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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Wear a mask indoors, vaccinated or not. "With the highly contagious Delta variant of the coronavirus continuing to spread statewide, the Los Angeles County Department of Public Health is recommending that all residents wear masks in public indoor spaces — regardless of whether they’ve been vaccinated for COVID-19.
Monday’s announcement is one of the clearest signals yet of just how seriously health officials are taking the strain, and the danger it poses, particularly to those who have yet to be inoculated.
Officials have said the available vaccines appear to offer strong protection. But there’s significant concern that those who have yet to receive all their required shots, or any doses at all, remain vulnerable to the Delta variant — which may be twice as transmissible as the conventional coronavirus strains.
More than 3 in 5 Californians have gotten at least one vaccine dose to date, but fewer than half are fully vaccinated, according to data from the U.S. Centers for Disease Control and Prevention. California has one of the nation’s highest vaccination rates, and that has many experts confident the Delta strain won’t cause the kinds of COVID-19 surges seen over the last year.
While not a new mask mandate, L.A. County is urging that, as a precaution, “people wear masks indoors in settings such as grocery or retail stores; theaters and family entertainment centers, and workplaces when you don’t know everyone’s vaccination status.”
“Until we better understand how and to who the Delta variant is spreading, everyone should focus on maximum protection with minimum interruption to routine as all businesses operate without other restrictions, like physical distancing and capacity limits,” officials wrote in a statement."
Source: https://www.latimes.com/california/story/2021-06-28/as-delta-variant-spreads-l-a-county-recommends-everyone-mask-indoors
Commentary: This has been my perspective all along. There's no harm or cost to me, a fully vaccinated person, to continuing to wear a mask. None. And it virtually guarantees I won't accidentally bring it home to my unvaccinated kid.
Delta is highly transmissible. Keep unvaccinated people away from other people, and if they have to be, continue double-masking with the best mask available to you.
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AstraZeneca proving less effective against variants than the mRNA vaccines. "Vaccines are proving to be highly effective in controlling hospitalisation and deaths associated with SARS-CoV-2 infection but the emergence of viral variants with novel antigenic profiles threatens to diminish their efficacy. Assessment of the ability of sera from vaccine recipients to neutralise SARS-CoV-2 variants will inform the success of strategies for minimising COVID19 cases and the design of effective antigenic formulations. Here, we examine the sensitivity of variants of concern (VOCs) representative of the B.1.617.1 and B.1.617.2 (first associated with infections in India) and B.1.351 (first associated with infection in South Africa) lineages of SARS-CoV-2 to neutralisation by sera from individuals vaccinated with the BNT162b2 (Pfizer/BioNTech) and ChAdOx1 (Oxford/AstraZeneca) vaccines. Across all vaccinated individuals, the spike glycoproteins from B.1.617.1 and B.1.617.2 conferred reductions in neutralisation of 4.31 and 5.11-fold respectively. The reduction seen with the B.1.617.2 lineage approached that conferred by the glycoprotein from B.1.351 (South African) variant (6.29-fold reduction) that is known to be associated with reduced vaccine efficacy. Neutralising antibody titres elicited by vaccination with two doses of BNT162b2 were significantly higher than those elicited by vaccination with two doses of ChAdOx1. Fold decreases in the magnitude of neutralisation titre following two doses of BNT162b2, conferred reductions in titre of 7.77, 11.30 and 9.56-fold respectively to B.1.617.1, B.1.617.2 and B.1.351 pseudoviruses, the reduction in neutralisation of the delta variant B.1.617.2 surpassing that of B.1.351. Fold changes in those vaccinated with two doses of ChAdOx1 were 0.69, 4.01 and 1.48 respectively. The accumulation of mutations in these VOCs, and others, demonstrate the quantifiable risk of antigenic drift and subsequent reduction in vaccine efficacy. Accordingly, booster vaccines based on updated variants are likely to be required over time to prevent productive infection. This study also suggests that two dose regimes of vaccine are required for maximal BNT162b2 and ChAdOx1-induced immunity."
Source: https://www.medrxiv.org/content/10.1101/2021.06.23.21259327v1.full.pdf
Commentary: While the paper doesn't cite it, Moderna also released data showing it is effective against the variants.
Source: https://www.bloomberg.com/news/articles/2021-06-29/moderna-s-covid-shot-produces-antibodies-against-delta-variant
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Minorities lacked access to virtual schooling. "Reduced access to in-person learning is associated with poorer learning outcomes and adverse mental health and behavioral effects in children.
Although access to in-person, hybrid, and virtual learning modes varied throughout the school year, during January–April 2021, access to full-time in-person learning for non-Hispanic White students increased by 36.6 percentage points, 31.1 percentage points for non-Hispanic Black students, 22.0 percentage points for Hispanic students, and 26.6 percentage points for students of other race/ethnicities.
To increase equitable access to full-time in-person learning for the 2021–22 school year, school leaders should focus on providing safety-optimized in-person learning options across grade levels in all geographic areas. Vaccination and other efforts to reduce levels of community transmission should be intensified."
Source: https://www.cdc.gov/mmwr/volumes/70/wr/mm7026e2.htm?s_cid=mm7026e2_w
Commentary: While the paper goes on to cite the importance of in-person schooling for equitable educational outcomes, I'd also argue that structural inequalities like cost of broadband access and computational resources also play a key role, and if we want everyone to have the same access to opportunity, they need at least similar equipment. It'd be like hosting a cooking contest in which one contestant gets a fully-stocked, decked out commercial kitchen and another contestant gets a bowl and a spoon and nothing else. Only situations where a total idiot gets the kitchen and a savant gets the bowl & spoon will you get results where the latter situation produces a winner. Give everyone the same starting line and let their natural talent take it from there.
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Delta is ripping through Africa. "The more-transmissible Delta variant of the coronavirus is surging across Africa, the continent with the least vaccines and weakest healthcare systems, feeding fears among epidemiologists and political leaders of a public-health disaster that could echo the tragedy that unfolded in India in the spring.
The speed of the takeover of the variant, which was first identified in India and is forcing governments around the globe to tighten restrictions on social and economic activities, has shocked health experts in Africa, a continent that—in part thanks to its younger population—has recorded fewer Covid-19 deaths than other regions. Some are warning that previous infection from another strain of the virus may not protect against Delta, leaving swaths of the population that were believed to be immune once again vulnerable.
In South Africa, families have been driving ailing relatives across state lines to try to secure one of the country’s few remaining intensive-care beds. On a recent June night, every one of the 30 Covid-19 patients in the intensive-care unit of Uganda’s largest hospital died as the oxygen supplies ran out. In Zambia’s capital, Lusaka, doctors say the mortuaries have run out of space."
Source: https://www.wsj.com/articles/delta-variant-of-covid-19-surges-across-unvaccinated-africa-11624896315?mod=searchresults_pos2&page=1
Commentary: Africa has vaccinated less than 1% of the billion people who live on the continent, and Delta is moving very, very fast. What that means is that Africa is poised to become the next source of major variants if we don't get vaccines on the ground there quickly and in massive quantity.
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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. 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 gettings an mRNA single shot booster (Pfizer/Moderna).
3. Wash/sanitize your hands every time you are in or out of your home.
4. Stay 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.
5. Get your personal finances in order now. Cut all unnecessary costs.
6. Replenish your supplies as you use them. Avoid reducing your stores to pre-pandemic levels in case an outbreak causes unexpected supply chain disruptions.
7. 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).
8. 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.