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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Next week, this newsletter as a regular weekday publication turns one year old. I honestly never thought I'd be doing it for this long, because I'd hoped we would have been out of the woods by now. The vaccines would have taken this long or longer - we've built those in record time thanks to amazing scientists, crazy funding, and unprecedented urgency. But the same cannot be said for our citizens in countries all over the world, a shocking number who haven't taken the pandemic seriously and have prolonged it.
I plan to continue the newsletter until such a time as there isn't enough news to share. I am hopeful by midsummer or late summer, the pandemic will be largely under control thanks to vaccination, and then I can bid farewell to this publication. For those of you who have shared it, thank you. For those of you who have taken the advice of experts and done all the right things - wearing masks, watching your distance, getting vaccinated as soon as you're eligible - thank you.
I am eager for the day when we say goodbye here, because it will mean saying hello to a more normal world outside. That day is not today and not soon, but it is on the way.
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Intent to vaccinate on the rise. "And, as COVID-19 vaccine production and administration efforts in the U.S. continue to ramp up, a new Pew Research survey finds public intent to get vaccinated is on the rise.
Overall, 19% of adults say they have already received at least one dose of a coronavirus vaccine. Another 50% say they definitely or probably plan to get vaccinated. Taken together, 69% of the public intends to get a vaccine – or already has – up significantly from 60% who said they planned to get vaccinated in November.
Differences across demographic and political groups continue to characterize public views of COVID-19 vaccines. Yet these dynamics are fluid, and there have been some notable changes as intent has risen and vaccines become more widely available in the U.S.
A majority of Black Americans (61%) now say they plan to get a COVID-19 vaccine or have already received one, up sharply from 42% who said they planned to get vaccinated in November. Differences in intent to be vaccinated among Black, White, Hispanic or Asian adults are generally smaller now than they were three months ago.
Among older adults – who are at greater risk of a serious case of the disease and have priority access to vaccines in most places – 41% say they have already received at least one dose; another 44% say they definitely or probably plan to get vaccinated. Intent to get vaccinated remains higher among those ages 65 and older than among younger adults.
People with lower income levels continue to be less inclined than those with higher incomes to get a vaccine, a dynamic that is borne out in the shares who say they have already received a COVID-19 vaccine: 14% of lower-income adults say they have gotten at least one dose of a vaccine, compared with 20% of middle-income adults and 27% of upper-income adults.
A smaller majority of women (66%) than men (72%) intend to get a vaccine or have already received at least one dose. Among those not planning to get vaccinated, women are more likely than men to cite concerns about the rapid pace of vaccine development and a lack of information about how well they work as major reasons why they don’t plan to get a vaccine.
Partisan differences, which have long characterized views about the outbreak, are increasingly seen in vaccine intent. Democrats are now 27 percentage points more likely than Republicans to say they plan to get, or have already received, a coronavirus vaccine (83% to 56%). This gap is wider than those seen at multiple points in 2020."
Source: https://www.pewresearch.org/science/2021/03/05/growing-share-of-americans-say-they-plan-to-get-a-covid-19-vaccine-or-already-have/
Commentary: In general, this is good news. If 69% of the public gets the vaccine, and another 10-20% has had COVID-19, we're at herd immunity. Keep sharing credible, science-based information about the vaccines to your friends, family, and colleagues to keep these numbers going up. The way out of the pandemic is vaccination, for everyone.
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What slows COVID-19? Masks. What speeds it up? On-premises dining. "Mask mandates were associated with statistically significant decreases in county-level daily COVID-19 case and death growth rates within 20 days of implementation. Allowing on-premises restaurant dining was associated with increases in county-level case and death growth rates within 41–80 days after reopening. State mask mandates and prohibiting on-premises dining at restaurants help limit potential exposure to SARS-CoV-2, reducing community transmission of COVID-19.
