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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How much faster does B.1.1.7 spread? New data from the UK suggests 35% faster, and about the same across most age groups.
"As of 5 January 2021, PHE has analysed secondary attack rates among contact tracing data (from NHS Test and Trace) for the variant of concern (VOC 202012/01) using both genomic sequence variant data and S-gene target failure (SGTF) data for pillar 2 cases tested by TaqPath labs. Between 30 November 2020 and 20 December 2020, 386,805 cases were reported to NHS Test and Trace. 9,321 (2.4%) of these cases had genomic sequencing data included; 3,801 (40.8%) of those cases were VOC 202012/01. 212,943 (55.1%) cases had data from TaqPath; 90,401 (42.5%) of those cases were isolates with SGTF. 956,519 contacts reported to NHS Test and Trace were exposed between 30 November 2020 and 20 December 2020. 20,497 contacts were reported by cases with genomic sequencing data; 9,228 of those contacts were reported by cases with VOC 202012/01. 525,001 contacts were reported by pillar 2 cases tested by TaqPath labs; 262,769 of those contacts were reported by cases with SGTF. 121,072 (12.7%) of all contacts were known to become cases (secondary attack rate) 2 : • 14.7% among those whose index case had VOC 202012/01; 14.9% among those whose index case had SGTF • 11% among those whose index case had a genomic result of wild type; 11% among those whose index case was tested by a TaqPath lab and did not have SGTF"
Source: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/950823/Variant_of_Concern_VOC_202012_01_Technical_Briefing_3_-_England.pdf
Commentary: The bottom line is the new strain spreads about 35% faster than the existing strains of COVID-19.
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Europe is buckling down. "With 22 countries in the Europe already reporting B117 variant cases, the head of the World Health Organization (WHO) regional office today warned that it could replace other lineages and without extra efforts to control the spread of the more transmissible virus, could further strain health systems already facing pressure.
At a briefing today, Hans Henri Kluge, MD, MPH, said COVID-19 transmission has been sustained at very high levels across the region and that a quarter of countries have seen incidence rise by more than 10% over the last 2 weeks. He also said that a quarter of the regions countries area already reporting strained health systems.
Health officials are worried that the variant could edge out other circulating lineages, as is happening in the United Kingdom and occurring increasingly in Denmark, Kluge said.
In the United Kingdom—where the B117 variant emerged—the COVID-19 situation continues to escalate, with media reports noting that the country's test and trace system is reporting a 24% rise in positivity over the past week.
In London, officials may reopen a field hospital, if needed, to help relieve the burden on hospitals. Also, the city's Mayor Sadiq Khan said today that the city's hospitals may run out of beds in the next few days, due to its surge in cases, according to CNN.
Kluge urged countries to do all they can to mitigate the increased burden on already impacted hospitals by stepping up efforts to reduce transmission and to stay alert for variants. Steps include investigating unusually rapid transmission or unexpected severity, increasing sequencing of samples from a systematically selected subset of cases, and sharing data so others can better understand the true extent of circulation.
"This is an alarming situation, which means that for a short period of time we need to do more than we have done and to intensify the public health and social measures to be certain we can flatten the steep vertical line in some countries, which may not have been seen to date," Kluge said."
Source: https://www.cidrap.umn.edu/news-perspective/2021/01/europe-braces-further-hospital-burden-variant-covid-spread
Commentary: A 24% rise in positivity rates - in a country that has been testing aggressively the whole time - is bad news for us. It shows the B.1.1.7 strain has a significant evolutionary advantage with its transmissibility. The race is on around the world to vaccinate before the disease spreads faster.
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The Biden administration plans to release all available vaccine.
"President-Elect Joseph R. Biden Jr. plans to release nearly all available coronavirus vaccine doses “to ensure the Americans who need it most get it as soon as possible,” a sharp break from the Trump administration’s practice of holding back some of the vaccine, the Biden transition team said Friday.
“The president-elect believes we must accelerate distribution of the vaccine while continuing to ensure the Americans who need it most get it as soon as possible,” T.J. Ducklo, a spokesman for the transition team, said.
“He supports releasing available doses immediately, and believes the government should stop holding back vaccine supply so we can get more shots in Americans’ arms now. He will share additional details next week on how his Administration will begin releasing available doses when he assumes office on January 20th.”
Because both of the vaccines that have emergency approval require two doses, the Trump administration has been holding back roughly half of its supply to ensure those already vaccinated receive the booster dose. But the vaccine rollout has been troubled from the start.
As of Thursday, the Trump administration had shipped more than 21 million vaccine doses, and millions more were already in the federal government’s hands. Yet only 5.9 million people had received them. State and local public health officials, already overwhelmed with rising infections, have been struggling to administer the vaccine to hospital workers and at-risk older Americans while most people remain in the dark about when they might be protected."
Source: https://www.nytimes.com/2021/01/08/world/biden-plans-to-release-nearly-all-available-vaccine-doses-in-an-attempt-to-speed-delivery.html
Commentary: We need a firewall against B.1.1.7. We are already going to have a serious problem with it - it's been detected in individuals with no history of travel, so we have it in community spread already. The faster we can provide even some efficacy, some stoppage of the virus, the better. If President Biden can then leverage the Defense Production Act to accelerate the manufacturing of more, we'll have a fighting chance against the strain in the United States.
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Is this a viable strategy? ACP Journal indicates yes.
"Under a steady vaccine supply of 6 million doses per week, the flexible strategy would result in an additional 23% to 29% of COVID-19 cases averted compared with the fixed strategy (Figure 1). In both scenarios, 24 million people received at least 1 dose by the eighth week, whereas 2.4 million additional people received 2 doses of vaccine in the flexible strategy because millions more received an initial dose during the first 3 weeks; all second doses were administered on schedule (within 3 weeks of first dose) in both strategies. If vaccine supply dropped to 3 million doses per week starting in week 4, overall benefits were reduced in both strategies, and the numbers of people receiving at least 1 dose by 8 weeks, 2 doses by 8 weeks, and 2 on-schedule doses by 8 weeks were 16.5, 12, and 12 million in the fixed strategy, respectively, and 20.1, 12.9, and 6.3 million in the flexible strategy, respectively. Overall, the flexible strategy averted an additional 27% to 32% of COVID-19 cases compared with the fixed strategy in the context of this moderate supply reduction."
Source: https://www.acpjournals.org/doi/10.7326/m20-8137
Commentary: with record high cases, hospitalizations, and deaths in the United States and accelerating spread around the world, anything we can do to avert more cases is a sound strategy.
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First anniversary. "Today is the 1st anniversary when GISAID learned from China CDC: "It is a novel coronavirus."
36 hrs later, the first genome sequence of the virus was sent to GISAID and released to the world. This data sharing enabled diagnostic tests and vaccine dev. at unprecedented speed."
Source:
Commentary: Hard to believe it's only been a year.
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Finally, this piece. "A House lawmaker sends us this: 'There's a severe COVID outbreak coming among (House) members. At the secure location yesterday at least 50 GOP members refused to wear masks. They were asked repeatedly. Older Dem members pleaded. And they wouldn't do it... the sergeant at arms made announcements'"
Source:
Commentary: Hopefully those members who were wearing masks will be safe. Masks work. Those who were not wearing masks... they are less safe.
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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. If you come in physical contact with others, wash your clothing upon returning home.
2. 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.
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).
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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.