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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Jobless claims increase another 4.4 million, bringing the 5 week total to 26 million jobs lost.
Source: https://www.cnbc.com/2020/04/23/weekly-jobless-claims.html
This might have slowed down had large companies not vacuumed up almost 70% of the payroll protection loan program funds.
Source: https://www.cnbc.com/2020/04/21/large-public-companies-are-taking-small-businesses-payroll-loans.html
Keep these businesses in mind as you do business in the future. CNBC makes the excellent point that publicly traded firms, by their very nature, have access to funding options (their stocks) that small businesses do not.
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A new pre-print paper reinforces that COVID-19 is an indoor disease. "We divided the venues in which the outbreaks occurred into six categories: homes, transport, food, entertainment, shopping, and miscellaneous. Among the identified outbreaks, 53.8% involved three cases, 26.4% involved four cases, and only 1.6% involved ten or more cases. Home outbreaks were the dominant category (254 of 318 outbreaks; 79.9%), followed by transport (108; 34.0%; note that many outbreaks involved more than one venue category). Most home outbreaks involved three to five cases. We identified only a single outbreak in an outdoor environment, which involved two cases. Conclusions: All identified outbreaks of three or more cases occurred in an indoor environment, which confirms that sharing indoor space is a major SARS-CoV-2 infection risk."
Source: https://www.medrxiv.org/content/10.1101/2020.04.04.20053058v1
While this paper has not been peer-reviewed, the findings align with what is generally accepted about respiratory viruses: outside, with plenty of fresh air and sunlight, they fare poorly. Inside, they flourish.
If you are indoors any place besides your home, treat that place as contaminated. Wear gloves and a face mask, and wash your clothes immediately upon returning home. Spray your shoes with disinfectant, especially the soles, and do not wear the same shoes in your home until they have been disinfected.
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54% of patients who were asymptomatic on the Diamond Princess still had lung changes in CT scans. "Of 104 cases, 76 (73%) were asymptomatic, 41 (54%) of which had lung opacities on CT. Other 28 (27%) cases were symptomatic, 22 (79%) of which had abnormal CT findings. Symptomatic cases showed lung opacities and airway abnormalities on CT more frequently than asymptomatic cases [lung opacity; 22 (79%) vs 41 (54%), airway abnormalities; 14 (50%) vs 15 (20%)]. Asymptomatic cases showed more GGO over consolidation (83%), while symptomatic cases more frequently showed consolidation over GGO (41%). The CT severity score was higher in symptomatic cases than asymptomatic cases, particularly in the lower lobes [symptomatic vs asymptomatic cases"
Source: https://pubs.rsna.org/doi/10.1148/ryct.2020200110
Per the article from the other day about SCUBA divers incurring permanent lung damage, the fact that you are asymptomatic but still having detectable lung changes is concerning. COVID-19's long-lasting legacy may in fact be a ton of people with lung damage.
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COVID-19's years of life lost assessment is 14 for men, 12 for women. "Deaths from COVID-19 represent a substantial burden in terms of per-person YLL, more than a decade, even after adjusting for the typical number and type of LTCs found in people dying of COVID-19. The extent of multimorbidity heavily influences the estimated YLL at a given age. More comprehensive and standardised collection of data on LTCs is needed to better understand and quantify the global burden of COVID-19 and to guide policy-making and interventions."
Source: https://wellcomeopenresearch.org/articles/5-75
Based on things like mortality probability tables, this study aimed to see how many years someone might have lived if they hadn't died from COVID-19. That it's in excess of 10 years means that this disease is affecting far more than just the elderly.
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An unintended consequence of COVID-19: heart attack patients being treated. "A survey of nine major hospitals earlier this month showed the number of severe heart attacks being treated in U.S hospitals had dropped by nearly 40% since the novel coronavirus took hold in March, leaving cardiologists worried about a second wave of deaths caused indirectly by Covid-19: patients so afraid to enter hospitals that they are dying at home or waiting so long to seek care that they’re going to suffer massive damage to their hearts or brains. Some call it “a virus of fear.” “The whole community is discussing this, asking where are all of our patients?” said Martha Gulati, chief of cardiology at the University of Arizona. “There’s nothing we’ve done overnight that has cured heart disease.” The same is true for appendicitis and stroke. Clinicians say patients with these life-threatening conditions have also stopped seeking treatment in large numbers. “My worry is some of these people are dying at home because they’re too scared to go to the hospital,” Gulati said. Others are coming in so late, she added, that some are presenting with massively damaged hearts, including heart muscles that have ruptured. “That was something I’d only seen before in textbooks, to study for exam questions,” she said. “Now we’re seeing those cases because people are putting off care.”"
