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 a qualified healthcare provider who knows your specific medical situation over advice from people on the Internet.
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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Commentary: I'm back from a week of travel. I spent 26 hours on planes and a total of 42 hours traveling, including through Istanbul, one of the world's busiest airports. On every single flight, masks were optional and almost no one wore one. I spoke at a conference in a room of 500 people, none of whom had a mask on.
Yet I just took my fourth consecutive rapid antigen test, now 3 days back from traveling, and all have been negative.
How? After all, the pandemic isn't over. Cases are on the rise in many places again. A few factors played a role.
First, I wore a mask almost always, except to eat and drink.
Second, airplanes have reasonably clean air that's cycled quickly through HEPA filters. I actually tested this by smacking my pillow at my seat repeatedly to launch a large cloud of dust in the air and within 90 seconds, it was cleared from the air. My seatmate probably thought I was nuts.
Third, especially on flights TO the USA, you are required to provide a certified negative COVID test 24 hours or less before the flight. That dramatically reduces the number of people who are likely contagious. Between air filtration and international travel requirements, international flights might be one of the safest places to be.
Fourth, the mask I wore was a P100 mask - rated to capture 99.97% of particles (compared to an N95 that captures 95% of particles). That dramatically reduces my vulnerability (and it's more comfortable!) so I can spend longer periods of time in risky places if necessary.
Even if no one else around you is masking up, wearing a strong mask - N95 or better - will keep you safe. Sure, it's better if others are also masking, but with sufficiently strong gear, you can be safe with or without the cooperation of those around you.
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Largest ever study of wearing masks and COVID. "We resolve conflicting results regarding mask wearing against COVID-19. Most previous work focused on mask mandates; we study the effect of mask wearing directly. We find that population mask wearing notably reduced SARS-CoV-2 transmission (mean mask-wearing levels corresponding to a 19% decrease in R). We use the largest wearing survey (n = 20 million) and obtain our estimates from regions across six continents. We account for nonpharmaceutical interventions and time spent in public, and quantify our uncertainty. Factors additional to mask mandates influenced the worldwide early uptake of mask wearing. Our analysis goes further than past work in the quality of wearing data–100 times the size with random sampling–geographical scope, a semimechanistic infection model, and the validation of our results."
Source: https://www.pnas.org/doi/10.1073/pnas.2119266119
Commentary: Wearing a mask, ANY mask, reduces the risk of COVID's transmissibility by an average of 19%.
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COVID mutates very quickly. " A remarkable view into the biology of this virus and just how fast new (sub)variants take over
For flu - its on order of months/years when sweeps occurs
With SARS-CoV-2, immunity & high transmissibility put pressure on the virus to shapeshift - and the most fit sweeps
Of not the sweeps in a single city are faster than global - so the comparison to flu on a global scale isn’t exactly correct, but the point remains - this virus changes fast
There were many people at the beginning who felt this virus would follow a trend of slow mutations - I never agreed w that. The difference is this is a new virus and arrived as a “baby virus” not nearly optimized. So we are watching it get optimized “within” the human species.
Essentially, the virus jumped into humans but should never have been expected to have done so in anything close to an optimal state for transmission. It always had to stretch its legs, learn to crawl, walk and run.
That takes mutations to do that. hopefully it’s running soon
Just to be clear “hopefully it’s running soon” is meant to mean, hopefully it stops accelerating soon and levels out. "
Source:
Commentary: SARS-CoV-2 continues to mutate as it becomes better at working inside humans. That's what the above thread means - it arrived basically not ready for primetime and still did a bunch of damage, and now it's finally calibrating properly to infect us.
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Long COVID has created mass disability. "The coronavirus pandemic has created a mass-disabling event that experts liken to HIV, polio or World War II, with millions suffering the long-term effects of infection with the virus. Many have found their lives dramatically changed and are grappling with what it means to be disabled.
The dramatic influx of newly disabled Americans changes the calculus for disability advocates, who have in recent years been uniting around a shared identity, pushing back against historic marginalization by affirming their self-worth and embracing their disabilities."
"In January, the journal Infection Control Today compiled other research forecasting more than 8 million Americans would develop long COVID. That’s at least three times the number of people currently diagnosed with ME/CFS (pre-COVID). The journal quoted #MEACTION editor Adriane Tilman feeling unsurprised.