Studies have confirmed the effectiveness of community mitigation measures in reducing the prevalence of COVID-19 (5–8). Mask mandates are associated with reductions in COVID-19 case and hospitalization growth rates (6,7), whereas reopening on-premises dining at restaurants, a known risk factor associated with SARS-CoV-2 infection (2), is associated with increased COVID-19 cases and deaths, particularly in the absence of mask mandates (8). The current study builds upon this evidence by accounting for county-level variation in state-issued mitigation measures and highlights the importance of a comprehensive strategy to decrease exposure to and transmission of SARS-CoV-2. Prohibiting on-premises restaurant dining might assist in limiting potential exposure to SARS-CoV-2; however, such orders might disrupt daily life and have an adverse impact on the economy and the food services industry (9). If on-premises restaurant dining options are not prohibited, CDC offers considerations for operators and customers which can reduce the risk of spreading COVID-19 in restaurant settings.*** COVID-19 case and death growth rates might also have increased because of persons engaging in close contact activities other than or in addition to on-premises restaurant dining in response to perceived reduced risk as a result of states allowing restaurants to reopen. Further studies are needed to assess the effect of a multicomponent community mitigation strategy on economic activity.
Increases in COVID-19 case and death growth rates were significantly associated with on-premises dining at restaurants after indoor or outdoor on-premises dining was allowed by the state for >40 days. Several factors might explain this observation. Even though prohibition of on-premises restaurant dining was lifted, restaurants were not required to open and might have delayed reopening. In addition, potential restaurant patrons might have been more cautious when restaurants initially reopened for on-premises dining but might have been more likely to dine at restaurants as time passed. Further analyses are necessary to evaluate the delayed increase in case and death growth rates."
Source: https://www.cdc.gov/mmwr/volumes/70/wr/mm7010e3.htm?s_cid=mm7010e3_e
Commentary: Is anyone surprised by these results? Any situation where you're taking off your mask for any reason is going to increase spread. To the question of whether you should be getting takeout or not, the answer is you should be getting takeout. Even after you've been vaccinated, I would still get takeout until we're positive the new strains are rendered ineffective by the vaccines. A few more months won't hurt - we've made it this far.
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Another study on B.1.1.7 and severe disease. "Methods and Findings: In an observational cohort study we included all SARS-CoV-2 RT PCR test-positive individuals in Denmark sampled between the 1st January and until the 9th February, 2021, identified in the national COVID-19 surveillance system. The surveillance system includes national individual RT PCR test results and viral WGS analyses and data from national health registers including COVID-19 related hospital admissions defined as first admission within 14 days of the test-positive swab. The odds ratio (OR) of admission according to infection with B.1.1.7, vs other co-existing lineages, was calculated in a logistic regression model adjusted for sex, age, period, follow-up time less than 14 days, region, and comorbidities. A total of 35,887 test-positive individuals were identified, 23,057 (64%) had WGS performed, of whom 18,499 (80%) resulted in a viral genome and a total of 2,155 of these were lineage B.1.1.7. The proportion of individuals with B.1.1.7 increased from 4% in early January to 45% in early February. Among the individuals with viral genome data, B.1.1.7 was associated with a crude OR of admission of 0.87 (95%CI, 0.72-1.05) and an adjusted OR of 1.64 (95%CI, 1.32-2.04) based on 128 admissions after B.1.1.7 infection and 1,107 admissions after infection with other lineages. The adjusted OR was increased in all strata of age and calendar time - the two most important confounders of the crude OR.
Conclusions: Infection with lineage B.1.1.7 was associated with an increased risk of hospitalisation compared with other lineages. This finding may have serious public health impact in countries with spread of B.1.1.7 and can support hospital preparedness and modelling of projected impact of the epidemic."
Source: https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3792894
Commentary: A 64% increase in severity of outcome for a more contagious variant isn't good news. What kills people with COVID-19 isn't necessarily the disease itself so much as degradation of care. We've known for a while that a COVID-19 patient with full spectrum of care has good odds of surviving, but when ICUs are packed, standards of care inevitably decline, leading to more deaths.
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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 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. 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. Masks must fit properly to work. Here's 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.