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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USA CDC reinstates some mask guidance. "If you are fully vaccinated, you can participate in many of the activities that you did before the pandemic.
To maximize protection from the Delta variant and prevent possibly spreading it to others, wear a mask indoors in public if you are in an area of substantial or high transmission.
Wearing a mask is most important if you have a weakened immune system or if, because of your age or an underlying medical condition, you are at increased risk for severe disease, or if someone in your household has a weakened immune system, is at increased risk for severe disease, or is unvaccinated. If this applies to you or your household, you might choose to wear a mask regardless of the level of transmission in your area.
You should continue to wear a mask where required by laws, rules, regulations, or local guidance."
Source: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/fully-vaccinated.html
Commentary: I disagree with this assessment because nuance isn't the strength of the general population. Make it easy for people: wear the best mask available to you indoors any place that isn't your home. That's it. It's easy. It's clear. It's more or less free now (because everyone should have masks of some kind).
Keep it simple.
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How are vaccines doing in the Delta era? Quite well. "Hospitalizations are surging in the least vaccinated places while barely changing in the most vaccinated."
Source:
Commentary: Delta is a problem to everyone but a THREAT to the unvaccinated. Protect the unvaccinated (like kids under 12) by taking precautions to keep COVID-19 away from them. Everyone else? Get vaccinated.
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6 false dichotomies of the pandemic. "Scientists across disciplines, policymakers, and journalists have voiced frustration at the unprecedented polarization and misinformation around coronavirus disease 2019 (COVID-19) pandemic. Several false dichotomies have been used to polarize debates while oversimplifying complex issues. In this comprehensive narrative review, we deconstruct six common COVID-19 false dichotomies, address the evidence on these topics, identify insights relevant to effective pandemic responses, and highlight knowledge gaps and uncertainties. The topics of this review are: 1) Health and lives vs. economy and livelihoods, 2) Indefinite lockdown vs. unlimited reopening, 3) Symptomatic vs. asymptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, 4) Droplet vs. aerosol transmission of SARS-CoV-2, 5) Masks for all vs. no masking, and 6) SARS-CoV-2 reinfection vs. no reinfection. We discuss the importance of multidisciplinary integration (health, social, and physical sciences), multilayered approaches to reducing risk (“Emmentaler cheese model”), harm reduction, smart masking, relaxation of interventions, and context-sensitive policymaking for COVID-19 response plans. We also address the challenges in understanding the broad clinical presentation of COVID-19, SARS-CoV-2 transmission, and SARS-CoV-2 reinfection. These key issues of science and public health policy have been presented as false dichotomies during the pandemic. However, they are hardly binary, simple, or uniform, and therefore should not be framed as polar extremes. We urge a nuanced understanding of the science and caution against black-or-white messaging, all-or nothing guidance, and one-size-fits-all approaches. There is a need for meaningful public health communication and science-informed policies that recognize shades of gray, uncertainties, local context, and social determinants of health."
Source: https://bmcinfectdis.biomedcentral.com/track/pdf/10.1186/s12879-021-06357-4.pdf
Commentary: An excellent, thorough read about the fact that nearly everything is shades of grey.
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The superpower of the mRNA vaccines. "Individuals facing the threat of COVID-19 may care most about a vaccine’s ability to forestall grave disease that could lead to a hospital bed or worse. And a number of vaccines perform that vital task well, including those from Johnson & Johnson and AstraZeneca, which are based on genetically engineered cold viruses, as well as the not-yet-authorized protein vaccine from Novavax. But for public health experts trying to halt a global pandemic, shutting down even the mildest infections is also crucial, especially as the highly infectious Delta variant surges in scores of countries. By that measure, according to a brace of new studies, the messenger RNA (mRNA) vaccines from the Pfizer-BioNTech collaboration and Moderna stand out.
“All COVID-19 vaccines are not created equal,” says Eric Topol, a physician-scientist at the Scripps Research Translational Institute. “It’s clear that the two mRNA vaccines are highly effective at preventing infection—and that others wouldn’t be expected to break the chain as well.”
The large clinical trials that persuaded governments around the world to authorize COVID-19 vaccines mostly looked at their ability to block symptomatic disease and illness severe enough to lead to hospitalization or death. Preventing all infections, including those with no symptoms at all, is “rather a neglected endpoint,” says Adeel Butt, an epidemiologist and infectious disease specialist at the Veterans Affairs Pittsburgh Healthcare System. Yet, “It’s very, very important … to break the transmission of infection,” says Butt, who also works at Weill Cornell Medicine, Qatar."
Source: https://www.sciencemag.org/news/2021/07/overlooked-superpower-mrna-vaccines
Commentary: To be clear, any authorized vaccine is better than no vaccine. But if you have a choice, get an mRNA vaccine. They are objectively better because they shut down transmission much more.
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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 other people, 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 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. Get your personal finances in order now. Cut all unnecessary costs.
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:
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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.