COVID Transmissions for 11-11-2020

Good morning! It has been 360 days since the first documented human case of COVID-19.

Yesterday was a big day for this newsletter; the number of daily reads tripled. I guess folks were interested in hearing about the vaccine! Whatever you are all doing to share this with others, I am very grateful to have earned your support and glad that you find the newsletter useful.

Today, I’m going to stick to headlines and some responses to reader comments. Later in the week I may do an in-depth on the logistical considerations that we need to think about for vaccine rollout. I’m open to other topics; feel free to suggest one.

As usual, bolded terms are linked to the running newsletter glossary.

Keep the newsletter growing by sharing it! I love talking about science and explaining important concepts in human health, but I rely on all of you to grow the audience for this:

Now, let’s talk COVID.

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Utah issues state of emergency and mask mandate

The state of Utah, which is known for a particularly prevalent political partisanship, has decided that masks shouldn’t be a partisan issue. They’re right.

Faced with 2,000 new cases of COVID-19 a day and no end in sight, the Governor of Utah has declared a state of emergency, and implemented new restrictions including a statewide mask mandate: https://abcnews.go.com/Health/utah-gov-gary-herbert-declares-state-emergency-madates/story?id=74105758

I applaud this because it’s common sense and it’s correct. Masks work. Speaking of that…

CDC changes guidance on masks

The CDC has altered its guidance on masks to be a lot more firm. Their website now unambiguously recommends the use of masks.

Previously, the CDC insisted that masks are worn to prevent you from spreading the virus, not to protect you from getting the virus. This made sense to me based on what I knew of the literature. However, yesterday the CDC revised the language on their site describing masks (https://www.cdc.gov/coronavirus/2019-ncov/more/masking-science-sars-cov2.html), which now reads the following:

Studies demonstrate that cloth mask materials can also reduce wearers’ exposure to infectious droplets through filtration, including filtration of fine droplets and particles less than 10 microns. The relative filtration effectiveness of various masks has varied widely across studies, in large part due to variation in experimental design and particle sizes analyzed. Multiple layers of cloth with higher thread counts have demonstrated superior performance compared to single layers of cloth with lower thread counts, in some cases filtering nearly 50% of fine particles less than 1 micron. Some materials (e.g., polypropylene) may enhance filtering effectiveness by generating triboelectric charge (a form of static electricity) that enhances capture of charged particles while others (e.g., silk) may help repel moist droplets and reduce fabric wetting and thus maintain breathability and comfort.

I haven’t seen the data they’re using to support this. I’m not sure it’s really convincing. There are issues relating to masks on which I’ve disagreed with the CDC in the past, such as whether valves actually make a big difference. Even the CDC admits that masks vary tremendously in filtration effectiveness.

All that said, I think it’s obvious on a macro level that masks work and everyone should wear one when they go out in public. It doesn’t really matter to me if they protect you personally or help protect others around you—or both. That’s an academic argument.

They slow the spread of COVID-19 the more people wear them. That’s all that matters.

Nasal spray for prevention of infection with SARS-CoV-2

Dr. Anne Moscona’s lab at Columbia University published an interesting paper recently about the prospect of a lipopeptide (fat-protein conjugate) nasal spray that could prevent SARS-CoV-2 entry in the nasal passages of humans: https://mbio.asm.org/content/11/5/e01935-20

Dr. Moscona’s lab demonstrated that this lipopeptide can inhibit the entry of SARS-CoV-2 into cells. Her lab focuses on technologies like this, mostly in emerging viruses—I met Dr. Moscona when I was part of one of the biodefense centers that used to exist, before funding dried up for them. She was working on a similar concept for the virus that I was studying at the time, if I remember correctly.

Entry inhibitors can be very valuable in the fight against a particular virus, because they might have use both to control infection in a person or possibly to prevent it. Right on the heels of the publication I linked above, Dr. Moscona’s lab also published a preprint suggesting that when used as a nasal spray, this lipopeptide could prevent transmission of SARS-CoV-2. These experiments were performed in ferrets, and they’re not peer-reviewed, so let’s not get ahead of ourselves. This is a concept only, and still has some hurdles to pass before I would consider it meaningful.

