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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Retuning to work. "Workplace health starts with asking employees to get vaccinated and making access to vaccines easier, including vaccination drives in the workplace. Employees should also stay home and seek testing if they or their close contacts are unwell. Braving a cold to come into the office will be a taboo. Businesses will have to provide ready access to testing, perhaps by distributing tests that can be taken at home. Workplaces will also have to improve airflow and filtration in confined spaces.
Over the winter, emerging cases may require businesses to limit large meetings and maintain systems for contact tracing. For employees who commute on mass transit, the use of masks will be encouraged, and employers should provide high-quality ones. The goal is to keep the virus from entering the workplace and, when that fails, to keep it from spreading.
If the business community leads, it can craft recommendations tailored to different types of work settings. Public-health input into work life is here to stay, and businesses should embrace this obligation, seizing the chance to develop practical principles for safety."
Source: https://www.wsj.com/articles/want-to-go-back-to-the-office-dont-wait-on-the-cdc-11619986366?mod=e2tw
Commentary: lots of people are waiting for guidance about when to reopen things under your control like offices. Common sense should make this easy: people should return to the office as they are fully vaccinated. Once someone is fully vaccinated (which means 1 shot for J&J or two shots for Pfizer/Moderna, PLUS the 14-day waiting period after the last shot), there's no reason to prohibit them from going to an office if they so choose. That said, there's also no reason to FORCE someone back to an office if they're getting their job done remotely, so maintaining a hybrid workforce is the most sensible way to accommodate your team, especially if they're fully remote now.
From an insurance and liability perspective, I would not permit unvaccinated employees to return to work unless your insurance company declares that you will not be held liable for negligence in doing so. Contact both your insurer and your legal team to determine what's needed to absolve your company of liability before letting unvaccinated people in the office.
And this:
"Braving a cold to come into the office will be a taboo."
This should already have been a taboo. Make it one now, and make it ironclad. If you are sick, stay home. Period. End of story. Especially for white collar jobs where you can just as easily work remotely if needed- if you're sick, keep your ass on the couch at home.
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Herd immunity may be unattainable. "Early in the pandemic, when vaccines for the coronavirus were still just a glimmer on the horizon, the term “herd immunity” came to signify the endgame: the point when enough Americans would be protected from the virus so we could be rid of the pathogen and reclaim our lives.
Now, more than half of adults in the United States have been inoculated with at least one dose of a vaccine. But daily vaccination rates are slipping, and there is widespread consensus among scientists and public health experts that the herd immunity threshold is not attainable — at least not in the foreseeable future, and perhaps not ever.
Instead, they are coming to the conclusion that rather than making a long-promised exit, the virus will most likely become a manageable threat that will continue to circulate in the United States for years to come, still causing hospitalizations and deaths but in much smaller numbers.
But as vaccines were developed and distribution ramped up through the winter and into the spring, estimates of the threshold began to rise. That is because the initial calculations were based on the contagiousness of the original version of the virus. The predominant variant now circulating in the United States, called B.1.1.7 and first identified in Britain, is about 60 percent more transmissible.
As a result, experts now calculate the herd immunity threshold to be at least 80 percent. If even more contagious variants develop, or if scientists find that immunized people can still transmit the virus, the calculation will have to be revised upward again.
Polls show that about 30 percent of the U.S. population is still reluctant to be vaccinated. That number is expected to improve but probably not enough. “It is theoretically possible that we could get to about 90 percent vaccination coverage, but not super likely, I would say,” said Marc Lipsitch, an epidemiologist at the Harvard T.H. Chan School of Public Health."
Source: https://www.nytimes.com/2021/05/03/health/covid-herd-immunity-vaccine.html
Commentary: The ongoing danger is that by having more hosts, the virus gains greater chances to mutate and evade vaccines. It is here to stay, unquestionably. The goal is to take away its ability to put you in a hospital or grave, or diminish your quality of life so much that every day is a struggle. If it becomes a common cold, we can live with that - literally.
But that also means once you're fully vaccinated, don't go throwing away your masks or stop using hand sanitizer. For situations where there's absolutely no harm or inconvenience, keep using your protective gear and countermeasures. I plan on continuing to wear a mask because it's comfortable and I really enjoyed not getting sick this winter. It costs me nothing to wear one, doesn't hurt, looks cool, and keeps me safe from more than just COVID-19. And if a mutation does arise that poses a serious threat, I'll be ahead of the game.
Will I do things like travel to conferences or go out to eat? Yes, once I'm fully vaccinated. Will I wear a mask to those things? Also yes.
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The P.1 strain is growing in the United States. "Just as we can decompose the US #COVID19 epidemic into a B.1.1.7 epidemic and a non-B.1.1.7 epidemic, we can further partition by variants of concern B.1.1.7, B.1.351 and P.1, where it's clear that P.1 has been gaining ground. 1/13
Here, using data from @GISAID, we see that in terms of frequencies across the US, P.1 has been undergoing more rapid logistic growth in frequency than B.1.1.7, while B.1.351 has been slower than B.1.1.7. 2/13
I'm plotting this with the unusual "logit" y-axis (with 1%, 10%, 50%, etc...) because a straight line in logit space is indicative of logistic growth. This sort of plot makes it easy to compare logistic growth rate of frequency between lineages with different frequencies. 3/13
We generally see more rapid logistic growth of P.1 across individual states as well. These 9 were chosen as those with the most data. All these plots only go to Apr 14, as there is a necessary lag to the genomic data as samples are processed. 4/13
The observation of faster logistic growth of P.1 compared to B.1.1.7 suggests that P.1 may have a transmission advantage over B.1.1.7 in the US and may continue to gain ground even as B.1.1.7 comes to dominate the virus population. 5/13
Given that P.1 frequency is growing rapidly, but overall cases are generally falling, the question becomes are vaccines and other control measures enough to curb spread of P.1 in absolute case counts? 6/13
To address this we can take these frequency estimates alongside case counts from @CDCgov and use frequencies to partition case counts by variant. Doing so results in this plot for the US, where the large majority of the epidemic is due to B.1.1.7 and non-B.1.351/P.1 viruses. 7/13
However, plotting partitioned case counts on a log-scale clearly shows the continued growth in absolute case counts of P.1. 8/13
We can use the same approach with state-level case counts and frequency data to estimate case counts for B.1.1.7, B.1.351 and P.1 variants. Here, we see that P.1 is still a minor (but growing) contribution but where some states like IL and WA have a larger P.1 share. 9/13
Looking at this same data on a log-scale makes the absolute growth of P.1 cases in CA, FL, IL, MA, MI, NY and WA quite clear. 10/13
Vaccination will continue bring down overall transmission rate, where I expect transmission chains of non-variant viruses to largely die out in the coming weeks. Variant viruses B.1.1.7 and P.1 raise the bar for the level of vaccination required to control the epidemic. 11/13
Mutations in P.1 suggest partial escape from antibody binding, which is borne out in drops in neutralization titer. I would expect P.1 to show some decrease in vaccine effectiveness, but remain largely effective. Figure from Wu et al (nejm.org/doi/full/10.10…). 12/13
Growth of P.1 alongside probable decrease in vaccine effectiveness suggests it's all the more important to get as many people vaccinated as possible as vaccination can still suppress circulation of P.1; it's just that the bar for herd immunity is higher. 13/13 "
Source:
Commentary: P.1 is a strain of greater concern because it is slightly more evasive of countermeasures. The current crop of vaccines does work against it, but we need more people vaccinated to suppress its spread.
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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, 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.
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. Masks must fit properly to work. Here's 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.