outbreak! (ebola, sars, coronavirus, etc)

Apologies in advance for not confining Yglesias hot takes to the designated thread:

I feel like at this point 99 percent of the population is either vaccinated and safe, under 5 and safe, or doesn’t care about Covid and it’s time for non-pharmaceutical interventions to basically go away. https://t.co/ilrfyV2sVY

— Matthew Yglesias (@mattyglesias) January 3, 2022

god he is the worst

my best friend has a litany of symptoms that could either be chronic sinusitis or Omicron. the symptoms she describes match what I had when I had my last sinus infection, including yellow discharge, which isn't a COVID symptom. she's also the type that begins to feel phantom symptoms after reading the internet to see what symptoms to expect, so it's possible it's not COVID. she tested negative yesterday, and i'm giving her one of my home tests to re-test today.

since I was around her briefly last week, now I have to test multiple times, wound up wearing a mask in the house yesterday for my dad's sake. first test negative, taking second now (managed to find some at home tests after hours of searching store by store. found in each instance the ONE STORE that had a few in stock).

btw for US Folk - On/Go is selling their test directly from their website, and Walmart has BinaxNow back in stock for online ordering/shipping in many regions. the website SimplyMedical occasionally has the QuickVue for sale but have been out lately.

the annoying thing for folks with sinus issues/allergies is that sinus infections are a common thing and if you get a bacterial infection, you could get very COVID-like symptoms. and then you might not trust your negative tests and then you might not go to the doctor to get an antibiotic and might suffer a while longer than usual.

in 2019 I got what I assumed was COVID so I decided to wait it out cos I couldn't easily get a test, but it wasn't, it was a bacterial sinus infection. temp was 101 every day for over a week, massive headache, discharge, sore throat, malaise, chills.

after day 10, I saw a doc who was like "this sounds way more like a bacterial infection, here's an antibiotic", and it was gone in days. the doctor said if I hadn't gotten the antibiotic, I mighta been fending it off another week or more.

so i'm suggesting to my friend if she tests negative again to possibly get checked for that. (of course she might test positive, so who knows).

I had a bad bacterial sinus infection in late November after a four-day headcold, probably exacerbated by a dental issue, not Covid, and antibiotics took care of it almost from the first tablet.

2019???

sorry, 2020!

It was 10/2020, shortly after I got my second shot in the trial.

another PSA from former ilxor kate78 (who is an RN in Seattle):

PSA: If you're doing an rapid test, don't forget to swab your throat for 15 seconds before swabbing your nose.

There's a growing body of literature (and anecdata) suggesting that omicron virally sheds earlier in throat and saliva, relative to nasal secretions. I have told numerous folks to try this after testing negative with just a nasal swab and they've all tested positive with the throat.

I had heard that drinking sodas prior to the throat swab could lead to a false positive (by Edward Nirenberg, virologist). can she confirm if that's the case? (i drink a lotta diet sodas so i'll make sure to avoid doing that if so)

I personally wouldn't drink anything before a throat swab? will check tho.

yeah good point. maybe i'll just do it first thing in the morning tomorrow.

btw please pass along our thanks to kate!

You’re not supposed to eat drink or smoke for 30 minutes before saliva pcr test and I would assume the same applies to ersatz saliva rapid tests (which I wouldn’t recommend tbh) but ymmv

No drinking, eating or smoking 30 minutes before LFTs but to be on the safe side, I do the test immediately on waking up, before any of those things can happen.

(who is an RN in Seattle)

(also doing a masters in epidemiology and working as a covid vaccine researcher for one of the main covid vaccine manufacturers fwiw)

Not a lot of surprises from what I've been seeing over the last week, UK-wise, so I'm posting this tweet on the lack of vaccination means Omicron is killing more people in Africa.

We are very lucky to live in the north of the globe.

The best illustration of this is Africa, where Covid deaths have passed 25% of their Delta peak in Mozambique and Angola, and are still rising.

In wealthy, well-boosted countries like the UK, deaths this wave may peak at 10-15% of the previous record. In others they may hit 50%. pic.twitter.com/toTRWLPNgp

— John Burn-Murdoch (@jburnmurdoch) January 4, 2022

thanks - Burn-Murdoch is one of the best at explaining the situation in South Africa.

