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 a qualified healthcare provider who knows your specific medical situation over advice from people on the Internet.
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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"We nowcast >80% of US population lives in counties either over 100% hospital capacity or risk of soon exceeding.
Admitted patients likely “boarding” in ERs, elective surgeries being cancelled just to keep it together."
Source:
Source: https://alexanderjxchen.github.io/circuitbreaker/
Commentary: We are reaching a critical stage... again... where hospitals are full and people will be denied care for non-life-threatening conditions because of COVID-19. The only silver lining is that Omicron seems to operate differently, so people are on fewer ventilators. Either way, if you need emergency care, you may not receive it. Do your best to minimize hazards and risks for the next 4-6 weeks.
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More on hospitals. "Unprecedented numbers of sick medical staff are causing gridlock in hospitals across San Diego County, significantly hampering efforts to efficiently treat the large number of residents coming forward for care amid continuing increases in the number who are testing positive for COVID-19.
The county health department reported 7,786 new positive cases Tuesday, down slightly from Monday’s total of 8,313. Too many of those positive test results, though, have been for health care workers, the people the community needs most to make it through the current coronavirus surge.
Chris Van Gorder, chief executive officer of Scripps Health, said in an email that an unprecedented 14.5 percent of the health system’s workforce, about 700 workers, including more than 400 in clinical roles, were out on unscheduled time off as of Tuesday afternoon.
“I never like to use the word crisis, but I’ve never seen a staffing issue this serious before, even last year when COVID admissions were much higher,” Van Gorder said. “We just passed the holidays; it’s bound to get worse before it starts to get better.”"
Source: https://www.sandiegouniontribune.com/news/health/story/2022-01-04/covid
Commentary: There was no scientific basis for reducing the isolation period from 10 days to 5 in the USA; the reason was driven by staffing of essential workers, as reflected in this piece.
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Omicron isn't safer. "The fact that #Omicron doesn’t replicate as much in the lung doesn’t make me feel better. Why? #COVID19 was never just a respiratory disease, that’s its primary mode of transmission. I’m increasingly concerned about what this means for vasculature/clot presentation in particular.
It makes sense to me that a virus would want to improve consolidation ability to be able to spread in higher aerosol concentrations @kprather88
If it either improves its stickiness or causes our secretions/proteins to become stickier I’m worried what that means for #LongCovid/2
It’s also concerning to me that frontline healthcare workers are *already* reporting seeing increased rates of MI, stroke, and PE with #Omicron wave despite decreased ARDS.
I guess only time will tell…
Cc: @resiapretorius @DrAnnaNZ @doctorasadkhan @WesElyMD #COVID19 /3
4/ *Do not mess around with SARS, it is a NOVEL VIRUS*
5/ Do what you can to prevent getting #COVID19. Even if you get infected using *multiple* layers of protection (vax/N95 masks/HEPA filters/ventilation) will reduce the DOSE of virus you are exposed to. If sick, please allow your body to rest and recover!
6/ I don't mean to scare anyone. I believe knowledge is power and powerful and people should know how to protect themselves from an #airborne virus and shouldn’t get infected with a NOVEL VIRUS, severely ill, disabled or die because leadership failed us.
7/ And yes, #COVID19 is a pan-body disease that can result in death, severe illness and long/short term disability of unknown duration after even mild initial illness. There is still so much we don't know and truthfully, what we *DO* know up to this point is concerning. Stay safe "
Source:
Commentary: This is a key point. Omicron is still COVID-19, which means that as it sweeps through our populations, it's going to leave a MASSIVE trail of Long COVID - substantial disability and lingering illness. It's going to be a monumental challenge to address over the coming years; do your best to keep from catching it by wearing masks and getting your full vaccine regimen.
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Omicron presenting differently. "Just leaving the ER.
It was a long day. And a stunning amount of Covid.
Today I worked in an area that was temporarily converted into a makeshift ICU during the first COVID wave.
Here’s what different from then.
And also what challenges we’re facing with this surge in NYC: 🧵
Back in March 2020, we were flooded with so many sick and short of breath patients, it seemed like there was nothing we could do.
I almost never feel like that anymore. We’ve learned so much. We have treatments. High-flow oxygen.
That nightmare is over. But this is scary too…
During the first surge, COVID was the only thing we saw in our ERs.
Now record-number COVID cases are hitting at a time when our ERs are already seeing extremely high numbers of non-COVID patients too.
Thankfully the Covid patients aren’t as sick.
BUT there’s SO many of them.
Today it seemed like everyone had COVID. Like, so many.
And yes, like before, there were some really short of breath and needing oxygen.
But for most, COVID seemed to topple a delicate balance of an underlying illness.
It’s making people really sick in a different way.
Diabetics in whom Covid precipitated diabetic ketoacidosis, a serious and life-threatening condition.
Older folks sick with Covid just too weak to get out of bed. Can’t walk. So can’t leave the hospital.
Thankfully not one needed a ventilator.
Relatively few needed oxygen…
But still so many needed hospitalization.
Right now NYC has over 5,000 Covid hospitalizations.
More than last winter’s peak.
Higher than any point since May 2020.
3 times higher than only two weeks ago.
And still climbing higher everyday. Hospitalizations for Covid ...
What’s also different now is those COVID cases are often in beds next to patients who’ve done everything to avoid the virus, and for whom an infection might have a dramatic toll.
The cancer patient on chemotherapy.
Those immunocompromised or severely sick with something else.
Overall it seems Omicron causes milder disease. We aren’t seeing as many patients gasping for air.
But there’s just SO much of it and it’s impacting patients in different ways.
So even if just a tiny portion of cases need to stay in the hospital, it can turn into a huge influx.
Unlike March 2020 we have vaccines. And they remain the best way to stay out of the hospital.
Even with Omicron the unvaccinated still make up a disproportionate share of the sickest COVID patients.
And those needing treatment in the ICU are disproportionately the unvaccinated. Hospitalizations in NYC sho...
As I sat in the part of the ER that used to serve as a makeshift ICU, I thought about all the really sick patients who lost their life there almost two years ago.
I felt sad for the colleagues we’ve lost to COVID.
I felt sad for my colleagues who are clearly just so exhausted.
I felt sick of wearing that damn N95 and face shield for 13 hours, again, after I hoped that phase was behind us.
The next few weeks will be really really tough for us.
A lot of healthcare workers will get sick.
We will have to work short-staffed and take on more patients.
If you do need to go to the ER, try to understand we are doing our best.
If you haven’t been vaccinated or boosted yet, now is really the time. It makes a difference.
I know you’re tired of this.
We are too.
But we’ll really need everyone’s help to get through it, again. 🙏 "
Source:
Commentary: Omicron's presentation appears to be amplifying existing issues - which makes sense as it's a full body disease. Mask up, and make sure you're fully vaccinated.
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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, including boosters. 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 available. If it's available, choose Moderna as your first choice for both vaccine and booster, Pfizer as your second choice. However, remember than any vaccine is better than no vaccine.
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.