Week of February 14, 2022
In general, most people's ability to estimate the risk of becoming infected, spreading the virus, or experiencing a particular COVID outcome (prolonged illness, hospitalization, or death) is poor. We are entering a period of states repealing mask mandates due to declining case rates. I am concerned that our collective wish to end the pandemic is premature and condones risky behavior. Immunocompromised patients and unvaccinated young children are not protected. Vaccines and masks are still our best defense.
A NY Times article from May 2021 highlighted how challenging risk estimation is. This survey looked at how political beliefs (both liberal and conservative) bias COVID risk estimation:
https://www.nytimes.com/2021/03/18/briefing/atlanta-shootings-kamala-harris-tax-deadline-2021.html
And, if you have some more time, look at the Gallup A to Z pandemic opinion data set:
https://news.gallup.com/poll/308222/coronavirus-pandemic.aspx
---- Latest Data
Deaths are now declining. Case rates and hospitalizations continue to decline.
https://www.nytimes.com/interactive/2021/us/covid-cases.html
and
https://theuscovidatlas.org/map
(You need to play with the variables on this one)
Country Comparison from FT.com
https://ig.ft.com/coronavirus-chart/?areas=eur&areas=usa&areas=gbr&areas=rus&areas=rou&areas=lva&areasRegional=usny&areasRegional=usla&areasRegional=usnv&areasRegional=usar&areasRegional=usks&areasRegional=usmo&cumulative=0&logScale=1&per100K=1&startDate=2021-06-01&values=cases
The CDC weekly review discusses the value and impact of boosters.
https://www.cdc.gov/coronavirus/2019-ncov/covid-data/covidview/index.html
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Omicron subvariants (BA.2) are becoming more predominant outside the U.S. and increasingly common in the U.S.
Here is a good roundup of what is known:
https://www.ama-assn.org/delivering-care/public-health/what-ba2-or-stealth-omicron-subvariant
and
https://fortune.com/2022/01/25/what-is-stealth-omicron-different-than-omicron-new-variant/
Dr. Bob Wachter shared some interesting predictions of a post-mask mandate world. https://twitter.com/bob_wachter/status/1491609678916239363?s=10
Dr. Eric Topol offered this fantastic substack post about how the CDC has underplayed the immunity conferred by prior infection. Topol argues that three exposures to the coronavirus's spike protein, any combination of prior Covid or vaccination, induces strong immunity vs. Omicron. However, in the CDC's defense, the general public often underappreciates such nuanced arguments.
https://erictopol.substack.com/p/ground-truths-on-prior-covid
Pfizer delayed its request for FDA approval to expand vaccine use in 6-month to 4-year-old children. THE DELAY IS NOT A SAFETY ISSUE. The delay is an efficacy issue - as Pfizer waits for more data on using three doses of the vaccine in this group to achieve a more significant antibody response.
https://www.nbcnews.com/health/health-news/pfizer-covid-vaccine-kids-fda-authorization-postponed-rcna15730
Twitter discussion
https://twitter.com/megtirrell/status/1492207749614252033
MMWR published a case-control study from California with a group of randomly selected groups of individuals obtaining COVID testing between February and December of 2021 (mostly pre-Omicron). Though mask adherence (type and frequency) was a self-reported variable, these data demonstrated that "always" wearing a mask reduced the risk of testing positive for COVID-19, with those reporting N95 mask use as the most significant protection. N95s conferred 83% lower risk, surgical masks conferred 66% lower risk, and cloth masks confer 56% lower risk than not wearing masks.
https://www.cdc.gov/mmwr/volumes/71/wr/mm7106e1.htm
And while many have given up on masks, Uber and Lyft drivers are weaponizing mask rules against passengers.
https://insidemedicine.bulletin.com/mask-wars-uber-lyft-edition-ride-hail-drivers-and-passengers-square-off
Andy Slavitt covered the trade-offs of Denmark's removal of all COVID restrictions in the face of Omicron subvariant BA.2.
https://twitter.com/aslavitt/status/1491651546060242944?s=10
A study published in Nature looking at 153,000 VA patients who had COVID-19 demonstrated an increased 1-year risk of cardiovascular events (heart attacks, strokes, etc.), even if they did not require hospitalization. In other words - having COVID increases your risk of other medical events - even a year beyond infection.
https://www.mdedge.com/cardiology/article/251656/arrhythmias-ep/substantial-cvd-risks-burden-year-after-covid-19
and
https://www.nature.com/articles/s41591-022-01689-3
Do not let your children drink COVID rapid antigen test reagent.
https://www.medscape.com/viewarticle/967960
Infographics!
HIPAA vs. HIPPA vs. HIPPO
https://twitter.com/UN3rd/status/1492260204204806144/photo/1
Things I learned this week:
The Guardian interviewed Ian Anderson, the lead flautist from Jethro Tull, about JT's first studio album since 2003. Amongst the shared wisdom, he offers a very definitive discussion of codpieces.
https://www.theguardian.com/music/2022/jan/28/jethro-tulls-ian-anderson-dressing-up-was-fun-but-my-codpiece-was-distinctly-unfragrant
If you are a resident of Montana or an active member of the U.S. military, you can get married without either you or your soon-to-be spouse being physically present. Double-proxy marriage, however, is unique to Montana. (Most states require one of the spouses to be present with the officiant.) I hope there is an excellent short story or Romcom about a person who is a serial wedding proxy – 1000 Marriages and still no spouse?
https://www.cbsnews.com/news/double-proxy-weddings-getting-hitched-in-montana-without-being-there/
and
https://www.proxymarriage.com/double-proxy-marriage
I would be in favor of more public officials offering free greeting cards. My wife received this Valentine's card thanks to our Surgeon General, Vivek Murthy. (And before anyone asks, she received an actual card too).
https://twitter.com/Surgeon_General/status/1492894280372965384
Clean hands and sharp minds,
Adam
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