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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Guidance on masks.
Source: https://www.wsj.com/articles/double-face-masks-n95-protect-yourself-against-new-covid-19-variants-with-these-mask-upgrades-11612473349
Commentary: What's important here, from a planning and preparation perspective, is that as this advice becomes more mainstream, N95/KN95/KF94 masks will grow more scarce. If you use them, stock up if you can. If you have the option, get something more durable like a reusable P100 respirator (what I wear) so that you're not constantly needing new masks. This is an example:
https://amzn.to/3aPczbR
Whatever masks you choose, make sure they are NIOSH-approved.
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Understanding where SARS-CoV-2 came from. "After a lengthy introduction of the mission and its terms of reference, Liang Wannian, who leads the Chinese team of the joint mission, says he will now begin to talk about the key findings, starting with molecular epidemiology.
Wannian still running through a lot of background that we all know: Similarity of viruses found in bats and pangolins, susceptibility of cats, genomes linked to Wuhan market being identical to each other...
Sequence data "also showed that some diversity of viruses was already present in the early phase of the pandemic in Wuhan, suggesting unsampled chains of transmission beyond the Huanan market cluster”, says Wannian.
ILI data from a hospital in Wuhan and SARI surveillance data from a hospital in Hubei province was reviewed, says Wannian. "The findings indicated that there was no substantial unrecognized circulation of #SARScov2 in Wuhan during the latter part of 2019."
Wannian runs through other evidence and concludes this part:
"This is our basic judgment: It is not possible on the basis of the current information to determine how #SARSCoV2 was introduced into the Huanan market."
One key goal was to understand what happened in early December 2019, says .
"Did we did we change dramatically the picture we had beforehand? I don't think so.
Did we improve our understanding? Did we add details to that story. Absolutely."
Team did a “detailed and profound search” for cases that might have been missed, says . “We did not find evidence of large outbreaks that could be related to cases of #COVID19 prior to December 19 in Wuhan or elsewhere."
Picture becoming clearer of Huanan market being just part of the spread of #sarscov2 in Wuhan in December, says @Peterfoodsafety. “It was not just only a cluster outbreak in the Huanan market, but the virus was also circulating outside of the market."
It "is a very classical picture of the start of an emerging outbreak, where we start with a few sporadic cases early on in the month of December and then we start to see small outbreaks where the disease starts to spread in clusters” incl. the Huanan market, says
"All the work that has been done on the virus, and trying to identify its origin continue to point towards a natural reservoir of this virus and similar viruses in bat populations”, says . “But … a direct jump from bats in the city of Wuhan is not very likely."
Team evaluated four hypotheses, says . “We sat down and went through these different hypotheses, one by one, and assessed the likelihood by putting forwards arguments for and arguments against such hypotheses. And then assessing the likelihood of each of them."
The 4 hypotheses:
1. direct zoonotic spillover
2. spillover from an intermediary host species that might have allowed virus to adapt more
3. introduction via food chain, for example from frozen products
4. lab-related incident
"Our initial findings suggest that the introduction through an intermediary host species is the most likely pathway”, says . But direct spillover and food chain also need some more investigation.
“However, the findings suggest that the laboratory incident hypothesis is extremely unlikely to explain introduction of the virus into the human population”, says suggests the team will not further follow-up that hypothesis with more studies.
Still important to "try to identify earlier cases” to better understand early events, says . “We would recommend to continue some of the good work that has been initiated in looking for material that can be analyzed, that is still available from that time."
“A lot of this material has been already looked at”, says , but there are more sources left to analyse. "One of them just to give an example is blood samples from blood banks, and not only here in Wuhan and other cities and provinces”, but also in other countries.
“We need to conduct more surveys into certain animal species that could be the reservoir or act as a reservoir and of course, including more sampling and more studies of bat populations, not only in China”, says .
More work also needs to be done to understand "the possible role of the cold chain, frozen products in the introduction of the virus over a distance”, says .
"We know that the virus can persist and survive in conditions that are found in these cold and frozen environments”, says . "But we don't really understand if the virus can then transmit to humans and under which conditions this could happen"
Q about exact likelihood of different hypotheses.
Only "broad categories: most likely, less likely”, says . May change with new data. "We can take this again and say okay with this new information does our assessment of the different pathways change?"
Q: why did you discard the lab hypothesis?
Detailed evaluation in the report, says . Accidents happen, but are rare, he says. Also “the fact that nowhere previously was this particular virus researched or identified, or known”.
