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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Poor decisions in Texas. "Conroe Independent School District students are set to return to class on Aug. 11. But as students return, the strict COVID-19 mandates of last year will not, and the district won’t be able to mandate that students positive with COVID-19 stay home to isolate.
While the district cannot mandate students stay home, it does strongly recommend that individuals who are positive: isolate for 10 days as of the onset of symptoms or test date if asymptomatic, be fever-free for at least 24 hours without the help of medication before returning to school, and be diarrhea-free for 24 hours without the help of medication before returning to school.
For students or staff who have COVID-19 symptoms but have not tested positive, the district recommends seeking medical guidance, isolating to prevent potential spread, wear a face covering, and get tested. This year there will be no virtual instruction option, it will all be face-to-face, so absences will have to be made up."
Source: https://www.houstonchronicle.com/neighborhood/moco/news/article/Conroe-ISD-won-t-keep-COVID-positive-students-16330362.php?utm_campaign=CMS%20Sharing%20Tools%20(Premium)&utm_source=t.co&utm_medium=referral
Commentary: Not requiring ill students to remain home and failing to offer a virtual option nearly guarantees large-scale outbreaks of COVID-19 among vulnerable students. If I were a parent in that school district, I would be examining the viability of homeschooling at least for the coming academic year.
For context, my family already homeschools our kids, not because of the pandemic, but because we wanted the highest quality education. My oldest child now does virtual high school with an online program that satisfies all federal and state education requirements plus gives them an associate's degree along with a high school diploma in four years. Homeschooling and virtual schooling is the way to go if you can make it work from a financial perspective, especially in locations where really bad, willfully ignorant decisions are being made.
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Vaccines and Delta, new data. "Effectiveness after one dose of vaccine (BNT162b2 or ChAdOx1 nCoV-19) was notably lower among persons with the delta variant (30.7%; 95% confidence interval [CI], 25.2 to 35.7) than among those with the alpha variant (48.7%; 95% CI, 45.5 to 51.7); the results were similar for both vaccines. With the BNT162b2 vaccine, the effectiveness of two doses was 93.7% (95% CI, 91.6 to 95.3) among persons with the alpha variant and 88.0% (95% CI, 85.3 to 90.1) among those with the delta variant. With the ChAdOx1 nCoV-19 vaccine, the effectiveness of two doses was 74.5% (95% CI, 68.4 to 79.4) among persons with the alpha variant and 67.0% (95% CI, 61.3 to 71.8) among those with the delta variant.
Only modest differences in vaccine effectiveness were noted with the delta variant as compared with the alpha variant after the receipt of two vaccine doses. Absolute differences in vaccine effectiveness were more marked after the receipt of the first dose. This finding would support efforts to maximize vaccine uptake with two doses among vulnerable populations. (Funded by Public Health England.)"
Source: https://www.nejm.org/doi/full/10.1056/NEJMoa2108891?
Commentary: This is excellent news and solid proof that the vaccines work if they're used as directed, even against the Delta variant. BNT162b2 is the Pfizer mRNA vaccine, ChAdOx1 nCoV-19 is the AstraZeneca vaccine. The Pfizer vaccine retains strong effectiveness after two full doses, 88% against all forms of illness for Pfizer and 67% for AstraZeneca. I'd imagine the J&J vaccine performs similarly to the AstraZeneca as they're both adenovirus platforms, and Moderna performs likely similarly to the Pfizer.
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How does Delta spread so fast? Higher load. "Since first appearing in India in late 2020, the Delta variant of SARS-CoV-2 has become the predominant strain in much of the world. Researchers might now know why Delta has been so successful: people infected with it produce far more virus than do those infected with the original version of SARS-CoV-2, making it very easy to spread.
According to current estimates, the Delta variant could be more than twice as transmissible as the original strain of SARS-CoV-2. To find out why, epidemiologist Jing Lu at the Guangdong Provincial Center for Disease Control and Prevention in Guangzhou, China, and his colleagues tracked 62 people who were quarantined after exposure to COVID-19 and who were some of the first people in mainland China to become infected with the Delta strain.
The team tested study participants’ ‘viral load’ — a measure of the density of viral particles in the body — every day throughout the course of infection to see how it changed over time. Researchers then compared participants’ infection patterns with those of 63 people who contracted the original SARS-CoV-2 strain in 2020.
In a preprint posted 12 July1, the researchers report that virus was first detectable in people with the Delta variant four days after exposure, compared with an average of six days among people with the original strain, suggesting that Delta replicates much faster. Individuals infected with Delta also had viral loads up to 1,260 times higher than those in people infected with the original strain.
The combination of a high number of viruses and a short incubation period makes sense as an explanation for Delta’s heightened transmissibility, says epidemiologist Benjamin Cowling at the University of Hong Kong. The sheer amount of virus in the respiratory tract means that superspreading events are likely to infect even more people, and that people might begin spreading the virus earlier after they become infected."
Source: https://www.nature.com/articles/d41586-021-01986-w
Commentary: Bigger viral load, faster shedding... in other words, masks on, please. The dominant strain is HIGHLY transmissible.
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Kids will get you sick if you're not vaccinated. "This retrospective study showed that the efficient transmission of SARS-CoV-2 from school-age children and adolescents to household members led to the hospitalization of adults with secondary cases of Covid-19. In households in which transmission occurred, half the household contacts were infected. The secondary attack rates in this study were probably underestimates because test results were reported by the patients themselves and testing was voluntary. In addition, a third of the index patients returned home from camp after the onset of symptoms, when they were presumably not as infectious as they were before and during the onset of symptoms,5 and two thirds adopted physical distancing because of a known exposure at camp; both of these factors probably reduced the transmission of SARS-CoV-2 in the household. When feasible, children and adolescents with a known exposure to SARS-CoV-2 or a diagnosis of Covid-19 should remain at home and maintain physical distance from household members."
Source: https://www.nejm.org/doi/full/10.1056/NEJMc2031915
Commentary: HALF of households were infected by their kids after they came home with COVID-19 from a summer camp. What do we think that will do once schools reopen in a couple of months?
If we listened to science, we would only reopen schools for kids 12+ who have been vaccinated. Everyone else should remain virtual until vaccination is available, and only kids who are vaccinated would be allowed to attend in-person. That would shut down what will be a major method of transmission, especially of the Delta variant.
But people around the world will not listen to what the science says, and in the Northern Hemisphere, we are in for a rough autumn... again.
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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 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. 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.
3. Wash/sanitize your hands every time you are in or out of your home.
4. Stay out of indoor spaces that aren't your home 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.
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/
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.