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.
---
79 years ago, US President Franklin Roosevelt proclaimed the loss of 2,403 Americans a date that will live in infamy from the attack on Pearl Harbor. 2020 has been the year that will live in infamy.
Over the past week, our COVID-19 daily death counts in the United States have exceeded the toll of Pearl Harbor almost every day - except instead of a foreign power attacking us, Americans are attacking each other by not wearing masks and staying home.
---
Dr. Scott Gottlieb: "Well, look, I think we have a worsening situation around the country, things are going to continue to get worse for the next four to six weeks, we're not likely to see a peak in the number of infections until about the end of December, maybe into January, we're going to see a peak and a number of deaths and hospitalizations, probably at some point in the middle of January. So as bad as things are right now, they're going to get a lot worse. I think by the end of the year, we'll be at probably about 300,000 deaths. And by the end of January, we could be pushing 400,000 deaths, we're going to see consistently, probably 2000 deaths a day. And as we get into January towards the peak, we're going to see over 300,000 3000 deaths a day. Unfortunately, we maybe get close to 4000 deaths a day. So this is going to get a lot worse, before it starts to resolve right now the statistic is that about 1.7% of diagnosed cases, will succumb to the infection within 22 days that has held pretty steady. So there's a grim future right now ahead of us for the next six weeks, people really need to protect themselves.
What we are where we are with the supply, so the supply will ramp as we get into 2021. But there's no way we're going to be able to celebrate that between now and say March. I think if you want to maximize preservation of life, you would vaccinate older Americans, you would prioritize vaccinating older Americans and Americans with comorbid conditions that if they do get COVID, they're more likely to have a bad outcome more likely to die from COVID. Those decisions are going to be made very soon about who that second tranche are people to be vaccinated it is I'm talking to a number of governors and I think governors are going to prioritize their older populations and in some targeted populations and their states where certain communities have been hit especially hard by COVID. They'll go in and make some targeted decisions.
There were some supply chain issues but the vaccine that they intended to produce in 2020 now gets pushed into 2021. This is a supply chain that ramps very quickly as you as time progresses. So every time a week gets pushed from 2020 into 2021, you lose a lot of supply in 2020. And that supply gets pushed into the next year. So the supply stays the same. It's just not going to be available this year. But those doses, the doses that have been promised right now have been made. So Pfizer has said that they'll have 50 million doses available globally, in 2020. Those doses by and large have been made. And in the UK, right after the authorization trucks rolled into the United Kingdom through the channel and actually delivered those doses. They're now sitting in the United Kingdom ready to go. And they're going to start vaccine probably on Tuesday, and UK authorities and said they may be able to vaccinate eight that 800,000 people in the first week."
Source:
Commentary: Due to regulatory and manufacturing issues, Pfizer's supply will not reach its projected vaccine capacity in 2020; those doses will be distributed in 2021. Combined with the FDA's approvals process even for an emergency authorization, vaccination at scale will not begin until 2021.
---
Dr. Deborah Birx: "But every state across this country needs to increase their mitigation and every state needs to be critically informing their state population that the gatherings that we saw in Thanksgiving will lead to a surge, it will happen this week and next week, and we cannot go into the holiday season Christmas Hanukkah Kwanzaa with this same kind of attitude, that those those gatherings don't apply to me, they apply to everybody. If you don't want to lose your grandparents, your aunt, let's be clear 70 if you're over 70 20% of those over 70, who contract COVID are hospitalized, and still 10% of them are lost. So if you have anyone in your family with comorbidities, or over 70, you cannot do those things. You cannot gather with your mask off, you cannot hug and kiss people outside, we will won't have a vaccine for even the most vulnerable Americans. I'm thrilled with the vaccine. But we won't have them for the most vulnerable Americans until February. So we need to do this now. Yes, the nursing homes will be vaccinated. But there's 100 million Americans that have these comorbidities that put them at substantial risk.
I think what's really critical for people to understand is our hospitals normally in the fall and winter, run between 80 and 90%, full, just caring for our routine health. So when you add 10, 15, 20% COVID-19 patients on top of that, that's what puts them at the breaking point, because our normal health care system runs at 80 to 90%. Full throughout the fall. Now I have seen in Part of the reason I've traveled, I've seen really successful examples. And that's part of the reason of going out is to find out what is not working. But what also is working. We've seen in Chicago, Illinois, hospitals come together and create a unified dashboard. So they know at any one time for every single patient that comes into the emergency room, where there is a bed that serves the needs of that individual patient, we've taken that across the states, so that they understand how to do that same kind of sharing and dashboard. And so there are good examples that can help preserve the lives of others. But I want to be very frank to the American people, the vaccines critical, but it's not going to save us from this current surge only we can save us from this current surge. And we know precisely what to do. So if you have loved ones that you want to protect, you have to follow these guidelines now"
Source:
Commentary: It should go without saying, but do not travel for the winter holidays. Whatever you observe - including nothing at all - do not travel. Stay home, stay safe.
---
Why is the FDA process slower than the UK? Dr. Fauci: "So then, and then what you do is you look at the history of vaccinology. And you look at all the vaccines that we've done, and when you see these types of adverse events occur. And when you analyze that, you see that the overwhelming majority, more than 90%, or more of them occur somewhere between 30 and 45 days. And that's the precise reason why you remember back a couple of weeks ago, the discussion that the FDA said they would not issue an EUA until they were 60 days beyond when half of the people receive their last dose. So they've already baked in that 60 day period of observation before they do anything. So right away, they will have captured the overwhelming majority, historically, of when you see so called long term side effects of a vaccine."
Source:
Commentary: The FDA and the EU are looking very stringently at the vaccine's data from the various manufacturers. When both regulatory bodies approve the vaccine, you will know it's safe for sure. The EU is expected to issue a ruling on December 29.
This is a sanity check for the vaccine. The US has no incentive to boost European pharmaceutical manufacturers. The EU has no incentive to bow to the will of American politicians. Together, if they both give the current vaccine candidates the nod, then you can be certain they are safe and work.
---
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. If you come in physical contact with others, wash your clothing upon returning home.
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. When going indoors to a place that isn't your home, wear the best protective mask available to you.
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. 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).
---
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
---
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.