I tried to swab my throat and wow was that hard but managed. I have the worst gag reflex in the world. doctors telling me to say "ahhhhhh" is the biggest source of anxiety during a dr appointment lol.

now...I wait ten mins.

xp -- that graph is a bit misleading tbh. Mozambique and Angola have among the lowest COVID death tolls per capita in the world, so even if their death rate doubled or tripled they wouldn't be anywhere close to the US, UK etc.

I don't know why that is. I would guess some of it is a mix of climate, population age, obesity levels, perhaps prevalence of heart disease and diabetes and other similar risk factors. But Angola with low vaccination could potentially still have lower per capita COVID deaths than the US with high vaccination rates. Obviously it's still long past time to get more vaccines to the rest of the world and there are plenty of poorer countries who aren't faring anywhere near as well.

Meanwhile, the Tennessee Department of Health has chosen now to begin reporting COVID data weekly rather than daily — right when Omicron has really taken off here. They made this decision in the fall, "in line with reporting of other infectious diseases," but the result is we're going to be a week behind on actually understanding what's going on.

So now "flurona" is a rhing.

thing too.

xxxpost Florida did that last summer and it utterly wrecked our data and ability to read it

another PSA from former ilxor kate78 (who is an RN in Seattle):

PSA: If you're doing an rapid test, don't forget to swab your throat for 15 seconds before swabbing your nose.

There's a growing body of literature (and anecdata) suggesting that omicron virally sheds earlier in throat and saliva, relative to nasal secretions. I have told numerous folks to try this after testing negative with just a nasal swab and they've all tested positive with the throat.

― chaos goblin line cook (sleeve), Monday, January 3, 2022 7:18 PM (yesterday)

FYI, rapid antigen tests are pH sensitive and throat pH is different than nose pH, so positives from a throat sample could be false

Yeah, seems like using a test in a way it hasn't actually been tested other than anecdotally could be problematic.

Rapid tests in the uk were both throat + nose to begin with (and 30mins to wait before reading your result). Different brands have been distributed more recently that are supposed to be nose-only - with a shorter swab stick! - and 15 min wait. One instructs you to leave the swab in the solution for 1 min before removing it, the others didn't.

would be interested to know if the tests mechanisms/ functions etc were significantly different.

I mean kate isn't the first (or even the 100th) physician to suggest this, and Michael Mina (the epidemiologist rapid test guru) has suggest there's nothing wrong with using them this way. that only saliva could hurt the results, but a throat/cheek swab is fine.

what I reject is the idea that these antigen tests can't get Omicron, as I see a lot of my friends suggesting today via gossip. my friend almost certainly has Omicron, and it detected it easily. the issue isn't that it won't detect Omicron - it's that it won't detect it 'early enough', is my understanding.

hence the throat swab

This is fairly standard in UK

Here is a how-to video

*In US it is NOT FDA authorized to do a throat swab

Does likely improve sensitivity. May potentially cause a slightly greater number of false positives. Don’t drink or eat for 30 mins beforehttps://t.co/D6lAYpwbJo

— Michael Mina (@michaelmina_lab) December 27, 2021

here's the UK guidance. the tests on sale in the US are not approved for this method. ymmv.

i'm not doing this, but i can see why you might.

good news for parents of under 5s after the pfizer fuck up (they reduced the dose so much they saw almost no response in the 2-5 group, it kind of worked in under 2s, they're now trialing a third dose):

https://www.wsaw.com/2021/12/30/moderna-vaccine-trial-young-children-nears-finish-line/

A lot of the LFTs in the UK are specifically nasal only and nobody I know who tested +ve (which is a lot of people!) needed a throat swab to do so. ¯\_(ツ)_/¯

8 w Covid in our house. We are all fine now (yay science! Thanks vaccines!!), but wanted to share our testing results in case it helps decision making. 🧵

TL;DR: antigen and PCR tests were both unreliable making it very difficult to know whom to quarantine from whom.

— Anne Carpenter, PhD (@DrAnneCarpenter) January 4, 2022

:shrug: what a mess.

