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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The D614G mutation is more serious than initially thought in this preprint study from UNC Chapel Hill and University of Tokyo. "The D614G substitution in the S protein is most prevalent SARS-CoV-2 strain circulating globally, but its effects in viral pathogenesis and transmission remain unclear. We engineered SARS-CoV-2 variants harboring the D614G substitution with or without nanoluciferase. The D614G variant replicates more efficiency in primary human proximal airway epithelial cells and is more fit than wildtype (WT) virus in competition studies. With similar morphology to the WT virion, the D614G virus is also more sensitive to SARS-CoV-2 neutralizing antibodies. Infection of human ACE2 transgenic mice and Syrian hamsters with the WT or D614G viruses produced similar titers in respiratory tissue and pulmonary disease. However, the D614G variant exhibited significantly faster droplet transmission between hamsters than the WT virus, early after infection. Our study demonstrated the SARS-CoV2 D614G substitution enhances infectivity, replication fitness, and early transmission."
Source: https://www.biorxiv.org/content/10.1101/2020.09.28.317685v1
Commentary: The D614G mutation is the dominant strain of COVID-19 for a reason, now proven out in vivo (in living creatures) whereas previous studies were in vitro (isolated lab experiments). It is more contagious, replicates better, and spreads faster. However, it has not been demonstrated that it causes more severe outcomes, which is a blessing.
Faster, better transmission = wear a mask all the time out of home unless you're literally the only person around. If you're in the middle of the forest and there are no other people around the entire time, you don't need a mask. If you see another human, you need to be wearing a mask.
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In the United States, the Dakotas are a hot spot. "Covid-19 extended its march across the Midwest on Tuesday, with the surge in North Dakota looking similar to Florida’s two months earlier. Cases were also on the rise in South Dakota and Wisconsin.
In North Dakota, the seven-day average of new cases climbed to a record 413, according to data compiled by Johns Hopkins University and Bloomberg News. That’s about 54 daily cases per 100,000 residents. By comparison, Florida’s July 15 peak was about 55 cases per 100,000. Deaths are climbing, too, but they typically appear in the data weeks after cases.
Many Midwestern states essentially dodged the virus earlier and are experiencing it for the first time. But notably, Utah is getting hit a second time after an initial peak in July.
Elsewhere, New York City Mayor Bill de Blasio, a Democrat, called for serious action to stop an uptick in positive tests, which appeared to be centered in Orthodox Jewish areas, where the Yom Kippur holiday was just observed. Overall, the city’s rate of positive tests eclipsed 3% for the first time in months, after being at or around 1% for most of September.
In Florida’s Miami-Dade County, the positivity rate hit the highest since Sept. 2. The increase comes after Republican Governor Ron DeSantis lifted remaining business restrictions and banned no-mask fines, essentially making local mandates impossible to enforce -- measures that probably aren’t yet reflected in the data."
Source: https://www.bloomberg.com/news/articles/2020-09-29/north-dakota-s-outbreak-is-as-bad-as-florida-arizona-in-july
Commentary: What do all these hotspots have in common? Gatherings, gatherings, gatherings. Being around other people in crowds. Stay away from other people as much as practical.
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Stosslüften. "Ventilating rooms has been added to the German government’s formula for tackling coronavirus, in refreshing news for the country’s air hygiene experts who have been calling for it to become official for months.
The custom is something of a national obsession, with many Germans habitually opening windows twice a day, even in winter. Often the requirement is included as a legally binding clause in rental agreements, mainly to protect against mould and bad smells.
But while some people may dismiss the method as primitive, “it may be one of the cheapest and most effective ways” of containing the spread of the virus, Angela Merkel insisted on Tuesday.
The German chancellor explained that the government’s guidelines to tackle the virus, encapsulated in the acronym AHA, which stands for distancing, hygiene and face coverings, will be extended to become AHACL. The “C” stands for the government’s coronavirus warning app, and “L” for Lüften or airing a room.
