Lunchtime Pandemic Reading, 24-April-2020
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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Since it apparently needs to be said. "As a gastroenterologist/ GI specialist, I have seen the damage that is done when people swallow disinfectant, bleach, cleaning products. It is horrible and causes burns to the entire oesophagus and stomach. In one case, the patient ended up on a feeding tube for life! #COVID"
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Open offices may become a thing of the past. "We described the epidemiologic characteristics of a COVID-19 outbreak centered in a call center in South Korea. We identified 97 confirmed COVID-19 case-patients in building X, indicating an attack rate of 8.5%. However, if we restrict our results the 11th floor, the attack rate was as high as 43.5%. This outbreak shows alarmingly that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can be exceptionally contagious in crowded office settings such as a call center. The magnitude of the outbreak illustrates how a high-density work environment can become a high-risk site for the spread of COVID-19 and potentially a source of further transmission. Nearly all the case-patients were on one side of the building on 11th floor."
Source: https://wwwnc.cdc.gov/eid/article/26/8/20-1274_article
You'd have to be mad to reopen an open office space right now in the absence of a vaccine. Until the vaccine is available, open office spaces should be declared off limits entirely.
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Testing for immunity is running into issues. "NEW: NYC Health Dept has sent alert to all medical providers advising *not* to use anti-body tests to diagnose prior covid infection nor to assess immunity. This is due to high rate of false negatives/positives and uncertainty about how immunity works. Dose of reality folks."
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This throws a wrench into the whole "immunity certificates" idea. We still have a long way to go when it comes to understanding this disease and how it works.
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Homeless shelters are COVID-19 hotbeds. "One study looked at the results of coronavirus testing conducted at homeless shelters in four American cities -- Atlanta, Boston, San Francisco and Seattle. Testing included almost 1,200 residents and 300 staffers and was done in late March and early April, according to a team led by Emily Mosites, from the U.S. Centers for Disease Control and Prevention. The findings: In Boston, 36% of homeless shelter residents and 30% of staff tested positive for the new coronavirus; in San Francisco those numbers were 66% and 16%, respectively; and in Seattle infections were 17% for both residents and staff."
Source: https://consumer.healthday.com/infectious-disease-information-21/coronavirus-1008/homeless-shelters-are-tinderboxes-for-coronavirus-studies-show-756991.html
San Francisco's numbers are off the charts. This disease attacks everyone, but populations of any kind that are at greater risk - homeless, ill, elderly, etc. - are especially hit hard. Any time someone's chanting to reopen your area, look to see how many at-risk groups there are. Anyone diabetic? Overweight? Pre-existing cardiac or respiratory condition? It's completely unsafe to reopen for those people.
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Global food shortages are likely. "This hunger crisis, experts say, is global and caused by a multitude of factors linked to the coronavirus pandemic and the ensuing interruption of the economic order: the sudden loss in income for countless millions who were already living hand-to-mouth; the collapse in oil prices; widespread shortages of hard currency from tourism drying up; overseas workers not having earnings to send home; and ongoing problems like climate change, violence, population dislocations and humanitarian disasters. There is no shortage of food globally, or mass starvation from the pandemic — yet. But logistical problems in planting, harvesting and transporting food will leave poor countries exposed in the coming months, especially those reliant on imports, said Johan Swinnen, director general of the International Food Policy Research Institute in Washington."
Source: https://www.nytimes.com/2020/04/22/world/africa/coronavirus-hunger-crisis.html
If this pandemic has taught us anything, it's how interconnected we all are. The cliche heard every day is "We're in this together" - and it's absolutely true, but few people realize just how large the scope of that truth is. Every food we eat comes from somewhere else, save for things we grow in our own homes. And the supply chain for food is bizarrely complex. Thinking, "Oh, that's a problem for India" ignores the reality that India supplies a massive percentage of things like nutritional supplements and manufactured foods, either whole or precursors.
If there are particular foods that you really love, stock up a little. Continue to obey guidance from officials about not hoarding, but if the supermarket lets you buy two, buy two. The longer the crisis goes on, the greater the strain on an already fragile supply chain.
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New data from New York City shows how hard COVID-19 is hitting, in a study of 5,700 patients. "Among the 2634 patients who were discharged or had died at the study end point, during hospitalization, 373 (14.2%) were treated in the ICU, 320 (12.2%) received invasive mechanical ventilation, 81 (3.2%) were treated with kidney replacement therapy, and 553 (21%) died (Table 5). Mortality for those who received mechanical ventilation was 88.1% (n = 282). Mortality rates for those who received mechanical ventilation in the 18-to-65 and older-than-65 age groups were 76.4% and 97.2%, respectively. Mortality rates for those in the 18-to-65 and older-than-65 age groups who did not receive mechanical ventilation were 19.8% and 26.6%, respectively. There were no deaths in the younger-than-18 age group."
Source: https://jamanetwork.com/journals/jama/fullarticle/2765184
These are the severe cases, the cases requiring hospitalization of some kind, whether normal hospital or ICU. The mortality rate for mechanical ventilation is astonishingly high; if you need it, chances are you're not going to make it.
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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:
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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