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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Severity correlated with immunity. "The immune response to SARS-CoV-2 is critical in controlling disease, but there is concern that waning immunity may predispose to reinfection. We analyzed the magnitude and phenotype of the SARS-CoV-2-specific T cell response in 100 donors at 6 months following infection. T cell responses were present by ELISPOT and/or intracellular cytokine staining analysis in all donors and characterized by predominant CD4+ T cell responses with strong interleukin (IL)-2 cytokine expression. Median T cell responses were 50% higher in donors who had experienced a symptomatic infection, indicating that the severity of primary infection establishes a ‘set point’ for cellular immunity. T cell responses to spike and nucleoprotein/membrane proteins were correlated with peak antibody levels. Furthermore, higher levels of nucleoprotein-specific T cells were associated with preservation of nucleoprotein-specific antibody level although no such correlation was observed in relation to spike-specific responses. In conclusion, our data are reassuring that functional SARS-CoV-2-specific T cell responses are retained at 6 months following infection."
Source: https://www.nature.com/articles/s41590-021-00902-8
Commentary: This is why the vaccine is so important - it delivers the impact of immunity of a strong case of COVID-19 without the disastrous health results, so those folks who may have had COVID-19 in mild or asymptomatic form may not have as strong an immune response, and should follow their healthcare provider's instructions on when to get vaccinated.
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"A new study published in Morbidity and Mortality Weekly Report, the primary public-facing medical journal of the US Centers for Disease Control and Prevention, gives new insights that may help us tease some of this out. Researchers in Mississippi tested blood samples from 1,630 children under 18 years of age, from May through September of 2020. The blood samples were obtained for unrelated reasons but were kept in storage so that they could be tested later. The researchers then checked the samples for antibodies against SARS-CoV-2, to see how many of the samples showed direct evidence of a prior infection. Around 11 percent of the samples were positive for antibodies, though after adjusting for the fact that the ages and races of the samples did not reflect the actual population, the authors concluded that approximately 16.3 percent of children under 18 had evidence of a prior SARS-CoV-2 infection during the five-month period from which the samples were drawn.
What does this say about herd immunity? Official data suggest that from May through September, around 100,000 coronavirus cases occurred among people of all ages. Since then, another 200,000 documented cases have occurred. Since the authors assume that around 16 percent of kids had been infected by the end of September, does this mean that half of the population already there has some degree of protection? Possibly. If that’s true, then fewer people will need to be vaccinated in order to achieved herd immunity, assuming antibodies acquired from natural infection are strong enough and do not wane in terms of their protectiveness. These data also imply that the rate of serious illness and fatality from pediatric infections is even lower than some have estimated.
On the other hand, these data imply that kids may be infected much more often than we realized. If that’s true, kids might be contributing to spread (either at school or at home) in ways that contact tracing and other testing regimens have simply failed to capture. If jurisdictions are opening schools on the supposition that kids do not spread coronavirus, the validity of such policies could be affected by data such as these that tend to suggest that our ability to track this virus is far less advanced than we realize."
Source: https://brief19.com/2021/03/08/brief/kids-and-seroprevalence-good-news-or-a-double-edged-sword
Commentary: I've said for a while that schools are vectors of infection. They're poorly ventilated, are high occupancy, and have occupants who will have spotty compliance with countermeasures. There is danger to kids, to be sure, but even more danger if they bring COVID-19 home with them from schools. Until schools are properly retrofitted with adequate ventilation, schools should remain virtual.
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What you can and can't do after vaccination. "The CDC has issued new guidance for vaccinated people, giving the green-light to resume some pre-pandemic activities and relax precautions that have been in place.
Specifically, people who are fully vaccinated can gather indoors with other fully vaccinated people without wearing masks or social distancing. People are considered fully vaccinated two weeks after they have gotten the second shot of the Pfizer or Moderna vaccines (or two weeks after receiving the single-dose Johnson & Johnson vaccine).
Vaccinated people can also gather, unmasked, with people from another household who are not yet vaccinated, as long as those people are at low risk of serious illness from the virus. However, the agency said, vaccinated people should continue to mask when they're in public, avoid crowds and take other precautions when gathering with unvaccinated people who are at high risk of serious illness from COVID-19.
The CDC said this new guidance is a "first step" to returning to everyday activities. There's accumulating evidence to show that people who are fully vaccinated are less likely to become infected and also "potentially" less likely to spread the virus to others, agency officials wrote in a press release."
"We know that people want to get vaccinated so they can get back to doing the things they enjoy with the people they love," CDC Director Dr. Rochelle Walensky said in a statement on the new guidelines.
The new guidance is specific to freedoms that vaccinated people can resume in their own homes, but the agency warns that everyone – even those who are vaccinated – should continue to follow recommended guidelines in public settings, including masking.
Source: https://www.npr.org/sections/coronavirus-live-updates/2021/03/08/974783644/cdc-says-its-safe-for-vaccinated-people-to-do-these-activities
Commentary: Keep your masks on in public but gatherings of other fully vaccinated people are safe now without masks, after everyone has been vaccinated - and you've verified that before inviting people into your home.
Masks in public means also that you still shouldn't be dining out. Support your local restaurants by ordering takeout or delivery.
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Dr. Fauci on the situation. "Over the past week and a half or so, we've seen that that decline is now done this essentially starting to plateau. And historically, if you look back at the different surges we've had, when they come down, and then start to plateau at a very high level, plateauing at a level of 60 to 70,000 new cases per day, is not an acceptable level that is really very high. And if you look at what happened in Europe, a few weeks ago, they're usually a couple of weeks ahead of us in these patterns, they were coming down to, then they plateaued, and over the last week or so they've had about a 9% increase in cases. So the message we're saying is that we do want to come back carefully and slowly about pulling back on mitigation methods, but don't turn it switch on and off, because it really would be risky to have yet again, another surge, which we do not want to happen because we're plateauing at of quite a high level 60 to 70,000 new infections per day is quite high.
I think we should point out every day that goes by, that we keep the lid on, things will get better and better, because we're putting now at least 2 million vaccinations into the arms of individuals each day. And as the days and weeks go by, you have more and more protection, not only of individuals, but of the community. So we're going in the right direction, we just need to hang in there a bit longer, we will be pulling back on these mitigation methods, it's not going to be this way indefinitely, for sure. We want to get those debt levels of virus very, very low. And then we will have much, much easier time to safely pull back and get the economy and all the other things that we want to be normal.
And right now the test is being done to determine both safety and comparable immunogenicity. In high school students, we project that high school students will very likely be able to be vaccinated by the full term, maybe not the very first day, but certainly in the early part of the fall for that full educational term, elementary school kids. We're doing this what's called age de escalation studies to make sure it's safe and immunogenic, and then they likely will be able to get vaccinated by the very first quarter of 2022."
Source:
Commentary: We are on the right path, as long as we can keep the new strains contained while we vaccinate, in the US and around the world. Hold on for a few months longer, and then things will start to open back up properly and safely. If everyone does their part, we might even be able to safely gather in larger groups by July. I've said that 2021 will be the mirror image of 2020 - the first half of the year will not be great, but the second half of 2021 will be fantastic. As long as we keep on our path, I think that'll be the case.
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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. 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.
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.