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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Bad ventilation can be the problem. "We investigated the epidemiological relationship among infected cases on a recent cluster infection of COVID-19 in an apartment building in Seoul, South Korea. All infected cases were found along two vertical lines of the building, and each line was connected through a single air duct in the bathroom for natural ventilation. Our investigation found no other possible contact between the cases than the airborne infection through a single air duct in the bathroom. The virus from the first infected case can be spread to upstairs and downstairs through the air duct by the (reverse) stack effect, explaining the air movement in a vertical shaft."
Source: https://www.ijidonline.com/article/S1201-9712(20)32558-3/fulltext
Commentary: In this case study, COVID-19 spread throughout a building because ventilation was being passed through restrooms, up the building. Infections came with it. If you live in a building that has any kind of shared ventilation, tape over it with cardboard and tape, and open some windows instead.
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The new SN501 variants appear to be spreading faster. "In preliminary work, researchers in the U.K. have found that the virus is spreading quickly in parts of southern England, displacing a crowded field of other variants that have been circulating for months.
However, a virus lineage becoming more common is not proof that it spreads faster than others. It could grow more widespread simply through luck. For instance, a variant might start out in the middle of a crowded city, where transmission is easy, allowing it to make more copies of itself.
Still, the epidemiological evidence gathered so far from England does seem to suggest that this variant is very good at spreading. In places where it has become more common, the overall number of coronavirus cases is spiking. Neil Ferguson, an epidemiologist at Imperial College London, estimates that the variant has an increased transmission rate of 50 to 70 percent compared with other variants in the United Kingdom.
Some scientists have raised the possibility that the increase in transmission is at least partly the result of how it infects children. Normally, children are less likely than teenagers or adults to get infected or pass on the virus. But the new variant may make children “as equally susceptible as adults,” said Wendy Barclay, government adviser and virologist at Imperial College London."
Source: https://www.nytimes.com/2020/12/21/health/new-covid-strain-uk.html
Commentary: It's vitally important to point out that none of this has been PROVEN yet; evidence is still scarce. However, early evidence also points to the fact that the things we know work against the current edition of COVID-19 also work against the new variants: wearing masks, washing your hands, watching your distance, walking out of indoor spaces that aren't your home as quickly as possible.
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Newborns gain immunity, but not the virus. "While the covid-19 pandemic has undoubtedly been an ongoing healthcare crisis for global citizens of all ages including young pregnant women, the question of whether unborn fetuses are at risk has been top of mind for many. Fortunately, a new study published today in JAMA Network Open should now allow pregnant women to breathe a sigh of relief.
The investigators gathered data from pregnant women in Boston between April and June 2020 in order to determine whether covid-19 positive mothers passed on the SARS-CoV-2 virus and/or antibodies to their babies through umbilical cord blood, respiratory fluid, and the placenta. The study setup was ideal, as all pregnant women are tested for covid-19 at some point before giving birth, so the researchers had a significant group of positive and negative patients to compare. In addition to sampling the previously mentioned tissues, the researchers tested infants born to covid-19 positive mothers 24 hours after birth.
In a surprise to many, among the 64 covid-19 positive mothers, not a single umbilical cord, placenta, or baby was found to have the virus. Reassuringly, however, mothers did pass on antibodies to their children, conferring some amount of acquired immunity to the infants. Compared to influenza, the antibodies passed along were not as numerous, but nevertheless, notable. For context, an estimated 20 percent of children hospitalized with covid-19 are between 0-2 years old.
It is exceedingly rare that a scientific study manages to find zero cases of the very outcomes of interest. That this one found exactly that provides commanding and compelling evidence that the placenta does its job of protecting fetuses from coming into contact with the SARS-CoV-2 virus circulating in a pregnant mother. While antibodies don't pass through the placenta as readily as in some other viruses, it seems, there is nevertheless some hope that infants obtain some immunity from the time they come into the world."