“Regular impact ventilation in all private and public rooms can considerably reduce the danger of infection,” the government’s recommendation explains.
Impact ventilation, or Stosslüften, which needs explanation for most people unfamiliar with Germany except for experts in air hygiene, involves widely opening a window in the morning and evening for at least five minutes to allow the air to circulate. Even more efficient is Querlüften, or cross ventilation, whereby all the windows in a house or apartment are opened letting stale air flow out and fresh air come in.
In Germany, windows are designed with sophisticated hinge technology that allows them to be opened in various directions to enable varying degrees of Lüften.
Since it has become known that 90% of Covid-19 patients pick up the virus indoors, the practice has come into its own. With winter on the doorstep, it will become even more important, experts insist.
The country’s leading coronavirus expert, Christian Drosten, who is head virologist at the Charité hospital in Berlin, has already dedicated an edition of his hit pandemic podcast to the importance of Luftverdünnung and Luftbewegung – air rarefaction and movement – in which he extols the praises for frequent airing, while the weekly Die Zeit has published a 10-page feature on ventilation, including the science behind it and, especially how to do it in winter.
Schools, which have increasingly been viewed as a testing ground for how society can learn to live with the disease, have long since adopted the practice. A recent gathering of the ministers of education for Germany’s 16 states was dedicated to how to air a classroom. Five experts, from fluid mechanics to indoor air hygienists and aerodynamicists, reinforced the importance of airing a room every 15 to 20 minutes, for five minutes in spring and autumn, and three minutes in winter."
Source: https://www.theguardian.com/world/2020/sep/30/germans-embrace-fresh-air-to-ward-off-coronavirus
Commentary: A breath of fresh air, literally. As winter sets in, it will become apparent and obvious which businesses are willing to keep tackling COVID-19 by who continues to air out establishments even when cold. Look for and reward those places which continue to fight COVID-19 vigorously.
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American withdrawal from WHO may cause a lack of access to working vaccines for COVID-19. "There are currently 9 vaccines for COVID-19 that have reached Phase 3 trials, the final phase of testing before they can be released for limited use and then broader release. Of these vaccines, only one is being produced by an American company — Moderna, which launched Phase 3 trials in late June, has received billions in funding from the NIH to accelerate its research. Four of the other vaccines are being tested by private and state-owned companies in China, one is the product of an Australian company, one is British, one German, and one Russian.
There is reason to believe the vaccines being developed in China may have a better shot at being the first to reach full approval for widespread use. Michael Kinch, director of the Centers for Research Innovation in Biotechnology and Drug Discovery at Washington University in St. Louis, has said China “has a more balanced portfolio” of potential vaccines — meaning their vaccines use a broader array of mechanisms to induce immunity to the virus relative to the American projects’ more narrowly focused approach. He argued the U.S. essentially putting all our eggs in one basket.
China has seen success in developing novel vaccines in recent years, according to a 2018 study of the country’s vaccine landscape. The authors noted that China “has a large domestic manufacturing base capable of producing [a] large quantity of vaccines at low prices,” including an oral rotavirus vaccine and both live-attenuated and inactivated Hepatitis A vaccines.
Should China or any other country beat America to the finish line in vaccine development, membership in the WHO would likely put us on the fast-track to sharing in those benefits. The WHO has urged its member states to share any vaccines when they’re developed “as a public good,” which is undeniably the right approach — in our interconnected global society, no country can fully eradicate the pandemic while others still battle it. In keeping with that philosophy, the WHO recently launched the “Covax” initiative for cooperative vaccine development, production, and distribution, which the Trump administration promptly declined to join."
Source: https://medium.com/@healthfininst/how-the-2020-election-could-affect-americans-access-to-a-covid-19-vaccine-5d7016dd3959
Commentary: For Americans, petition your elected representatives today to introduce legislation mandating that America rejoin the World Health Organization.
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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.
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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:
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.