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 leads the world... in COVID cases. We crossed 3 million cumulative cases yesterday.
Stay in the green: wear a mask, watch your distance, wash your hands.
Share the attached infographic here: http://www.ezekielemanuel.com/writing/all-articles/2020/06/30/covid-19-activity-risk-levels
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How to measure testing. "The U.S. has conducted more COVID-19 tests than any other country. However, there is no expert consensus on a recommended target for the raw number of tests or even the rate of tests per capita – and the graph above demonstrates why using these statistics alone can be misleading.
In order for governments to identify new cases and effectively respond to the pandemic through tracing and treatment, testing programs should be scaled to the size of their epidemic, not the size of the population. In this visualization, you’ll see that several countries effectively controlled the spread of the virus through testing programs that had a far lower number of tests per capita than the U.S. Meanwhile, despite having the highest rate of tests per capita, the U.S. faces the largest outbreak in the world and new cases continue to trend upwards in many states.
Looking at the positivity rate (ie, out of all tests conducted, how many came back positive for COVID-19) is the most reliable way to determine if a government is testing enough. A high rate of positive tests indicates a government is only testing the sickest patients who seek out medical attention and is not casting a wide enough net. The WHO has issued guidance stating that governments should see positivity rates below 5% for at least 14 days before relaxing social distancing measures."
Source: https://coronavirus.jhu.edu/testing/international-comparison
Source: https://coronavirus.jhu.edu/testing/testing-positivity
Commentary: The United States is in the middle of the pack in terms of effective testing - but that's falling as our testing capacity falls behind.
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How should you handle an airborne COVID-19? "The coronavirus can stay aloft for hours in tiny droplets in stagnant air, infecting people as they inhale, mounting scientific evidence suggests.
This risk is highest in crowded indoor spaces with poor ventilation, and may help explain super-spreading events reported in meatpacking plants, churches and restaurants.
It’s unclear how often the virus is spread via these tiny droplets, or aerosols, compared with larger droplets that are expelled when a sick person coughs or sneezes, or transmitted through contact with contaminated surfaces, said Linsey Marr, an aerosol expert at Virginia Tech.
What is clear, they said, is that people should consider minimizing time indoors with people outside their families. Schools, nursing homes and businesses should consider adding powerful new air filters and ultraviolet lights that can kill airborne viruses.
For a virus to be airborne means that it can be carried through the air in a viable form. For most pathogens, this is a yes-no scenario. H.I.V., too delicate to survive outside the body, is not airborne. Measles is airborne, and dangerously so: It can survive in the air for up to two hours.
For the coronavirus, the definition has been more complicated. Experts agree that the virus does not travel long distances or remain viable outdoors. But evidence suggests it can traverse the length of a room and, in one set of experimental conditions, remain viable for perhaps three hours."
Source: https://www.nytimes.com/2020/07/06/health/coronavirus-airborne-aerosols.html
Commentary: The article outlines the steps clearly we should take: place as much emphasis on masks and ventilation as on washing hands. Straightforward and practical: wear the best quality mask, in terms of filtration, anywhere indoors that isn't your home. Wear lighter cloth masks etc. outdoors where you can maintain distance from people and there's an abundance of fresh air.
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Progress on vaccination in China. "Good news: Chinese team show inactivated virus effectively vaccinates macaques against SARS-CoV-2. Human trials next.
Bad news: White House has eroded relationship with China so badly, who knows if and when we'll get our hands on it."
"The coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has resulted in an unprecedented public health crisis. Because of the novelty of the virus, there are currently no SARS-CoV-2–specific treatments or vaccines available. Therefore, rapid development of effective vaccines against SARS-CoV-2 are urgently needed. Here, we developed a pilot-scale production of PiCoVacc, a purified inactivated SARS-CoV-2 virus vaccine candidate, which induced SARS-CoV-2–specific neutralizing antibodies in mice, rats, and nonhuman primates. These antibodies neutralized 10 representative SARS-CoV-2 strains, suggesting a possible broader neutralizing ability against other strains. Three immunizations using two different doses, 3 or 6 micrograms per dose, provided partial or complete protection in macaques against SARS-CoV-2 challenge, respectively, without observable antibody-dependent enhancement of infection. These data support the clinical development and testing of PiCoVacc for use in humans."
Source:
Source: https://science.sciencemag.org/content/369/6499/77
Commentary: We're all in this together means that literally - the entire human race. Playing on nationalism and xenophobia only cuts you off from valuable international resources.
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Watch droplets stay in the air in this useful simulation. "Airborne for 20 minutes. That’s how long microdroplets from breathing can stay in the air.
Video simulation of how a single cough spreads microdroplets throughout an entire room."
Source:
Source:
(full video)
Commentary: This is why masks are vital. Watch the full video to see the science and imaging. It's amazing to see how much we emit even just from talking.
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Florida has reached capacity. "At least 56 intensive care units in Florida hospitals reached capacity on Tuesday, state officials said. Another 35 hospitals show ICU bed availability of 10% or less, according to the Agency for Health Care Administration in that state.
Georgia surpassed 100,000 reported coronavirus cases, becoming the ninth state to pass the mark.
In California, the number of hospitalizations across the state were at an all-time high and the virus positivity rate jumped more than 2% in Los Angeles."
Source: https://www.cnn.com/2020/07/07/health/us-coronavirus-tuesday/index.html
Commentary: Hospitalizations today means some deaths in the weeks to come. An awful lot of people are saying, "It can't be that bad, the death rate isn't increasing!" which belies their complete lack of understanding about how disease works. Cases have been going up for weeks. Hospitalizations are going up now. Deaths will come in 2-4 weeks as patients get more ill and as hospitals, now at capacity, lose the ability to provide full care to everyone.
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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. Wear gloves and a mask when out of your home. Consider wearing a face shield if you can't breathe at all through a mask. 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. Avoid indoor places as much as you can.
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.
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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.