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.
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Dr. Scott Gottlieb from the weekend circuit, on projections: "I think we're seeing it right now we're seeing a near term peak in terms of the number of New Delhi cases. Now, unfortunately, deaths and hospitalizations will continue to grow over the next two or three weeks, because they're a lagging indicator. But we'll see continued declines probably for about four weeks, maybe five weeks, until this new variant starts to take over. Right now this new variant is about point 5% of all infections nationally, there's hotspots in Southern California and Florida that may be closer to 1%. But it's going to double every week. So it's about doubling every week. That's the experience from other countries. And that's the experience we've seen so far in the United States. So it's 1%. Now, there'll be 2%, and 4%, and 8%, and 16%, then 32%. So in about five weeks, this is going to start to take over the only backstop against this new variant is the fact that we will have a lot of infection by then. So there'll be a lot of immunity in the population, and we will be vaccinating more people. But this really changes the equation. And I think what we're looking at is a relentless strike from this virus heading into the spring, whereas infections really would have started to decline in the spring would have had a quiet spring, we could have persistently high levels of infection in the spring until we finally get enough people vaccinated.
Well, Illumina the company that I'm on a board of is doing a lot of the sequencing work right now. And unfortunately, the sample is very small, we should be sampling about 5% of all the positive cases, we're doing a lot less than that we're doing well under 1%. We haven't found any of the B 1351 variant that's the South African and Brazilian variant, but we have just started looking for it. What we're finding is b 117. So it's about point three 2.5% of all infections as of this weekend data that's available right now. But it's going to increase and we've seen it double already week over week. So this information is available. aluminous tweeted some of it out there partner helix has tweeted some of it about some of it out there working with CDC on this. So the data is starting to be available. But as the CDC director said, we're not doing a lot of surveillance work right now. So we're probably not detecting the full scope of what's underway in this country."
Source:
Commentary: The new strains of SARS-CoV-2 are going to make for a very difficult spring. Let's hope the new administration, at least here in America, can live up to its goals of vaccinating 100 million people. By mid-year, that could put our immunity pool at roughly 50-60% of the population - short of the goal of 70% for true herd immunity, but a much better place to be.
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Incoming CDC Director Dr. Rochelle Walensky: "I think that, you know, we've, we've, as you noted, nearly 4000 deaths a day, almost 400,000 deaths total, by the middle of February, we expect half a million deaths in this country. That doesn't speak to the 10s of 1000s of people who are living with a yet uncharacterized syndrome after they've been recovered after they've recovered. And we still yet haven't seen the ramifications of what happened from the holiday travel from holiday gathering in terms of high rates of hospitalizations and the deaths thereafter. So yes, I think we still have some dark weeks ahead.
I will brief as often as I can I as often as new information comes. I also want to make sure that the subject matter experts at the Centers for Disease Control and Prevention who have been reading and reviewing the literature, understanding the science you hear from them. When there are new things to report you will hear from somebody at the CDC, and it may very well be me.
We have looked carefully and we are confident that we have enough vaccine for the 100 million doses over the next 100 days. That is what the President Elect has promised it will be a hefty lift, but we have it in us to do that. And in order to do that, we have to look at the supply for sure. We have to titrate and make sure that there are enough people getting vaccinated but not too many. It's to overwhelm the system. So looking at our eligibility, we have to make sure that there are enough vaccinators, I know that the President Elect has committed to use the defense production act to make sure that where there are any bottlenecks in that supply. "
Source:
Commentary: I'm just happy to see American administration officials allowed to talk to the press again. Leveraging the Defense Production Act to increase the speed at which companies produce vaccines and PPE is essential. The faster we can ramp up production of essentials, the faster we can end the pandemic.
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New mutations at K417N and E484K have evaded antibodies in some South African studies. "People who have recovered from SARS-CoV-2 infection are usually protected from being infected a second time (called re-infection). This is because they develop neutralizing antibodies that remain in their blood for at least 5-6 months, maybe longer. These antibodies bind to specific parts of the spike protein that have mutated in the new variant (K417N and E484K mentioned above). We now show that these mutations have allowed the virus to become resistant to antibody neutralization.
The blood samples from half the people we tested showed that all neutralizing activity was lost. This suggests that they may no longer be protected from re-infection. In the other half, the levels of antibodies were reduced and so the risk of re-infection is not known. It is therefore important that people who have previously had COVID-19 continue to adhere to public health measures. Protecting ourselves through masks, regular washing or sanitising of hands, cleaning of surfaces, and social distancing remain the best defense against all SARS-CoV-2 viruses, including the new lineage."
Source: https://www.nicd.ac.za/wp-content/uploads/2021/01/New-Variant-of-SARS-CoV-2_Frequently-Asked-Questions_v10_18-January-2021.pdf
Commentary: This report is concerning; the E484K mutation has been suspected of being able to evade some antibody responses, but this is the first report I've seen of it evading all neutralizing activity.
The message here is clear: for everyone who's had COVID-19 or had the vaccine, continue to observe precautions. Pretend you've never had it and wear a mask, always, outside your home. Stay away from others as much as you can.
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Why are we hearing about new strains so much? "Early on in the pandemic, a mutation known as D614G seems to have given the virus a boost in its infectiousness, and variants with the mutation became the most prevalent around the world.
Beyond the fact that the virus is constantly changing, there are other reasons why these “fitter” variants have started to emerge. In the early days of the pandemic, when just about all of us were vulnerable to Covid-19, any infectious variant had a pretty easy time circulating. But as more people in certain areas have become protected — either after an initial infection or vaccination — pressure on the virus has increased. A so-so spreader might no longer be able to find new hosts (that’s us) to infect, but variants with mutations that help them spread can still transmit, and can take off from there.
“We’ve reached a point one year on and in certain parts of the world where the density of natural immunity is sufficient so that the variants that have got a fitness advantage … are more likely to emerge and spread,” said Wendy Barclay, the head of infectious diseases at Imperial College London.
The variant that first appeared in the U.K. — and perhaps others as well — is a bit of a special situation. Most people who have an acute case of Covid-19 will vanquish the virus after a relatively short period of time. But it’s thought that this variant, dubbed B.1.1.7, came from a person who was immunocompromised and had a rare chronic case, essentially providing an incubator for the virus to accrue mutations as it replicated for weeks or months in that person’s body. The virus, the hypothesis goes, then spread from that person to others."
Source: https://www.statnews.com/2021/01/19/coronavirus-variants-transmissibility-disease-reinfection/
Commentary: The penalty for allowing rapid spread of the disease is increased mutation. The more people the virus transits through, the faster it changes and adapts. That's another reason to control the spread as much as possible.
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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.
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:
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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
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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.