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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The United States recorded an all-time high of 122,000 new COVID-19 infections in a single day, blowing past the 110,000 mark.
As we head into the winter and holiday season, this is the worst case scenario. If you haven't already, do not travel for the holidays and take full precautions at all times. Wear the best mask available to you, especially if you're doing holiday shopping in person. Shop online as much as you can.
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Deaths in the US to increase between 4,600 and 11,000 in four weeks.
"This week’s national ensemble forecast predicts that the number of newly reported COVID-19 deaths will likely increase over the next four weeks, with 4,600 to 11,000 new deaths likely to be reported in the week ending November 28, 2020. The national ensemble predicts that a total of 250,000 to 266,000 COVID-19 deaths will be reported by this date.
The state- and territory-level ensemble forecasts predict that over the next 4 weeks, the number of newly reported deaths per week will likely increase in 15 jurisdictions, which are indicated in the forecast plots below. Trends in numbers of future reported deaths are uncertain or predicted to remain stable in the other states and territories."
Source: https://www.cdc.gov/coronavirus/2019-ncov/covid-data/forecasting-us.html
Commentary: We are not prepared and winter is coming. Instead of being lax, now is the time to redouble your precautions. Assume that everyone around you is highly contagious. Wear the best mask available to you.
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Mobility data is slowing worldwide as more places lock down. "Google mobility data in U.S. slowly declining, probably as people react to growing epidemics and reduce activity. Effects are mostly in outbreak states in midwest and west. Here: Selected states; and U.S. vs. Europe. Note: Spike in mobility in South Dakota coincides with Sturgis."
Source:
Commentary: Some nations are reacting quickly and reimposing lockdowns. They'll see case counts decline.
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A patient shed infectious virus for up to 70 days. "Long-term SARS-CoV-2 shedding was observed from the upper respiratory tract of a female immunocompromised patient with chronic lymphocytic leukemia and acquired hypogammaglobulinemia. Shedding of infectious SARS-CoV-2 was observed up to 70 days, and genomic and subgenomic RNA up to 105 days past initial diagnosis. The infection was not cleared after a first treatment with convalescent plasma, suggesting limited impact on SARS-CoV-2 in the upper respiratory tract within this patient. Several weeks after a second convalescent plasma transfusion, SARS-CoV-2 RNA was no longer detected. We observed marked within-host genomic evolution of SARS-CoV-2, with continuous turnover of dominant viral variants. However, replication kinetics in Vero E6 cells and primary human alveolar epithelial tissues were not affected. Our data indicate that certain immunocompromised patients may shed infectious virus for longer durations than previously recognized. Detection of subgenomic RNA is recommended in persistently SARS-CoV-2 positive individuals as a proxy for shedding of infectious virus."
Source: https://www.cell.com/cell/fulltext/S0092-8674(20)31456-2
Commentary: 70 days is highly atypical, an outlier to be sure, but it shows that it's possible to be infectious for a very, very long time. Again, this is an outlier, but it's possible to be infectious for that long.
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What's the impact of a lockdown? "COVID-19 mitigation measures (e.g., stay-at-home orders and public mask mandate) and fundamental public health interventions (e.g., case investigations and contact tracing with prompt isolation or quarantine) are primary approaches to preventing and controlling SARS-CoV-2 community transmission.
State-mandated stay-at-home orders and public mask mandates coupled with case investigations with contact tracing contributed to an 82% reduction in COVID-19 incidence, 88% reduction in hospitalizations, and 100% reduction in mortality in Delaware during late April–June.
The combination of state-mandated community mitigation efforts and routine public health interventions can reduce the occurrence of new COVID-19 cases, hospitalizations, and deaths."
Source: https://www.cdc.gov/mmwr/volumes/69/wr/mm6945e1.htm
Commentary: Contact tracing, masks, and staying at home reduced the disease by 82%. That's the effect of mitigation measures. If a nation wants to get its cases under control, that's what must be done.
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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. Always 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, 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.
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.
6. Participate in your local political process. For Americans, go to Vote.org and register/verify your vote.
7. Ventilate your home as frequently as weather and circumstances permit.
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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.
This is also available as an email newsletter at https://lunchtimepandemic.substack.com if you prefer the update in your inbox.