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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If you've had COVID-19, get a shot. "In addition to the original virus first identified in Wuhan, China, SARS-CoV-2 variants first identified in the United Kingdom (B.1.1.7), South Africa (B.1.351), and Brazil (P.1) have been detected in recent months.2 Samples from persons who had been vaccinated or previously infected with the original virus or the B.1.1.7 variant were shown to have significantly less neutralizing activity against the B.1.351 variant than against the other variants.3,4 In this study, we investigated whether one dose of the BNT162b2 vaccine would increase neutralizing activity against the B.1.1.7, B.1.351, and P.1 variants in persons previously infected with SARS-CoV-2.
This study showed that, in our small cohort, one vaccine dose substantially increased neutralizing activity against all variants tested, with similar titers detected across patients for each variant. This highlights the importance of vaccination even in previously infected patients, given the added benefit of an increased antibody response to the variants tested. Limitations of the study include the small cohort of only women and the lack of evaluation of T-cell response. However, we think the fact that all six patients responded similarly to vaccination supports our conclusions. Further studies could investigate the effects of a second vaccine dose on neutralizing activity against variants of concern in persons who have and persons who have not been previously infected."
Source: https://www.nejm.org/doi/full/10.1056/NEJMc2104036
Commentary: This is important research. In essence, it says if you had COVID-19, especially early on, your innate immunity may not provide as much protection against all the new variants. With a shot to reinforce your system, immune response is good against all variants. Get a shot even if you've had COVID-19.
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How long is your nose out of commission after COVID-19? Up to 12 months. "More than 1 year into the pandemic, we describe the long-term prognosis for a cohort of patients with COVID-19–related anosmia, most of whom (96.1%) objectively recovered by 12 months. Our findings suggest that an additional 10% gain in recovery can be expected at 12 months, compared with studies with 6 months of follow-up that found only 85.9% of patients with recovery.4 This supports findings from fundamental animal research, involving both imaging studies and postmortem pathology, suggesting that COVID-19–related anosmia is likely due to peripheral inflammation.4
Persistent COVID-19–related anosmia has an excellent prognosis with nearly complete recovery at 1 year. As clinicians manage an increasing number of people with post-COVID syndrome, data on long-term outcomes are needed for informed prognostication and counseling."
Source: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2781319
Commentary: Let's hope other long-haul COVID conditions clear up just as well.
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Delta taking hold in California. "The Delta variant of the coronavirus is beginning to spread in California, offering a preview of how the battle of the pandemic is going to change as officials move to protect a shrinking minority who remain at risk because they have not been vaccinated.
The Delta variant may be twice as transmissible as the conventional strain. But California and the rest of the nation are far more protected against COVID-19 than ever before. California has one of the highest vaccination rates in the nation, and the U.S. has one of the highest per capita rates of inoculation in the world.
And vaccines available in the U.S. are believed to be effective against the Delta variant, as they have been for all known variants. But that still leaves tens of millions of unvaccinated people still potentially vulnerable.
“If you’re vaccinated, it’s nothing,” UC San Francisco epidemiologist Dr. George Rutherford said of the Delta variant. “If you’re not vaccinated, you’re hosed.”
Officials don’t expect another deadly COVID-19 surge on the order of those that walloped the nation three times in the past 15 months. Rather, the risk is more that the Delta variant will take root in pockets of unimmunized communities that haven’t been previously been infected with the coronavirus.
This is the kind of future experts expect: one in which most of the population, who are vaccinated, are well protected against the world’s worst pandemic in the last century, while risks remain for those who aren’t vaccinated.
Now, “nearly every death due to COVID-19 is particularly tragic,” said Dr. Rochelle Walensky, director of the U.S. Centers for Disease Control and Prevention, “because nearly every death — especially among adults — due to COVID-19 is, at this point, entirely preventable.”"
Source: https://www.latimes.com/california/story/2021-06-24/covid-19-delta-variant-spread-california-how-bad-is-it
Commentary: The commentary is really important - if you have been vaccinated, Delta won't do much to you, even if it breaks through. But if you're not vaccinated, it's a serious problem. Kids will spread it and catch it in gatherings, so if your child is not vaccinated, keep them away from others. They are just as much at risk today as we all were a year ago.
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Get a Pfizer or Moderna booster if you've had AstraZeneca or J&J as vaccines. "The SARS-CoV-2 B.1.617.2 (Delta) variant was first identified in the state of Maharashtra in late 2020 and has spread throughout India, displacing the B.1.1.7 (Alpha) variant and other pre-existing lineages. Mathematical modelling indicates that the growth advantage is most likely explained by a combination of increased transmissibility and immune evasion. Indeed in vitro, the delta variant is less sensitive to neutralising antibodies in sera from recovered individuals, with higher replication efficiency as compared to the Alpha variant. In an analysis of vaccine breakthrough in over 100 healthcare workers across three centres in India, the Delta variant not only dominates vaccine-breakthrough infections with higher respiratory viral loads compared to non-delta infections (Ct value of 16.5 versus 19), but also generates greater transmission between HCW as compared to B.1.1.7 or B.1.617.1 (p=0.02). In vitro, the Delta variant shows 8 fold approximately reduced sensitivity to vaccine-elicited antibodies compared to wild type Wuhan-1 bearing D614G. Serum neutralising titres against the SARS-CoV-2 Delta variant were significantly lower in participants vaccinated with ChadOx-1 as compared to BNT162b2 (GMT 3372 versus 654, p<0001). These combined epidemiological and in vitro data indicate that the dominance of the Delta variant in India has been most likely driven by a combination of evasion of neutralising antibodies in previously infected individuals and increased virus infectivity. Whilst severe disease in fully vaccinated HCW was rare, breakthrough transmission clusters in hospitals associated with the Delta variant are concerning and indicate that infection control measures need continue in the post-vaccination era."
Source: https://www.researchsquare.com/article/rs-637724/v1
Commentary: Delta is able to punch through natural immunity easier than previous variants (people who have previously had COVID-19) and it's able to override the J&J and AstraZeneca vaccines easier. If you've had AstraZeneca or J&J as your vaccine and Pfizer or Moderna vaccines are available in your area, get an mRNA booster.
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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 other people, 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. 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 gettings an mRNA single shot booster (Pfizer/Moderna).
3. Wash/sanitize your hands every time you are in or out of your home.
4. Stay home 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.
5. Get your personal finances in order now. Cut all unnecessary costs.
6. Replenish your supplies as you use them. Avoid reducing your stores to pre-pandemic levels in case an outbreak causes unexpected supply chain disruptions.
7. 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).
8. Masks must fit properly to work. Here's how to properly fit a mask:
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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.