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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How much more contagious is the B.1.1.7 strain? "Contact tracers in York Region are finding that some individuals who have tested positive for the highly contagious variant have been in a retail store for just a few minutes. Dr. Kurji is in talks with Public Health Ontario to lower the threshold of what is typically considered a high-risk contact: face-to-face interaction within two metres for at least 15 minutes.
A spokeswoman for Ontario Health Minister Christine Elliott said on Sunday that the government has provided interim guidance to the province’s public-health units for screening and tracing contacts of cases associated with COVID-19 variants of concern.
“This guidance does include a lower threshold for classifying contacts as high risk of exposure and requiring quarantine,” Alexandra Hilkene said in an e-mail.
Ms. Austin wonders whether she has been swept up in the more stringent measures. After isolating for 14 days, she worked a shift on Jan. 25 at a grocery store in Barrie, where she has a part-time job. She was scheduled to work this weekend until a public-health official advised her to stay home again. “I don’t know what’s going on,” Ms. Austin said in an interview.
Following confirmation of the variant, the Simcoe Muskoka District Health Unit has shortened the exposure time to as little as a second if individuals were not wearing face masks."
Source: https://www.theglobeandmail.com/canada/article-covid-19-variant-in-barrie-outbreak-upends-conventional-wisdom-of/
Commentary: One second.
Think about that.
ONE SECOND of exposure with no mask can yield a COVID-19 infection with the newer, more easily transmitted strains.
That means you shouldn't be outside your home - even outdoors - without a mask if there's any chance of being in a contaminated airspace. That jogger running by your home? If you're directly in their draft, you're at risk with the new strains.
If you have a backyard and neighbors aren't easily near you - meaning you have lots of space between yards - then it's probably safe to not wear a mask. But if you're about to talk to your neighbor over the fence - wear a mask, even in your own backyard. If the neighbors are having a barbecue next door, wear a mask in your own yard.
In short, wear a mask. We knew the numbers behind B.1.1.7's transmissibility were higher, but this is the first guidance we've seen about the exposure window being so short for people with no mask at all. Previous guidance was arouhd 15 minutes of cumulative exposure.
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Vaccine rollouts may not be representative. "The US Centers for Disease Control and Prevention released a detailed look at the demographics of those who have received coronavirus vaccinations in the first month of widespread rollouts across the United States. Data was obtained from information reported to the CDC by vaccinators around the country and the findings were published in Morbidity and Mortality Weekly Report (MMWR), the agency’s medical journal.
The report covers just under the first 13 million people to receive at least 1 dose of the Pfizer/BioNtech or Moderna covid-19 vaccine, representing just 4 percent of the total US population and 5 percent of the US population 16 years of age or older. Most of the vaccinations have been in persons in the “Phase 1a group,” as defined by the CDC’s Advisory Committee on Immunization Practices (ACIP). ACIP has recommended priority to healthcare workers and long-term care facility staff and residents.
Thus far, more women (63 percent) have received the vaccine than men. The most vaccinated age group was 50 years and older (55 percent) followed next by those 18-39 years (28 percent). Information on race and ethnicity was known in a little over half of the recipients. A majority of those in whom the race or ethnicity was known have been White, at 60 percent of all recipient. While the White demographic makes up 76 percent of the US population overall, that is not necessarily the breakdown of the regions where vaccine rollout has occurred in the highest numbers. For example, in some regions, disparities have been noted, including in New York City, where just 25 percent of the people vaccinated so far have been Black or Latino, despite the fact that together, these two groups make up around 53 percent of the local population.
The Phase 1a group, which the published data reflect, is estimated to cover around 24 million people. But it is unlikely that 50 percent of the Phase 1a group actually received their first jabs. That’s because some places, like Florida and Texas, expanded vaccination to all persons 65 years of age or older, meaning that some people in lower priority groups have been vaccinated ahead of those in higher priority groups.
Regional data reporting under representation of vaccine recipients who are minorities in this first round of vaccination is concerning. While some of the low numbers could be due to a lack of complete data (the race or ethnicity were known in only around 52 percent of those vaccinated so far). Moving forward, the focus of vaccination rollout organizers should be to monitor these data, making sure to track emerging inequalities and to determine to the extent possible the reason for any such finding. Whether lower rates of vaccination are due to lack of access, outreach, or hesitancy will be important to measure so that the necessary policy adjustments are made."
Source: https://mailchi.mp/31a31dfeda45/your-daily-roundup-from-brief19-5902240
Commentary: Why does racial parity matter in vaccine administration? Because minorities form a disproportionate number of front line workers - and those are people who are not only at higher risk of contracting COVID-19, but also at higher risk of spreading it if they become infected, especially if they're asymptomatic or pre-symptomatic for a long period of time.
In short, it protects EVERYONE when people who have the highest probability of catching and spreading the disease are vaccinated. Lobby your local officials to ensure vaccine distribution is not only equitable, but based on clear science.
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The COVID Tracking Project comes to an end. "Every day for almost a year, hundreds of COVID Tracking Project contributors from all walks of life have compiled, published, and interpreted vitally important COVID-19 data as a service to their fellow Americans. On March 7, the one-year anniversary of our founding, we will release our final daily update and our data compilation will stop. Documentation, analysis, and archival work will continue for another two months, and we will bring the project to a close in May.
