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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Why boosters? "Even if protection against severe outcomes remains robust, observed waning suggests that boosters will be necessary to reduce circulation. Delta has generated a late summer wave, but steady state is likely a winter "COVID season" with vaccination recommended beforehand. 14/14"
Source:
Commentary: This makes logical sense. As long as there is idle supply, better to use them as boosters than to simply discard them. Best of all would be shipping excess vaccine to supply nations that don't have enough, but whatever the use, any use of a vaccine is better than the trash can.
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Immunity may last longer than previously thought. "All around the world, there seem to be signs that immunity to SARS-CoV-2, the coronavirus that causes the disease COVID-19, doesn't last very long after you're vaccinated.
Israel is now having one of the world's worst COVID-19 surges about five months after vaccinating a majority of its population. And in the U.S., health officials are recommending a booster shot eight months after the original vaccine course.
It all depends on which type of immunity you're talking about, says immunologist Ali Ellebedy at Washington University in St. Louis. Six months after your vaccine, your body may be more ready to fight off the coronavirus than you might think.
"If you were vaccinated six months ago, your immune system has been training for six months — you are better ready to fight a COVID-19 infection," says Ellebedy.
A series of new studies, including two led by Ellebedy, suggests that mRNA vaccines like those from Pfizer-BioNTech and Moderna trigger the immune system to establish long-term protection against severe COVID-19 — protection that likely will last several years or even longer, Ellebedy says.
To understand what he's talking about, let's say you received the second Moderna or Pfizer vaccine six months ago. Right away, your immune system got to work and began making antibodies.
These antibodies are a bit like archers outside the moat of a castle. They set up in the lining of your nose and throat, ready to shoot down (aka neutralize) any SARS-CoV-2 particles that try to enter the moat (aka your nasal tissue).
These antibodies can prevent an infection, says bioimmunologist Deepta Bhattacharya at the University of Arizona. They stop the virus from entering cells and setting up shop. They are the body's front-line defense.
But right after vaccination, this initial round of antibodies has a few problems. The antibodies are a bit wimpy. They're not that well trained at killing SARS-CoV-2, and they're not very durable, Bhattacharya says.
About a month after the second mRNA shot, the number of antibodies in the blood reaches its peak level and then starts to decline. The antibodies themselves degrade and the cells that make them die, a study published in the journal Nature reported in June.
This happens with every vaccine, whether it's for COVID-19, the flu or measles, Bhattacharya says. "In every single immune response, there is a sharp rise in antibodies, a period of sharp decline, and then it starts to settle into a more stable nadir."
The media has largely focused on this decline of antibodies as the cause of "waning immunity." And it's true, Bhattacharya says, that this decline in antibodies, combined with the high potency of the delta variant, which began dominating many countries this year, is likely increasing the rate of infection in fully vaccinated people.
"If you get a big dose of delta, as the variant often gives, the virus can slip past the initial wall of antibodies," he says. "So I think we may be seeing some signs of that. But the [level of breakthrough infections] is probably not as dramatic as I think it's being made out to be."
Why? Because the media has largely overlooked several key facts about the antibodies present eight months after the vaccine. For starters, they're more powerful than the original ones triggered by the vaccine, Bhattacharya says.
While the first round of archers (antibodies) was out guarding the moat of your castle (respiratory tract), the immune system wasn't just sitting around idly, hoping those soldiers would be enough. Instead, it was busy training better archers — and a whole bunch of foot soldiers too.
After your second shot, the immune system sets up a training center in the lymph nodes to teach special cells how to make more powerful antibodies, the Nature paper from June reported."
Source: https://www.npr.org/sections/goatsandsoda/2021/08/30/1032520934/immunity-to-covid-19-could-last-longer-than-youd-think
Commentary: This is a fascinating piece, worth the read, about how our immune systems are dealing with COVID-19. The key message is that the vaccines protect against severe illness and death. In that regard, they fulfill their role perfectly. None of us have perfect sterilizing immunity (i.e. you never get sick) against anything we've been vaccinated against; breakthroughs are always possible.
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A fascinating piece on why Black Americans suddenly started outperforming other demographics in COVID survival. "Dr. Jerome Adams, who served as the 20th Surgeon General of the United States: “I do feel in my personal life that I see far greater percentages of the Black community embracing mitigation versus other races. Many of them stayed home/hunkered down as instructed. My intuition is that, interestingly, Black people were much more able to access government supports that were designed to facilitate social distancing than many Hispanic/Latino people were. Anecdotally I’ve also seen many more Black people wearing masks in public than other racial groups- both white and Hispanic.”
Dr. Rhea Boyd, pediatrician, public health advocate and scholar, and the Director of Equity and Justice for The California Children’s Trust: “Speaking in churches over the past 7 months, I heard from folks who lost multiple family members, attended funeral after funeral for beloved neighbors and friends, and as a result, changed many of their daily routines (like staying home all year and having groceries brought by a friend), began projects to look out for neighbors and bring them food or take them to doctors’ appointments, or worked to get other community members vaccinated.""
Source: https://insidemedicine.bulletin.com/560044628470214
Commentary: The general consensus is that the Black population functions more as a cohesive community than other populations, making decisions in a more unified way. Other demographic groups have much to learn from the Black community.
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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.