Coronavirus Tidbits #102 12/9/20
News Diagnostics Drugs Devices Epidemiology/Infection control Tips Politics Feel good du jour Comic relief Perspective/Poem Bits of beauty
First, there is now a Resources Page here for the most commonly asked questions I’m getting.
Happy to continue to answer your questions/concerns as best I can, so don’t be shy about that.
Chanukah begins tomorrow night at sundown. In that spirit, this seemed apt:
My neighbor’s J fell down but this way is better. #2020 pic.twitter.com/eU9Zl9wiAi— Monica Hesse (@MonicaHesse) December 7, 2020
Greatly encouraging results from Pfizer released today.
Red = Covid infections in Placebo group; Blue = vaccine group. Darker spots are severe cases.
See Drugs section, below for details
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President-elect Biden brings hope back by naming competent people to important roles:
NEW: @HelenBranswell weighs in on Biden’s CDC pick, @RWalensky, a popular choice among public health professionals.https://t.co/ZP17dq2VdH via @statnews— Rick Berke (@rickberke) December 7, 2020
I can’t remember when I’ve seen such rejoicing in #MedTwitter #IDTwitter communities!
I wrote about his Covid Task Force picks here, incl Drs. Vivek Murthy, Marcella Nunez-Smith, David Kessler, Celine Gounder, Rick Bright, and more…
still an incredible, negligent last of testing.
Pfizer COVID Vaccine. Amazing! The numbers speak for themselves. I’m sure Moderna has similar numbers. One of the greatest achievements in medicine of all time. I’m all in. @ASlavitt pic.twitter.com/WqAmjKjZV6— Vincent Rajkumar (@VincentRK) December 8, 2020
Here’s the breakdown. 20% were over age 65. And 5 % over age 75. Age range 12-91. pic.twitter.com/dtneIKF7Qx— Vincent Rajkumar (@VincentRK) December 8, 2020
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Pfizer board member @ScottGottliebMD on the report US declined to purchase additional doses: "$PFE did offer an additional allotment coming out of that plan … multiple times and as recently as after the interim data came out and we knew this vaccine looked to be effective." pic.twitter.com/VFC4evF8Ay— Squawk Box (@SquawkCNBC) December 8, 2020
The Art of the Deal guru turned down 100 million doses of the Pfizer vaccine, knowing preliminary data showed good efficacy. Was it because they refused to be part of Operation Warp Speed–though 45 is claiming credit? Or because they didn’t release results before the election? Or simply because of stupidity?
Reportedly also turned down more of Moderna’s.
Gottlieb says that some of Pfizer’s supply *manufactured in Michigan* will be exported to satisfy foreign contracts by April. Months before most Americans are expected to get a vaccine.
And the Feds are ill-prepared to distribute the vaccine, especially to rural America:
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Instead, the feds developed this mess of a system – a “fumbling” effort by “inexperienced” people with no background in supply chain logistics, manufacturing, disaster preparedness, or healthcare.
We learned very early in this pandemic that our national strategy was one of bluster & photo ops — not one of doing the hard work to get supplies in the hands of those who need them.
For PPE, we set up workarounds – groups like @getusppe developed data networks & equitable distribution strategies. https://getusppe.org/data For testing, the country relied on public-private partnerships, like RI’s work with CVS. https://cnbc.com/2020/04/06/cvs-launches-drive-thru-rapid-testing-in-rhode-island-and-georgia.html
But let’s be clear: these efforts are simply SUBSTITUTES for a federal strategy. And there is no way that they are equivalent to a good, organized, all-50-state, publicly-funded effort.
Which brings me to vaccines. Alarm bells have been ringing about the lack of strategy for vaccine manufacturing, distribution, & messaging, for months.
In September, @healthyamerica1 & @DavidLakey_MD wrote a piece in @statnews
imploring “Operation Warp Speed” to come up with a plan. Simultaneously, potential breakdowns in the cold-storage distribution chain were highlighted, by @pharmalot and others:
In OCTOBER, @ASTHO sounded the alarm that they *still* had no funds & no federal guidance on strategy. https://astho.org/Press-Room/Public-Health-Leaders-Request-COVID-19-Vaccine-Infrastructure-and-Administration-Funding/10-15-20/… (pdf from 11/20: https://astho.org/COVID-19/Vaccine-Distribution-and-Implementation-in-States-and-Territories-Brief/…)
As of NOVEMBER – despite knowing that multiple Phase 3 trials were nearing the end, & despite earlier promises to release vaccines pre-election – there was still no central repository for distribution plans, according to @KHNews Not to mention that months on, NO ONE is talking about how to handle longstanding, well-founded mistrust from Black & brown communities, as outlined so beautifully by @DrBrittaniJ. Without trust, even the best supply chain is useless. Let’s be clear: Almost 300K Americans have died. Another 300K will likely die before inauguration. And a vaccine is *the best chance we have* at getting things back to normal, quickly. But what good is a vaccine, if it stays on the shelves? ~ ~ ~
Dr. Katalin Kariko, 65, fled Communist-run Hungary for the US in 1985 with $1,200 hidden inside her daughter’s teddy bear. She isn’t powerful or rich or celebrated. But her 40 years of research into synthetic messenger RNA led to the new COVID vaccines. https://t.co/qh60Z66EFI— Shannon Watts (@shannonrwatts) December 6, 2020
More on the story behind mRNA’s development:
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Here’s another kicker: If my colleague lived in Texas and I were her physician, it would be ILLEGAL for me to sell her this medicine for $3.30 or $50. It is legal for MDs to dispense out of the office in many states for a profit. Also illegal for me to ship across state lines. https://t.co/9kn5S0I0fA— Emily Porter, M.D. (@dremilyportermd) December 7, 2020
Interesting jury-rigged room air filter.
