, meaning vaccinated people can transmit the virus and infect others.
Previous studies in hospitals in India; Provincetown, Massachusetts; and Finland have also shown that after vaccine breakthrough infections with Delta, there can be high levels of virus in people’s nose whether they are vaccinated or not. The next logical step was to determine whether vaccinated people could shed infectious virus. Many experts suspected they did, but until this study it hadn’t been proven in the lab.
“We're the first to demonstrate, as far as I'm aware, that infectious virus can be cultured from the fully vaccinated infections,” says Kasen Riemersma, a virologist at University of Wisconsin who is one of the authors of the study.
“Delta is breaking through more preferentially after vaccines as compared to the non-Delta variants” because it’s extremely infectious and evades the immune response, says Ravindra Gupta, a microbiologist at University of Cambridge. Gupta’s lab was one of the first to document that fully vaccinated healthcare workers could get infected with Delta and had high levels of virus in their noses.
If the Wisconsin study finding holds up, then people with breakthrough infections—many of whom do not develop COVID symptoms—can unknowingly spread the virus. “It [is] an alarming finding,” explains Katarina Grande, a public health supervisor and the COVID-19 Data Team Lead of Madison & Dane County, who led the study.
What concerns Eric Topol, the founder and director of the Scripps Research Translational Institute, is that fully vaccinated individuals who are infected with the Delta variant can transmit the virus and this can happen at a higher rate than previous strains in the days before symptoms, or in the absence of symptoms. “Which is why masks and mitigation measures are important, even for people [who are] vaccinated,” he says."
Source: https://www.nationalgeographic.com/science/article/evidence-mounts-that-people-with-breakthrough-infections-can-spread-delta-easily
Commentary: The bottom line is simple: wear the best mask available to you anyplace you're going to be around other people. You don't need a mask if you're walking alone in the woods. You don't need a mask if you're on a sailboat by yourself in the middle of the ocean. But any time you're around people you don't live with, mask up.
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Mutations will continue to improve. "As the world grapples with the hyper-infectious Delta coronavirus variant, scientists are racing to understand the biological basis for its behaviour.
A slew of studies has highlighted an amino-acid change present in Delta that might contribute to its swift spread. Delta is at least 40% more transmissible than is the Alpha variant identified in the United Kingdom in late 2020, epidemiological studies suggest.
“The key hallmark of Delta is that transmissibility seems to be ramping up to the next notch,” says Pei-Yong Shi, a virologist at the University of Texas Medical Branch in Galveston. “We thought Alpha was pretty bad, very good at spreading. This one seems to be even more.”
Shi’s team and other groups have zeroed in on a mutation that alters a single amino acid in the SARS-CoV-2 spike protein — the viral molecule responsible for recognizing and invading cells. The change, which is called P681R and transforms a proline residue into an arginine, falls within an intensely studied region of the spike protein called the furin cleavage site.
“I think the virus is succeeding on volume and speed,” says Whittaker. “It’s become a much more efficient virus. It’s going through people and going through cells a lot quicker.”
Regardless of its role in Delta’s dominance, Whittaker and other scientists say, the mutation has underscored the importance of understanding changes in the coronavirus’s furin cleavage site. Whittaker doesn't expect P681R to be the last furin cleavage site mutation to cause concern. “I’m waiting to see what happens next.”"
Source: https://www.nature.com/articles/d41586-021-02275-2
Commentary: It is only a matter of time before another strain that incorporates the P681R mutation improves upon Delta's performance, either with immune evasion or even higher viral loads. We're in the bottom of the 7th inning and the other team has busted out an all-new all-star player who has evened the score. If we want to win the game, we have to bring back everything we were doing last year to contain the pandemic until vaccines arrived, while simultaneously vaccinating as many people planet-wide as possible to slow down the number of mutations.
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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. 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 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.