Good op-ed from David Leonhardt about how kids continue to bear the heaviest burdens of COVID restrictions despite having the least health risk:

https://www.nytimes.com/2022/01/04/briefing/american-children-crisis-pandemic.html

i got unironically emotional watching the queer eye episode about a school prom under covid last night. (i have never seen this show. is it always like this?)

xxxpost I think people's mindset is less "antigen tests can't detect Omicron" but "antigen tests might not pick them up on the first few days of infectiousness", which....has kinda always been the case? I was told during all prior variants that a negative antigen didn't *necessarily* mean I wasn't infected, and almost all of the at-home tests here (other than On/Go I think) suggest re-testing in 24-36 hours to re-confirm (and to confirm positive results with PCRs).

the problem is, and continues to be, misuse of the results. If you are all rapid testing before a family gathering, the understanding should be "it looks like we're all not sick, but there is a non-zero risk that we are. We are accepting that risk by gathering". People instead are using it to say "WE are not at risk, now let's have a big household orgy".

Likewise, people WITH Omicron-like symptoms are testing once via antigen, getting a negative, and not re-testing (either because they CAN'T due to no appointments/at-home tests, or think they're in the clear), and they go out and think they're in the clear and test positive a few days later and scream B-B-BUT I JUST HUNG OUT WITH 30 PEOPLE.

when in reality, you should be isolating if you have those symptoms until you've had a second negative. these antigens reduce risk, they don't eliminate it, but perfect is always the enemy of good with the "elimination" folk.

It's just like the people who scream during hurricane season about the changing forecast over several days, but whose city has been in the cone of uncertainty for 3 days. They already gave you the warning that you might be hit - they gave you time to prepare! They didn't tell you to wait until they could give you GPS coordinates of where the hurricane would hit.

(with that being said - I swabbed my throat today and I see no issue if people want to do it to catch the infection earlier - there are good reasons why someone exposed but not symptomatic might want to do that if wanting to avoid exposing others).

i'm gonna say don't make up your own testing procedure because of anecdata but that's just me

@caek It's become a very touching show. Pretty much every episode gets to me.

xp that's my take.

my uk boy's whatsapp chat is now forwarding videos about how to use australian and american tests and saying they should do it like that and i'm like jfc just follow the instructions on *your* test.

Lol yes I was about to say that it’s often really emotional

Fwiw I have been doing both throat and nose since reading that is the best way to go.

xp i had to watch one of those F1 episodes to calm down!

xxxxxxpost I think this throat swab thing has the backing of prominent doctors/scientists at this point versus just internet randos, it's gotten mainstream. (https://slate.com/technology/2021/12/throat-swab-rapid-testing-omicron-effective.html, especially with Mina backing it).

but this is the fundamental problem with social media/Twitter. the news now moves too slowly, people want updates on things like hurricane forecasts, which sports players are injured/likely to start, the pandemic. so they go to Twitter/social media to get this "intermediate" data, which they get from a variety of people unqualified/qualified to give it, and entire new strategies get adopted by big pockets of people. often dispensed by cult-like personalities who attack the mainstream experts and implore you to adopt their strategy instead!

it's why people flock to this complete amateur asshole named Mike who lives in Oldsmar, FL, and runs Mike's Weather Pages. Thousands of people flock to him INSTEAD of the NHC to get HIS take on where the hurricane is REALLY going to go and insist that HE'S made the right call EVERY TIME and we should listen to him INSTEAD of the experts.

(btw, still seconding my thanks to kate for this tip - even if we don't all adopt it, it's good to hear about these suggestions. i'd rather get a false positive than false negative at this point)

The way I've seen lateral flow/antigen flow tests explained is to think of them as red or yellow lights. If you get a positive, definitely isolate until better or you're consistently getting negative tests. But a negative test isn't a green light for going out and doing whatever, it just means you're not likely to be infectious at that minute, and could change within hours.

That doesn't seem super hard to understand?

one would think, buuuuuut....

Good op-ed from David Leonhardt about how kids continue to bear the heaviest burdens of COVID restrictions despite having the least health risk:

https://www.nytimes.com/2022/01/04/briefing/american-children-crisis-pandemic.html

― o. nate, Tuesday, January 4, 2022 12:04 PM (one hour ago) bookmarkflaglink

Yeah I liked this. One thing he also leaves out is that child obesity is way, way up, which has a lot of its own long-term health consequences.

the suicide stat in that story is motivated reasoning and reductive bs (see thread)

The problem with this story is that the graph from the MMWR clearly shows suicidality DECLINED during the lockdowns and rose during the SUMMER of 2020, and has risen the most in 2021 when most kids are back in school! https://t.co/dZVI3cSCj3

— Lyman Stone 石來民 🦬🦬🦬 (@lymanstoneky) January 4, 2022