Sounds promising; Linsey Marr, VT airborne transmission expert, responded to my inquiry:
Yes, there is theoretical and observational evidence that it works. It’s the @CorsIAQ box!
This was also rec by another: https://www.texairfilters.com/how-to-improve-the-efficiency-of-the-box-fan-and-merv-13-filter-air-cleaner/
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CDC has new guideline on ventilation
incl: Use fans to increase the effectiveness of open windows. To safely achieve this, fan placement is important and will vary based on room configuration. Avoid placing fans in a way that could potentially cause contaminated air to flow directly from one person over another. One helpful strategy is to use a window fan, placed safely and securely in a window, to exhaust room air to the outdoors. This will help draw fresh air into room via other open windows and doors without generating strong room air currents.
In homes and buildings where the HVAC fan operation can be controlled at the thermostat, set the fan to the “on” position instead of “auto,”
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Airflow and the pandemic: @Zeynep's careful explanation of deep dive research into why 2 people caught COVID in a restaurant one evening and the rest did not. The answer is unsettling but important to know. https://t.co/WBLr4nsgEc— Anxiety knob dialed down to 11 (@dweinberger) December 6, 2020
Original Korean journal article: https://jkms.org/DOIx.php?id=10.3346/jkms.2020.35.e415
“Per Zeynep: https://zeynep.substack.com/p/small-data-big-implications
If you just want the results: one person (Case B) infected two other people (case A and C) from a distance away of 6.5 meters (~21 feet) and 4.8m (~15 feet). Case B and case A overlapped for just five minutes at quite a distance away. These people were well beyond the current 6 feet / 2 meter guidelines of CDC and much further than the current 3 feet / one meter distance advocated by the WHO. And they still transmitted the virus.
[When is the last time you heard this phrase?:] First, just reading the study is an exercise in what it means to do a study really, really well, with the resources of a government that’s committed to generating useful information…
the initial case infected others the day before his symptom began—the fact that the window of highest infectivity includes the day before symptoms start has made this a very challenging pandemic.
This study confirms the results of an earlier fascinating study highlighting the risk of indoor dining…There, too, people were infected at far greater distances than 6 feet.
What we consider close contact for purposes of tracing and testing in this country (generally an unmasked interaction within less than six feet for more than fifteen minutes) is inadequate.
People sitting the next table over who had their backs to the airflow were not infected,
‘Only the visitors (cases A and C) sitting in the air flow path of case B were infected with COVID-19, while other visitors (V2, V3) closer to the infector for a longer period of time but in the absence of direct air flow did not become infected. In addition, the visitors sitting at tables with cases A and C (V1, V6, and V7) were not infected with COVID-19 because they faced away from the infector’s face.’
I (Zeynep) have not found a single outbreak traced to a movie theater.
We should follow Japan’s lead and discourage talking, especially loud talking indoors or on public transportation.””
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Real footage of telling your parents you won’t be able to come home for Christmas this year. pic.twitter.com/GGh9WgV0ll— Saturday Night Live – SNL (@nbcsnl) December 6, 2020
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Tips, general reading for public:
Wash your hands.
Rinse and repeat.
This is going to be the story to watch in the near future.
2/— Rebekah Jones (@GeoRebekah) December 7, 2020
They took my phone and the computer I use every day to post the case numbers in Florida, and school cases for the entire country.
They took evidence of corruption at the state level.
They claimed it was about a security breach.
This was DeSantis.
He sent the gestapo.
This is what happens to scientists who do their job honestly. This is what happens to people who speak truth to power. I tell them my husband and my two children are upstairs… and THEN one of them draws his gun. On my children. This is Desantis’ Florida.
