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 NFL debunked 6 feet/15 minutes a while ago. ANY exposure can transmit COVID-19. "The NFL was slowly discovering something far deeper: a core tenet of Covid-19 transmission wisdom—how to define when individuals are in “close contact”—was just wrong.
The safety of interactions during this global pandemic had been for months measured by a stopwatch and a tape measure. The guidance was that someone had been exposed to the virus if they had been within six feet of an infected person for more than 15 minutes. It was drilled into everyone for so long it became coronavirus gospel.
But that wasn’t proving true during the NFL’s outbreaks. People were testing positive for the virus even though they had spent far less than 15 minutes or weren’t within six feet of an infectious person—and the league had the contact-tracing technology to prove it.
“That was a wake-up call,” said Dr. Allen Sills, the NFL’s chief medical officer. “We had to be more precise in our definition of high-risk close contacts because clearly transmission could occur outside those basic boundaries of time and distance.”
The league’s finding is the critical reason why the NFL got through its regular season playing all 256 games and made it all the way to the upcoming Super Bowl on Feb. 7, between the Tampa Bay Buccaneers and Kansas City Chiefs, as scheduled.
In the days, weeks and months after the Titans’ outbreak, the NFL changed its rules to further reduce close contacts, for any length of time. It counted people as having been exposed to the virus if they had unmasked, indoor interactions with an infected person for any length of time. And it introduced lengthier quarantine periods for those exposed people—preventing them from further spreading the virus.
Those findings are now laid out in a paper, written by various doctors who worked with the NFL and NFL Players Association and published by the Centers for Disease Control, that opens a new window into the numbers that upended this thinking.
“This has implications far beyond the NFL,” said Dr. Thom Mayer, the NFLPA’s medical director. “This thing is more transmissible than people thought.”"
Source: https://www.wsj.com/articles/super-bowl-nfl-covid-cdc-11612104460
Commentary: The NFL's science teams have confirmed what we've long suspected: even the basic versions of COVID-19 are a lot more contagious than arbitrary rules like 6 feet/15 minutes of exposure. Combined with the new strains, treat every case of COVID-19 like it's almost instantly transmissible and protect yourself accordingly.
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Well, that didn't take long. "Detection of E484K mutation in B.1.1.7 VOC 202012/01 - The COG-UK dataset (total sequences 214,159) was analysed on 26/01/2021. The spike protein mutation E484K (found in VOC 202012/02 B1.351 and VOC 202101/02 P1) has been detected in 11 B1.1.7 sequences. Preliminary information suggests more than one acquisition event. "
Source: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/957504/Variant_of_Concern_VOC_202012_01_Technical_Briefing_5_England.pdf
Commentary: It was only in yesterday's newsletter that we were discussing an unpleasant scenario: a strain of SARS-CoV-2 that inherits B.1.1.7's transmissibility and the B.1.351/P.1 strain's resistance to immunity. The virus has mutated again; time will tell if the new variant which has both mutation attributes has stronger fitness for survival.
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Mix and match might be okay. "As vaccine manufacturers have announced plans to develop boosters for the variants, we should begin to look at "mix-and-match" boosting strategies that use a combination of vaccine platforms. For example, it may be possible to mix the active components of the Pfizer or Moderna vaccines with a boost that uses another vaccine platform. Such an approach may also improve the side effect profile. This would also help with some logistical issues, as individuals may be able to get a boost from any number of options, allowing them to receive any appropriate vaccine that is available to them. Currently, these data for heterologous "mix-and-match" dosing across platforms and manufacturers are not available, but they have important implications for adapting to new emerging coronavirus variants, and for flexible and equitable vaccine access."
Source: https://brief19.com/2021/02/04/brief
Commentary: It makes sense for older vaccine technology - like the Oxford platform - to be less effective in two doses because the underlying virus has been targeted by the immune system. That's one of the beauties of the mRNA technology - there's no immune response to the delivery vehicle. In the meantime, it may turn out that mix and matching the Oxford and the J&J vaccines could give enhanced immunity.
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Beware Super Bowl parties. "The US reported 110,679 new COVID-19 cases yesterday, and 3,389 deaths, according to the Johns Hopkins COVID-19 tracker. There are 92,880 COVID-19 patients in US hospitals, according to the COVID Tracking Project. According to Johns Hopkins University, the country now has 26,454,319 confirmed cases, including 447,852 deaths.
New modeling from the CDC projects 496,000 to 534,000 deaths by Feb 27.
Though the US numbers have come down, Walensky warned they were overall still very high. She also said the early efforts at contact tracing with variant cases in the United States showed people were contracting the virus when not wearing masks and when attending in-person social events with people outside their households.
On that note, Walensky said Americans should be mindful on Sunday to avoid any Super Bowl parties that are not virtual or take place with people from other households, a recommendation Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases seconded."
Source: https://www.cidrap.umn.edu/news-perspective/2021/02/cdc-covid-19-cases-drop-pre-thanksgiving-levels
Commentary: We're clear that the only parties anyone should be attending are in your own household or virtually, yes?
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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. Respirators are back in stock at online retailers, too. Wear an N95/FFP2/KN95 or better mask if you can obtain it.
2. Get vaccinated as soon as you're able to.
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. 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.