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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Wear the best mask available, properly. "We recruited COVID-19 cases to give blood, saliva, mid-turbinate and fomite (phone) swabs, and 30-minute breath samples while vocalizing into a Gesundheit-II, with and without masks at up to two visits two days apart. We quantified and sequenced viral RNA, cultured virus, and assayed sera for anti-spike and anti-receptor binding domain antibodies.
We enrolled 49 seronegative cases (mean days post onset 3.8 ±2.1), May 2020 through April 2021. We detected SARS-CoV-2 RNA in 45% of fine (≤5 µm), 31% of coarse (>5 µm) aerosols, and 65% of fomite samples overall and in all samples from four alpha-variant cases. Masks reduced viral RNA by 48% (95% confidence interval [CI], 3 to 72%) in fine and by 77% (95% CI, 51 to 89%) in coarse aerosols; cloth and surgical masks were not significantly different. The alpha variant was associated with a 43-fold (95% CI, 6.6 to 280-fold) increase in fine aerosol viral RNA, compared with earlier viruses, that remained a significant 18-fold (95% CI, 3.4 to 92-fold) increase adjusting for viral RNA in saliva, swabs, and other potential confounders. Two fine aerosol samples, collected while participants wore masks, were culture-positive.
SARS-CoV-2 is evolving toward more efficient aerosol generation and loose-fitting masks provide significant but only modest source control. Therefore, until vaccination rates are very high, continued layered controls and tight-fitting masks and respirators will be necessary."
Source: https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciab797/6370149
Commentary: It's no surprise that the virus has evolved to escape some protective measures. We've been saying for a while that variants - especially Delta - spread farther and faster. That they work around low quality masks is no surprise either - smaller particles have an evolutionary advantage.
This is why masking and vaccination is so important. The disease has to be tamped down before it can evolve faster than our protective measures.
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New data suggests 2 shots of J&J. "A two-dose version of Johnson & Johnson's coronavirus vaccine provides 94% protection against symptomatic infection, the company said Tuesday -- making a two-dose regimen of J&J's Janssen vaccine comparable to a two-dose regimen of Moderna's or Pfizer's.
Plus, the company said, adding a booster dose to a single shot of the vaccine raised immunity even more, and should also protect people strongly against infection.
The company released some details of three studies looking at various aspects of its Janssen vaccine, and said that, taken together, they showed the vaccine provided long-lasting protection that could be boosted with an extra shot.
Johnson & Johnson's single-dose vaccine was given emergency use authorization by the US Food and Drug Administration on February 27. It has been given to about 14.8 million Americans, according to the US Centers for Disease Control and Prevention.
The company's ongoing Phase 2 trial of a two-dose regimen showed giving two doses 56 days apart provided 100% protection against severe Covid-19 and 94% protection against moderate to severe Covid-19 in the United States. Globally, the two-dose regimen provided 75% protection against moderate-to-severe Covid-19, the company said.
A second study showed people given a booster shot six months or longer after their first dose had a 12-fold increase in antibodies -- compared to a four-fold increase for people who got a second dose at two months. So protection should be stronger if people get boosters later, Dr. Dan Barouch, head of Beth Israel Deaconess' Center for Virology and Vaccine Research, told CNN.
"If you wait longer and have boost at six months or later then you likely will have better boost," said Barouch.
Third, the company said a real-world evidence study of 390,000 people in the US, using health insurance records through July -- so covering the Delta variant -- showed the one-shot J&J vaccine was 81% effective at preventing hospitalizations."
Source: https://www.cnn.com/2021/09/21/health/johnson-vaccine-two-doses-booster/index.html
Commentary: We've been waiting for a while to hear about J&J. No surprise the booster helps bolster immunity. That said, I would contact your physician or healthcare provider about a booster from a heterogenous source - i.e. an mRNA vaccine.
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Deadlier than the flu. "The Covid-19 pandemic has become the deadliest disease event in American history, with a death toll surpassing that of the 1918 Spanish flu.
The Spanish flu was previously the disease event that caused the biggest loss of life in the United States; the Centers for Disease Control and Prevention estimate that 675,000 Americans died during the 1918 pandemic, in waves of illness that stretched out over roughly two years in this country.
According to STAT’s Covid-19 Tracker, Covid deaths stand at more than 675,400.
“In terms of raw numbers of deaths, that’s a high number,” said Howard Markel, director of the Center for the History of Medicine at the University of Michigan School of Public Health. “And it’s higher still than it should have been, frankly.”
U.S. deaths make up roughly 14% of the nearly 4.7 million fatalities that have been reported worldwide in this pandemic to date, even though the country’s population comprises only about 4.2% of the global population."
Source: https://www.statnews.com/2021/09/20/covid-19-set-to-overtake-1918-spanish-flu-as-deadliest-disease-in-american-history/
Commentary: Is anyone surprised?
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"Ummmm—please don’t take ivermectin via tampon insertion. I am not aware of any study or medical organization recommending that ludicrous idea. But feel free to correct me. I kinda feel vaccination is maybe way easier? #COVID19"
Source:
Commentary: I just... I don't even know what to say. If you want to shove something in your body... try a vaccine. Bonus, you don't need to take a vaccine with a tampon, it just goes in your arm.
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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.