Keep Calm and Carry On

Alabama is the latest state to lift its mask mandate.

More scientists and public health experts finally admit the outdoors are safe. Beaches and parks “are some of the safest places you can gather,” said Linsey Marr, an expert on airborne virus transmission at Virginia Tech. “Outdoors now is even safer than before, because we have more people who are vaccinated and who have already had covid-19.”

In other news:

  • According to a new Lancet study, people infected with the more contagious COVID variant first identified in the United Kingdom did not experience more severe symptoms and were not at higher risk of death.
  • Writing in the Wall Street Journal, Drs. Martin Kulldorff and Jay Bhattacharya argue vaccine passports are antithetical not just to freedom, but to public health, as well.
  • Concerned Ontario Doctors recently hosted a COVID Summit with the authors of the Great Barrington Declaration. Here’s the transcript and video.
  • The U.K. is a cautionary example of neuroses run amok as it stays locked down despite vaccinations, says Joseph Sternberg.

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COVID News

A year into the pandemic, it’s even more clear that it’s safer to be outside

https://www.washingtonpost.com/health/2021/04/13/covid-outside-safety/

The photos of Clearwater Beach, Fla., went viral last spring: people crowded on the sand, seemingly unconcerned about the deadly new contagion coursing across the world. Local officials, accused of fueling a public health crisis, quickly shut 35 miles of county beaches and left them closed for weeks.

What a difference a year makes. The beaches were even busier this year, but officials say there were no talks of closure. There was also far less outcry.

And with good reason, according to many scientists and public health experts, who say that the outdoor spaces now warming under spring sun should be viewed as havens in the battle against a stubborn virus and restriction-induced fatigue. For more than a year, the vast majority of documented coronavirus clusters have been linked to indoor or indoor-outdoor settings — households, meatpacking plants, nursing homes and restaurants. Near-absent are examples of transmission at beaches and other open spaces where breezes disperse airborne particles, distancing is easier, and humidity and sunlight render the coronavirus less viable.

Alabama governor lifts mask rules, urges common sense

https://apnews.com/article/alabama-kay-ivey-coronavirus-pandemic-5be825405fd2c8bb2d1d09a8865609cf

MONTGOMERY, Ala. (AP) — Gov. Kay Ivey said Wednesday that Alabama is shifting to personal responsibility in the fight against COVID-19, keeping her promise to let a statewide face mask order expire Friday.

Ivey said she’s issuing a “greatly slimmed down” health order that has few restrictions. It encourages people to keep taking precautions such as voluntarily wearing masks, but no longer includes a statewide mask order.

Alabama opened vaccine eligibility to anyone 16 and older two days ago, and state health officials said virus hospitalizations, percentage of positive tests and daily case numbers are hitting some of the lowest numbers in a year.

“We are finally rounding the corner. While we haven’t whipped this deadly disease just yet, it appears that, thank the good Lord we are in the home stretch. Please, please continue to use good common sense and we will see the end of COVID-19 soon,” Ivey said.

The Republican governor said she’ll keep wearing a mask around others after Friday, and urged other Alabamians to do the same. She also urged people to respect businesses who require customers to wear masks.

California lifts capacity limits on places of worship

https://www.latimes.com/california/story/2021-04-12/ca-lifts-capacity-limits-on-places-of-workshop

The California Department of Public Health has modified its guidance on religious gatherings, saying Monday that capacity limits on places of worship are no longer mandatory but still strongly recommended.

The new guidance goes into effect immediately.

It follows recent Supreme Court rulings that have lifted California’s worship-related COVID-19 restrictions.

On Friday, the Supreme Court, citing religious liberty, held that the state may not prevent people from gathering in homes for Bible study and prayer meetings. In the 5-4 order, the conservative justices noted that the state has opened public businesses while more strictly restricting religious gatherings.

And in February, the Supreme Court lifted California’s ban on indoor church services. It said the state may limit attendance at indoor services to 25% of a building’s capacity, and that singing and chanting may be restricted as well.

Commentary/Analysis

The Harms of Lockdowns, The Dangers of Censorship, And A Path Forward

Below is the video and the full transcript of Concerned Ontario Doctors’ Covid-19 Summit, April 11, 2021. It features detailed discussion of public health, Covid-19, and various lockdown policies deployed around the world. 

