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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Watch this video. It's 5 minutes and it shows what's happening from the perspective of healthcare workers fighting on the front lines.
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Commentary: This is why we mask up and stay home.
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More data from Moderna's trials. "Continuing the spate of stunning news about COVID-19 vaccines, the biotech company Moderna announced the final results of the 30,000-person efficacy trial for its candidate in a press release today: Only 11 people who received two doses of the vaccine developed COVID-19 symptoms after being infected with the pandemic coronavirus, versus 185 symptomatic cases in a placebo group. That is an efficacy of 94.1%, the company says, far above what many vaccine scientists were expecting just a few weeks ago.
More impressive still, Moderna’s candidate had 100% efficacy against severe disease. There were zero such COVID-19 cases among those vaccinated, but 30 in the placebo group. The company today plans to file a request for emergency use authorization (EUA) for its vaccine with the U.S. Food and Drug Administration (FDA), and is also seeking a similar green light from the European Medicines Agency.
The data released today bolster an interim report from the company two weeks ago that only analyzed 95 total cases but produced similarly impressive efficacy. “I would still like to see all of the actual data, but what we’ve seen so far is absolutely remarkable,” says Paul Offit, a vaccine researcher at the Children’s Hospital of Philadelphia who is a member of an independent committee of vaccine experts that advises FDA."
Source: https://www.sciencemag.org/news/2020/11/absolutely-remarkable-no-one-who-got-modernas-vaccine-trial-developed-severe-covid-19
Commentary: The fact that the larger dataset released by Moderna not only confirms the news release two weeks ago but improves on it is a very good thing. If we can survive this winter, we will be able to stop COVID-19 for anyone who takes the working vaccines in the next year or so.
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Who will get vaccines first? "We are short on supply, we're not going to have enough supply to vaccinate everyone who could be eligible for this vaccine and who could benefit from certain from it. Certainly, the federal government this week on December 1 is going to make recommendations a vaccine advisory committee that advises CDC will make recommendations on who should get the vaccine First, the so called one a group the people who should get it immediately when it becomes available, hopefully in December. If there's one or more authorisation of vaccines this month, including from the company, I'm on the board of Pfizer, that's going to be healthcare workers and residents of long term care facilities. There's about 20 million healthcare workers who might be eligible. And about 3 million residents of long term care facilities and staff of those facilities. Those will be the first group of patients who get access to it. That's pretty much decided they're going to vote on it this week. But I wouldn't be I'd be very surprised if they deviate from that. But there's only going to be 40 million doses available throughout the whole month of december if both companies get off authorized on time. So there's probably not enough vaccine to work fully through both of those groups. And then there's a question of who's going to be in that second tranche. What we're calling one B, and there is some debate whether that's going to be older Americans, those over the age of 65, or 75, or certain essential workers or some combination of both. There's about 85 million essential workers who might be eligible to be vaccinated if you if you bifurcated to that group. And there's about 50 million people over the age of 65 20 million over the age of 75. And so that's going to be some debate about which group gets prioritized."
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Commentary: Who gets vaccinated first will depend on what the priorities are - protecting life versus protecting life enablers. I'd lean towards healthcare workers, personally - they are folks who have a multiplier effect on lives saved.
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Will Thanksgiving make the third surge worse? Dr. Deborah Birx: "I think what worries Dr. Fauci and I the most is going and I loved your opening, where you talked about several waves. And this being the third wave, if you look at the second wave, going into the Memorial Day weekend, we had less than 25,000 cases a day, we had only 30,000 in patients in the hospital. And we had way less mortality way under 1000. We're entering this post Thanksgiving surge with three, four and 10 times as much disease across the country. And so that's what worries us the most, we saw what happened post Memorial Day. Now we are deeply worried about what could happen post Thanksgiving because the number of cases 25,000 versus 180,000 a day. That's where that's why we are deeply concerned. And as you described, it looked like things were starting to improve in our northern plains states. And now with thanksgiving, we're worried that all of that will be reversed.
And that's why we're really asking states and mayors to really test for impact. And consider vaccinating for impact. We know who's at highest risk, making sure that all of those individuals are tested. We know people may have made mistakes over the hospet over the Thanksgiving time period. So if you're young and you gathered, you need to be tested about five to 10 days later, but you need to assume that you're infected and not go near your grandparents and aunts and others without a mask. Were really asking families to even mask indoors if they chose to gather during Thanksgiving and others went across the country or even into the next state. And if you're over 65, or you have comorbidities and you gathered at Thanksgiving, if you develop any symptoms, you need to be tested immediately because we know that our therapeutics work best with our antivirals and our monoclonal antibodies work best, very early in disease. So we're really asking governors and mayors to make testing more available so we can prevent people having to be hospitalized. But obviously, we're deeply worried we're over 90,000 inpatients right now, if we have a surge two weeks on top of that, even when we're starting to see some improvement, I appreciate that you have Mayor from Detroit on there really all these mayor's are working to decrease their number of cases and getting to a plateau and now we could have a fourth surge."
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Commentary: Is it a fourth surge if you never exited the third surge? Either way, we are about to see things in the United States go from bad to very bad. Be prepared for local and regional lockdowns. If your supplies have dwindled at all, replenish them now.
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If you haven't already done so, cancel your holiday travel plans. Dr. Fauci:
"Dr. Fauci, you have said that again, and again, and again, we saw all those people traveling, so you know what's coming. And with Christmas, just around the corner, do you think will be under the same restrictions that you recommended on Thanksgiving going into Christmas?
You know, Martha, I, I can't see how we're not gonna have the same thing. Because when you have the kind of inflection that we have, it doesn't all of a sudden turn around like that. So clearly, in the next few weeks, we're going to have the same sort of thing and perhaps even two or three weeks down the line, Martha, we may see a surge upon a surge, you know, we don't want to frighten people. But that's just the reality. We said that these things would happen as we got into the cold weather. And as we began traveling, and they've happened, it's going to happen again. So I cannot see all of a sudden, a relaxation of the kinds of recommendations or restrictions because we're getting into colder weather. And in a in an even larger holiday season, as people traveled to come back and forth for Christmas. So I don't see a relaxation of the kind of recommendations and restrictions that we've made."
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Commentary: Cancel your holiday travel plans and plan to stay in for the winter holidays. Please.
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A reminder of the simple daily habits we should all be taking.
1. Wash/sanitize your hands every time you are in or out of your home for any reason. Consider also spraying the bottoms of your shoes with a general disinfectant (alcohol/bleach/peroxide) when you return home. Remember that cleaners are NEVER to be ingested or injected.
2. Always wear a mask when out of your home and if going to a high risk area, wear goggles. Respirators are back in stock at online retailers, too.
3. 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.
4. Get your personal finances in order now. Cut all unnecessary costs.
5. Replenish your supplies as you use them. Avoid reducing your stores to pre-pandemic levels in case an outbreak causes unexpected supply chain disruptions.
6. Participate in your local political process. For Americans, go to Vote.org and register/verify your vote.
7. Ventilate your home as frequently as weather and circumstances permit.
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Common misinformation debunked!
There is no genomic evidence at all that COVID-19 arrived before 2020 in the United States and therefore no hidden herd immunity:
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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.