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.
You are welcome to share this.
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For those in the northern hemisphere, as warmer weather arrives, remember to air out your homes. Open the windows if you can (and it's safe to do so) and enjoy the benefits of increased ventilation, not only for pandemic purposes, but also general health.
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Why peer review matters. "After months or years of research, authors prepare a paper to submit for publication. TheLancet.com has clear guidance on how to prepare a manuscript, and to help identify which journal is the best fit.
Journal editors carefully read every piece of content that is submitted but of course, not every paper submitted can be published. After careful consideration, the editor will send the paper for peer review, inform the authors that the paper has not been accepted, or pass it to another journal within the Lancet family, if the content might fit more appropriately within another specialty.
If our editors agree a paper is of the highest quality and could potentially make an important contribution to the field, it is sent out for peer review.
Editors identify and invite independent experts with relevant expertise from around the world to review each paper, ensuring their complementary knowledge and skills provide a thorough review of the research. All research articles are also sent to a statistical specialist.
These experts make suggestions for improvements, critique the analysis, and provide recommendations to the authors and the editors.
Once the peer review comments are submitted, usually three, plus the statistics review, the editors meet to review the comments and decide whether to take the next step in the process. Papers submitted to any Lancet journal benefit from the broad expertise of the cross-journal editorial team."
Source:
Source: https://www.thelancet.com/journey-paper
Commentary: Peer review is important so that we know findings have been vetted and independently verified. When you're reading studies and papers, be sure you know whether a paper has been peer-reviewed or not. That's not to say papers that haven't gone through the process of peer-review aren't valuable, but a fair number of them have been later retracted after failing the peer-review process.
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The eyes have it, literally. "Anyone who has been tested for covid-19 knows the brain tickling discomfort of the nasopharyngeal (NP) swab. Recent reports from China on the use of rectal swabs for coronavirus detection did not reduce anyone's anxiety about being tested. Now, a new possibility exists however, in the form of conjunctival swabs. The conjunctiva is the white area between the eyeball and the eyelid.
A study from Italy examined the efficacy of conjunctival swabs in lieu of the more invasive swabs. Published in JAMA Ophthalmology, the paper outlines how researchers obtained conjunctival swabs from 91 confirmed covid-19 patients in a single intensive care unit (ICU) during the early phase of pandemic. A total of 17 swabs were obtained from healthy volunteers to assess for applicability of the test. In order to obtain the specimen, the swab was placed near the tear duct for five seconds and then rubbed across the lower eyelid for five more seconds. The swabs were then tested for SARS-CoV-2 using a rRT-PCR analysis, similar to the way NP swabs are evaluated.
At time of testing, only 64 percent of the ICU patients had positive NP swabs, whereas the virus was detectable in the conjunctiva of 57 percent of the known positive patients. Interestingly, the viral load (i.e. the quantity of viral genetic material) varied between eyes; 71 percent of subjects had different quantities of viral genetic material in each eye. In 60 percent of the positive patients, the virus was detectable in both eyes. In a subset of patients it was found that NP swab and conjunctival swab had agreement of 61 percent if performed within two days of each other. Interestingly in 17 patients whose NP swabs were negative, 10 had positive eye swabs.
The main conclusion is that SARS-CoV-2 can be detected on the surface of the eye, and testing the conjunctiva is a feasible alternative in some cases. While this research studied adults, this option may be preferable for some young children. (For anyone who has ever worked in pediatrics, obtaining a throat swab from an unwilling child can be extremely uncomfortable for everyone involved). While the sensitivity of the eye-based test was modest, it did diagnose some individuals in which the NP swabs failed. That said, the study addressed whether the eye contained evidence of viral genetic material but did not assess whether that virus was infectious. It's a stretch to say that this offers proof that eye protection is warranted for all covid-19 patients and those hoping to avoid infection, but at the very least, it makes sense to continue protecting our eyes in high-risk environments (such as patient care) until we know more. And we certainly should avoid touching our faces. "
Source: https://brief19.com/2021/03/05/brief
Commentary: Hopefully, testing will expand to include eye swabs, along with saliva testing, so that we have a broad range of tools to detect COVID-19 as it stops being a pandemic and becomes an endemic disease like the flu, part of human civilization. This will not be the last pandemic we endure as a species, so if we can develop better, faster, cheaper tools for detecting diseases - and get people comfortable using them - we will better be able to intercept diseases and outbreaks.
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Pediatric surge in Sweden. "Warning sign HUGE INCREASE IN KIDS—New Swedish Flag of Sweden data showing a sudden dramatic surge in pediatric #COVID19 cases across Sweden since Jan.
Kids age 0-9: Up Upwards arrow 123%
Kids age 10-19: Up Upwards arrow 72%
Likely due to surging #B117 variant, where it’s now 50% in Stockholm.
2) Is this pediatric surge in #COVID19 a statistical fluke? No. If we just look at the change from late Feb to first week of March, we still see this consistent surge in kids.
This matches data in UK... where #B117 is near complete dominant, and where kids now hold the highest positivity of all age groups in Feb, which was not previously the case."
Source:
Commentary: More data suggesting that kids are a significant vector of infection, underreported and underdiagnosed. If you have the means to do so, keep your kids at home until vaccination has reached peak levels in your community and educators in particular are vaccinated.
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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.