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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5 of the worst days in America's COVID-19 pandemic have occurred in the last 10 days. Dr. Ashish Shah of Brown University's School of Public Health:
"we are in a difficult situation. As a country. We, as those numbers pointed out, we have hundreds of thousands of infections happening, nearly 1000 Americans dying if we do nothing. We are going to get to a point where I'm guessing between now and Inauguration Day, as many as 100,000 additional Americans might die. So we do have to act and we have to act. Now. The first thing I think is Congress needs to pass a bill that gets money to states, I'm not expecting a lot of action out of this White House. But states can lead and they need resources. What Mr. Biden can do is do a lot of signaling instead of just him or one of his political leaders speaking out, we need to start hearing from the scientists on his Advisory Committee, clear communication to the American people about what's ahead and what they can do to stem this tide.
the virus doesn't much care with who you voted for whether you voted at all what what people need to do is understand that the next two to three months, probably the hardest two to three months of the pandemic. People really need to be careful. They need to keep their gatherings to a minimum. Do you know I think one of the major places where virus is spreading is indoor gatherings, people are getting relaxed and having friends and family over. Those are causing big outbreaks. People need to really figure out how to curtail that. Keep activities outside. wear a mask all the time when you're outside of your home. Those things are going to be absolutely critical."
Source:
Commentary: Gatherings of any kind are indeed a significant source of infection right now. From post-election parties to the holidays, gatherings of any kind are a substantial risk, especially if eating or drinking is involved in any capacity.
Wearing a mask all the time except for eating and drinking is like wearing a condom all the time except for when you're having intimate relations - it's one of the highest risk behaviors because you're actively using your respiratory system and emitting aerosols. The easiest way to protect yourself is not to eat or drink in the presence of other people outside your household.
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The first interim analysis of Pfizer's phase 3 trial results. "“Today is a great day for science and humanity. The first set of results from our Phase 3 COVID-19 vaccine trial provides the initial evidence of our vaccine’s ability to prevent COVID-19,” said Dr. Albert Bourla, Pfizer Chairman and CEO. “We are reaching this critical milestone in our vaccine development program at a time when the world needs it most with infection rates setting new records, hospitals nearing over-capacity and economies struggling to reopen. With today’s news, we are a significant step closer to providing people around the world with a much-needed breakthrough to help bring an end to this global health crisis. We look forward to sharing additional efficacy and safety data generated from thousands of participants in the coming weeks.”After discussion with the FDA, the companies recently elected to drop the 32-case interim analysis and conduct the first interim analysis at a minimum of 62 cases. Upon the conclusion of those discussions, the evaluable case count reached 94 and the DMC performed its first analysis on all cases. The case split between vaccinated individuals and those who received the placebo indicates a vaccine efficacy rate above 90%, at 7 days after the second dose. This means that protection is achieved 28 days after the initiation of the vaccination, which consists of a 2-dose schedule. As the study continues, the final vaccine efficacy percentage may vary. The DMC has not reported any serious safety concerns and recommends that the study continue to collect additional safety and efficacy data as planned. The data will be discussed with regulatory authorities worldwide.
- Vaccine candidate was found to be more than 90% effective in preventing COVID-19 in participants without evidence of prior SARS-CoV-2 infection in the first interim efficacy analysis
- Analysis evaluated 94 confirmed cases of COVID-19 in trial participants
- Study enrolled 43,538 participants, with 42% having diverse backgrounds, and no serious safety concerns have been observed; Safety and additional efficacy data continue to be collected
- Submission for Emergency Use Authorization (EUA) to the U.S. Food and Drug Administration (FDA) planned for soon after the required safety milestone is achieved, which is currently expected to occur in the third week of November
- Clinical trial to continue through to final analysis at 164 confirmed cases in order to collect further data and characterize the vaccine candidate’s performance against other study endpoints
Based on current projections we expect to produce globally up to 50 million vaccine doses in 2020 and up to 1.3 billion doses in 2021."
Source: https://www.pfizer.com/news/press-release/press-release-detail/pfizer-and-biontech-announce-vaccine-candidate-against
Commentary: This is excellent news. 90% efficacy is a much higher efficacy rate than folks were hoping for; as long as the final data analysis holds up, these results mean a vaccine could be on the horizon in the next couple of years.
Take note of the production numbers. They'll be able to crank out 1.3 billion doses in 2021. Recalling that this vaccine requires 2 doses, that's enough for about 650 million people - out of a planet of 7 billion people, and that's for all of calendar year 2021. Vaccinating enough people to fully reopen without restriction with just Pfizer's vaccine would require a couple of years at least, so expect to be wearing masks and other non-pharmaceutical interventions for some time.
Pfizer's vaccine also requires deep cold storage, so that will produce some logistical challenges. Nonetheless, it's good to see some early results.
Also, Pfizer was not part of Operation Warp Speed, so those 1.3 billion doses will be allocated worldwide, not to one particular nation.
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Dr. Scott Gottlieb from the weekend circuit. "The other thing that the President Elect and his team could be doing is working directly with the National Governors Association. We have one president at a time. They cannot govern. They are not in position to govern, but they can start working with the governor's to try to formulate policy, through the governor's with the governors, and try to create a more national strategy that way. Because if you're not going to have a federally led national strategy in the next couple of months, and it's going to be led at the state level, you at least want to coordinate across the different states. So it starts to have the semblance of a more cohesive plan.
We're past the election, I think the Trump administration need to focus on what we can be doing nationally, we've been sort of arguing politically over what I think is a false dichotomy, a straw man, that it's really a choice between lockdowns and no lock downs. And that's not the case. We don't need to shut down the country closed. Businesses tell people they need to stay at home, to get some measure of control over this virus, we're not going to get perfect control over this virus. It's a contagious virus, it's going to spread. But it doesn't need to spread at the levels and at the velocity that's going to start to press the healthcare system, which is what we're seeing. We're seeing that in Wisconsin now. It's building field hospitals, Utah's building Fieldhouse, but also El Paso built their fourth mobile morgue, we now have we're gonna have a record number of hospitalizations this week. Now, 56,000 people are hospitalized, 11,000 are in the ICU. These are very big numbers nationally, and it's accelerating very quickly."
Source:
Commentary: The next 70-ish days until Inauguration Day are also the most dangerous days for COVID-19. We have half a dozen major holidays that usually involve large gatherings of people - Diwali, Thanksgiving, Black Friday, Hanukkah, Christmas, Kwanzaa, New Year's Day, and of course, Inauguration Day itself.
And El Paso has added 6 more mobile morgues.
Source: https://kfoxtv.com/news/coronavirus/el-paso-moves-to-10-mobile-morgues-for-covid-19-deaths-as-judge-wants-to-extend-shutdown
America leads the world... in COVID-19 cases. I can't wait for Inauguration Day and the start of a true federally-managed strategy to contain the pandemic.
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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. Always wear a mask when out of your home and if going to a high risk area, wear goggles. 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, 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.
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.
6. Participate in your local political process. For Americans, go to Vote.org and register/verify your vote.
7. Ventilate your home as frequently as weather and circumstances permit.
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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.
This is also available as an email newsletter at https://lunchtimepandemic.substack.com if you prefer the update in your inbox.