The seeds of this choice have been with us from the beginning. From its inception, this project was both unlikely and unprecedented: No one expected a volunteer pop-up collective to publish and interpret public health data for the United States for the first year of a global pandemic. We began the work out of necessity and planned to do it for a couple of weeks at most, always in the expectation that the federal public health establishment would make our work obsolete. Every few months through the course of the project, we asked ourselves whether it was possible to wind down. Instead, we saw the federal government continue to publish patchy and often ill-defined data while our world-famous public health agencies remained sidelined and underfunded, their leadership seemingly inert.
That we were able to carry the data through a full year is a testament to the generosity of the foundations and firms that gave us the resources we needed, to the counsel of our advisory board, to The Atlantic’s support for our highly unusual organization, and above all to the devotion of our contributors. But the work itself—compiling, cleaning, standardizing, and making sense of COVID-19 data from 56 individual states and territories—is properly the work of federal public health agencies. Not only because these efforts are a governmental responsibility—which they are—but because federal teams have access to far more comprehensive data than we do, and can mandate compliance with at least some standards and requirements. We were able to build good working relationships with public health departments in states governed by both Republicans and Democrats, and these relationships helped bring much more data to into public view. But ultimately, the best we could hope to do with unstandardized state data was to build a bridge over the data gaps—and the good news is that we believe we can now see the other side.
Although substantial gaps and complexities remain, we have seen persuasive evidence that the CDC and HHS are now both able and willing to take on the country’s massive deficits in public health data infrastructure, and to offer the best available data and science communication in the interim."
Source: https://covidtracking.com/analysis-updates/covid-tracking-project-end-march-7
Commentary: Believe it or not, this is a good thing. It means that the US government has once again assumed responsibility for the reporting of public health data in clear ways. It's amazing that a consortium of volunteers was able to fill the void left by the previous administration, but deplorable that the void ever existed in the first place. Public health data is a public good, paid for by citizens, and citizens are entitled to all of it.
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The AstraZeneca vaccine does something critically important: cuts TRANSMISSION by 67%. "The vaccine developed by the University of Oxford and AstraZeneca not only protects people from serious illness and death but also substantially slows the transmission of the virus, according to a new study — a finding that underscores the importance of mass vaccination as a path out of the pandemic.
The study by researchers at the University of Oxford is the first to document evidence that any coronavirus vaccine can reduce transmission of the virus.
Researchers measured the impact on transmission by swabbing participants every week seeking to detect signs of the virus. If there is no virus present, even if someone is infected, it cannot be spread. And they found a 67 percent reduction in positive swabs among those vaccinated.
The results, detailed by Oxford and AstraZeneca researchers in a manuscript that has not been peer-reviewed, found that the vaccine could cut transmission by nearly two-thirds.
Matt Hancock, the British health secretary, hailed the results on Wednesday as “absolutely superb.”
“We now know that the Oxford vaccine also reduces transmission and that will help us all get out of this pandemic,” Mr. Hancock said in an interview Wednesday morning with the BBC."
Source: https://www.nytimes.com/live/2021/02/02/world/covid-19-coronavirus#astrazeneca-coronavirus-vaccine
Commentary: We've not seen data yet on the Pfizer and Moderna vaccines or the J&J vaccine about reducing transmission; hopefully we will get that data soon. If all the vaccines can knock down transmission by two-thirds, then you're talking about really and truly ending the pandemic by shutting down nodes of transmission. This is why it's urgent we vaccinate as many people as possible, as quickly as possible. Tamping down spread with vaccines will be the way out.
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COVID-19 may cause diabetes. "Infection-related diabetes can arise as a result of virus-associated β-cell destruction. Clinical data suggest that the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), causing the coronavirus disease 2019 (COVID-19), impairs glucose homoeostasis, but experimental evidence that SARS-CoV-2 can infect pancreatic tissue has been lacking. In the present study, we show that SARS-CoV-2 infects cells of the human exocrine and endocrine pancreas ex vivo and in vivo. We demonstrate that human β-cells express viral entry proteins, and SARS-CoV-2 infects and replicates in cultured human islets. Infection is associated with morphological, transcriptional and functional changes, including reduced numbers of insulin-secretory granules in β-cells and impaired glucose-stimulated insulin secretion. In COVID-19 full-body postmortem examinations, we detected SARS-CoV-2 nucleocapsid protein in pancreatic exocrine cells, and in cells that stain positive for the β-cell marker NKX6.1 and are in close proximity to the islets of Langerhans in all four patients investigated. Our data identify the human pancreas as a target of SARS-CoV-2 infection and suggest that β-cell infection could contribute to the metabolic dysregulation observed in patients with COVID-19."
Source: https://www.nature.com/articles/s42255-021-00347-1
Commentary: COVID-19 is creating a legion of injured individuals, with complications from heart disease to lung damage to neurological damage. Add pancreatic disorder and diabetes to the list - while it may not kill more than 1-1.3% of its victims, COVID-19 is leaving a massive trail of damage behind it that will impair millions of people for years or longer.
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A reminder of the simple daily habits we should all be taking.
1. Always wear the best mask available to you when out of your home and you'll be around other people. Respirators are back in stock at online retailers, too. Wear an N95/FFP2/KN95 or better mask if you can obtain it.
2. Get vaccinated as soon as you're able to.
3. Wash/sanitize your hands every time you are in or out of your home for any reason.
4. 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.
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. How to properly fit a mask:
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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.