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.
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Lassie, fetch. Lassie, find COVID-19. "Four Covid-19 sniffer dogs have begun work at Helsinki airport in a state-funded pilot scheme that Finnish researchers hope will provide a cheap, fast and effective alternative method of testing people for the virus.
A dog is capable of detecting the presence of the coronavirus within 10 seconds and the entire process takes less than a minute to complete, according to Anna Hielm-Björkman of the University of Helsinki, who is overseeing the trial.
“It’s very promising,” said Hielm-Björkman. “If it works, it could prove a good screening method in other places” such as hospitals, care homes and at sporting and cultural events.
After collecting their luggage, arriving international passengers are asked to dab their necks with a wipe. In a separate booth, the jar containing the wipe is then placed next to others containing different scents, and the dog starts sniffing.
If it indicates it has detected the virus – usually by yelping, pawing or lying down – the passenger is advised to take a free polymerase chain reaction (PCR) test using a nasal swab to verify the dog’s verdict.
In the university’s preliminary tests, dogs – which have previously been used to detect diseases such as cancer and diabetes – were able to identify the virus with nearly 100% accuracy, even days before before a patient developed symptoms.
Scientists are not yet sure what exactly it is that the dogs sniff when they detect the virus. A French study published in June concluded that there was “very high evidence” that the sweat odour of Covid-positive people was different to that of those who did not have the virus, and that dogs could detect that difference.
Dogs are also able to identify Covid-19 from a much smaller molecular sample than PCR tests, Helsinki airport said, needing only 10-100 molecules to detect the presence of the virus compared with the 18m needed by laboratory equipment."
Source: https://www.theguardian.com/world/2020/sep/24/close-to-100-accuracy-airport-enlists-sniffer-dogs-to-test-for-covid-19
Commentary: Gone to the dogs means something quite potentially positive here. Logically, if there's a difference in odor, it would seem relatively straightforward to build electronic equipment to detect the same particles in similar concentrations?
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Russian malware on COVID-19 sites. "On September 8, 2020 Oxford University and AstraZeneca placed their COVID-19 vaccine (AZD1222) development on hold. During Phase 3 trials, a woman in the United Kingdom experienced an adverse neurological condition consistent with a rare spinal inflammatory disorder known as transverse myelitis. As is typical with large-scale vaccine trials, the woman’s condition triggered a pause in the trial, lasting until September 12, at which time the trial was officially resumed. Analysis was conducted on the Twitter conversation surrounding the AstraZeneca adverse reaction event and detected social media posts spreading malware and malicious software via links embedded within those posts. One possible goal of the perpetrators is to identify the audience that is most interested in the issue of vaccines in order to micro-target the group with future items of interest, possibly to artificially tilt the conversation for or against certain vaccines.
Seen in figure 1, our analysis includes 136,597 tweets from September 2nd – 12th. Tweets were collected from the Twitter developer’s API using keyword searches for “AstraZeneca”, “AZN”, “AZD1222” and the stock symbol “$AZN”. Beginning on the 8th, coinciding with the adverse event report, there is a large increase in the volume of tweets, with over 80,000 tweets identified on September 9th.
Within all collected tweets, 15,820 unique URLs were discovered (approximately 11.5% of tweets contained a URL). Most Twitter users utilize URLs within their tweets with the intent to flag or to redirect their audience to a related news story as shown in Figure 2. This particular URL for the popular news site, Stat News was shared in 1,265 tweets.
These tweets can also serve as vectors for the spread of malware. Malware can be loaded onto a webpage whose URL is shared with others. This is a technique that is of increasing concern in the spread of disinformation and propaganda. Through the open source malware detection platform VirusTotal (www.virustotal.com), we detected 53 sites hosting malware within the Astrazeneca conversation. Four URLs in particular were returned as malicious from the domain of Russian state sponsored Spanish-language Sputnik News (mundo.sputniknews.com). We deciphered that these set of domains were hosting seven distinct malware packages. Seen below in figure 3, these include executable files, android phone-specific malware, Microsoft Office XML, and a zipped folder rated as malicious. Notably, Russia’s Sputnik news site rests at the center of the malicious network.
While we do not know how many people were infected by the malware we found, we can say that the wrong person clicking the wrong link could have disastrous effects. One feature in particular could capture sensitive information on a user’s screen, like addresses, to credit card numbers, identification, or even confidential information in sectors like banking, or government. While we were able to catch the malware in advance, those without the same robust security would be at a much steeper risk.
This malware technique can also be used to identify users who are interested in vaccine stories in order to target them with future vaccine news. Micro-targeting allows for companies to define specific, rigid user profiles in order to create an audience for content and ads. If users are placed within one of these audiences, companies placing ads are able to send them content tailored for their interests. For instance, if someone is flagged as being interested in vaccine news, they might be a targeted recipient of an ad buy meant to highlight misleading, false, or sponsored news about the development of another vaccine. Since ads often appear organically in social media feeds, it is sometimes difficult to distinguish between an article your friend shared and an article a company paid to place in front of you."
