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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A new pre-print paper suggests COVID-19 immunity may not be all that strong. "The degree of protective immunity conferred by infection with SARS-CoV-2 is currently unknown. As such, the possibility of reinfection with this virus is not well understood. Herein, we describe the data from an investigation of two instances of SARS-CoV-2 infection in the same individual. Through nucleic acid sequence analysis, the viruses associated with each instance of infection were found to possess a degree of genetic discordance that cannot be explained reasonably through short-term in vivo evolution. We conclude that it is possible for humans to become infected multiple times by SARS-CoV-2, but the generalizability of this finding is not known."
Source: https://papers.ssrn.com/sol3/Delivery.cfm/55195c77-c275-4b08-bc21-d1902cfa44ad-MECA.pdf?abstractid=3681489&mirid=1
Dr. Akiko Iwasaki on the findings:
"A 25 yr old patient in Nevada has a confirmed case of #COVID19 reinfection (48 days apart between 1st and 2nd PCR).
This time, unlike the case in Hong Kong, the immune system did not protect this person from reinfection or disease.
During the 1st infection in April, patient recovered after about a month in isolation, testing negative for viral RNA in 2 subsequent tests. Patient was well until end of May, became ill and tested positive 2nd time. This time needing hospitalization & oxygen support.
Viral genome of 1st and 2nd isolates differed significantly, indicating that reinfection occurred.
This case highlights the need for further examination of the range of outcomes from reinfection by #COVID19. As more and more reinfection cases will be reported, we should get a better sense of how well the immune system after natural infection protects against disease."
Source:
Dr. Eric Ding:
"More importantly—unlike Hong Kong reinfection case where 2nd infection was asymptomatic mild, this Nevada person’s reinfection was SERIOUS that it needed hospitalization in June whenever the first March infection did not need hospitalization!"
Source:
Commentary: It's too early to draw firm conclusions from this study, but the ad hoc peer review by respected doctors like Dr. Iwasaki suggest that reinfection is not only possible, but that the second occurrence could be more severe. Thus, anyone who's had COVID-19 should still be practicing the basics - wear a mask, wash your hands, watch your distance, withdraw from indoor spaces as fast as possible.
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News finds a way. "On March 15, as the novel coronavirus was beginning to surge in the United States, Dr. Anthony S. Fauci accomplished a rare Washington feat: He appeared on all five major Sunday talk shows.
But the White House worried that Dr. Fauci might upstage (and sometimes contradict) President Trump, and soon his media handlers were no longer approving his high-profile interview requests.
So Dr. Fauci found another way to get his message out: He said yes to pretty much every small offer that came his way: academic webinars, Instagram feeds and niche science podcasts, as well as a few celebrity interviews.
That renown has pushed him into the higher echelons of media interest. Most people need a slot on a major show to have a better chance of reaching a huge audience. But reporters track all of Dr. Fauci’s appearances, however obscure.
“He can talk anywhere, and if he has something he wants to say, people will notice it,” said Brendan Buck, who was the communications director for former House Speaker Paul Ryan, another man who could make news even in obscure places. Dr. Fauci, he said, “could talk to a P.T.A. newsletter if he wanted to, and it would be covered, and there would be follow-on eyes for it.”
Asked about his rules for media appearances, Dr. Fauci said (by email) he frequently says yes. His only automatic nos are for fund-raisers or “anything remotely political.”
Whether by design or not, Dr. Fauci has effectively circumvented efforts by the White House to mute him. Since Mark Meadows took over as chief of staff on March 31, White House communications officials have approved very few requests from major outlets. But there is no such review process for smaller ones, like the weekly podcast of the Journal of the American Medical Association, or the KC O'Dea radio show."
Source: https://www.nytimes.com/interactive/2020/08/27/upshot/fauci-media-appearances.html
Commentary: The truth always finds a way. I only wish I had thought to try booking Dr. Fauci on my podcast.
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Some states are staying the course. "Several large U.S. states are not heeding new federal health officials’ calls to reduce COVID-19 testing of some exposed to the virus, joining a broad rebuke of the Trump administration by public health leaders.
Arizona, California, Connecticut, Florida, Illinois, Texas, New Jersey and New York all plan to continue to test asymptomatic people who have been exposed to COVID-19, despite new guidance from the Centers for Disease Control and Prevention (CDC) suggesting that such tests may not be needed.
“The current Texas guidance recommends testing for all close contacts of a confirmed case because it allows for early case identification among people who are at a higher risk of infection,” a spokesman for the Texas Department of State Health Services in a statement. “There’s not a planned change at this point.”
California and New York made similar statements. The Florida Department of Health said asymptomatic testing was continuing while the new CDC recommendations were evaluated, and Texas also said it would evaluate.
The CDC said this week that people exposed to COVID-19 but not symptomatic may not need to be tested, shocking doctors and politicians and prompting accusations the guidance was politically motivated.
Even before the CDC guidance, coronavirus testing in the United States had dropped. The United States tested on average 675,000 people a day last week, down from a peak in late July of over 800,000 people a day."
Source: https://www.reuters.com/article/us-health-coronavirus-usa-testing-idUSKBN25N31H
Commentary: Glad to see that states are staying the course. Rare are situations when less critical data is helpful compared to more critical data, and testing to identify where the disease is certainly qualifies as critical data. If you live in a locale that is considering reducing testing, contact your elected officials to urge them otherwise.
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COVID-19 isn't the only danger in schools. "The new coronavirus is not the only illness that teachers, students, parents and staff will have to worry about as some schools attempt to reopen this fall. Legionella could lurk in the water supplies of school buildings, and some measures to keep people in schools safe from coronavirus may even increase risks from deadly illnesses caused by the bacteria.
Last week in Ohio, officials found Legionella at five schools in an assortment of towns. On Friday, a district in Pennsylvania also announced it had found Legionella at four of its schools.
“It is unusual to hear about nine schools in a one-week period having a detection of Legionella,” said Andrew Whelton, an associate professor of civil, environmental and ecological engineering at Purdue University in Indiana who has been studying the effects of lockdown on water systems. He said that more schools may be testing for the bacteria than in a typical year.
Legionella, usually Legionella pneumophila, is the bacteria that causes Legionnaires’ disease, a respiratory condition. It can form in stagnant water and then disperse through the air and be inhaled when, for example, a shower or tap is turned on. It can be fatal in one in 10 cases, according to the Centers for Disease Control and Prevention. Although young children are less at risk of Legionnaires’, older students, adults and people with compromised immune systems are vulnerable.
To protect against the spread of coronavirus, many school buildings have been unoccupied since March. Their bathrooms, cafeterias and sports facilities have gone unused. While low occupancy in schools is typical during summer breaks, many are open for summer school and other activities. Experts worry that water was left to stagnate in plumbing during lockdown, and that schools don’t have plans or effective guidance from health authorities for dealing with the effects of prolonged shutdowns.
“Schools generally do not have a water management plan,” Dr. Whelton said. “There’s a myth that most do. They don’t in my experience.”"
Source: https://www.nytimes.com/2020/08/27/health/covid-schools-legionnaires-disease.html
Commentary: Any building that is restarting after a long period of dormancy needs a full reboot plan - and we may discover as we reboot that the infrastructure our society is built on is in much worse condition than we thought.
COVID-19, as disruptive as it has been, has also presented us with an opportunity to pivot, to repair, to replace things that clearly don't work. It has laid bare our underinvestment in critical infrastructure, and hopefully before it is over, we will use the opportunity to fix what needs to be fixed in our socities.
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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. 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.