If Desantis thought pointing a gun in my face was a good way to get me to shut up, he’s about to learn just how wrong he was. I’ll have a new computer tomorrow. And then I’m going to get back to work. If you want to help, my website is still at floridacovidaction.com
[I’m not an attorney nor a computer geek, but two things immediately struck me about this:
Reports: “users in the StateESF-8.Planning group all use the same username and passwords, but says, “once they are no longer associated…they are no longer allowed to access… the group.”
So if she did send an unauthorized message, she used an unsecured system with her old credentials…
How irresponsible for a government agency (or anyone) to have such lax security!
And for this, heavily armed goons raid her house?]
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NEW: ICE investigators issued a subpoena this week demanding BuzzFeed News identify its sources — an extraordinary attempt by the government to interfere with a news outlet acting under the protections of the First Amendment.https://t.co/X3t1nIFmHS— Hamed Aleaziz (@Haleaziz) December 5, 2020
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Scoop: The Trump administration invited Pfizer and Moderna, the two companies expected to soon receive Covid-19 vaccine authorizations, to the White House for a "Vaccine Summit" tomorrow seen largely as a P.R. move. Both will be conspicuous no-shows: https://t.co/6mHryCfmBi— Lev Facher (@levfacher) December 7, 2020
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NEWS — Senate Republicans have invited a leading anti-vaxxer to be the lead witness at a Homeland Security committee hearing on Tuesday at a time when the US is preparing the largest-ever vaccination campaign to fight Covid. From @SherylNYT https://t.co/ISdrVoOXV6— Michael D. Shear (@shearm) December 7, 2020
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Fauci: Federal agents “drive me to work, they stay here, they make sure that nobody tries to break in [to my home] and, as Steve Bannon would like, have somebody behead me. I don’t socialize. It’s my wife and I and the federal agents.” https://t.co/fhCAeXFVci— Elise Foley (@elisefoley) December 3, 2020
The three brothers who created MeidasTouch are making Kelly Loeffler and David Perdue shit their pants and deserve a follow. Retweet, follow them and pass it @BMeiselas, @J_Mei21 and @meiselasb pic.twitter.com/xVnuiqnnjN— Adam Parkhomenko (@AdamParkhomenko) December 7, 2020
Feel good du jour:
Guy Fieri has raised $21.5 million for unemployed restaurant workers, which means Guy Fieri has done more for unemployed restaurant workers than Congress has in the last 8 months.https://t.co/Y8APlt5jah— Dan Price (@DanPriceSeattle) December 6, 2020
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This is the guy that needs to be vaccinating everyone #VaccinesWork #stewardmeme pic.twitter.com/fpGN6n5d4l— Adi (@IDdocAdi) December 3, 2020
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My other favorite was by superb turner John Kelsey, who loves playing with magnets and puzzle boxes. #Woodturning @AAWoodturners #scicomm #sciart pic.twitter.com/RNGjJjJf0q— Judy Stone (@DrJudyStone) December 4, 2020
Obituary for 81-year-old who died from COVID is also a tell-off to anti-maskers, who deserve every bit of it.— Peter Bonilla (@pebonilla) December 4, 2020
(Article: https://t.co/8weKYUz8S9) pic.twitter.com/zY3gqKuc5g
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This is amazing and moving. Please watch and share widely. pic.twitter.com/wYHjNuYp27— David Corn (@DavidCornDC) November 7, 2020
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This must have taken enormous determination:
Grover Wilhelmsen, retired orchestra teacher, hospitalized with Covid-19 in Ogden, Utah played his violin while on hi-flow nasal cannula in the ICU as a tribute to nurses and doctors who had been caring for him. God bless him!pic.twitter.com/dubmkUnhAy— Cleavon MD (@Cleavon_MD) November 24, 2020
More about Mr. Wilhelmsen at https://abc7news.com/covid-patient-plays-violin-health-care-workers-utah-hospital-icu/8100070/ He has since died…
Here is a lovely profile of him:
…One memorable repair came when Wilhelmsen began a new teaching assignment. He found a violin under his desk that had been sitting there for several years. The case had been crushed, run over by a car tire, and half of the violin was a mesh of pieces. Wilhelmsen figured he would try to put it back together, spending hours piecing and gluing the pieces, one time even holding two pieces together while he conducted so the pieces could dry because he didn’t have a small enough clamp. The violin is still being played by students up in the Bear River area, Wilhelmsen said.
“Some violins are not worth resurrecting, but forgive me for saying this,” as Wilhelmsen got slightly emotional, “each instrument has a soul, and it speaks to me. There are ones that say, ‘I’m done,’ so I find something else for them to do, like using parts from it. But for the most part, most musical instruments in a school setting can’t afford to be replaced, so teachers say, ‘What can you do to repair them?’”
‘Music is not what I do, it’s who I am.’
Bits of beauty:
Latest piece by Mark Skinner. Cherry, abalone, and infinite patience.