Source: https://brief19.com/2020/12/22/brief
Commentary: This is excellent news for expecting mothers. The challenge for newborns will be the air breathed at and around delivery; a mother who is positive CAN pass COVID-19 to the newborn by breathing.
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How well do masks work? Another study. "Without a face mask, it is almost certain that many foreign droplets will transfer to the susceptible person. Wearing a mask will offer substantial, but not complete, protection to a susceptible person by decreasing the number of foreign airborne sneeze and cough droplets that would otherwise enter the person without the mask.
Consideration must be given to minimize or avoid close face-to-face or frontal human interactions, if possible. If the relevant social distancing guidelines are compromised, the study shows that foreign airborne sneeze and cough droplets could pass through all the masks tested (except for the N-95 mask) even when assuming a 100% snug fit."
Source: https://aip.scitation.org/doi/10.1063/5.0035072
Commentary: Watching your distance does matter. Masks reduce, but do not eliminate, risk. That said, in the notes, the researchers show a standard cloth mask reduces particle escape by 96%, which is astonishingly good. N95 masks are near-perfect when fitted and worn correctly.
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COVID vaccines didn't happen overnight. "When scientists began seeking a vaccine for the SARS-CoV-2 coronavirus in early 2020, they were careful not to promise quick success. The fastest any vaccine had previously been developed, from viral sampling to approval, was four years, for mumps in the 1960s. To hope for one even by the summer of 2021 seemed highly optimistic.
But by the start of December, the developers of several vaccines had announced excellent results in large trials, with more showing promise. And on 2 December, a vaccine made by drug giant Pfizer with German biotech firm BioNTech, became the first fully-tested immunization to be approved for emergency use.
That speed of advance “challenges our whole paradigm of what is possible in vaccine development”, says Natalie Dean, a biostatistician at the University of Florida in Gainesville. It’s tempting to hope that other vaccines might now be made on a comparable timescale. These are sorely needed: diseases such as malaria, tuberculosis and pneumonia together kill millions of people a year, and researchers anticipate further lethal pandemics, too.
The COVID-19 experience will almost certainly change the future of vaccine science, says Dan Barouch, director of the Center for Virology and Vaccine Research at Harvard Medical School in Boston, Massachusetts. “It shows how fast vaccine development can proceed when there is a true global emergency and sufficient resources,” he says. New ways of making vaccines, such as by using messenger RNA (mRNA), have been validated by the COVID-19 response, he adds. “It has shown that the development process can be accelerated substantially without compromising on safety.”"
Source: https://www.nature.com/articles/d41586-020-03626-1
Commentary: The mRNA vaccines are built on top of 25 years of research and development, supercharged with unprecedented funding and focus. This is marvelous news for MANY diseases, because the mRNA platform has now been proven and can be used for more viruses than just SARS-CoV-2. A lot of the R&D for the COVID-19 vaccine can be repurposed to other diseases.
As awful as 2020 and the pandemic have been, this might be the equivalent of substantial advancedments after wartime, a COVID dividend of sorts. Many technologies developed for wartime get repurposed to other things after the war. The worldwide effort to build a vaccine for COVID-19 may have jumpstarted an entirely new era of reduced disease burden, and while we will probably not look back on this year fondly, we may remember it as the start of something great.
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A reminder of the simple daily habits we should all be taking.
1. Wash/sanitize your hands every time you are in or out of your home for any reason. Consider also spraying the bottoms of your shoes with a general disinfectant (alcohol/bleach/peroxide) when you return home. Remember that cleaners are NEVER to be ingested or injected. If you come in physical contact with others, wash your clothing upon returning home.
2. Always wear a mask when out of your home and if going to a high-risk area, wear goggles. Respirators are back in stock at online retailers, too. When going indoors to a place that isn't your home, wear the best protective mask available to you.
3. 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.
4. Get your personal finances in order now. Cut all unnecessary costs.
5. Replenish your supplies as you use them. Avoid reducing your stores to pre-pandemic levels in case an outbreak causes unexpected supply chain disruptions.
6. 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).
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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.