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.
---
More on how COVID-19 attacks the brain. "People infected with SARS-CoV-2 can develop a wide variety of neurological conditions: Endothelial dysfunction can lead to ischemic and hemorrhagic strokes, even in young adults. Demyelinating diseases occur. Autoantibodies that affect the function of neural targets have been identified. The virus also can infect astrocytes, although infection appears to be short lived.
Investigators painstakingly measured gene expression (i.e., RNAs being transcribed) inside the nuclei of individual cells from 8 deceased older adults with COVID-19, 1 person who died from influenza, and 13 older control subjects. All told, 65,309 cells of 14 different types from different parts of the brain were evaluated, including neurons, glial cells (the innate immune cells of the brain), and cells of the choroid plexus involved in the blood–brain barrier. Among COVID-19 patients, gene-expression patterns in cells of the choroid plexus and in glial cells were very different from patterns in control patients — and the COVID-19 patterns were similar, although not identical, to patterns seen in patients with several neurodegenerative diseases (including dementias and schizophrenia). Synaptic signaling was impaired in the excitatory neurons that are important in cognition. There was no evidence of SARS-CoV-2 in the brain at the time of autopsy.
This report supports other research indicating that, in COVID-19 patients, the severe inflammation occurring outside the brain (in the lungs and elsewhere) sends signals through the blood–brain barrier that activates the brain's immune system. This causes neuropathology that likely generates symptoms — impaired cognition, mood disorders, hallucinations, and delusions — reported in COVID-19."
Source: https://www.jwatch.org/na53882/2021/08/03/insights-how-sars-cov-2-causes-brain-pathology
Commentary: This explains a lot of COVID fog - and for as long as COVID-19 is causing immune malfunction, it's likely that the neurological symptoms continue. That means that long COVID sufferers will have to contend with the fog for the duration of their symptoms.
---
Want to reopen X (where X is schools, concerts, whatever)? Rapid antigen testing is the way to go. "Throughout the pandemic rapid antigen tests have been tragically misunderstood. Rapid antigen tests do not generate too many false negative results (that is, negative results even though the person being tested is actually positive). They simply are not designed to identify cases in the pre- and post-contagious periods. Rapid antigen tests reliably indicate whether or not a person is contagious. It may sound jarring, but if someone either just caught coronavirus or is on the tail end of their infection, they pose no threat to others. People who have tested positive for coronavirus can safely go about their normal life provided they are not contagious. That, more than anything, is what matters in controlling a pandemic.
The recommendations on the duration of isolation and quarantine are based on averages which were derived from population data. The reality is that many people are contagious for less than 10 days, and a select few may be contagious for longer. Asking people to hunker down for too short a period is dangerous for obvious reasons. Asking them to sequester for too long comes with other costs, ranging from days of missed work to pandemic fatigue (i.e. losing steam and ignoring all of the guidelines). The Delta variant adds complexity because it may lengthen the contagious window compared to previous versions of the virus. Vaccines may shorten that window, but apparently not entirely. With a negative rapid test, though, one can truly say “I’m not contagious,” and not be guessing. Think how powerful that information is.
Can we afford this? We can’t afford not to. Let’s run the numbers. There are over 8 million employees in the US elementary and secondary school system and around 56 million children. Schools in most states are open 36 weeks per year. At scale, rapid tests cost $5 each. That means we could administer a rapid test to every person in the US school system twice per week for the coming year for around $23 billion. That may sound like a lot until you remember that the last stimulus package was $1.9 trillion. Isn’t keeping schools open safely worth 1.2% of the last stimulus? Not to mention, we’d quickly recover those costs by allowing the economy in these communities to remain open more often. Employed people do not need paycheck support."
Source: https://insidemedicine.bulletin.com/378975113857960
Commentary: this is the way, if we want to reopen things even with variants like Delta and Lambda floating around. We should be testing rapidly and frequently, using that data to make very fast decisions. Advocate to your elected officials wherever you are to embrace rapid antigen testing.
---
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. 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 permitted.
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. Get your personal finances in order now. Cut all unnecessary costs.
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:
---
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
---
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.
---
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.