Still, the idea that this type of work is taking place is what I wanted to highlight. It’s an interesting idea that could be used to slow or stop spread of infection if it bears out. When that ferret study gets published in a peer-reviewed journal, I’ll write it up.

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What am I doing to cope with the pandemic? This:

Preparing for The Liver Meeting Digital Experience (TLMDx)

I’ve been managing several oral presentations at my day job, where I work as a Senior Manager in scientific communications. Our company is in the liver disease space, and this year we successfully submitted over a dozen presentations to The Liver Meeting, the annual meeting of the American Association for the Study of Liver Diseases (AASLD). 100% of them were accepted, which is great news.

It’s also a lot of work. The meeting is this weekend and we’ve had to coordinate last minute changes, requests from authors and from the meeting, and other sorts of excitement.

Live meetings have changed a lot this year, which is why I bring it up. Medical meetings are really important for physicians and scientists; they allow the sharing of research, the asking of questions, and extensive professional networking. The latter two are unique to meetings—it’s hard to meet new people and ask questions about their research when you’re reading it on a journal website.

A lot of these meetings have had to make major changes in this pandemic year, to help sustain these key functions. On the whole, I’m impressed with what they’ve managed to do with limited notice. I went to a European conference earlier this year, from the comfort of my own home, and I felt like I had actually attended something. They even had a lounge with a “food truck”; when you clicked on it, it gave you easy recipes for healthy snacks.

I’m interested to see what this upcoming meeting has to offer.

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Continuing our theme of ferrets, a reader named Ferret posted two comments on the newsletter from Monday that I’d like to address here. This is the first, about the safety of unmasked performers in filmed television:

In the SNL cold open, a maskless Jim Carrey and Alec Baldwin, both ~60 years old, stood right next to each other arm in arm. I don't expect you to know exactly what protocols SNL is following, but even if testing right before the show I can't imagine this is particularly wise given testing error rates and rising covid rates in NYC. Is there a way they could be doing this that's legitimately safe?

To this I responded:

There is. They could be getting tested and then isolating completely from others until they have gotten two negative tests a week apart, and then after that continuing to isolate while living together in a secret SNL village that has no contacts with anyone from the outside world.

I have my doubts that they are doing this; however, this is the idealized "safe" circumstance. There are degrees of safety that can be achieved.

I understand from firsthand accounts that the film industry is actually being quite responsible with how it handles COVID-19 testing and control as it has reopened in New York. People on sets are being tested with a high regularity, and I'm talking about crew as well as cast here. There is an understanding that total isolation is not possible, but that they can do their best to try to detect and trace any infections that do occur and continue to operate as long as tests keep coming back negative. This is an expensive way to operate but it is also the only way to operate. That does offer some mitigation of the risk. It does not mitigate it completely, however. Presumably the onscreen talent and the crew have been counseled as to the risks they are potentially taking on.

And here’s the second comment, which is about whether social distancing practices impact the spread of other infectious diseases and not just COVID-19:

I've been wondering if social distancing would result in reduced spread of other diseases, like flu. Is there any evidence of that?

And my answer:

Yep! There is. In fact, in September, an article was published in Pediatrics showing that other infectious disease rates dropped in children due to widespread social distancing efforts. You can find that here: https://pediatrics.aappublications.org/content/146/4/e2020006460

Interestingly, this paper pointed out that while rates of contagious diseases declined notably, rates of UTIs did not--and UTIs are not typically contagious or acquired through contagious means. This proves a useful gut-check of whether the decline is due to contagion control efforts.

There have been other studies as well. This article synthesizes some WHO data and a paper from the New York area showing similar trends: https://www.nature.com/articles/d41586-020-01538-8

I really enjoyed answering these! I love receiving comments and am happy to share them here with my answers when they come in.

Likewise, I am sure that you all still have questions about the Pfizer vaccine and what it may imply. Please do ask!

Join the conversation, and what you say will impact what I talk about in the next issue.

Also, let me know any other thoughts you might have about the newsletter. I’d like to make sure you’re getting what you want out of this.

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This newsletter will contain mistakes. When you find them, tell me about them so that I can fix them. I would rather this newsletter be correct than protect my ego.

Though I can’t correct the emailed version after it has been sent, I do update the online post of the newsletter every time a mistake is brought to my attention.

No corrections since last issue.

Thanks for reading, everyone!

See you all next time.

Always,

JS