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 to start: "We don't know yet" is the major takeaway from all the news about the Omicron variant. But what we do know, without a doubt, is that it is still SARS-CoV-2, which means that non-pharmaceutical measures - masks, distancing, ventilation, avoiding large crowds, continue to still be effective. Wear the best mask available to you at all times in spaces other than your home. Wear a mask outside if you'll be around other people close enough to smell them if they were smoking.
If you or someone you know is not vaccinated, do your best to persuade them to be. If you or someone you know is eligible for a booster shot and it's available in your region, get it.
Delta is still raging in many areas, and I have no doubt Omicron is already in many nations. Our best defense remains a layered one - distancing, sanitation, ventilation, masks, and vaccines in combination.
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Omicron early data from wastewater. "Monitoring wastewater for viral load estimates outbreak size
In just a few weeks, in Pretoria S. Africa (north of Johannesburg) viral load detected in wastewater has reached similar levels as the peak of Delta
This at least indicates that transmission may be remarkably swift.
Many are asking a very reasonable question:
If detected cases are low but wastewater viral loads high, does this mean most cases are so mild that are going undetected?
This is one hypothesis. The other is wastewater is a leading indicator. Time will tell.
I expect wastewater is leading indicator & clinical cases/hospitalizations will rise. Do I know this for sure? Nope. But there isn’t much in this virus sequence suggesting it should be very mild
On other hand, Delta just blew through S Africa which should offer protection today"
Source:
Commentary: Wastewater monitoring has proven to be an essential surveillance tool. I hope we continue using it for the foreseeable future for many diseases, not just one. But if we can detect viral shedding this early at a municipal level, hopefully we can track where outbreaks are beginning faster.
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More on what we do and don't know. " B.1.1.529 (Omicron): Likely first concerning Covid variant since Delta, though still many unknowns. The emergence of this variant is a shot across the bow and underscores why it’s so urgent we address vaccine inequity. Here’s what we know and don’t know about Omicron. 1/thread
The South Africa Health Ministry did the right thing and its actions will save lives: quickly identified Omicron through sequencing where there is evidence of increased transmission and immediately shared this information with the world. @WHO labeled it a Variant of Concern. 2/
The rapidity with which the Omicron variant has become predominant in Gauteng Province is concerning. Evidence from other provinces suggests the variant has already spread across South Africa. B.1.1.529 has now been detected in samples from patients in multiple countries. 3/
The Omicron variant has >30 mutations in the spike protein. That’s a lot. Some are associated with increased transmission and possible immune escape, though not possible to predict reliably how the variant will act in the real world. 4/
Data suggests Omicron may be even more easily spread than Delta (which was already 2X more transmissible than the original strain.) We don’t have data yet on whether or not Omicron causes more severe or less severe illness or can escape existing immunity. 5/
One piece of good news: we can easily track spread because B.1.1.529 causes something called S-gene target failure which creates a specific pattern in PCR test results. This can make it easier to spot than Delta. 6/
Lots more we need to find out. Major q's:
More transmissible?
Able to evade vaccine and/or infection-induced immunity?
More severe illness?
Getting science right can take time. Epidemiologists get this; many in media don’t. The more we learn, the better we can fight Covid. 7/
How might Omicron affect treatment, including Regeneron as well as new antiviral medications? Time will tell whether they'll continue to be as effective for strains with these mutations. 8/
The virus that causes Covid adapts—faster than many thought possible. We too must adapt, working together around the world. A global pandemic requires a global response. 9/end "
Source:
Commentary: We still don't know a lot about the new variant, but initial data suggests it's potentially more problematic. No matter what, wearing the best mask available to you and avoiding gathering with folks you don't live with as much as practical will be the way to go.
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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. 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 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.
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.