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.
---
Spike protein mutations likely do have an impact on antibodies. "Multiple SARS-CoV-2 vaccines have shown protective efficacy, which is most likely mediated by neutralizing antibodies recognizing the viral entry protein, Spike. Antibodies from SARS-CoV-2 infection neutralize the virus by focused targeting of Spike and there is limited serum cross-neutralization of the closely-related SARS-CoV. As new SARS-CoV-2 variants are rapidly emerging, exemplified by the B.1.1.7, 501Y.V2 and P.1 lineages, it is critical to understand if antibody responses induced by infection with the original SARS-CoV-2 virus or the current vaccines will remain effective against virus variants. In this study we evaluate neutralization of a series of mutated Spike pseudotypes including a B.1.1.7 Spike pseudotype. The analyses of a panel of Spike-specific monoclonal antibodies revealed that the neutralizing activity of some antibodies was dramatically reduced by Spike mutations. In contrast, polyclonal antibodies in the serum of patients infected in early 2020 remained active against most mutated Spike pseudotypes. The majority of serum samples were equally able to neutralize the B.1.1.7 Spike pseudotype, however potency was reduced in a small number of samples (3 of 36) by 5–10-fold. This work highlights that changes in the SARS-CoV-2 Spike can alter neutralization sensitivity and underlines the need for effective real-time monitoring of emerging mutations and their impact on vaccine efficacy."
Source: https://www.biorxiv.org/content/10.1101/2021.01.15.426849v1
Commentary: B.1.1.7 substantially evaded about 10% of samples by up to an order of magnitude. This is why speed is of the essence for rolling out vaccines. The sooner we can put out the fire, the better.
---
The United States rejoins WHO and the COVAX initiative. "A day after President Biden reinstated American ties with the World Health Organization, Dr. Anthony S. Fauci told the organization that the United States was committed to working closely with other nations to implement a more effective global response to the pandemic.
“Given that a considerable amount of effort will be required by all of us,” Dr. Fauci, the nation’s leading infectious disease expert, said via video link during a meeting of the group’s executive board, “the United States stands ready to work in partnership and solidarity to support the international Covid-19 response, mitigate its impact on the world, strengthen our institutions, advance epidemic preparedness for the future, and improve the health and well-being of all people throughout the world.”
Dr. Fauci said the United States would re-engage at all levels with the W.H.O. and intended to join Covax, a program set up by the agency to distribute vaccines to poorer nations."
Source: https://www.nytimes.com/live/2021/01/21/world/covid-19-coronavirus#fauci-who-covid
Commentary: At the start of the pandemic, the world used the tagline "We're in this together". It's nice to see the United Stats finally living up to that. We need access to all the data and technologies available, to evaluate their effectiveness, and then to distribute them to our people, as well as contribute what we've learned to the global pool of knowledge about COVID-19. More brains are better in this situation.
---
The UK warns that vaccines may not end the pandemic. "The vaccine rollout may not signal an immediate end to the Covid-19 epidemic, according to latest modeling from Imperial’s Covid-19 Response Team.
Interim results from the team’s model suggests that the timing of relaxing non-pharmaceutical interventions (NPIs), such as social distancing, while managing the impact on hospitals, will depend on the speed and uptake of the vaccine rollout.
Imperial’s researchers say that lifting Covid restrictions with the current number of hospital patients could lead to hospitals continuing to be overwhelmed for several weeks.
The researchers estimate that in all scenarios, full-lifting of restrictions before the summer will lead to prolonged and potentially multiple periods of pressure on hospitals, and substantial additional deaths.
The researchers say that partial lifting of NPIs before patient numbers in hospital have dropped significantly will have the same consequences.
The team say that Covid is currently overwhelming hospitals and there is a severe shortage in resources, including beds and staff. There are nearly 40,000 Covid patients currently in hospital and the researchers say that this number will take some time to fall significantly."
Source: https://www.imperial.ac.uk/news/212993/vaccines-signal-immediate-epidemic-researchers/
Commentary: The B.1.1.7 strain is having substantial negative impacts in the UK, defeating many of their countermeasures. We have a limited time to learn from their issues and adapt in other nations. Key things to do:
1. Assume that the variant is already in your locale.
2. Use the best mask available. It's looking more and more like cloth masks no longer cut it; surgical or N95/FFP2/KN95 are the way to go.
3. Strictly adhere to staying out of indoor places that aren't your home as much as possible. Shorter trips out. No discretionary trips. Absolutely no dining in or going to bars - eat and drink at home.
---
The 501Y.V2 strain escapes antibodies entirely. "SARS-CoV-2 501Y.V2, a novel lineage of the coronavirus causing COVID-19, contains multiple mutations within two immunodominant domains of the spike protein. Here we show that this lineage exhibits complete escape from three classes of therapeutically relevant monoclonal antibodies. Furthermore 501Y.V2 shows substantial or complete escape from neutralizing antibodies in COVID-19 convalescent plasma. These data highlight the prospect of reinfection with antigenically distinct variants and may foreshadow reduced efficacy of current spike-based vaccines."
Source: https://www.biorxiv.org/content/10.1101/2021.01.18.427166v1
Commentary: The paper highlights that reinfection with new strains is possible, and may also blunt existing vaccines. mRNA vaccines fortunately can be adapted relatively quickly, but this underscores a point many have been making repeatedly: vaccine or not, had it or not, pretend you've never been exposed to COVID-19 and protect yourself accordingly.
---
The US suspends evictions further. "As a protective public health measure, I will extend the current order temporarily halting residential evictions until at least March 31, 2021. The COVID-19 pandemic has presented a historic threat to our nation’s health. It has also triggered a housing affordability crisis that disproportionately affects some communities.
Despite extensive mitigation efforts, COVID-19 continues to spread in America at a concerning pace. We must act to get cases down and keep people in their homes and out of congregate settings — like shelters — where COVID-19 can take an even stronger foothold."
Source: https://www.cdc.gov/media/releases/2021/s0121-eviction-moratorium.html
Commentary: It's not just charity; the point about shelters and groups of people is the key. We need to diminish the size of infection reservoirs as much as possible, and that means prisons, homeless shelters, etc. - anywhere you pack a lot of people into a small space - needs to shrink in order to reduce the impact of mass infections.
---
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:
---
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
---
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.