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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Moderna boost. "Moderna Inc (MRNA.O) said on Monday that a booster dose of its COVID-19 vaccine appeared to be protective against the fast-spreading Omicron variant of the coronavirus in laboratory testing and that the current version of the shot would continue to be its "first line of defense against Omicron."
The company said its decision to focus on the current vaccine, mRNA-1273, was driven in part by how quickly the recently-discovered variant is spreading.
Moderna said it still plans to develop a vaccine to protect against Omicron specifically and hopes to start clinical trials early next year.
"What we have available right now is 1273," Dr. Paul Burton, Moderna's chief medical officer, said in an interview. "It's highly effective, and it's extremely safe. I think it will protect people through the coming holiday period and through these winter months, when we're going to see the most severe pressure of Omicron."
Moderna's shares were down more than 4% at $282.26 in afternoon trading.
The company said a two-dose course of its vaccine generated low neutralizing antibodies against the Omicron variant, but a 50-microgram booster dose increased neutralizing antibodies against the variant 37 fold. A 100-microgram booster - the same strength as the original shots - drove neutralizing antibodies to more than 80 times pre-boost levels."
Source: https://www.reuters.com/business/healthcare-pharmaceuticals/moderna-says-booster-dose-its-covid-19-vaccine-appears-protective-vs-omicron-2021-12-20/
Commentary: If you have the option, get Moderna as your booster. If your healthcare provider permits it, consider getting a full dose instead of a booster if you work in a high risk profession.
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Situation in Germany. "Germany’s new expert council weighs in on #omicron:
"Due to the simultaneous, extreme number of patients, a considerable overload of the hospitals is to be expected - even in the unlikely case of significantly weakened disease severity compared to the Delta variant"
They call for:
- further measures to reduce contacts
- enforcing current measures
- intensifying vaccination and booster campaigns
"all models show that booster vaccinations alone do not adequately contain the omicron wave, but that additional contact restrictions are necessary"
Beyond political decisions, "the population must be called upon to actively control infections. This includes avoiding larger gatherings, the consistent, preferred wearing of FFP2 masks, especially indoors, as well as the increased use of rapid tests at gatherings…"
"Particularly vulnerable groups require increased protective measures through high-frequency testing and FFP2 masks.
In all decisions, interests of particularly stressed and vulnerable groups, such as children, young people or those in need of care, must be given top priority."
The experts “expect enormous challenges in the coming weeks and months, which will require joint and timely action from all.
In addition to consistent action, clear explanations are crucial."
"The omicron wave hits a population that has been exhausted by a nearly two-year pandemic and its control, and in which massive tensions are evident on a daily basis.”
Communication "with clear explanations of the new risk situation and the resulting measures is essential."
The committee of 19 experts includes scientists like @ViolaPriesemann, @CorneliaBetsch, @alena_buyx, @Sander_Lab and @c_drosten. They unanimously agreed to this text.
(My two cents:
Seems in line with the conclusions that countries sightly ahead of us in the omicron wave are reaching.
There is a lot of uncertainty, but by the time we’re certain it will be too late.
Good to see communication feature prominently in the opinion. Huge challenge!)
(Also worth remembering that Germany is in a worse position than countries like Norway, Denmark or UK in terms of immunity given comparatively low vaccination rate and low levels of immunity from infections.
Boostering quite fast though.)"
Source:
Commentary: FFP2 - aka N95 - masks are now the norm in many places because they are effective. Given the increased infectivity of Omicron, they are now the bare minimum.
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"1) New York #COVID19 record cases—deaths are quickly rising too. Broadway shows are cancelling abruptly again. I’m cancelling trips myself. The #Omicron wave will hit hospitals hard—pray for doctors, nurses & respiratory therapists over the holidays. #MaskUp #GetBoosted Stay safe 🙏
2) Just in - @CNN will be closing its US offices to most workers ASAP due to rising cases. I remember when CNN last did this suddenly in spring 2020 as NYC got hit real bad. This is very deja vu.
3) I’m switching from regular KN95 to N95 now in indoor places with other people— #Omicron is so contagious. Make sure your kids use a minimum KN95 or KF94 or FFP2 mask. I’ve been warning about this for over a year. But I’m upgrading to N95 now— see @projectn95 (no commission).
4) I have a really foreboding feeling again. For those who have followed me since Jan 2020, many of you know the difference when I’m cautiously worried and when I’m foreboding worried. I’m now at the latter again.
5) In spring 2020, @cyrushabib (when he was Lt Governor of Washington state) and I were writing a proposal for a national N95 govt mass production and distribution program — @ASlavitt did too. But I thought someday it will eventually roll it out—It’s sad it hasn’t yet—we need it!
6) My sources say that folks inside the CDC are whispering that #Omicron is now **as contagious or more contagious than MEASLES**. We epidemiologists have been muttering it for a week. I haven’t heard any CDC or govt official admit on 📺 yet. They should —people need to hear it.
7) based on the rate of Danish #Omicron vs Delta - @JPWeiland (and many others) have modeled Omicron to be anywhere from 4x to 6x more transmission advantage over Delta. Delta meanwhile has 2x R advantage over old Wuhan. Wuhan had an R0 of 3-4. Omicron is worrisome.
8) Let this sink in— worldwide cumulative #Omicron spiked up ⬆️ 31% in just **one day**. You can try to delude yourself that a slightly “milder” virus won’t kill many people — but only if you lie to yourself about how exponential math works.
9) Short lesson how exponential #Omicron math will work— even if we hypothetically set it extreme at 1/10th as lethal—but just merely 2x more contagious (ignoring it’s likely 4-6x)… you will ultimately have way more deaths even if 90% milder but more contagious—EXPONENTIAL MATH!
10) And it’s doubtful if that much milder, if at all. A 🇬🇧 study found no significant difference in severity for #Omicron vs Delta (odds ratio of 0.95). And the OR excluded anything remotely close to 1/10th the risk. “Milder” is not big driver versus exponential contagiousness!⚠️
11) "Some of my infectious disease colleagues say [#Omicron] appears to be as transmissible as diseases like measles" says Dr. David Reich of Mount Sinai Hospital— this buttresses what I’ve been saying and what I’m hearing from sources within govt.
12) Yes, this is what “as infectious as measles” would mean for #Omicron.
13) The only way a virus can be this damn contagious like #Omicron is if it’s highly airborne for rapid transmission. This is a good thread 🧵 below of what that means 👇— please ventilate and disinfect the air and wear PREMIUM masks. No more cloth please.
14) New York hospitals now no longer providing Monoclonal antibody therapies for #Omicron hospital cases— because several studies now show they don’t work against the new Omicron variant anymore. This is why I worry we are having a major reset moment in this pandemic.
15) here is the ominous announcement from @MountSinaiNYC hospital system suspending 2 monoclonal antibody drugs due to lack of efficacy against #Omicron. Many R state leaders rely and tout MABs drugs as a COVID strategy. "
Source:
Commentary: If Omicron is in fact as contagious as measles, then it is highly likely that the pandemic becomes endemic by early next year. At that level of contagiousness, there's really no escaping it unless you never interact with others. The best way to manage it is being fully vaccinated and boosted.
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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.
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.