Source: https://fas.org/blogs/fas/2020/09/vaccine-news-stories-hosting-malware-disseminated-across-spanish-language-twitter-fas-disinformation-report/
Commentary: Russia is proving you don't need to engineer the biological agent in order to conduct biological warfare. You simply have to sow enough dissent and discord in a target population to erode trust in medicine, and the existing infectious diseases will have the same net outcome.
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Viral load matters. "Patients with cancer may be at increased risk of severe coronavirus disease 2019 (COVID-19), but the role of viral load on this risk is unknown. We measured SARS-CoV-2 viral load using cycle threshold (CT) values from reverse transcription-polymerase chain reaction assays applied to nasopharyngeal swab specimens in 100 patients with cancer and 2914 without cancer who were admitted to three New York City hospitals. Overall, the in-hospital mortality rate was 38.8% among patients with a high viral load, 24.1% among patients with a medium viral load, and 15.3% among patients with a low viral load (P<0.001). Similar findings were observed in patients with cancer (high, 45.2% mortality; medium, 28.0%; low, 12.1%; P=0.008). Patients with hematologic malignancies had higher median viral loads (CT=25.0) than patients without cancer (CT=29.2; P=0.0039). SARS-CoV-2 viral load results may offer vital prognostic information for patients with and without cancer who are hospitalized with COVID-19."
Source: https://www.sciencedirect.com/science/article/pii/S1535610820304815
Commentary: The more of the virus you have, the worse your outcome. This is why wearing a mask is essential for everyone - even if it's not 100% protective, if you are infected, chances are the mask could reduce the amount of viral load you carry, and thus lead to potentially better outcomes for you.
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"2020 will be the deadliest year in modern American history. We will see >3 million deaths for the first time ever.
In fact, well over that number. We'll probably see 3.15 - 3.25 million deaths this year (from all causes). That is around 300,000 or more will be more than was "expected" But is that normal variance? Is that just a "bad year" combined with a bigger population? No and no.
How do we keep track of deaths in this country? It's easy. The CDC counts all the deaths, and divides by the population. (We're not talking about deciding what caused the deaths. This is ALL CAUSES). We express deaths as "deaths per 100,000 people." So how are we looking?
In 2018, there were 867 deaths per 100,000 people, or 8.67 for every 1,000. The number can vary (see below). As you can see, we were on track to have around 2.9 million deaths in 2020, and somewhere around 870 and closer to 890 deaths per 100,000, if we had a really bad year.
With 250,000+ excess deaths already recorded by CDC and others, it is reasonable to guess that we'll be closer to 300,000 by Dec 31. With over 330 million Americans, that's 3.2 million deaths, and a crude rate of 970 deaths per 100,000. 970 deaths per 100,000 is *a lot*. That's around a 10% increase in all cause deaths. A 10% increase in all deaths in *one year* Usually, as per above, you might see a 1-2% change in either direction over a couple of years. To have a 10% increase in all-cause deaths is truly impressive (and not in a good way)"
Source:
Commentary: Deadliest year in modern times for America - and it didn't have to be this way. It still doesn't have to be this way if everyone does their part and we have a coordinated national response.
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Risk awareness is softening. In an Ipsos poll, survey respondents see reduced risks from COVID for risky activities.
Source:
Commentary: Call it whatever sounds trendy, Corona fatigue, the reality is that people are letting their guard down. Don't be one of those people. The disease is no less deadly than it was in March 2020, no less dangerous to your health, and is in fact MORE infectious now than it was at the beginning of the year thanks to the D614G mutation that occurred in April, increasing the viral load in the nasal passages.
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It's not about droplets. "The global pandemic of COVID-19 has been associated with infections and deaths among health-care workers. This Viewpoint of infectious aerosols is intended to inform appropriate infection control measures to protect health-care workers. Studies of cough aerosols and of exhaled breath from patients with various respiratory infections have shown striking similarities in aerosol size distributions, with a predominance of pathogens in small particles (<5 μm). These are immediately respirable, suggesting the need for personal respiratory protection (respirators) for individuals in close proximity to patients with potentially virulent pathogens. There is no evidence that some pathogens are carried only in large droplets. Surgical masks might offer some respiratory protection from inhalation of infectious aerosols, but not as much as respirators. However, surgical masks worn by patients reduce exposures to infectious aerosols to health-care workers and other individuals. The variability of infectious aerosol production, with some so-called super-emitters producing much higher amounts of infectious aerosol than most, might help to explain the epidemiology of super-spreading. Airborne infection control measures are indicated for potentially lethal respiratory pathogens such as severe acute respiratory syndrome coronavirus 2."
Source: https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(20)30323-4/fulltext
Commentary: The consensus in the medical and research community has changed over the last 6 months as we've grown to understand SARS-CoV-2 better. Here's the reality: it's an aerosol, airborne disease FIRST, a droplet/fomite disease second. 6 feet of distance isn't enough in indoor spaces, not by a long shot. Wearing a mask is essential; wearing an N95 or better is essential if you're at risk. Stay out of enclosed spaces as much as practical. Stay away from other people as much as practical.
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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. 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.
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.
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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.