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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As I mentioned the other day, I bought a CO2 air quality detector off Amazon. I've been testing it around my home and it does exactly what it says: it looks at the concentration of CO2 in the air. CO2 concentration is a proxy for how fresh the air is; outside air generally has a concentration of 450-500 ppm. At my desk, with me sitting there breathing, I hit 660 ppm about a meter away. If this were a shared office space, 6 feet/2 meters would not be far enough away to protect against aerosols without a mask.
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Distancing doesn't work if the air isn't fresh and ventilated. "The results reconstruct the initial transmission events in May 2020: Originating from a single employee, the virus was transmitted to several other workers within a radius of more than eight meters. The main transmission took place in the deboning area for beef quarters, where air is circulated and cooled to ten degrees Celsius. In contrast, the housing conditions of the workers did not play a significant role during the investigated phase of the outbreak.
"Our results indicate that the conditions within the deboning work area of the meat processing plant - namely the low temperature, low fresh air supply and constant air circulation through the air-conditioning system in the hall, together with hard physical work - promoted the aerosol transmission of SARS-CoV-2 particles over greater distances,” says Prof Adam Grundhoff, co-author of the study and research group leader at the HPI. “It is very likely that these factors in general play a significant role in the globally occurring outbreaks in meat or fish processing plants. Under these conditions, a distance of 1.5 to 3 meters alone is obviously not sufficient to prevent transmission.""
Source: https://www.helmholtz-hzi.de/en/news-events/news/view/article/complete/sars-cov-2-ausbruch-in-deutschem-fleischzerlegebetrieb-uebertragungen-erfolgten-ueber-weite-distanze/
Commentary: Fresh air is everything for an aerosol/airborne disease. You need to be wearing the best mask available to you in any indoor setting. Give some thought to possibly carrying a CO2 meter on your person as well; it'll tell you how well the air is freshened in any indoor space.
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An excellent, in-depth explanation of R0, the viral reproduction number. This lecture from Adam Kucharski will walk through what it is, how it's measured, and how to interpret data about it.
Source: http://www.newton.ac.uk/seminar/20200703170018001
Source: http://www.newton.ac.uk/files/seminar/20200703170018001-1892172.pdf
Commentary:
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Testing saves lives. "In the present study, we found that one additional test per 100 people was associated with a 8% reduction in mortality rate, even after adjusting for case number, critical case rate, and various country-related factors.
These results suggest that scaling up testing might potentially serve as an effective approach to attenuate mortality when governments were less effective in controlling disease outbreaks or when hospital beds were less sufficient.
Greater government effectiveness was found in this study to be associated with lower Covid-19 mortality rates. This indicator captures capacity of government to effectively formulate and implement sound policies, and is a key dimension of good governance.
In conclusion, we found that higher Covid-19 mortality is associated with lower test number, lower government effectiveness, aging population, fewer beds, and better transport infrastructure. Increasing Covid-19 test number and improving government effectiveness have the potential to reduce Covid-19 related mortality."
Source: https://www.nature.com/articles/s41598-020-68862-x
Commentary: This is excellent country-level guidance for all nations. Want to slow COVID-19's impact? Test more. Test, trace, isolate, and mitigate.
Want to see how to do it wrong? Look at the United States. Poor testing with substantial delays, lack of hospital space, an unhealthy population, and ineffective government response have made the United States the world leader in COVID-19 infections.
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The CDC published a shocking statistic. 47.2% of the US population is at greater risk of comorbidities from COVID-19. "Older adults and those with chronic obstructive pulmonary disease, heart disease, diabetes, chronic kidney disease, and obesity are at higher risk for severe COVID-19–associated illness.
The median model-based estimate of the prevalence of any of five underlying medical conditions associated with increased risk for severe COVID-19–associated illness among U.S. adults was 47.2% among 3,142 U.S. counties. The estimated number of persons with these conditions followed population distributions, but prevalence was higher in more rural counties.
These findings can be used by state and local decision-makers to help identify areas at higher risk for severe COVID-19–associated illness because of underlying medical conditions and guide resource allocation and implementation of prevention and mitigation strategies. Future analyses could include weighting the contribution of each underlying medical condition according to the risk for severe COVID-19–associated outcomes, as well as identifying and incorporating other aspects of vulnerability to both infection and severe outcomes to better estimate the number of persons at increased risk for COVID-19. These findings highlight the prevalence of underlying medical conditions at the local (county) level that are important causes of morbidity and mortality on their own and increase risk for severe COVID-19–associated illness. These findings also emphasize the importance of prevention efforts to reduce the prevalence of these underlying medical conditions and their risk factors such as smoking, unhealthy diet, and lack of physical activity."
Source: https://www.cdc.gov/mmwr/volumes/69/wr/mm6929a1.htm
Commentary: America has, quite frankly, been lucky so far in the death rates from COVID-19. As more cities get overwhelmed, that luck will run out. We also do not have studies or data yet about the state of recovery; recovery is not binary. It's a spectrum from "fully healed" to "barely able to function, but not in a hospital bed".
The fact that nearly half of the population of America is in such poor health makes containment and mitigation all the more urgent.
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4 million. America went from 3 million to 4 million cases in 16 days.
Source:
Commentary: Look carefully at the chart in the shared tweet. That's what loss of control looks like. Stay home, stay safe. Don't contribute to the number of infected.
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Massachusetts is going to start requiring quarantine for travelers from out of state. " Individuals who fail to comply with a new travel order in Massachusetts could be fined $500 per day, Gov. Charlie Baker announced Friday. Visitors and in-state residents returning home must fill out a “Massachusetts Travel Form” and quarantine for 14 days unless they are coming from an exempt, lower-risk state or can provide a negative COVID-19 test from the last 72 hours.
The travel restrictions go into place on August 1. Incoming college students are included in the order.
The current exempt states are: Connecticut, New Hampshire, Rhode Island, Vermont, Maine, Hawaii, New Jersey, and New York.
For a state to be considered lower risk, the seven-day rolling average of daily cases must be below six per 100,000 cases and the positive test rate must be below five percent."
Source:
Source: https://boston.cbslocal.com/2020/07/24/coronavirus-massachusetts-governor-charlie-baker-update-friday-july-24-travel-order-fine-quarantine/
Commentary: The order from the governor says they will not be stopping cars - but how long until we have to do that? Does this violate your rights? No. The Constitution requires that interstate travel be permitted. It says nothing about what you can do once you arrive in another state.
Stay home. Stay safe.
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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.
2. Wear gloves and a mask when out of your home. Respirators are back in stock at online retailers, too.
3. Stay home as much as possible. Minimize your contact with others and maintain physical distance of at LEAST 6 feet / 2 meters. 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.
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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, 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.