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.
You are welcome to share this.
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There will be no pandemic newsletter 12/24 or 12/25. Stay safe, stay home, enjoy time away from others. Consider doing a digital detox and just reading a good book.
I wish you a safe and healthy holiday season.
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The SN501 strains are moving around. "A case of the '#SouthAfrica' variant has been detected in the UK. There's also talk about a 501Y mutation in Wales.
It's getting confusing!
First: all 3 of these 501Y mutations are independent. It's appeared a few times, separately."
Source:
Commentary: This whole thread from Dr. Hodcroft is an excellent read. The short of it is that the new variations of SN:501Y - the UK, Welsh, and South Africa - are spreading faster than the current-generation D614G version of SARS-CoV-2. That's the limit of what we can prove right now.
What is being SPECULATED - and emphasis on speculation - is that the changes in the virus make it more easily transmitted. But again, that is speculation. There is currently no vetted, proven evidence of that - but scientists are working on it.
There is also no current tracing that indicates it has spread beyond the EU for now. It probably will, so keep an eye on sites like NextStrain for genomic proof of spread.
Here's the good news: everything that works against the current SARS-CoV-2 shows every indication of working against the new variants. Wearing masks. Washing hands. Watching your distance. Staying home. These mutations likely have no effect on the current vaccines because the current vaccines weren't deployed until very recently - so the virus had no reason to mutate to adapt to them.
This is why masking up and staying home is essential NOW. If we can shut down the virus through non-pharmaceutical measures (wearing masks, etc.) then the virus will have less of a chance to mutate and beat the current vaccines. We want a solid 1-2 punch to put COVID-19 down for the count - the 1 is our current precautions, and the 2 is the vaccine. We need both to work well.
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Eli Lilly's monoclonal antibody suffers a setback. "Another monoclonal antibody, Eli Lilly's LY-CoV555, is currently under investigation. Yesterday, represented a significant setback. In a paper published yesterday in The New England Journal of Medicine, researchers reported that enrollment for a trial of this treatment was stopped in October because it was deemed by statisticians to have been futile; there was no longer any statistical chance that a favorable outcome might have been achieved by continuing the trial.
The trial, conducted by the National Institutes of Health, enrolled over 300 hospitalized patients, who were randomized to receive the antibody cocktail or a placebo, in addition to the standard of care for all enrolled patients—95 percent also received remdesivir, while oxygen and dexamethasone were administered on a case-by-case basis.
The primary outcome measured was sustained recovery over a 90-day period. However, futility was determined after comparing outcomes on day 5, which showed no sign of improvement after receiving the antibody cocktail compared to the placebo. In fact, while the data did not reach statistical significance, it seems that the antibody group fared just slightly worse. Even at the day 28 follow-up for the initially enrolled patients, the treatment group had a slightly increased rate of "primary safety events," a cause for concern.
While data for this particular neutralizing antibody is less than promising for the treatment of covid-19, it is important to remember that these types of treatments have been shown to vary widely in efficacy for other viruses (including Ebola). Thus, the scientific community shouldn't close the door on other potential antibody therapies."
Source: https://brief19.com/2020/12/23/brief
Commentary: This is why we test, test, test. Clinical trials show true effectiveness compared to placebos, and monoclonal antibodies are not performing well.
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Newly released data in America shows the situation to be worse than previously thought. "First, let’s discuss the latest epidemiology. It’s great that CDC and HHS have FINALLY been allowed to release some of the information they have. This information belongs to the public, not to anyone in Washington. It’s 10 months late, but the headline says it all.
Unfortunately, what the data shows is NOT great. Every U.S. region and most counties for which there are data are at the highest level in terms of case incidence — more than 200 cases per 100,000 a week. That’s about six times the rate at which we figured contact tracing would be hard or impossible.
Counties across the US are sustained hotspots, meaning there is a high case burden and a risk of overwhelming health care systems. Here’s the point: the longer you delay closures, the longer you have to keep things shut, the higher the risk of overwhelmed ICUs, and the more people die.
Hospital beds are being filled by Covid patients. There were 156,000 admissions in the past week and there are more than 113,000 people currently hospitalized. Cases are still increasing, and a further increase in hospitalizations will follow. Note the increase after Thanksgiving in most regions.
This post-Thanksgiving bump is evident in cases and test positivity. With December holidays coming, it’s best to celebrate at home. When people travel, the virus travels. When people share air, the virus spreads. Not every state had a bump — protection protocols save lives.
Now that this CDC and HHS information is finally public, it’s clear what’s happening. There are very high rates in most of the country, but much of the country has seen decreases over the past week, particularly the Upper Midwest. The Thanksgiving surge is ebbing, just in time for the next holiday surge. Tennessee has become a new hottest spot: deeply red, deeply concerning.
It’s worth focusing on the graphic below, which gives a sense of both test positivity and trend. States all over the map are … all over the map. Some states are high and increasing, some are high and decreasing, some are staying high, and some are staying low. Hawaii, Vermont, and Maine are the Covid-safest places in the United States to be today."
Source: https://www.tomfriedenpublichealth.net/tom-frieden-blog
Commentary: There will be strong lessons from how the pandemic was handled by the United States government in 2020, but the most stark of all is that withholding information only helps the virus. Data is a powerful tool in any fight, and suppressing or withholding it only helps the enemy - the virus. I am hopeful in the new year, with a new federal administration, that we will get more and better data to work with.
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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.