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 a qualified healthcare provider who knows your specific medical situation over advice from people on the Internet.
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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Moderna showing an edge. "It was a constant refrain from federal health officials after the coronavirus vaccines were authorized: These shots are all equally effective.
That has turned out not to be true.
Roughly 221 million doses of the Pfizer-BioNTech vaccine have been dispensed thus far in the United States, compared with about 150 million doses of Moderna’s vaccine. In a half-dozen studies published over the past few weeks, Moderna’s vaccine appeared to be more protective over the long term than the Pfizer-BioNTech vaccine.
Research published on Friday by the Centers for Disease Control and Prevention found that the efficacy of the Pfizer-BioNTech vaccine against hospitalization fell from 91 percent to 77 percent after a four-month period following the second shot. The Moderna vaccine showed no decline over the same period.
If the efficacy gap continues to widen, it may have implications for the debate on booster shots. Federal agencies this week are evaluating the need for a third shot of the Pfizer-BioNTech vaccine for some high-risk groups, including older adults.
Scientists who were initially skeptical of the reported differences between the Moderna and Pfizer-BioNTech vaccines have slowly become convinced that the disparity is small but real.
“Our baseline assumption is that the mRNA vaccines are functioning similarly, but then you start to see a separation,” said Natalie Dean, a biostatistician at Emory University in Atlanta. “It’s not a huge difference, but at least it’s consistent.”
But the discrepancy is small and the real-world consequences uncertain, because both vaccines are still highly effective at preventing severe illness and hospitalization, she and others cautioned.
“Yes, likely a real difference, probably reflecting what’s in the two vials,” said John Moore, a virologist at Weill Cornell Medicine in New York. “But truly, how much does this difference matter in the real world?”
“It’s not appropriate for people who took Pfizer to be freaking out that they got an inferior vaccine.”"
Source: https://www.nytimes.com/2021/09/22/health/covid-moderna-pfizer-vaccines.html
Commentary: What the data is currently showing is that if you're not vaccinated, and you have a choice, get Moderna if you can. But remember that ANY authorized vaccine right now is better than no vaccine. If you're fully vaccinated and in a high risk category, get a booster if it's available to you. For everyone else, just keep masking up.
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Pfizer might just need more time. "While the standard regimen of the BNT162b2 mRNA vaccine includes two doses administered three weeks apart, some public health authorities decided to space them, raising concerns about vaccine efficacy. Here, we analyzed longitudinal humoral responses including antibody binding, Fc-mediated effector functions and neutralizing activity against the D614G strain but also variants of concern and SARS-CoV-1 in a cohort of SARS-CoV-2 naive and previously infected individuals, with an interval of sixteen weeks between the two doses. While the administration of a second dose to previously infected individuals did not significantly improve humoral responses, we observed a significant increase of humoral responses in naive individuals after the 16-weeks delayed second shot, achieving similar levels as in previously infected individuals. Our results highlight strong vaccine-elicited humoral responses with an extended interval BNT162b2 vaccination for naive individuals."
Source: https://www.medrxiv.org/content/10.1101/2021.09.17.21263532v1
Commentary: Contrary to expectations, spacing out the shots for Pfizer seems to be more efficacious. That said, asking someone to wait 3-4 months between shots is a recipe for compliance disaster; people will simply forget. However, waiting at least that long would seem to be indicated for boosters - if you got your final shot less than 6 months ago, hold off on getting a booster (if available) unless otherwise directed by your healthcare provider.
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The UN General Assembly might become a superspreader event. "The Biden administration worries that this year's U.N. General Assembly could become a COVID-19 "superspreader event" as world leaders descend on New York City without necessarily abiding by local vaccine requirements. On Friday, President Biden's U.N. Ambassador, Linda Thomas-Greenfield, told CBS News at a press conference, "We are concerned about the U.N. event being a superspreader event, and that we need to take all measures to ensure that it does not become a superspreader event."
Unlike last year, when COVID-19 pandemic forced the largest annual gathering of world leaders to go virtual, this year, a hybrid format means that heads of state can either send in a video or appear in person.
Despite a note from Thomas-Greenfield urging diplomats to send in videos, more than 100 presidents, prime ministers and others are set to give in-person speeches at the two-week event. Mr. Biden will be attending with a scaled-down White House entourage.
Vaccination rules quickly became a flashpoint.
Brazil's President Jair Bolsonaro, who says he is unvaccinated but has antibodies from a COVID-19 infection last year, announced he would attend in person, defying the New York City vaccine requirement."
Source: https://www.cbsnews.com/amp/news/united-nations-new-york-city-covid-19-vaccine-mandate-superspreader-event/
Commentary: While New York City cannot arrest people on the UN grounds itself - it's considered sovereign territory not under the jurisdiction of any part of the United States government - the city is welcome to enforce its laws once delegates set foot on US soil.
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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.