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 a qualified healthcare provider who knows your specific medical situation over advice from people on the Internet.
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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Commentary: keep wearing your mask out and about. BA.2 isn't messing around - and no matter what your local government says about what's required, wearing a mask has little cost and substantial benefit.
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A federal judge has ruled that mask-optional laws violate the rights of people who are immune compromised. "A federal judge has ruled in favor of the families of 12 immunocompromised students, who filed a lawsuit claiming that Virginia’s new mask-optional law violates their rights under the Americans with Disabilities Act.
In his ruling, Judge Norman Moon makes clear that SB739 is law in Virginia, but the law is precluding the students’ rights to seek masking as an accommodation under the ADA, even if it’s the most reasonable option.
“This is not a class action, and the twelve plaintiffs in this case have no legal right to ask the Court to deviate from that state law in any schools in Virginia (much less school districts) their children do not attend, or indeed even those areas of their schools in which Plaintiffs’ children do not frequent,” he wrote."
Source: https://wtop.com/virginia/2022/03/judge-rules-in-favor-of-immunocompromised-students-but-masking-still-optional-in-virginia/
Commentary: In other words, asking students around you to wear a mask was ruled a "Reasonable accommodation" under the ADA, an interesting twist in mask laws.
Bottom line: wear a mask. It doesn't cause harm, it doesn't cost you anything, and it also protects others around you as well as you.
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Omicron BA.2 might be more severe in kids. "Findings: Four deaths (0.35%) occurred during the Omicron wave, resulting in a higher in-hospital case fatality rate than other SARS-CoV-2 variants (0%), influenza (0.05%) and parainfluenza (0.04%). PICU admission was higher for Omicron than other SARS-CoV-2 variants (OR=18.50, 95% CI 2.42-140.70, p=0.005) and influenza (OR=2.32, 95% CI 1.48-3.64, p<0.001). The proportion with neurological complications was 14.91% (171 out of 1,147) for Omicron, which was higher than influenza and parainfluenza (OR=1.75 95% CI 1.48-2.08 and OR=2.06 95% CI 1.74-2.46, p<0.001 for both, respectively). Croup occurred for Omicron more than other SARS-CoV-2 variants (OR=11.47, 95% CI 2.77-47.46 p = 0.001) and influenza (OR= 2.08, 95% CI 1.58-2.74 p<0.001) but not parainfluenza.
Interpretation: The intrinsic severity of Omicron BA.2 is not mild as evident by the fatality and severe complications of the uninfected and unvaccinated children."
Source: https://papers.ssrn.com/sol3/papers.cfm?abstract_id=4063036
Commentary: The pandemic isn't done with us, even if we feel like we're done with the pandemic. If you have kids and they're eligible for vaccination, get them fully vaccinated ASAP. If they're not eligible, get them masked up with the best possible mask available to you.
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The United States is in for a world of hurt very soon. "This week, Congress nixed $15 billion in coronavirus funding from a $1.5 trillion spending bill, which President Joe Biden then signed on Tuesday. The decision is catastrophic, and as the White House has noted, its consequences will unfurl quickly. Next week, the government will have to cut shipments of monoclonal-antibody treatments by a third. In April, it will no longer be able to reimburse health-care providers for testing, vaccinating, or treating millions of uninsured Americans, who are disproportionately likely to be unvaccinated and infected. Come June, it won’t be able to support domestic testing manufacturers. It can’t buy extra doses of antiviral pills or infection-preventing treatments that immunocompromised people are banking on but were already struggling to get. It will need to scale back its efforts to improve vaccination rates in poor countries, which increases the odds that dangerous new variants will arise. If such variants arise, they’ll likely catch the U.S. off guard, because surveillance networks will have to be scaled back too. Should people need further booster shots, the government won’t have enough for everyone."
Source: https://www.theatlantic.com/health/archive/2022/03/congress-covid-spending-bill/627090/
Commentary: Cutting pandemic funding while in the middle of a pandemic is... deeply stupid. There's no other way to describe it. Right now, the two signals we'll have that something is wrong will be wastewater data and hospital admissions.
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BA.2 spreading among the vaccinated. "Between March 17 and March 23, Cornell recorded 515 positive COVID-19 infections among students, staff and faculty, according to data from the university.
"COVID-19 cases on the Ithaca campus are increasing beyond our predictions, indicating a substantial prevalence of the virus on campus," Provost Michael Kotlikoff said in a statement on Wednesday. "This rising transmission is likely due to a number of factors, including relaxing mask requirements, the emergence of the BA.2 variant, and increased social activities."
Data shows 97% of the student population is vaccinated, while 92% of those eligible are boosted."
Source: https://www.msn.com/en-us/health/medical/cornell-university-reports-indications-of-substantial-prevalence-of-covid-on-campus/ar-AAVt9CR
Commentary: Mask up. When 92% of the population is vaccinated and boosted and you're still seeing surprisingly high case numbers, you have an immune-evasive variant running around. Mechanical interventions - masks and ventilation - are the way to control it.
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China locks down all of Shanghai. "China began its most extensive lockdown in two years Monday to conduct mass testing and control a growing COVID-19 outbreak in Shanghai as questions are raised about the economic toll of the nation's "zero-COVID" strategy.
China's financial capital and largest city with 26 million people, Shanghai had managed its smaller, past outbreaks with limited lockdowns of housing compounds and workplaces where the virus was spreading.
The citywide lockdown that will be conducted in two phases will be China's most extensive since the one in the central city of Wuhan, where the virus was first detected in late 2019, which confined its 11 million people to their homes for 76 days in early 2020. Millions more have been kept in lockdown since then."
Source: https://www.cbc.ca/news/world/shanghai-lockdown-mass-testing-covid-19-1.6399546
Commentary: When you close down a city of 26 million people - your largest city - you know there's a problem.
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COVID + flu is a killer. "As public health restrictions are lifted, respiratory virus co-infections are more likely to occur during future winters. The marked increase in risk among patients with co-infection has several implications for policy. First, our results provide further support for vaccination against both SARS-CoV-2 and influenza viruses. Second, they suggest that testing for influenza viruses is important in hospital inpatients with COVID-19 to identify patients at risk and a cohort of patients who might have different responses to immunomodulatory and antiviral therapy."
Source: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)00383-X/fulltext
Commentary: COVID + flu is 4 times as deadly as COVID alone. The good news is that wearing a mask stops both.
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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, including boosters. 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 available. If it's available, choose Moderna as your first choice for both vaccine and booster, Pfizer as your second choice. However, remember than any vaccine is better than no vaccine.
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, or you know, a global war breaks out.
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.