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.
You are welcome to share this.
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I didn't think I'd still be doing this newsletter on the last day of 2020. I thought by now we would have learned the lessons of early spring 2020 and been in a lockdown long enough to suppress the worst of COVID-19. Instead, we are on the cusp of a fourth wave as ambulances line up outside of hospitals and declare people dead on the scene, refusing transport. In the United States, hospitaliztions and deaths are at record highs, new highs almost every day. Meanwhile, vaccines go unused and a new variant threatens to overwhelm us before we, collectively as a planet, get it together and get the vaccine out in the world.
I honestly thought we'd be better than this, as a species.
2021 is probably going to be a mirror of 2020. At least I hope so. It'll be a disastrous start, but by the end, hopefully things are better.
In the meantime, because I know you care and are paying attention and doing the right things, thank you. Thank you for doing your part and encouraging others, thank you for staying safe even when it hurts. Thank you for continuing to believe in science and data.
We're in this together was a call for solidarity in the early days of the pandemic. Now, in its darkest days, we're in this together is a sign of our collective commitment to get each other through it safely.
May our 2021 be leagues better once we've gotten through the darkest days ahead.
There will be no pandemic newsletter on January 1; it'll resume on January 4.
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Early, non-peer reviewed evidence that the new variant isn't beating antibodies yet. "I would prefer this in a manuscript, but given the time of year and that I'm tired, I'll just tweet the data regarding the UK #COVID19 variant:
PRNT50 values from COVID patients for SARS2 WT WA1 vs a mutant that contains N501Y (among other spike mutations).
At least for N501Y, there is not huge shifts in neutralization based on sera from previously infected COVID patients.
UK Variant has other spike mutations that could impact neutralizations. This does not say anything about transmissibility or infection.
So this wasn't what I expected when I posted.
This is obviously not peer reviewed & we had this mutant and this data before the UK variant was a thing.
Many groups I have talked with have already started working on this, so the definitive data and experiments are on the way"
Source:
Commentary: While not peer-reviewed, this is from Doctor Vineet Menachery at the University of Texas, Galveston and seems credible. It's good news - it means COVID-19's new mutations have not helped it dodge existing immunity in people who have already had it, yet.
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Yes, the vaccines have side effects. They've been well-documented. They are safe and effective, but not without a little discomfort.
"Solicited adverse events at the injection site occurred more frequently in the mRNA-1273 group than in the placebo group after both the first dose (84.2%, vs. 19.8%) and the second dose (88.6%, vs. 18.8%) (Figure 2 and Tables S3 and S4). In the mRNA-1273 group, injection-site events were mainly grade 1 or 2 in severity and lasted a mean of 2.6 and 3.2 days after the first and second doses, respectively (Table S5). The most common injection-site event was pain after injection (86.0%). Delayed injection-site reactions (those with onset on or after day 8) were noted in 244 participants (0.8%) after the first dose and in 68 participants (0.2%) after the second dose. Reactions were characterized by erythema, induration, and tenderness, and they resolved over the following 4 to 5 days. Solicited systemic adverse events occurred more often in the mRNA-1273 group than in the placebo group after both the first dose (54.9%, vs. 42.2%) and the second dose (79.4%, vs. 36.5%). The severity of the solicited systemic events increased after the second dose in the mRNA-1273 group, with an increase in proportions of grade 2 events (from 16.5% after the first dose to 38.1% after the second dose) and grade 3 events (from 2.9% to 15.8%). Solicited systemic adverse events in the mRNA-1273 group lasted a mean of 2.6 days and 3.1 days after the first and second doses, respectively (Table S5). Both solicited injection-site and systemic adverse events were more common among younger participants (18 to <65 years of age) than among older participants (≥65 years of age). Solicited adverse events were less common in participants who were positive for SARS-CoV-2 infection at baseline than in those who were negative at baseline (Tables S6 and S7)."
Source: https://www.nejm.org/doi/full/10.1056/NEJMoa2035389
Commentary: In short, expect a couple of days feeling under the weather and a sore spot where the vaccine was injected. You'll have a sore arm and a bit of a cold for a couple of days once you've received it, if you have an adverse reaction.
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You can still get COVID-19 after vaccination if insufficient time has passed. "Moderna's Phase 3 #COVID19 vaccine trial is now peer reviewed & online.
These figures demonstrating vaccine efficacy, beginning ~12 days after the 1st of 2 doses, are some of the brightest highlights of 2020.
(Blue line = really really good)."
Source:
Commentary: Efficacy - meaning prevention - begins roughly 12 days after injection. So if you rip off your mask and go partying the day after you're vaccinated, you are NOT protected. That's why it's important that we message the vaccine needs at LEAST two weeks before being effective.
And frankly, we still do not know whether the vaccine affects transmissibility yet, so until we do, act like you haven't been vaccinated and keep wearing a mask, watching your distance, washing your hands, and staying out of indoor spaces that aren't your home as much as you can.
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Flying blind... again. "As health officials in the United States announced a second and possibly a third person infected with a new, more transmissible strain of the SARS-CoV-2 virus, infectious diseases experts are feeling a sense of déjà vu all over again.
A little less than a year ago, the early response to the coronavirus crisis was stifled by an inability to scale up testing to detect the virus and curb its spread. Now, once again, it’s unclear how prevalent the new strain, which first surfaced in the U.K., might be in the U.S. Already a possible and a probable case have been detected in Colorado and one case has been reported in California. But it’s likely the variant’s spread hasn’t stopped there.
“It feels a lot like that time between Jan. 19 or so when we had that first case in the Seattle area and six weeks later, when all of a sudden, it looks like we’ve got community transmission in California and Seattle and who knows where else,” said Michael Worobey, a professor of evolutionary biology at the University of Arizona. “It does have that feeling.”
“We’re a little behind the eight ball in terms of our genomic sequencing, both in terms of absolute numbers and the sort of delay between sampling and getting the sequences out there, compared to the U.K.,” Worobey said. He warned that if the U.S. doesn’t find the cases and slow spread it will likely see the same kind of rapid dissemination of the variant that the U.K. has seen.
The new variant sports an unusual number of mutations, including some that appear to change the virus’ behavior. It seems to be significantly more transmissible, increasing the rate at which infected people infect others.
There’s no evidence to date that the variant triggers more severe disease. But hospitals are straining to handle Covid patients as it is; more infections could lead to a higher death rate, because of diminished quality of care.
“The case fatality rate increases if health care systems get overwhelmed,” said Nahid Bhadelia, medical director of the special pathogens unit at Boston Medical Center. “That’s just how it works.”"
Source: https://www.statnews.com/2020/12/31/with-limited-surveillance-of-covid-19-variant-its-deja-vu-all-over-again/
Commentary: The most disappointing part of all this is that we learned these lessons in early 2020. We need rapid, mass surveillance of the disease with as much sequencing as possible to understand not only whether B.1.1.7 is here (it is) or how widespread (probably a lot), but most important to get ahead of future mutations - especially when future mutations learn how to beat the current generation of vaccines. We are fighting a war against a relentless, slippery enemy that is constantly on the move, which means we cannot rest, cannot take our eyes off the field, cannot pretend it's not there.
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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. If you come in physical contact with others, wash your clothing upon returning home.
2. 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.
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. 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).
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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.