Source: https://www.statnews.com/2020/04/23/coronavirus-phobia-keeping-heart-patients-away-from-er/
The reality is that even though COVID-19 is the current focus, if you or a loved one has a serious condition, you need to seek care. Don't wait - many of these conditions leave permanent, debilitating damage, if they don't kill you outright.
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"As companies scramble to contain the outbreaks by closing more than a dozen U.S. plants so far – including a Smithfield pork plant in South Dakota that handles 5% of U.S. pork production – the crisis has raised the specter of mass meat shortages. But experts say there's little risk of a dwindling protein supply because, given the choice between worker safety and keeping meat on grocery shelves, the nation’s slaughterhouses will choose to produce food. “If this goes on for a long time, there is a reality of a shortage,” said Joshua Specht, an assistant professor of history at the University of Notre Dame who studies the meat industry. “The politics of this could play out that they reopen at enormous risks to workers, rather than face an actual shortage … I wouldn’t bet against that.” The meatpacking industry already has been notorious for poor working conditions even before the coronavirus pandemic. Meat and poultry employees have among the highest illness rates of all manufacturing employees and are less likely to report injuries and illness than any other type of worker, federal watchdog reports have found. And the plants have been called out numerous times for refusing to let their employees use the bathroom, even to wash their hands – one of the biggest ways to reduce the spread of the coronavirus."
Source: https://www.usatoday.com/in-depth/news/investigations/2020/04/22/meat-packing-plants-covid-may-force-choice-worker-health-food/2995232001/
Source:
Which is worse - a food shortage, or a whole bunch of people killed in poor working conditions? Upton Sinclair would be having a field day with this, were he still alive. What can you do? Eat less meat, for one thing. That might not be a bad change in general.
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The new report by the National Governor's Association lays out a solid roadmap for reopening America safely. The top two steps? Massively scaled testing and detection. It's the strategy that has worked everywhere else: test, trace, treat.
Source: https://www.nga.org/wp-content/uploads/2020/04/NGA-Report.pdf
Without the ability to test, trace, and treat, no nation can reopen safely.
The good news on this front is a pre-print paper documenting testing for COVID-19 with saliva instead of nasopharyngeal swabs. "When we compared SARS-CoV-2 detection from patient-matched nasopharyngeal and saliva samples, we found that saliva yielded greater detection sensitivity and consistency throughout the course of infection. Furthermore, we report less variability in self-sample collection of saliva. Taken together, our findings demonstrate that saliva is a viable and more sensitive alternative to nasopharyngeal swabs and could enable at-home self-administered sample collection for accurate large-scale SARS-CoV-2 testing."
Source: https://www.medrxiv.org/content/10.1101/2020.04.16.20067835v1
If this testing protocol works and is effective, it would clear the way to very different, large scale testing.
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A woman who hadn't left her house in weeks contracted COVID-19. The culprit? A keypad at the pharmacy. "Remember that trip to the pharmacy three weeks before testing positive? That March 18 errand was her last into the outside world. An epidemiologist called Brummert Tuesday, April 21 with the news: They had traced her exposure back to the keypad at the pharmacy. "I felt a little relieved it wasn't the groceries," Brummert told WCNC Charlotte's Nate Morabito in a follow-up interview. "When you pick up a prescription, you have to sign for it."
Source: https://www.wfmynews2.com/article/news/health/coronavirus/charlotte-woman-hasnt-left-her-house-in-three-weeks-but-tested-positive-for-covid-19/275-77707b1d-fd2f-4a36-bf3e-16beca4104c4?fbclid=IwAR1hBVp0xgoyKWyQGdT3-K7zSY8ylJmE_zQgSWXu0OPLDommy_ZkakI_ERw
Gloves and masks, please.
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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.
2. Wear gloves and a mask when out of your home.
3. Stay home as much as possible.
4. Get your personal finances in order now. Cut all unnecessary costs.
5. Donate any PPE you can. https://getusppe.org/give/
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Common misinformation debunked!
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.
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