Week of October 11, 2021
Due to upper respiratory infection symptoms and the need to not miss school, we took my older son for rapid PCR COVID testing last week. The test site is at the former Godiva store in the Annapolis Mall, with ornate built-in shelves and white subway tile walls. The testing company uses Pottery Barn cubicle shelving (adorned with tasteful fake plants and a ceramic bull) to separate the nasal-swab testing stations. The gentle hum of air purifiers completes the atmosphere of calm, soothing, and accurate viral detection. Say what you will about capitalism, but cash-based healthcare can lead to a delightful spa aesthetic distinct from typical hospitals or medical offices. (I'm looking at you cosmetic dentists and plastic surgeons!) However, I wonder if ceramic bulls set the right ambiance in a pandemic virus testing location. (And what message is this projecting - Carpe Diem? This pandemic is bull$#!%? You will feel like a gored matador if you are PCR positive?) I would have gone with Warhol-esque pop art-painted N95 masks in shadowboxes—whimsical, topical, and responsible. Oh, and thank goodness, my son did not have coronavirus.
Maybe this will be a thing of the past shortly.
https://www.nytimes.com/2021/10/06/us/politics/biden-rapid-covid-tests.html
---- Latest Data
Deaths, case rates, and hospitalizations are slowly declining for the 3rd week in a row. Sill, 1700 people per day are dying. The prevalence varies significantly in different regions.
https://www.nytimes.com/interactive/2021/us/covid-cases.html
and
https://theuscovidatlas.org/map?src=county_usfacts&var=Confirmed_Count_per_100K_Population&mthd=lisa&v=2
Country Comparison from FT.com
https://ig.ft.com/coronavirus-chart/?areas=eur&areas=usa&areas=gbr&areasRegional=usny&areasRegional=usla&areasRegional=usnv&areasRegional=usar&areasRegional=usks&areasRegional=usmo&cumulative=0&logScale=1&per100K=1&startDate=2021-06-01&values=cases
CDC Weekly Review of Data and Variant Tracking
https://www.cdc.gov/coronavirus/2019-ncov/covid-data/covidview/index.html
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Numerous articles about vaccine effectiveness over time have started appearing. While waning antibody levels are the easiest to publish, the NY State Department of health offered a prerelease paper on clinical outcomes (COVID infections and hospitalizations) in 8 million New Yorkers as a function of time from vaccination.
https://www.medrxiv.org/content/10.1101/2021.10.08.21264595v1.full.pdf
commentary
https://twitter.com/EricTopol/status/1447204715507322885
Here is a NEJM paper on declining antibodies over time.
https://www.nejm.org/doi/full/10.1056/NEJMoa2114583
Lay press coverage:
https://www.cnn.com/2021/10/06/health/pfizer-vaccine-waning-immunity/index.html
Dr. Jeremy Faust offered this fantastic write-up about the opportunities and limits of boosters, focusing on recent Israeli data. Boosters are not a long-term answer.
https://insidemedicine.bulletin.com/625509648475625/
Antibodies and clinical outcomes are all still a bit confusing, but more data is becoming available. Here is my take: even at six months, the risk of hospitalization and death in vaccinated individuals is very, very low. But the risk of breakthrough infection starts to rise. For the immune-compromised and 65+-year-old individuals, boosters have the most apparent benefit. In other groups, and depending on your activities and risk level, boosters may offer increased protection for some window of time. It will be interesting to see how the CDC responds to updated data as more vaccinated Americans hit the 6-month mark from their second dose. I have not seen any indications of different or new side effects due to boosters of the COVID vaccine.
There continues to be mounting data about the long-term impact of having COVID. In this study, a majority of hospitalized COVID patients experience ongoing symptoms for months after infection. (Conveniently, vaccines substantially reduce the risk of hospitalization and death .)
https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(21)00383-0/fulltext
commentary
https://twitter.com/VincentRK/status/1446560064941273089?s=20
Ars Technica offered this very readable version of the available data on vaccine effectiveness, immunity after infection, and the various statements I see floating around the interwebs.
https://arstechnica.com/science/2021/10/prior-infection-vs-vaccination-why-everyone-should-get-a-covid-19-shot/
But, vaccination is only one layer of protection. Masks are still essential for safety, doubly so if you are around people with unknown vaccination status or in indoor public spaces in communities with high viral prevalence. Though I find him a bit dramatic, Dr. Feigl-Ding offers a good summary thread with lots of data.
https://twitter.com/drericding/status/1446548486355357716?s=10
NPR addressed one of the questions on my mind - how do you determine what a "sincerely held" belief is?
https://www.npr.org/2021/10/04/1042577608/religious-exemptions-against-the-covid-19-vaccine-are-complicated-to-get
Infographics!
Check out compound interests infographics on the 2021 Nobel Prize-winning discoveries:
https://www.compoundchem.com/category/nobel-prizes/
Things I learned this week. Some things I wish I could unlearn.
I learned about the fascinating mating rituals of Japanese Pufferfish. I could see decorating with pufferfish-like circle patterns, maybe even cash-based medical practices‽
https://www.livescience.com/40132-underwater-mystery-circles.html
Thanks to a loyal reader, I went intellectually spelunking into the world of fried chicken parts. I learned two valuable take-home points:
1) There is some distinct and defined difference between chicken nuggets, tenders, wings, patties, and fingers. When using the spectrum of nuggets to tenders to measure things, it is better to be the tender.
https://www.insider.com/difference-chicken-nuggets-tenders-2019-3
2) There is a National Chicken Council, and you can go to their meetings. Imagine the swag.
https://www.nationalchickencouncil.org/meetings/
Our Trader Joe's box of graham crackers prompted my teenage sons and me to look up Sylvester Graham. Thanks to our Googling, graham crackers can no longer be discussed without snarky comments and knowing looks. Read on at the risk of forever changing your view of this humble cracker.
https://www.mentalfloss.com/article/571915/graham-crackers-invented-to-fight-vices
Clean hands and sharp minds,
Adam
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