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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An eighth coronavirus has jumped species. "As the world is dealing with a pandemic caused by one novel coronavirus that likely jumped from animals, researchers have identified another novel coronavirus from a child with pneumonia in Sarawak, Malaysia, in 2017-18, reports a study today in Clinical Infectious Diseases.
Dubbed CCoV-HuPn-2018, this new virus is the first canine coronavirus (CCoV) to ever be isolated from a human.
If CCoV-HuPn-2018 is confirmed as a pathogen, it would be the eighth known coronavirus to cause infection in humans.
Lead study author Anastasia Vlasova, DVM, PhD, of The Ohio State University, and her team used reverse transcription-polymerase chain reaction (RT-PCR) assays, cultured the virus in A72 canine cells, and pieced together the genome using the Sanger method. The article highlights their in-depth findings, but here are a few items of note:
First, the virus is a novel canine-feline recombinant alphacoronavirus, and it shares multiple genomic traits with the widespread CCoV-II. (SARS-CoV-2, the virus that causes COVID-19, is a betacoronavirus.)
Second, the N protein of CCoV-HuPn-2018 has a deleted portion, a mutation that has been seen only in the SARS-CoV human—but not bat—strains. (SARS-CoV causes SARS, or severe acute respiratory disease, which caused more than 8,000 human cases in 2003.)
Third, no mutations were found in the spike protein, which Vlasova says could indicate that certain strains of CCoV could already potentially infect humans."
Source: https://www.cidrap.umn.edu/news-perspective/2021/05/another-new-coronavirus-has-jumped-people
Commentary: There's nothing to panic about yet on this particular virus, but it highlights two very important things.
First, we need to ensure that we are appropriately funding disease surveillance around the world, so that when we detect new viruses or diseases that jump species, we are prepared and not caught unaware, as we were with COVID-19.
Second, animal-human crossover is going to happen as there are more humans on the planet. That's inevitable, which means there WILL be another pandemic with a novel disease. It's not a question of if, but when. So all that stuff you bought for COVID-19, extra masks, sanitizer, etc.? Don't throw it out. Put it safely away if you're not going to continue using it, but have it on hand for when the next big thing comes along. You won't regret it. I still use all my gear, but I've been using PPE for years now just for general life stuff. Having an N95 or better mask is a head-saver when you're dusting.
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Don't get antibody-tested if you've been vaccinated. "“The FDA is reminding the public of the limitations of COVID-19 antibody, or serology, testing and providing additional recommendations about the use of antibody tests in people who received a COVID-19 vaccination.
Antibody tests can play an important role in identifying individuals who may have been exposed to the SARS-CoV-2 virus and may have developed an adaptive immune response. However, antibody tests should not be used at this time to determine immunity or protection against COVID-19 at any time, and especially after a person has received a COVID-19 vaccination.
The FDA will continue to monitor the use of authorized SARS-CoV-2 antibody tests for purposes other than identifying people with an adaptive immune response to SARS-CoV-2 from a recent or prior infection.”"
Source: https://www.fda.gov/news-events/press-announcements/fda-brief-fda-advises-against-use-sars-cov-2-antibody-test-results-evaluate-immunity-or-protection
Commentary: Antibody tests are only to determine if someone had the natural disease. Don't ask your doctor for one to see if your vaccine worked.
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Signs that B.1.617.2 is outcompeting B.1.1.7 in the UK. "A new variant of coronavirus was detected in India last year and arrived in Britain this spring. Cases have grown quickly in recent weeks, particularly in Bolton. The viral geneticists call it B.1.617.2. The media call it the “Indian variant”. The government’s scientific advisers believe that 617.2 is more infectious than the “Kent variant”, B.1.1.7, which drove Britain’s deadly second wave through January. Indeed, 617.2 has started to outcompete 1.1.7 (see chart).
The majority of new cases being found in Britain are in teenagers. In the seven-day period to May 13th just four people per 100,000 aged between 85 and 89 tested positive in England. The equivalent number for 10-14 year olds was 46. Even though cases of 617.2 are growing proportionally, cases of coronavirus overall are flat. So are measures of hospitalisation and death. Whereas last week saw cases surge in Bolton and other places with clusters of infection, growth rates slowed through the beginning of this week and even declined in some areas.
The health service will struggle to deal with another covid-19 surge even if it comes with a lower rate of serious illness and death. Waiting lists for other conditions have grown long and staff morale is low. A surge would also pose risks to children’s education. Some schools in Bolton have already moved entire year groups back to online classes.
