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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Both doses needed for variants. "Vaccine effectiveness was also assessed with the use of a cohort study design by comparing the incidence of infection among vaccinated persons with the incidence in the national cohort of persons who were antibody-negative (Section S2). Effectiveness was estimated to be 87.0% (95% CI, 81.8 to 90.7) against the B.1.1.7 variant and 72.1% (95% CI, 66.4 to 76.8) against the B.1.351 variant, findings that confirm the results reported above."
Source: https://www.nejm.org/doi/full/10.1056/NEJMc2104974
Commentary: Critically important in the associated tabular data is that a single dose of the mRNA vaccines only offers 29.5% protection against B.1.1.7 and 16.9% protection against B.1.351. Even more important, after a single dose, they are only 54.1% effective against severe illness or death from B.1.1.7 and 0% against B.1.351 but both are 100% effective after two doses.
So the short of it is, don't skip your second dose. Get it on time, and encourage everyone you know to get their second dose on time. That's the surest protection you have against the new variants.
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Why the vaccines are working. "Recent studies have provided insights into innate and adaptive immune dynamics in coronavirus disease 2019 (COVID-19). However, the exact features of antibody responses that govern COVID-19 disease outcomes remain unclear. In this study, we analyzed humoral immune responses in 229 patients with asymptomatic, mild, moderate and severe COVID-19 over time to probe the nature of antibody responses in disease severity and mortality. We observed a correlation between anti-spike (S) immunoglobulin G (IgG) levels, length of hospitalization and clinical parameters associated with worse clinical progression. Although high anti-S IgG levels correlated with worse disease severity, such correlation was time dependent. Deceased patients did not have higher overall humoral response than discharged patients. However, they mounted a robust, yet delayed, response, measured by anti-S, anti-receptor-binding domain IgG and neutralizing antibody (NAb) levels compared to survivors. Delayed seroconversion kinetics correlated with impaired viral control in deceased patients. Finally, although sera from 85% of patients displayed some neutralization capacity during their disease course, NAb generation before 14 d of disease onset emerged as a key factor for recovery. These data indicate that COVID-19 mortality does not correlate with the cross-sectional antiviral antibody levels per se but, rather, with the delayed kinetics of NAb production."
Source: https://www.nature.com/articles/s41591-021-01355-0
Commentary: This is a super important study because it explains the mechanics of COVID-19 better. Seroconversion is the speed at which antibodies are produced in our blood. What this article is saying is that COVID-19 is fatal in cases where our bodies don't produce antibodies fast enough.
And that's why the vaccines work. Once we have enough antibodies in our systems, we can fight off COVID-19. By getting vaccinated, we already have enough antibodies in us that when the real disease comes knocking, if we don't block it entirely, the case of COVID-19 we have is mild - because we already have a ton of antibodies in us. The disease never gets a chance to run wild inside us if we're vaccinated - and that explains why we need both doses of the vaccine. We may not produce enough antibodies from 1 dose, and then the disease can still have a party. But with two doses, the bouncer at the door is strong enough to block COVID-19 before it ever gets into the club.
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India's surge has spread to Nepal. "Nepal is struggling to contain an explosion in Covid-19 cases, as fears grow that the situation in the Himalayan country may be as bad, if not worse, than in neighbouring India, with which it shares a long and porous border.
Following warnings by health officials earlier this week that the country was on the brink of losing control of its outbreak, Nepal has appealed for urgent international help.
As the country reported its highest daily number of new infections – 9,070 – the prime minister, KP Sharma Oli, who has been criticised for his handling of the crisis, asked the army to help manage emergency facilities to take pressure off the health system."
Source: https://www.theguardian.com/world/2021/may/06/nepal-facing-human-catastrophe-similar-to-india-amid-rampant-covid-surge
Commentary: These outbreaks will continue until we have planet-wide vaccine distribution. We need to be shipping vaccine everywhere as quickly as possible.
And again, it's not just humanitarian. It's blatant self-interest. The more people who catch COVID-19, the more variants will form, and the more likely those variants will evolve to beat the vaccine. We want to make sure that doesn't happen, and that means we need to put the fire out everywhere.
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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, 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. Get vaccinated as soon as you're able to, and fulfill the full vaccine regimen.
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.