Lunchtime pandemic reading.
Standard disclaimer: this is a roundup of informative pieces I've read that interest me on the severity of the crises and how to manage them. I am not a qualified medical expert in ANY sense; at best I am reasonably well-read laity. ALWAYS prioritize advice from a qualified healthcare provider who knows your specific medical situation over advice from people on the Internet.
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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Immune response decay. "A short update on how waning immunity and immune evasion by convergent mutants BQ.1.1 and XBB stack together. Data suggest that most serum obtained ~7.5 months after BA.1 breakthrough infection would hardly neutralize BQ.1.1 and XBB. (NT50 of 20 is the lower limit of our assay)"
Source:
Commentary: What the chart shows is alarming for the newest crop of variants (BQ.1, BQ.1.1, and XBB): while current vaccines and BA.1 infections offer high antibody titers 1 month after administration or recovery for older variants, the new variants are already somewhat evasive. Stretch out the timeframe to 7.5 months, and the new variants function as if people have had no vaccines or infections - in other words, they're back to square one for immunity.
This is bad for obvious reasons. If you haven't already gotten your bivalent booster and it's been at least 3 months since a COVID infection or your last booster, go and get one as soon as you can.
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Trouble on the horizon. "The rapid growth rate concerns scientists, including leading U.S. infectious disease expert Dr. Anthony Fauci, who recently called the viral family’s doubling time “pretty troublesome.”
What concerns Rajnarayanan more though, is that hospitalizations in New York are also on the rise. In mid-September they sat at around 2,000 a day. A month later, they’re nearing 3,000, according to data from the state.
The state’s current hospitalization wave is “pretty close, if not higher than the Delta peak,” he said, referring to the deadly COVID wave that rocked the U.S. late last year, right before Omicron hit.
Another sign of rising viral activity: Google searches in New York for “cough” are five to seven times higher than usual, Rajnarayanan said, citing a dashboard he created with data from Google Trends. And searches for “nasal congestion,” “headache,” and “migraine” are also up, in addition to those for “sore throat” and “diarrhea.”
“Something is going on there,” he said. "
Source: https://fortune.com/well/2022/10/22/omicron-bq-bq11-wave-rising-new-york-pandemic-covid-fall-winter-wave-belllwhether-xbb-variant-soup-convergence-recombination-viral-evolution/
Commentary: Hospitals are once again filling up (especially pediatric). This is a great time to get your booster and if you haven't been staying masked, get back in the habit. Consider a P100 mask; these are heavier duty, offer far more protection, and are oddly more comfortable for some users (because there's nothing pressing against your nose or mouth). I've been wearing a P100 mask all along, and I MUCH prefer them to N95 masks.
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A tripledemic may be in progress. "For more than two years, shuttered schools and offices, social distancing and masks granted Americans a reprieve from flu and most other respiratory infections. This winter is likely to be different.
With few to no restrictions in place and travel and socializing back in full swing, an expected winter rise in Covid cases appears poised to collide with a resurgent influenza season, causing a “twindemic” — or even a “tripledemic,” with a third pathogen, respiratory syncytial virus, or R.S.V., in the mix.
Cases of flu have begun to tick up earlier than usual, and are expected to soar over the coming weeks. Children infected with R.S.V. (which has similar symptoms to flu and Covid), rhinoviruses and enteroviruses are already straining pediatric hospitals in several states.
“We’re seeing everything come back with a vengeance,” said Dr. Alpana Waghmare, an infectious diseases expert at Fred Hutchinson Cancer Center and a physician at Seattle Children’s Hospital.
Most cases of Covid, flu and R.S.V. are likely to be mild, but together they may sicken millions of Americans and swamp hospitals, public health experts warned.
“You’ve got this waning Covid immunity, coinciding with the impact of the flu coming along here, and R.S.V.,” said Andrew Read, an evolutionary microbiologist at Penn State University. “We’re in uncharted territory here.”
The vaccines for Covid and flu, while they may not prevent infection, still offer the best protection against severe illness and death, experts said. They urged everyone, and especially those at high risk, to get their shots as soon as possible.
Older adults, immunocompromised people and pregnant women are most at risk, and young children are highly susceptible to influenza and R.S.V. Many infected children are becoming severely ill because they have little immunity, either because it has waned or because they were not exposed to these viruses before the pandemic."
Source: https://www.nytimes.com/2022/10/23/health/flu-covid-risk.html
Commentary: What stops colds, flu, RSV, and COVID? Masks.
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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 people you don't live with, even after you've been vaccinated. P100 respirators are back in stock at online retailers, too and start around US$40 for a reusable respirator. 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. Verify your mask's NIOSH certification here: https://www.cdc.gov/niosh/npptl/usernotices/counterfeitResp.html
3. Get vaccinated as soon as you're eligible to, and fulfill the full vaccine regimen, including boosters. Remember that you are not vaccinated until everyone you live with is vaccinated. For COVID, if you received an adenovirus vaccine (J&J/AstraZeneca), consider getting an mRNA single shot booster (Pfizer/Moderna) if available. If it's available, choose Moderna as your first choice for both vaccine and booster, Pfizer as your second choice. However, remember that any vaccine is better than no vaccine.
4. Wash/sanitize your hands every time you are in or out of your home. Sanitize the bottom of your shoes with a simple peroxide spray using ordinary drugstore/supermarket peroxide in a spray bottle. If you've come in close contact with others (rubbing or brushing up against them, hugging, etc.) consider showering and washing your clothes as well.
5. Stay out of indoor spaces that aren't your home and away from people you don't live with as much as practical. Minimize your contact with others and avoid indoor places as much as you can; indoor spaces spread disease through aerosols and distance is less effective at mitigating your risks.
6. Aim to have 3-6 months of living expenses on hand in case the pandemics give another crazy plot twist to the economy, or you know, a global war breaks out.
7. Replenish your supplies as you use them. Avoid reducing your stores to pre-pandemic levels in case an outbreak causes unexpected supply chain disruptions.
8. 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).
9. Masks must fit properly to work. Here's how to properly fit a mask:
10. If you think you may have been exposed to COVID-19, purchase several rapid antigen tests and/or acquire them from your healthcare provider or government. This will detect COVID-19 only when you're contagious, so follow the directions clearly. https://amzn.to/3fLAoor
If you think you may have been exposed to monkeypox, contact your healthcare provider about available testing.
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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 or monkeypox. 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 or monkeypox, nor do I financially benefit in any way from sharing information about COVID-19 or monkeypox.
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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.