2,675 Matching Annotations
  1. Sep 2020
    1. There are two possible approaches to build widespread SARS-CoV-2 immunity: (1) a mass vaccination campaign, which requires the development of an effective and safe vaccine, or (2) natural immunization of global populations with the virus over time. However, the consequences of the latter are serious and far-reaching—a large fraction of the human population would need to become infected with the virus, and millions would succumb to it.

      Take away: Mass infection without vaccination to achieve herd immunity will result in millions of deaths based on the observed death rate and may not result in herd immunity due to virus mutation. Historically, vaccination results in less deaths than the disease.

      The claim: Herd immunity from widespread disease instead of vaccination will lead to many people dying.

      The evidence: Approximately 50-67% of a given population is estimated to need to be infected for herd immunity to COVID-19 to exist which will result in millions of deaths. This is supported by additional publications (1, 2). This number assumes that the virus will not mutate to the point where re-infection is possible. If mutation occurs, COVID could become established in the general population similar to influenza or the common cold (3). A third publication estimates a needed infected percentage of 29-74% (4). These publications support the statement that millions will die if herd immunity is achieved via infection without vaccination. Historically, vaccination results in fewer deaths/disease on a population level than the disease for which the vaccine is designed to prevent (5-7).

      Sources:

      1 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7314002/

      2 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7262166/pdf/JMV-9999-na.pdf

      3 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7164482/

      4 https://www.cambridge.org/core/services/aop-cambridge-core/content/view/A1480DAE803D4CD4A3E9F79B82309584/S1935789320001913a.pdf/covid19_reflections.pdf

      5 https://pubmed.ncbi.nlm.nih.gov/28708957/

      6 https://pubmed.ncbi.nlm.nih.gov/29668817/

      7 https://pubmed.ncbi.nlm.nih.gov/12531323/

    1. Ten minutes of massage or rest will help your body fight stress
      • Short-term treatments like a massage, or just resting for a bit, reduce stress by boosting the parasympathetic nervous system (PNS).
      • Relaxation therapies show promise as a way to treat stress, but so far scientists haven’t developed a standardised method to test them - until now.
      • This study is the first standardised approach, and the results show that both rest and a massage increase heart rate variability (HRV) - higher HRV = greater relaxation.
      • Researchers say this shows we don’t need professional treatment in order to relax, even a 10-minute rest can boost our PNS and calm us down.
      • These conclusions will enable further experiments to study how different relaxation methods can help people with stress-related conditions like depression
    1. Take away: People are infectious for only part of the time they test positive. The tests for COVID-19 were granted emergency status by the FDA so some debate concerning the most ideal number of cycles is to be expected. It is worth noting that the FDA has the disclaimer "Negative results do not preclude 2019-nCoV infection and should not be used as the sole basis for treatment or other patient management decisions. Negative results must be combined with clinical observations, patient history, and epidemiological information (2)."

      The claim: Up to 90 percent of people diagnosed with coronavirus may not be carrying enough of it to infect anyone else

      The evidence: Per Walsh et al. (1), SARS-CoV-2 virus (COVID-19) is most likely infectious if the number of PCR cycles is <24 and the symptom onset to test is <8 days. RT-PCR detects the RNA, not the infectious virus. Therefore, setting the cycle threshold at 37-40 cycles will most likely result in detecting some samples with virus which is not infectious. As the PCR tests were granted emergency use by the FDA (samples include 2-9), it is not surprising that some debate exists currently about where the cycle threshold should be. Thresholds need to be set and validated for dozens of PCR tests currently in use. If identifying only infectious individuals is the goal, a lower cycle number may be justified. If detection of as many cases as possible to get closer to the most accurate death rate is the goal, setting the cycle threshold at 37-40 makes sense. A lower threshold will result in fewer COVID-19 positive samples being identified. It is worth noting that the emergency use approval granted by the FDA includes the disclaimer that a negative test does not guarantee that a person is not infected with COVID-19. RNA degrades easily. If samples are not kept cold or properly processed, the virus can degrade and result in a false negative result.

      Source: 1 https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciaa638/5842165

      2 https://www.fda.gov/media/134922/download

      3 https://www.fda.gov/media/138150/download

      4 https://www.fda.gov/media/137120/download

      5 https://www.fda.gov/media/136231/download

      6 https://www.fda.gov/media/136472/download

      7 https://www.fda.gov/media/139279/download

      8 https://www.fda.gov/media/136314/download

      9 https://www.fda.gov/media/140776/download

  2. Aug 2020
    1. Lozano, R., Fullman, N., Mumford, J. E., Knight, M., Barthelemy, C. M., Abbafati, C., Abbastabar, H., Abd-Allah, F., Abdollahi, M., Abedi, A., Abolhassani, H., Abosetugn, A. E., Abreu, L. G., Abrigo, M. R. M., Haimed, A. K. A., Abushouk, A. I., Adabi, M., Adebayo, O. M., Adekanmbi, V., … Murray, C. J. L. (2020). Measuring universal health coverage based on an index of effective coverage of health services in 204 countries and territories, 1990–2019: A systematic analysis for the Global Burden of Disease Study 2019. The Lancet, 0(0). https://doi.org/10.1016/S0140-6736(20)30750-9

    1. Nguyen, L. H., Drew, D. A., Graham, M. S., Joshi, A. D., Guo, C.-G., Ma, W., Mehta, R. S., Warner, E. T., Sikavi, D. R., Lo, C.-H., Kwon, S., Song, M., Mucci, L. A., Stampfer, M. J., Willett, W. C., Eliassen, A. H., Hart, J. E., Chavarro, J. E., Rich-Edwards, J. W., … Zhang, F. (2020). Risk of COVID-19 among front-line health-care workers and the general community: A prospective cohort study. The Lancet Public Health, 0(0). https://doi.org/10.1016/S2468-2667(20)30164-X

    1. Independent SAGE {@independentSage} (2020) LIVE now: Independent SAGE's weekly briefing. Please join us for latest analysis & questions from the press & public. All welcome! Twitter. Retrieved from: https://twitter.com/IndependentSage/status/1296787775354630146

    1. Harper, Craig A., and Darren Rhodes. ‘Ideological Responses to the Breaking of COVID-19 Social Distancing Recommendations’, 19 August 2020. https://doi.org/10.31234/osf.io/dkqj6.