The world should keep an eye on Britain’s struggle with 617.2. The outbreak in Bolton has already shown that uneven vaccine coverage can offer new variants a foothold. For as long as understanding of the virus and its variants remains murky, a risk remains that any foothold can become a platform for exponential growth. That threatens everyone.■"
Source: https://www.economist.com/britain/2021/05/22/a-covid-variant-is-spreading-in-britain-but-this-time-is-different
Commentary: Vaccine coverage is essential - and the distribution matters. What you want is large numbers of vaccinated people evenly distributed through the population. Think of it like mixing rocks in with paper. The more rocks you evenly mix in, the harder it is for the thing as a whole to catch fire. What you don't want is a pile of rocks and a separate pile of paper. The paper will still catch fire just as easily - and that's what overwhelms hospitals. To do that, rich and poor, majority and minority, rural and city need even vaccination numbers.
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Brown University mandates vaccines for all. "PROVIDENCE, R.I. [Brown University] — In an effort to achieve near-universal COVID-19 vaccination on its campus and return to more traditional operations, Brown University will require all employees to receive the final dose of a COVID-19 vaccine by July 1.
The University will require that Brown students engaged in on-campus activity this summer receive the vaccine by the same date, as part of the student vaccination requirement communicated in April. Students who are currently away from campus but will return for the 2021-22 academic year must be vaccinated by the fall semester.
Brown President Christina H. Paxson outlined the requirements in a May 20 letter to faculty, staff and students. She wrote that strong evidence that authorized COVID-19 vaccines are safe and effective, and the wide availability of vaccines in Rhode Island, offer optimism that the ability to gather in-person on campus without masks and social distancing, and reduce or eliminate the need for routine COVID-19 testing, is near.
“Based on discussions with Brown’s public health and medical experts, it is clear that our priority should be to achieve near-universal levels of vaccination — 90% or greater — in the Brown community,” Paxson wrote. “People who are vaccinated are much less likely to get COVID-19. They are also less like to become seriously ill or spread the illness to others if they do contract the virus… The sooner we can achieve near-universal vaccination, the sooner we’ll be able to lift public health restrictions on campus and return to a more normal environment for teaching and research, with full confidence that the health of the community is being protected.”
After receiving the vaccine, all employees and students must verify their vaccination status by uploading their vaccination card. For both students and employees, medical and religious exemptions to Brown’s requirement will be granted and reasonable accommodations provided under applicable law."
Source: https://www.brown.edu/news/2021-05-20/campus-vaccination
Commentary: This is the way to go. While democratic governments cannot mandate vaccines (authoritarian governments can, of course), private businesses may choose to operate however they want.
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Rural USA vaccinations far below urban. "While much of the focus during the covid-19 pandemic has centered upon urban centers, the reality is that case incidence in rural America surpassed that in cities as early as September of 2020. And it's not an insignificant number of people who reside in these less populous areas, as 60 million people (or nearly 20 percent of the US population) call them home. With this rise in covid-19 cases has come increased morbidity and mortality, and a greater focus on the clear healthcare disparities that exist by virtue of geography, among other well-documented factors.
These disparities are also playing out in emerging vaccination data. According to a new study released by the US Centers for Disease Control and Prevention, Morbidity and Mortality Weekly Report, the agency's internal medical journal, US adults living in rural areas were vaccinated at a far lower rates those living urban centers (39 percent versus nearly 46 percent). Furthermore, of those who did manage to receive vaccinations outside of cities, 15 percent actually had to leave their county of residence in order to get a shot. These data were collected from 49 states and the District of Columbia at the county level between mid-December and early April (only Hawaii was entirely excluded due to data-sharing restrictions).
These findings highlight a number of issues. Namely, there are multifactorial reasons contributing to lower healthcare access outside of urban centers, including lack of health insurance, frequency of medical comorbidities, aging populations, "and medical deserts" (which are regions with inadequate healthcare facilities and workforces to match the population). In particular, the fact that so many Americans had to travel to adjacent counties, or even further, is particularly startling. Of the many healthcare improvements are needed in the US, decreasing this disparity of basic medical services for rural communities should be high on the list."
Source: https://brief19.com/2021/05/20/brief
Commentary: These rural pockets are problematic for two reasons - first, healthcare in rural areas is already stretched thin, and second, it creates the aforementioned pockets where the disease can run rampant and mutate.
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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, 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. Get vaccinated as soon as you're able to, and fulfill the full vaccine regimen.
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. Masks must fit properly to work. Here's how to properly fit a mask:
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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/
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
To be clear, 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.