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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Be careful of case counts; testing should remain steady or increasing before case counts are reliable. "Good news: new cases in Florida have been down consistently since 22 July
Or is it? Testing has been down consistently as well.
In fact, testing has been down MORE than cases
The drop in cases started at the same time testing dropped more"
Source:
Commentary: Remember our statistical rule: absence of evidence is not evidence of absence. In other words, putting your hands over your eyes and pretending you don't see the problem does not in any way solve the problem before you. Politicians seeking to make themselves look better by trying to manipulate the data does nothing to fix the actual problem.
If you suspect data manipulation is happening, petition your elected officials for full data transparency.
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Cancer does not pause. "Our prepandemic data represented a good share of the National Cancer Institute weekly incidence estimates of the 6 cancers, ranging from 16% (lung cancer) to 42% (breast cancer).4 A potential limitation of this study is that the association of delayed diagnoses of cancer with outcomes likely depends on the final stage of disease at diagnosis, relative to baseline, and associated treatment implications (curative vs palliative).
Our results indicate a significant decline in newly identified patients with 6 common types of cancer, mirroring findings from other countries.5 The Netherlands Cancer Registry has seen as much as a 40% decline in weekly cancer incidence, and the United Kingdom has experienced a 75% decline in referrals for suspected cancer since COVID-19 restrictions were implemented.5
While residents have taken to social distancing, cancer does not pause. The delay in diagnosis will likely lead to presentation at more advanced stages and poorer clinical outcomes. One study suggests a potential increase of 33 890 excessive cancer deaths in the Untied States.6 Our findings are consistent with previous research,1-3,5 and they call for urgent planning to address the consequences of delayed diagnoses. Planning may entail more robust digital technology to strengthen clinical telehealth offerings and other patient-clinician interactions, including self-service scheduling across specialties and well-designed collection processes."
Source: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2768946
Commentary: Disease of every kind is relentless. It does not care about our opinions. It ignores our wants and desires. If you've been conducting routine, regular health checks and you find something wrong, don't wait to seek treatment. As epidemiologists say, time is tissue - get help sooner rather than later.
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CDC on prolonged health consequences. "In a multistate telephone survey of symptomatic adults who had a positive outpatient test result for SARS-CoV-2 infection, 35% had not returned to their usual state of health when interviewed 2–3 weeks after testing. Among persons aged 18–34 years with no chronic medical conditions, one in five had not returned to their usual state of health.
COVID-19 can result in prolonged illness, even among young adults without underlying chronic medical conditions. Effective public health messaging targeting these groups is warranted.
These findings have important implications for understanding the full effects of COVID-19, even in persons with milder outpatient illness. Notably, convalescence can be prolonged even in young adults without chronic medical conditions, potentially leading to prolonged absence from work, studies, or other activities."
Source: https://www.cdc.gov/mmwr/volumes/69/wr/mm6930e1.htm
Commentary: Share these findings with folks under 35 years of age who believe COVID-19 is mostly harmless to them. 1 in 5 in their cohort hasn't recovered in the usual amount of time.
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COVID-19 shows up on surfaces even after daily deep cleaning in ophthalmology offices. "Question: Do ophthalmologists run the risk of encountering individuals who are asymptomatically carrying severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) when maintaining elective examinations during the coronavirus disease 2019 pandemic?
Finding: In this quality improvement study of samples from 1 examination room, slitlamp breath shield and phoropter surface samples were analyzed by real-time polymerase chain reaction. In 2 of 7 postexamination samples, SARS-CoV-2 viral material was found.
Meaning: Despite triage systems to exclude patients with coronavirus disease 2019, viral material was found on ophthalmology examination room surfaces; however, the infectivity of the virus samples was unknown."
Source: https://jamanetwork.com/journals/jamaophthalmology/fullarticle/2769121
Commentary: Viral material was detected at the end of the day in an eye doctor's office, even after the office was cleaned deeply and let sit for 18 hours. This shouldn't be a surprise to anyone at this point, but it does raise the issue that if you have to be in an indoor space, you should be wearing a mask. If you can't wear a mask - such as in an optometrist's office, a restaurant, a bar, etc. you should avoid that space as much as possible.
In the case of an optometrist, dentist, or other healthcare appointment, do your best to be the first appointment of the day.
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Do masks work? A fun, lighthearted video filled with fire.
Source:
Commentary: The more folks who are helping showcase real, actual evidence of mask effectiveness, the better. I love this demonstration involving flammable aerosols.
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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. 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. 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.