COVID Transmissions for 7-29-2020
Greetings from an undisclosed location in my apartment.
It has been 255 days since the first documented human case of COVID-19.
Housekeeping note:
No in-depth today; you got two in a row this week and I do have a day job!
Glossary terms are bolded words with links to the running newsletter glossary.
If you like what you see—or what you might see in the future—tell others about it so the newsletter continues to grow:
Now, let’s talk COVID.
Origins of the virus:
A paper in Nature involves an international coalition of researchers who looked at the origins of SARS-CoV-2 by three distinct methods, all of them showing a likely origin in horseshoe bats in Asia. This is another piece of evidence debunking some of the wilder origin theories: https://www.nature.com/articles/s41564-020-0771-4
But what is even more remarkable is that this paper suggests, and has good backup to support, that this virus family has a unique ability to engage in genetic recombination that facilitates the jumps into humans that we have seen over the last 20 years, and that the particular strain SARS-CoV-2 may have existed for decades.
This is something revolutionary and I am digesting the paper still myself, but it suggests that intermediate hosts, which are suspected in both SARS and COVID-19 pandemics, may not have been involved at all and the viruses may have come directly from bats and engaged in recombination to take root in humans.
The results imply that we will need to be on the lookout for SARS-CoV-3 for certain. If these researchers are correct, it is not so much a question of “if” but “when.”
Comparing with past pandemics:
This is a cool Lancet opinion piece that I stumbled on while preparing yesterday’s in-depth, looking at past pandemics of influenza viruses and SARS and comparing to COVID-19: https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30484-9/fulltext
Mild, but noticeable and annoying, safety profile for vaccines:
STAT News has a piece about vaccine safety that I think is worth reading: https://www.statnews.com/2020/07/27/covid-19-vaccines-may-cause-mild-side-effects-experts-say-stressing-need-for-education-not-alarm/
Basically, we can expect that the vaccines in development are going to cause irritation and adverse effects. Nothing serious has popped up, but these are the sorts of things that people will notice and dislike. If you’ve ever had a Tdap (tetanus, diptheria, pertussis) booster, that’s the sort of thing we’re talking about—soreness, chills, fever, things like that. Patients need to be educated on what to expect, in advance, so that they don’t panic. None of these things are life threatening, and they won’t mean the vaccine made you sick.
Don’t believe everything you read:
Also in STAT, a piece about the unreliability of preprint papers: https://www.statnews.com/2020/07/28/boosting-promise-reining-in-peril-covid-19-preprints/
I’m going to use this as an opportunity to note that this newsletter is only going to feature preprints when two conditions are satisfied:
I have read the entire paper and agree with its conclusions or am able to provide a review-style critique
Someone else who I know and is qualified has also done the same
I think the media have been really out of line reporting on preprints in this pandemic. These papers are not ready for the public eye and can be misleading. I will not let that become a part of this newsletter.
Racial disparities in COVID:
CIDRAP has a story that racial disparities in death due to COVID, as seen in two recent studies, are still present even after you correct for differences in socioeconomic status: https://www.cidrap.umn.edu/news-perspective/2020/07/studies-people-color-bear-larger-share-covid-19-burden
People of color are clearly more severely affected by COVID-19. The question remains whether this is due to racial bias in the healthcare system, some sort of inherent biological circumstance that tends to associate with race, or a combination of both. Only time and additional research will tell.
What am I doing to cope with the pandemic? This:
Getting away
We’re preparing for a short vacation to the Finger Lakes in NY State. Right now we’re at a lull in the pandemic and we figure now’s the time to spend some time away. It’s not exactly a far-flung getaway, but it’s going to be a nice change of pace.
Join the conversation, and what you say will impact what I talk about in the next issue.
Also, I welcome any feedback on structure and content. I want this to be as useful as possible, and I can only make that happen with constructive comments.
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.
Correction: Thanks to an overzealous autocorrect feature working on yesterday’s issue, the meaning of the following sentence was turned into an error: “Thankfully, either of those viruses are terribly good at spreading human-to-human.”
This should have read, “Thankfully, neither of those viruses are terribly good at spreading human-to-human.”
This has been corrected in the web edition of the newsletter.
Clarification: It was mentioned to me that I seemed to be saying that a third SARS-CoV would emerge in exactly 17 years. I do not feel this way; this was intended as an estimate only, based on extrapolation from one data point, which is all that we have. The key message was that if we can eradicate SARS-CoV-2 for a comparable length of time, that would be pretty great!
See you all next time.
Always,
JS