“Long COVID is not a new phenomenon — there are millions of Americans who got sick with a virus and never recovered before the pandemic, and developed ME/CFS,” Tilman told ICT. “The only difference is that we are seeing this happen now in real time on a massive scale.”
Vaccines have proved effective at preventing deaths and extreme immediate complications from COVID infections. But a recent study by the federal Veteran’s Administration looked at more than 30,000 COVID victims and found a neutral response for long COVID — the chance someone would get long COVID was even whether they had the vaccine or not. "
Source: https://www.washingtonpost.com/health/2022/06/06/long-covid-disability-advocacy/
Source: https://missoulian.com/news/local/missed-risk-long-covid-threat-extends-far-beyond-pandemic/article_70311453-1f78-5068-b1ea-02886b41741a.html?utm_medium=social&utm_source=twitter&utm_campaign=user-share
Commentary: We still don't know the long-term results of COVID, the long-term impact, but we do know it will be massive. In terms of an infection event, this is the largest ever seen in human history with 533 million people infected worldwide and 6.3 million deaths. Long COVID and its successors
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Get vaccinated in the mornings. "The immune system is highly time-of-day dependent. Pioneering studies in the 1960s were the first to identify immune responses to be under a circadian control. Only in the last decade, however, have the molecular factors governing circadian immune rhythms been identified. These studies have revealed a highly complex picture of the interconnectivity of rhythmicity within immune cells with that of their environment. Here, we provide a global overview of the circadian immune system, focusing on recent advances in the rapidly expanding field of circadian immunology."
Source: https://www.science.org/doi/10.1126/sciimmunol.abm2465
Commentary: In this paper, which is paywalled, the immune system has a rhythm and tends to work best in the mornings. To maximize the benefit of vaccines, get vaccinated in the morning when you can for any vaccine.
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A reminder of the simple daily habits we should all be taking.
1. Wear the best mask available to you when you'll be around people you don't live with, even after you've been vaccinated. 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. Verify your mask's NIOSH certification here: https://www.cdc.gov/niosh/npptl/usernotices/counterfeitResp.html
3. Get vaccinated as soon as you're able to, and fulfill the full vaccine regimen, including boosters. Remember that you are not vaccinated until everyone you live with is vaccinated. If you received an adenovirus vaccine (J&J/AstraZeneca), consider getting an mRNA single shot booster (Pfizer/Moderna) if available. If it's available, choose Moderna as your first choice for both vaccine and booster, Pfizer as your second choice. However, remember than any vaccine is better than no vaccine.
4. Wash/sanitize your hands every time you are in or out of your home.
5. Stay out of indoor spaces that aren't your home and away from people you don't live with as much as practical. Minimize your contact with others and avoid indoor places as much as you can; indoor spaces spread the disease through aerosols and distance is less effective at mitigating your risks.
6. Aim to have 3-6 months of living expenses on hand in case the pandemic gives another crazy plot twist to the economy, or you know, a global war breaks out.
7. Replenish your supplies as you use them. Avoid reducing your stores to pre-pandemic levels in case an outbreak causes unexpected supply chain disruptions.
8. 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).
9. Masks must fit properly to work. Here's how to properly fit a mask:
10. If you think you may have been exposed to COVID-19, purchase a rapid antigen test. This will detect COVID-19 only when you're contagious, so follow the directions clearly. https://amzn.to/3fLAoor
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Common misinformation debunked!
There is no basis in fact that COVID-19 vaccines can shed or otherwise harm people around you.
Source: https://www.reuters.com/article/factcheck-covid19vaccine-reproductivepro-idUSL1N2MG256
There is no mercury or other heavy metals in the Pfizer mRNA vaccine.
Source: https://www.technologyreview.com/2020/12/09/1013538/what-are-the-ingredients-of-pfizers-covid-19-vaccine/
There is no basis in fact that COVID-19 vaccines pose additional risks to pregnant women.
Source: https://www.nejm.org/doi/full/10.1056/NEJMoa2104983
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/
Source: https://www.smh.com.au/national/are-we-ignoring-the-hard-truths-about-the-most-likely-cause-of-covid-19-20210601-p57x4r.html
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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Disclosures and Disclaimers
I declare no competing interests on anything I share related to COVID-19. I am employed by and am a co-owner in TrustInsights.ai, an analytics and management consulting firm. I have no clients and no business interests in anything related to COVID-19, nor do I financially benefit in any way from sharing information about COVID-19.
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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.