    2. Harper, Craig A., and Darren Rhodes. ‘Ideological Responses to the Breaking of COVID-19 Social Distancing Recommendations’, 19 August 2020. https://doi.org/10.31234/osf.io/dkqj6.

    3. Harper, Craig A., and Darren Rhodes. ‘Ideological Responses to the Breaking of COVID-19 Social Distancing Recommendations’, 19 August 2020. https://doi.org/10.31234/osf.io/dkqj6.

    1. Sherrard-Smith, E., Hogan, A. B., Hamlet, A., Watson, O. J., Whittaker, C., Winskill, P., Ali, F., Mohammad, A. B., Uhomoibhi, P., Maikore, I., Ogbulafor, N., Nikau, J., Kont, M. D., Challenger, J. D., Verity, R., Lambert, B., Cairns, M., Rao, B., Baguelin, M., … Churcher, T. S. (2020). The potential public health consequences of COVID-19 on malaria in Africa. Nature Medicine, 1–6. https://doi.org/10.1038/s41591-020-1025-y

    1. Malani, A., Soman, S., Asher, S., Novosad, P., Imbert, C., Tandel, V., Agarwal, A., Alomar, A., Sarker, A., Shah, D., Shen, D., Gruber, J., Sachdeva, S., Kaiser, D., & Bettencourt, L. M. A. (2020). Adaptive Control of COVID-19 Outbreaks in India: Local, Gradual, and Trigger-based Exit Paths from Lockdown (Working Paper No. 27532; Working Paper Series). National Bureau of Economic Research. https://doi.org/10.3386/w27532

    1. Though important, social distancing could be reduced to one metre instead of 2m

      Take away: As with most things in nature, there are always exceptions – transmission occurring at greater distances than 3 ft and evidence of aerosolization have been reported.

      Discussion: In scientific terms, this virus is still very new so the data supporting an optimal physical distance to prevent transmission remains scarce. In the absence of data, public health agencies have used what they understand about this virus and similar viruses to infer a “best” answer. Public health agencies try to simplify the recommendation to a single answer, but the reality is much more complex.

      According to reports the WHO bases their recommendation for 1 meter (~3 ft) distancing off of an understanding that SARS-CoV-2 behaves like similar respiratory viruses that are primarily transmitted via larger droplets (as opposed to smaller aerosols). Assuming most spread is via droplets, the WHO reportedly follows the results of a 1934 study indicating most respiratory droplets fall to the ground within 3 feet.

      However, as with most things in nature, there are always exceptions – transmission occurring at greater distances than 3 ft and evidence of aerosolization have been reported.

      The evidence basis for the CDCs guidance for 6 feet of separation is less clear, but probably reflects lower risk tolerance, or greater weight to evidence of aerosolization or wider droplet spread.

      Even with further study, there may never be a clear answer for optimal physical distancing. This is because, (1) the area of high risk for transmission is probably dependent on the specific conditions of the interaction (e.g. loud talking, windy environment), and (2) the “optimal” distance is based on risk tolerance. There is no single distance between individuals where risk of transmission drops off precipitously to zero.

      All evidence indicates that greater distances are safer but, for example, consider how restrictive a physical distancing recommendation of >50 ft would be. In the end, because we can’t control how far others stand away from us, we ask governments to consider these tradeoffs and deliver a “best” answer to guide their citizenry.

    1. @who published a massive review/meta-analysis of interventions for flu epidemics in 2019, found "moderate" evidence AGAINST using masks.

      Take away: In their 2019 report the WHO actually recommended for, not against, the use of masks in severe influenza epidemics or pandemics, contrasting the statement made in this tweet. Further, recent evidence overwhelmingly supports the benefit of masks for preventing the spread of SARS-CoV2, the virus that causes COVID-19.

      The claim: Overall the claim here appears to be that masks are ineffective against the spread of SARS-CoV2, the virus that causes the clinical syndrome known as COVID-19. The evidence used in support of this claim is that “the WHO found ‘moderate’ evidence AGAINST using masks” in their 2019 report on the use of non-pharmaceutical interventions for mitigating influenza pandemics.

      The evidence: This overall claim is poorly supported by data and the evidence used to support this claim is incorrectly characterized by the claimant. Narrowly, the claim that the WHO recommended against mask use is patently false. In their report, the WHO reviewed 10 separate studies and did conclude that there was scant evidence that masks significantly decreased spread of the flu. However, they found no evidence that masks increased spread, and based on mechanistic plausibility (i.e. masks are barriers that prevent droplets from passing between people) and the low risk/high reward, they made a conditional recommendation for mask use in severe influenza epidemics or pandemics.

      While influenza does not behave exactly like the SARS-CoV2 virus, the similarities in mode of transmission make it reasonably likely that masks would also have protective effects against the spread of this virus is well. The best evidence is hard data, and that too increasingly points to the benefit of masks for slowing down or preventing the transmission of SARS-CoV2. A recent summary of that data is available here.