Team also looked at the BSL4 lab in Wuhan Institute of Virology and "it was very unlikely that anything could escape from such a place”, says .
During visit of Wuhan Institute of Virology, team had a "very long, frank, open discussion with the management and the staff of the Institute“, says @Peterfoodsafety. They gave a "very detailed description of their research, both present and past." Minutes will be in report.
Well, this was a very long press conference considering there was not all that much news. The big take-away is that the origins mission has concluded that lab origin is “extremely unlikely” and that an intermediate host is the most likely scenario.
The most interesting clue was what explained:
That some animals known (rabbits) or suspected (ferret-badgers, bamboo rats) to be susceptible to #SARSCov2 were at Huanan market and came from farms/traders in regions where bats are known to harbor related viruses. "
Source:
Commentary: Two things stand out from this press conference. First, it's no surprise that the virus is likely of zoonotic origin with an intermediary species. When you think about things like ferrets and mink being highly susceptible to it, it's no stretch to think that they got it somehow from bats. A dead bat with it, eaten by a rat would be enough to start jumping species. That would also explain why it uses a furin spike for attachment unlike other coronaviruses.
Second, and more important for day to day, was the revelation that the cold chain could be a vector. By cold chain, we mean things like the grocery store and frozen food aisle. There's no action to take yet because there's no research to support it being a problem; the obvious vector of spread is still respiratory. Wearing the best mask available to you does FAR more to stop the spread and reduce your risk than sanitizing your groceries. The cold chain aspect is an important one for places where COVID-19 is already under control, like New Zealand, to reduce risks of new outbreaks. In places like America, it's irrelevant until we stop the obvious spread.
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The seriousness of B.1.1.7 and other strains. "Anyone who has already had Covid-19 is highly resistant to B-117, a variant of SARS-CoV-2. So in one respect the old virus is helping us against the new one. Most important, the new vaccines that have been developed against SARS-CoV-2 and that are being rolled out in the U.S. and several other countries around the world are likely to protect us against B-117, meaning vaccination campaigns could defeat both viruses.
Yet B-117 has two critical advantages. One is that we’re justifiably exhausted from fighting Covid-19. People may struggle to muster the energy to respond to a new viral threat, especially when the rise of the new virus is hidden in the larger sea of SARS-CoV-2 cases. The other is that cases of B-117 can rise far faster than those of our 2020 foe. In the United Kingdom, where B-117 appears to have evolved, most districts that imposed Tier 4 stay-at-home conditions kept SARS-CoV-2 cases flat only to see B-117 increase 10-fold every three weeks or so. The same pattern of exponential growth seems to have begun in Denmark.
What might this mean for the at least 32 countries outside of the U.K. with confirmed cases of B-117?
Assume that your community is using masks and distancing to maintain flat SARS-CoV-2 transmission levels, but it has detected a single case of B-117 (plus 1,000 cases of SARS-CoV-2). In three weeks, your community may have ten daily B-117 cases (plus 1,000 SARS-CoV-2 cases). In six weeks, there could be 100 cases of the novel variant (plus 1,000 SARS-CoV-2). In nine weeks, half of all cases may be B-117, and the number will continue to increase even once the spread of both viruses slows due to infection and vaccination building up immunity in the population. These estimates are meant to illustrate what can happen, but are consistent with what we know about the comparative spread of B-117 and other strains of SARS-CoV-2.
Because B-117 can grow exponentially even in communities that are keeping SARS-CoV-2 under control, the situation is extremely urgent. If we want vaccination to win this new race, we have to slow down the new virus while it’s still rare."
Source: https://www.statnews.com/2021/01/09/we-lost-to-sars-cov-2-in-2020-we-can-defeat-b-117-in-2021/
Commentary: Unfortunately, as we saw in data from Florida yesterday, B.1.1.7 is no longer rare in many places. In Florida, it crossed the 4% mark recently as a percentage of infections. That's enough, based on how the United States did last year at utterly failing to contain COVID-19, for B.1.1.7 to have substantial runway to get going.
Places like Austria are already seeing the B.1.351 strain become dominant - and B.1.351 has the immune-evading mutation. So we've got a lot of work still to do, and despite being tired of the pandemic, we can't let our guard down. We're boxers in the fourth round and the virus has got a second wind. If we drop our guard, it'll resume punching us in the face repeatedly.
Source about Austria: https://www.derstandard.at/story/2000123979537/streit-um-tiroler-massnahmen-entzweit-schwarze-und-tuerkise-oevp
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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 or better mask if you can obtain 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. 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.