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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Pregnant women, consult your physician but strongly consider getting vaccinated. "A total of 35,691 v-safe participants 16 to 54 years of age identified as pregnant. Injection-site pain was reported more frequently among pregnant persons than among nonpregnant women, whereas headache, myalgia, chills, and fever were reported less frequently. Among 3958 participants enrolled in the v-safe pregnancy registry, 827 had a completed pregnancy, of which 115 (13.9%) resulted in a pregnancy loss and 712 (86.1%) resulted in a live birth (mostly among participants with vaccination in the third trimester). Adverse neonatal outcomes included preterm birth (in 9.4%) and small size for gestational age (in 3.2%); no neonatal deaths were reported. Although not directly comparable, calculated proportions of adverse pregnancy and neonatal outcomes in persons vaccinated against Covid-19 who had a completed pregnancy were similar to incidences reported in studies involving pregnant women that were conducted before the Covid-19 pandemic. Among 221 pregnancy-related adverse events reported to the VAERS, the most frequently reported event was spontaneous abortion (46 cases).
Preliminary findings did not show obvious safety signals among pregnant persons who received mRNA Covid-19 vaccines. However, more longitudinal follow-up, including follow-up of large numbers of women vaccinated earlier in pregnancy, is necessary to inform maternal, pregnancy, and infant outcomes."
Source: https://www.nejm.org/doi/full/10.1056/NEJMoa2104983
Commentary: The key message is that there appears to be no statistical difference in pregnancy outcomes for women who are vaccinated versus women who are not. However, there's a flip side to this story making it much more compelling.
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COVID-19 22x more deadly to pregnant women. "Many would-be parents have been hesitant to start family planning in the covid-19 era, and according to a new study published in JAMA Pediatrics, this may be for good reason. It turns out that some anxiety around childbearing with covid-19 is well-founded: women infected with SARS-CoV-2 during pregnancy were found to be 22 times more likely to die than otherwise healthy pregnant women.
The authors of the new study compared pregnant women with and without covid-19 between March and October 2020 in 18 different countries, including the United States. Over 2,000 women were included in the study, of whom approximately one-third of whom were covid-19 positive.
It is increasingly understood that pregnancy carries a higher degree of risk in some parts of the world due to altered physiology during pregnancy, including suppressed immune systems. These changes leave women more vulnerable to a variety of infections, altered inflammatory reactions, and a host of other conditions. In addition to the increased mortality risk, the authors of this new report discovered that covid-19-positive pregnant women were more likely to suffer from other complications of pregnancy, including preeclampsia and eclampsia–a condition characterized by high blood pressures which can be a harbinger of seizures, and which can require intensive care and longer hospital stays. These conditions also impart a higher risk of preterm birth. These complications were much more likely to affect mothers who were actively symptomatic with covid-19.
It is clear that covid-19 is not benign for pregnant women. In light of these new data, when comparing the risks of getting a covid-19 vaccine while pregnant, and getting covid-19 itself, the vaccine has emerged as the safer option by a substantial margin. The vaccines are well-tolerated by pregnant persons and help fend off cases of covid-19 that would otherwise introduce profound medical suffering, disability, and even death. Furthermore, despite rumors on the internet, there is no evidence that vaccines have any effect on fertility. The more data emerges, the more we are finding that vaccination is proving to be safe for pregnant persons–and certainly far safer than SARS-CoV-2 infection."
Source: https://brief19.com/2021/04/22/brief/pregnancy-and-covid-19-more-data-show-them-to-be-a-risky-combination
Commentary: a 22x increase in risk is no small margin. If you're pregnant, strongly consider getting vaccinated unless your primary care provider advocates against it. Consult with them for the best medical opinion, but the evidence indicates that the vaccine is by far the safer choice than risking a COVID-19 infection.
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Keep on taking those selfies. "If you’ve spent any time on social media this week, you’ve come across scores of selfies from Gen X’ers — sleeves rolled up to their shoulders — receiving hand-clapping emojis and other kudos for getting their AstraZeneca jabs.
As the hashtag #GenXZeneca trended on Twitter on Wednesday, Gen X’ers took their moment in the social media sun to indulge in a bit of gloating about how “fearless” they were and, in some cases, to take a few subtle pot-shots at vaccine-shoppers, while waxing nostalgic about icons of their childhood: the Sony Walkman, the Commodore 64, Big Wheels and processed cheese.
While some consider the self-promotion to be a bit rich and worry it could stoke “vaccine envy,” the explosion of vaccine selfies — or “vaxxies” — by Gen X’ers may be just the type of guerrilla marketing that gets the vaccine-hesitant among us out the door, some experts say.
“Gen X’ers may not see themselves as vaccine ambassadors ... but they are doing that kind of work,” said Maya Goldenberg, a University of Guelph professor specializing in the philosophy of science and medicine. “That may make hesitaters more open to vaccinating.”
Since several provinces announced this week that forty-somethings would be eligible for the AstraZeneca vaccine, many Gen X’ers have jumped at the opportunity, resulting in a mad scramble to book appointments that some on social media have compared to the “Hunger Games.”"
Source: https://www.thestar.com/news/canada/2021/04/22/love-them-or-hate-them-gen-xers-vaccine-selfies-or-vaxxies-may-be-the-marketing-campaign-we-needed.html
Commentary: Mass social proof is a good thing in this case. It encourages people to see that not only are celebrities and prominent public figures sharing their vaccine images, but so are regular people. We need as many people as possible to get vaccinated to get to herd immunity, as quickly as possible to deny the virus a chance to mutate.
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Long COVID affects nearly every major system in the body. "The acute clinical manifestations of COVID-19 are well characterized1,2; however, its post-acute sequalae have not been comprehensively described. Here, we use the national healthcare databases of the US Department of Veterans Affairs to systematically and comprehensively identify 6-month incident sequalae including diagnoses, medication use, and laboratory abnormalities in 30-day survivors of COVID-19. We show that beyond the first 30 days of illness, people with COVID-19 exhibit higher risk of death and health resource utilization. Our high dimensional approach identifies incident sequalae in the respiratory system and several others including nervous system and neurocognitive disorders, mental health disorders, metabolic disorders, cardiovascular disorders, gastrointestinal disorders, malaise, fatigue, musculoskeletal pain, and anemia. We show increased incident use of several therapeutics including pain medications (opioids and non-opioids), antidepressants, anxiolytics, antihypertensives, and oral hypoglycemics and evidence of laboratory abnormalities in multiple organ systems. Analysis of an array of pre-specified outcomes reveals a risk gradient that increased across severity of the acute COVID-19 infection (non-hospitalized, hospitalized, admitted to intensive care). The findings show that beyond the acute illness, substantial burden of health loss — spanning pulmonary and several extrapulmonary organ systems — is experienced by COVID-19 survivors. The results provide a roadmap to inform health system planning and development of multidisciplinary care strategies to reduce chronic health loss among COVID-19 survivors."
Source: https://www.nature.com/articles/s41586-021-03553-9_reference.pdf
Commentary: We still don't know the full extent to which long COVID (PASC, its new name) will have detrimental effects in the future, but we do know already that it's dangerous and impacts many systems. This study shows just how much of the body it can negatively affect. Don't get it. Get vaccinated instead.
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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 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.