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.
You are welcome to share this.
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Happy holidays. I hope you've been safe and healthy.
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An early, pre-print, not peer-reviewed paper on the new SARS-CoV-2 variant from the reputable Centre for Mathematical Modelling of Infectious Diseases in London.
"A novel SARS-CoV-2 variant, VOC 202012/01, emerged in southeast England in November 2020 and appears to be rapidly spreading towards fixation. We fitted a two-strain mathematical model of SARS-CoV-2 transmission to observed COVID-19 hospital admissions, hospital and ICU bed occupancy, and deaths; SARS-CoV-2 PCR prevalence and seroprevalence; and the relative frequency of VOC 202012/01 in the three most heavily affected NHS England regions (South East, East of England, and London). We estimate that VOC 202012/01 is 56% more transmissible (95% credible interval across three regions 50-74%) than preexisting variants of SARS-CoV-2. We were unable to find clear evidence that VOC 202012/01 results in greater or lesser severity of disease than preexisting variants. Nevertheless, the increase in transmissibility is likely to lead to a large increase in incidence, with COVID-19 hospitalisations and deaths projected to reach higher levels in 2021 than were observed in 2020, even if regional tiered restrictions implemented before 19 December are maintained. Our estimates suggest that control measures of a similar stringency to the national lockdown implemented in England in November 2020 are unlikely to reduce the effective reproduction number Rt to less than 1, unless primary schools, secondary schools, and universities are also closed. We project that large resurgences of the virus are likely to occur following easing of control measures. It may be necessary to greatly accelerate vaccine roll-out to have an appreciable impact in suppressing the resulting disease burden."
Source: https://cmmid.github.io/topics/covid19/uk-novel-variant.html
Commentary: A 56% increase in transmissibility is bad news. Why? Because a disease that's deadlier means it burns itself out faster. Diseases that kill in great numbers don't have a survival advantage - they kill off too many of their hosts. Diseases that don't kill, but spread like wildfire even with a low fatality rate kill many more people because they just spread so much faster.
We are now in a global race between the new variant - which is likely to spread and take over the current variant (the D614G mutation observed in early to mid 2020) - and the vaccine rollout. Let's hope we can beat the clock.
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Care rationing has begun in California. From the image:
"If a patient becomes ill and the doctor believes the patient needs extra care in an ICU or needs mechanical ventilation, their case will be reviewed along with other patient cases, to determine how these resources should be shared throughout the hospital.
If a patient becomes extremely sick and very unlikely to survive his/her illness - even with lifesaving treatment - limited medical resources may go to treat other patients who are more likely to survive."
Source:
/photo/1
Commentary: This is how COVID kills in larger numbers. When the healthcare system is operating normally, as it was close to doing this past summer, every patient who needed a high standard of care could receive it. When the healthcare system is overloaded, as happened in Wuhan, in Milan, and throughout the United States, care standards have to drop because of limited resources, and fatalities spike.
How do we stop this? Simple. Obey the public health measures asked of us. Stay home as much as possible. Wear a mask outside your home, always. Watch your distance around others, staying as far away as practical. Stay out of indoor spaces that aren't your own, and when indoors, wear the best mask available to you.
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Has the new variant reached the United States? Trevor Bedford at Bedford Labs runs a statistical analysis suggesting the answer is currently no. “Using this method, observing 0 variant viruses in 112 specimens collected in December yields a 95% uncertainty interval of 0% to 2.2% frequency. These December specimens are primarily from California, Michigan, Minnesota and Utah. 6/12”
Source:
Commentary: When - and it’s largely a question of when, not if, the new variants from the UK and South Africa reach America, they will still find fertile grounds for replication. For any nation that doesn’t currently have the new variants, double your diligence.
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No need to disinfect EVERYTHING all the time. “At the start of the pandemic, stores quickly sold out of disinfectant sprays and wipes. People were advised to wipe down their packages and the cans they bought at the grocery store.
But scientists have learned a lot this year about the coronavirus and how it's transmitted, and it turns out all that scrubbing and disinfecting might not be necessary.
If a person infected with the coronavirus sneezes, coughs or talks loudly, droplets containing particles of the virus can travel through the air and eventually land on nearby surfaces. But the risk of getting infected from touching a surface contaminated by the virus is low, says Emanuel Goldman, a microbiologist at Rutgers University.
"In hospitals, surfaces have been tested near COVID-19 patients, and no infectious virus can be identified," Goldman says.
What's found is viral RNA, which is like "the corpse of the virus," he says. That's what's left over after the virus dies.
"They don't find infectious virus, and that's because the virus is very fragile in the environment — it decays very quickly," Goldman says.”
Source: https://www.npr.org/sections/health-shots/2020/12/28/948936133/still-disinfecting-surfaces-it-might-not-be-worth-it
Commentary: COVID-19 is a respiratory disease. Ventilation matters a great deal more. That said, things which are in proximity to your nose and mouth should absolutely still be cleaned regularly such as handkerchiefs, toothbrushes, etc. and obviously toss every cloth mask in the wash after use.
I will also add that there remains very strong benefit to washing your hands regularly, regardless of COVID-19. They touch your face regularly - sometimes subconsciously- and can bring not only SARS-CoV-2 but a plethora of other viruses and bacteria into your body. So in short, wash your hands and other surfaces in close proximity to your nose and mouth regularly. The rest can go to a normal cleaning schedule.
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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. If you come in physical contact with others, wash your clothing upon returning home.
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. When going indoors to a place that isn't your home, wear the best protective mask available to you.
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. 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).
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Common misinformation debunked!
There is no mercury or other heavy metals in the Pfizer mRNA vaccine. https://www.technologyreview.com/2020/12/09/1013538/what-are-the-ingredients-of-pfizers-covid-19-vaccine/
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.