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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Delta Airlines imposes insurance surcharge on unvaccinated employees. "Delta Air Lines is putting a new deadline on unvaccinated employees that will require them to take weekly Covid tests and, depending on their insurance, pay a $200 per month surcharge.
Delta (DAL) CEO Ed Bastian made the announcement in a company-wide memo, which the company shared with CNN. The airline says may of its employees are already vaccinated, but it has room for improvement.
"While we can be proud of our 75% vaccination rate, the aggressiveness of the variant means we need to get many more of our people vaccinated, and as close to 100% as possible," said Bastian.
Delta says starting September 12, any US employee who is not fully vaccinated will be required to take a weekly coronavirus test "while community case rates are high." The airline says those with a positive result will need to isolate and remain out of the workplace.
Beginning November 1, all unvaccinated Delta employees "enrolled in Delta's account-based health care plan will be subject to a $200 monthly surcharge."
"The average hospital stay for Covid-19 has cost Delta $40,000 per person," said the airline. "This surcharge will be necessary to address the financial risk the decision to not vaccinate is creating for our company.""
Source: https://www.cnn.com/2021/08/25/business/delta-unvaccinated-insurance-cost-increase/index.html
Commentary: This is the way. And in the long term, this is how we'll solve for vaccination in a way that allows people to still make a choice, but that choice has real, financial consequences. Insurance companies will not want to foot the bill for preventable illness, and they will be a massive driver of change in the USA, where company-provided health insurance is the primary means folks get healthcare coverage.
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Window of science is closing. "Our group was convened by the World Health Organization (WHO) in October 2020. We have been the designated independent international members of a joint WHO–China team tasked with understanding the origins of SARS-CoV-2. Our report was published this March1. It was meant to be the first step in a process that has stalled. Here we summarize the scientific process so far, and call for action to fast-track the follow-up scientific work required to identify how COVID-19 emerged, which we set out in this article.
The window of opportunity for conducting this crucial inquiry is closing fast: any delay will render some of the studies biologically impossible. Understanding the origins of a devastating pandemic is a global priority, grounded in science.
The search for the origins of SARS-CoV-2 is at a critical juncture. There is willingness to move forward from both the WHO international team and the Chinese team.
Crucially, the window is rapidly closing on the biological feasibility of conducting the critical trace-back of people and animals inside and outside China. SARS-CoV-2 antibodies wane, so collecting further samples and testing people who might have been exposed before December 2019 will yield diminishing returns. Chinese wildlife farms employ millions of people (14 million, according to a 2016 census11) and supplied live mammals to cities across China, including Wuhan3. In response to the SARS-CoV-2 pandemic, many of these farms are now closed and the animals have been culled, making any evidence of early coronavirus spillover increasingly difficult to find.
In July, four months after the full report and five months after our debriefing, the WHO informed member states of plans to create a committee that will oversee future origins studies. We are pleased to see both this and its implication that outbreak investigations will be conducted routinely, rather than in an ad hoc manner that could be perceived as politically motivated or with potentially punitive goals."
Source: https://www.nature.com/articles/d41586-021-02263-6
Commentary: Let's hope the politicians can keep their noses out of the investigation long enough for us to get the research done needed to trace the origins of COVID-19. We still need a lot of work done.
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Why efficacy against spread may be waning but severity holding up. "SARS-CoV-2 mRNA vaccines have shown remarkable efficacy, especially in preventing severe illness and hospitalization. However, the emergence of several variants of concern and reports of declining antibody levels have raised uncertainty about the durability of immune memory following vaccination. In this study, we longitudinally profiled both antibody and cellular immune responses in SARS-CoV-2 naïve and recovered individuals from pre-vaccine baseline to 6 months post mRNA vaccination. Antibody and neutralizing titers decayed from peak levels but remained detectable in all subjects at 6 months post-vaccination. Functional memory B cell responses, including those specific for the receptor binding domain (RBD) of the Alpha (B.1.1.7), Beta (B.1.351), and Delta (B.1.617.2) variants, were also efficiently generated by mRNA vaccination and continued to increase in frequency between 3 and 6 months post-vaccination. Notably, most memory B cells induced by mRNA vaccines were capable of cross-binding variants of concern, and B cell receptor sequencing revealed significantly more hypermutation in these RBD variant binding clones compared to clones that exclusively bound wild-type RBD. Moreover, the percent of variant cross-binding memory B cells was higher in vaccinees than individuals who recovered from mild COVID-19. mRNA vaccination also generated antigen-specific CD8+ T cells and durable memory CD4+ T cells in most individuals, with early CD4+ T cell responses correlating with humoral immunity at later timepoints. These findings demonstrate robust, multi-component humoral and cellular immune memory to SARS-CoV-2 and current variants of concern for at least 6 months after mRNA vaccination. Finally, we observed that boosting of pre-existing immunity with mRNA vaccination in SARS-CoV-2 recovered individuals primarily increased antibody responses in the short-term without significantly altering antibody decay rates or long-term B and T cell memory. Together, this study provides insights into the generation and evolution of vaccine induced immunity to SARS-CoV-2, including variants of concern, and has implications for future booster strategies."
Source: https://www.biorxiv.org/content/10.1101/2021.08.23.457229v1.full.pdf
Commentary: This is a really important paper; what it's saying is that Delta and Beta evade short-term early immune response, but not the long-term response. That's why Delta in particular can spread so easily, but deaths and hospitalizations are remaining low. In effect, Delta and Beta can avoid the early immune response, thus remaining highly contagious, but they can't dodge the heavy-duty immune response, so they can't cause severe illness or death as easily as in someone unvaccinated.
That means that to control spread, boosters might be a good idea. But to control severe illness and death, the existing vaccines continue to work for now. Evolutionarily, this makes total sense: a dead host cannot help you replicate and survive. A living host that shakes off your severe effects but still lets you spread is an evolutionary advantage.
What this means, however, is that if you're unvaccinated, you're at substantial risk. Stay masked up, and get vaccinated as soon as it's available to you.
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Unrelated to COVID-19 but in the vein of preparedness, the Panama Canal is shutting down for two weeks for maintenance. Compound this with the Ningbo terminal shutdown in China, and supply chains for everything are thoroughly hosed right now and will be for weeks to come.
What this means for you is that if you need stuff that comes from overseas, stock up a little if it's available now. If you're thinking about the holidays and holiday shopping, start now in case shipping and delivery times are substantially extended. Don't get caught unawares - get your preparations done now while the masses aren't paying attention.
Source: https://www.tradewindsnews.com/tankers/ships-could-be-delayed-for-weeks-as-panama-canal-plans-maintenance/2-1-1056123
Source: https://www.tradewindsnews.com/containerships/container-congestion-spreads-as-key-china-terminal-remains-closed/2-1-1053403
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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. 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. Verify your mask's NIOSH certification here: https://www.cdc.gov/niosh/npptl/usernotices/counterfeitResp.html
3. 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 getting an mRNA single shot booster (Pfizer/Moderna) if permitted.
4. Wash/sanitize your hands every time you are in or out of your home.
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 the 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 pandemic gives another crazy plot twist to the economy.
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 a rapid antigen test. This will detect COVID-19 only when you're contagious, so follow the directions clearly. https://amzn.to/3fLAoor
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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.