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 UK scientific group Independent SAGE rates the pandemic as out of control. "It is now clear that the new variant of the virus, which seems to have emerged in the South East of England, is substantially more transmissible than earlier variants, by 40-80%. This increases the R number by between 0.4 and 0.8. It is also clear that the current Tier 4 restrictions are unable to contain its spread, even with closure of schools and universities. The pandemic is now out of control, and the NHS is struggling, with some hospitals having to stop non-COVID activities. The NHS is no longer being protected. For these reasons, there is a strong argument for maximising the coverage of the population with at least one dose of vaccine, even though this requires a change to the dosage schedule. The urgency of concerted and effective action to supress the new variant cannot be overstated. While it is a very difficult and finely balanced decision, Independent SAGE endorses the decision to pursue coverage of as high a proportion of the population as possible, as quickly as possible as part of a comprehensive strategy. "
Source: https://www.independentsage.org/wp-content/uploads/2021/01/IndependentSAGE-comment-on-proposal-to-reschedule-second-dose.pdf
Commentary: The UK strategy is placing a bet that a single dose of a two-dose vaccine will help stem the tide of the B117 variant of SARS-CoV-2, as it is overwhelming their national healthcare system. B117 has outpaced the previous strains of COVID-19 and has forced parts of the UK such as Scotland into full lockdown.
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Children are a substantial spreader of the new B117 variant. "1/ SAGE paper on #COVID19 tranmission in children, dated 17 Dec, published 31 Dec. This paper was "approved prioer to the emergence of data on the new variant". It includes analysis on household transmission risk.
2/ As you can see from the graph above, children were more likely to be the index case (i.e. bring the infection home). Compared to those aged 17 and over, the likelihood was 7 times higher for children aged 12-16 years and almost 3 times higher for children under 12.
3/ The 'relative transmissibility' means passing the virus on to others. As you can see in the graph, this was also more than twice as likely in children (both under 12 and 12-16) compared to adults.
4/ The paper states: "accumulating evidence is consistent with increased transmission occurring amongst school children when schools are open, particularly in children of secondary school age (high confidence).
Source:
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Commentary: In any place where B117 is present, the immediate action should be to temporarily close schools while testing and tracing occurs to find out how prevalent the variant is in the community. Given how infectious children are with regard to the strain, having schools open at all is unsafe for all.
If your community is one where B117 has been detected, and you have school-age children, keep them away from other children. No activities together, no parties or playdates, no school, nothing in person. Host gaming parties online, Zoom, whatever - but if B117 has been detected at all in your community, do not let children congregate AT ALL.
And obviously ensure you and your family are wearing the best mask available to you at all times outside your home.
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China is rolling out its vaccines. "In what has become a familiar pattern, the COVID-19 vaccine landscape has changed overnight, simultaneously raising hopes that more people may soon get vaccinated and triggering confusion. “It’s crazy,” says immunologist John Moore, a vaccine researcher at Weill Cornell Medicine. “Every morning, it’s just, ‘What’s going on?’"
First, Beijing Biological Products Institute, a division of China National Biotec Group (CNBG), posted a brief announcement online that its vaccine had 79.34% efficacy in a phase III study and was safe. The company, part of state-owned Sinopharm—one of the world’s largest vaccine manufacturers—said it is seeking approval from China’s regulatory agency.
Although apparently good news, the statement left vaccine scientists clamoring for details. It said nothing about the number of trial participants, the rates of COVID-19 in the vaccinated and placebo groups, or even the locations of the trials. And it came 3 weeks after the health ministry in the United Arab Emirates (UAE), one country staging efficacy trials of the Sinopharm vaccine, issued a short press release that claimed 86% efficacy.
China’s National Medical Products Administration announced today it has granted conditional marketing authorization for the Beijing Biological Products Institute’s COVID-19 vaccine, 1 day after the company said it had filed an application to deploy the inactivated two-shot vaccine within China. An official with the National Health Commission said the COVID-19 vaccine, the first to gain regulatory approval in the country, “will be provided free of charge to all Chinese people,” according to Xinhua News."
Source: https://www.sciencemag.org/news/2020/12/it-s-crazy-upbeat-covid-19-vaccine-news-china-and-uk-leave-scientists-wanting-more
Commentary: Unsurprising that the Chinese government will subsidize its vaccines entirely to its population. The early experiences in Wuhan and other cities showed that they're serious about crushing the virus by any means necessary in order to keep their economy going. This is the lesson that other nations haven't yet learned: the economy is dependent on public health. Even with a 79% efficacy rate, China will create herd immunity because it has the power to compel every citizen to take the vaccine. More democratic societies will struggle to achieve similar adoption rates because citizens cannot be compelled to take a vaccine.
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An argument for opening the floodgates. Dr. Scott Gottlieb: "Well, look, we've we have 40 million vaccines that were delivered in December 5 million were injected into arms, that's 35 million vaccines sitting on a shelf somewhere I'm saying that we can be delivering these vaccines directly to Walmart, Walgreens, in New Jersey, they're shipping them through shop, right and allow these retail establishments to start opening up more general vaccination programs for the broader public. Instead of working very slowly through these pre ordained phases that we've we've articulated, continued to accomplish that mission because it's important, but also take some of this excess supply and push it through a retail channel to the general public. If someone who's seven years old or 65 years old, wants to schedule an appointment at CVS to get a vaccination. They should be able to do that this month. So I think we should start working through the age brackets and just work our way down until we work off some of this supply. There's more vaccine coming on the market. Every day we're gonna have a significant backlog right now or, you know, warehouse inventory of vaccines. And that's tragic because these could be accomplishing an important public health purpose.
It is a reality that some people aren't going to want to get vaccinated are going to be reluctant to get vaccinated, it's going to take more work. There's about 150 million Americans who get vaccinated for flu each year, about 60 million of them are under the age of 15. So that's about 90 million people who get vaccinated for flu. I think that's your low hanging fruit for getting COVID vaccinations out, some high proportion of the people get a flu vaccine are also going to get a COVID vaccine. If we just simply make this generally accessible to 65 and above this month, that's 50 million Americans, probably about 30 million of them will take it. That's your low hanging fruit. That's the pent up demand. We need to start working that off because trying to push it into, you know, very discrete populations, you're going to be bumping up against people who don't want it and it's going to create friction. It's going to create a slowdown and trying to get this vaccination out. We need to get more people vaccinated quickly and recognize that every vaccination at this point really is a public health win."
Source:
Commentary: The fact that America has not distributed 90% of the vaccine supply it has on hand is borderline criminal, given the thousands of deaths daily. Hopefully things will change soon, at least in the new administration, to accelerate distribution of the vaccine. The sooner we can get everyone vaccinated who will take the vaccine, the better. At this point, with the new variant detected in the United States, time is of the essence.
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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.