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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Globally, we stand at 43 million cumulative cases and 1.1 million deaths. Last week we saw a new peak of over 500,000 cases per day.
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From the weekend circuit, Dr. Scott Gottlieb. "We're at a dangerous tipping point. Right now we're entering what's going to be the steep slope of the curve of the epidemic curve. We know what that looks like from the spring, we know what looks like from the summer, these cases are going to continue to build, there's really no back stop here. I don't see forceful policy intervention happening anytime soon. We have a moment of opportunity right now to take some forceful steps to try to abate the spread that's underway. But if we don't do that, if we miss this window, this is going to continue to accelerate, and it's going to be more difficult to get under control. Now in a lot of parts of the country, it doesn't feel really, really bad right now, because it's a little bad everywhere. We don't have regions where it's extremely dense in any one region, like we did when it was epidemic in New York or epidemic in the south, outside of states like Wisconsin or Iowa, most states just have a lot of spread. But most states aren't at the point where they're extremely pressed right now. That's going to change over the next two to three weeks, I think things are going to look much more difficult. And so we need to take some steps right now. There is no public support for shutdowns nationally, like we did in the spring, that's not going to happen. So we need to reach for other measures.
There's things that we can do to slow the spread. I mean, a national mask mandate can be put into place it doesn't need to be backed up with fines or or stringent enforcement. We have other requirements that we expect of a civil society that we enforce with, you know, political jawboning leadership, we give people warnings at first. So I think masks are one thing that we could be doing, we need to look at targeted mitigation starting to close congregate settings where we know spread is happening. Remember, even if we get a vaccine this year, and I'm on a board of Pfizer, one of the companies that's pretty far along in developing a vaccine, even that if that becomes available this year, and we get shots into the arms of the first tranche or patients, which is likely to be the elderly and health care workers. They're not going to have protective immunity until 2021 at some point in 2021, because it takes time for that vaccine to kick in and you need two doses. So this vaccine is not going to affect the contours of what we're going to go through which is going to play out in the next two or three months right now.
Remember, the masks serve two purposes. One is to protect other people from you. So if you're asymptomatic or pre symptomatic, if you have a mask on, you're less likely to expel respiratory droplets that can infect other people. The other purpose is to provide you some measure of protection, if in fact you're around people who are infected. So if you want a mask to afford us some protection from other people Quality Matters a cloth mask maybe 10% to 30% protective, a surgical mask level two or level three surgical mask procedure mask may be about 60% effective and N95 mask or an equivalent like a KN95 mask, which is a Chinese equivalent, or we call an FFP2 mass which is a European equivalent to an N95. That could be 90-95% protective. So if you want a mask to afford you a level of protection, wear higher quality mask if you only can get a cloth mask, thickness matters and cloth masks with polyester in them and a combination of polyester and cotton do better."
Source:
Commentary: Two takeaways. First, two rounds of shots for the vaccine to be effective; that complicates things because it means twice the delivery infrastructure.
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A fantastic video by the Slow Mo Guys of particle and aerosol project - and how masks help.
Source:
Commentary: The whole video is worth watching, especially the commentary on vaccines. The trials are aiming for 60% efficacy, but the higher it goes, the less of the population needs to be vaccinated in order to provide true, actual herd immunity. At 60% efficacy, basically everyone needs to get it.
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Shortages, part 1. "Across the U.S. and Europe, 29 out of 40 drugs used to combat the coronavirus are currently in short supply. And those shortages are expected to grow even worse as the number of Covid-19 cases and hospitalizations surge in the coming winter months, according to a new report by the Center for Infectious Disease Research and Policy at the University of Minnesota.
Moreover, the problem is likely to be exacerbated by the vagaries of the global pharmaceutical supply chain, which is heavily dependent on China for active pharmaceutical ingredients and on manufacturers based in India. As of now, 43% — or 67 of 156 — of acute care medicines used to treat various illnesses are running low. This group includes such staples as antibiotics, blood thinners, and sedatives.
“The supply chain has already been stressed over the past few years, but as we go through the fall and into the winter, we’re going to have some real challenges” thanks to Covid-19, said Michael Osterholm, director of CIDRAP and co-principal investigator of the center’s Resilient Drug Supply Project."
Source: https://www.statnews.com/pharmalot/2020/10/21/covid19-coronavirus-pandemic-shortages/
Commentary: If there are staple medications you need, be sure you have enough on hand in the event of more shortages. If you've stocked up, make sure you stay stocked - as you use them, replenish your stocks.
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Shortages, part 2. "Retailers and wholesalers have been stockpiling items that would be most coveted if customers must retreat to their homes again, and they are hopeful that shoppers will be less likely to hoard supplies this time around — reducing the strain on the system.
But supply chains take a long time to align with fast-moving shifts in customer demand. Some goods, including paper towels and cleaning products, still have not entirely caught up.
“There are still some items that we really cannot get,” said Michael Violette, chief executive of Associated Grocers of New England, a wholesale distribution center for the region’s independent grocers.
A resurgence of the virus could also disrupt production of products such as fresh produce and meat.
Georgia-Pacific, the massive producer whose brands include Sparkle and Brawny, said people are buying 15 to 20 percent more than usual, which a spokesman said is “a big increase to absorb for an industry that is used to a very consistent demand.”
The increase may be linked to the sustained demand in other cleaning products, such as sanitizing wipes, which have remained hard to come by through the summer and into fall.
“For folks wondering about turkeys for Thanksgiving and Christmas, we believe we’re well-positioned for the holidays. Orders for these meats are placed much earlier in the year, so these items are already in cold storage,” Jennifer Brogan, spokeswoman for Stop & Shop, said in an e-mail. “We have not only increased our buy, we have also shifted the focus into smaller turkey sizes, anticipating more small gatherings.”"
Source: https://www.bostonglobe.com/2020/10/19/business/supermarkets-theyre-prepping-panic-buying/
Commentary: As with pharmaceuticals, shop early and stock up (without hoarding). Each time you go out, if you need something (and there are no posted limits on what you are permitted to buy), pick up two. If you've let supplies dwindle down over the summer, take a trip to restock before the holiday season.
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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.
6. Participate in your local political process. For Americans, go to Vote.org and register/verify your vote.
7. Ventilate your home as frequently as weather and circumstances permit.
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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.
This is also available as an email newsletter at https://lunchtimepandemic.substack.com if you prefer the update in your inbox.