•Opening/Closing Address:

Dr. Kulvinder Kaur Gill, MD, FRCPC

President and Co-Founder of Concerned Ontario Doctors, Frontline Physician

•Moderator:

Dr. Richard Schabas, MD, MSHC, FRCPC

Former Chief Medical Officer of Health for Province of Ontario, Retired Physician

•Panelists:

-Dr. Jay Bhattacharya, MD, PHD

Professor of Medicine at Stanford University, Physician, Infectious Disease Epidemiologist

-Dr. Sunetra Gupta, PHD

Professor of Theoretical Epidemiology at University of Oxford

-Dr. Martin Kulldorff, PHD

Professor of Medicine at Harvard University, Infectious Disease Epidemiologist, Biostatistician

Vaccine Passports Prolong Lockdowns

https://www.wsj.com/articles/vaccine-passports-prolong-lockdowns-11617726629

As tens of millions are inoculated against Covid-19, officials in places as diverse as New York state, Israel and China have introduced “vaccine passports,” and there’s talk of making them universal. The idea is simple: Once you’ve received your shots, you get a document or phone app, which you flash to gain entry to previously locked-down venues—restaurants, theaters, sports arenas, offices, schools.

It sounds like a way of easing coercive lockdown restrictions, but it’s the opposite. To see why, consider dining. Restaurants in most parts of the U.S. have already reopened, at limited capacity in some places. A vaccine passport would prohibit entry by potential customers who haven’t received their shots. It would restrict the freedom even of those who have: If you’re vaccinated but your spouse isn’t, forget about dining out as a couple.

Planes and trains, which have continued to operate throughout the pandemic, would suddenly be off-limits to the unvaccinated. The only places where restrictions would be relatively eased would be those still fully locked down, such as many live-event venues and schools. Yet even there, the passport idea depends on keeping the underlying restrictions in place—giving officials an incentive to do so for much longer as leverage to overcome vaccine resistance.

The vaccine passport should therefore be understood not as an easing of restrictions but as a coercive scheme to encourage vaccination. Such measures can be legitimate: Many schools require immunization against common childhood illnesses, and visitors to some African countries must be vaccinated against yellow fever. But Covid vaccine passports would harm, not benefit, public health.

No Reopening Please, We’re British

https://www.wsj.com/articles/no-reopening-please-were-british-11617907044

The U.K. has delivered at least one dose of Covid-19 vaccine to more than 47% of its total population. This means that well over half of all adults, and the vast majority of the most vulnerable elderly, have received a sufficient level of inoculation to reduce serious illness, death, and probably transmission dramatically for the several months it will take to deliver second doses. Rates of hospitalization and fatality tumble by the day.

So why on earth is Boris Johnson slow-rolling the country’s emergence from lockdown?

The exit plan from the current—third—lockdown began March 8, when schools reopened, and won’t be complete until late June. Sorry, make that “until late June at the earliest,” appending Mr. Johnson’s favorite three words. Nonessential retail, beer gardens and gyms won’t reopen until next week, restaurants not until May, and no one can say when draconian restrictions on international travel will be eased.

Research

Outdoor Transmission of SARS-CoV-2 and Other Respiratory Viruses: A Systematic Review

https://academic.oup.com/jid/article/223/4/550/6009483?login=true

Abstract

Background:

While risk of outdoor transmission of respiratory viral infections is hypothesized to be low, there are limited data on SARS-CoV-2 transmission in outdoor compared to indoor settings.

Methods:

We conducted a systematic review of peer-reviewed papers indexed in PubMed, EMBASE, and Web of Science and preprints in Europe PMC through 12 August 2020 that described cases of human transmission of SARS-CoV-2. Reports of other respiratory virus transmission were included for reference.

Results:

Five identified studies found a low proportion of reported global SARS-CoV-2 infections occurred outdoors (<10%) and the odds of indoor transmission was very high compared to outdoors (18.7 times; 95% confidence interval, 6.0–57.9). Five studies described influenza transmission outdoors and 2 adenovirus transmission outdoors. There was high heterogeneity in study quality and individual definitions of outdoor settings, which limited our ability to draw conclusions about outdoor transmission risks. In general, factors such as duration and frequency of personal contact, lack of personal protective equipment, and occasional indoor gathering during a largely outdoor experience were associated with outdoor reports of infection.

Conclusions:

Existing evidence supports the wide-held belief that risk of SARS-CoV-2 transmission is lower outdoors but there are significant gaps in our understanding of specific pathways.

Genomic characteristics and clinical effect of the emergent SARS-CoV-2 B.1.1.7 lineage in London, UK: a whole-genome sequencing and hospital-based cohort study

https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(21)00170-5/fulltext

Summary:

Background:

Emergence of variants with specific mutations in key epitopes in the spike protein of SARS-CoV-2 raises concerns pertinent to mass vaccination campaigns and use of monoclonal antibodies. We aimed to describe the emergence of the B.1.1.7 variant of concern (VOC), including virological characteristics and clinical severity in contemporaneous patients with and without the variant.

Methods:

In this cohort study, samples positive for SARS-CoV-2 on PCR that were collected from Nov 9, 2020, for patients acutely admitted to one of two hospitals on or before Dec 20, 2020, in London, UK, were sequenced and analysed for the presence of VOC-defining mutations. We fitted Poisson regression models to investigate the association between B.1.1.7 infection and severe disease (defined as point 6 or higher on the WHO ordinal scale within 14 days of symptoms or positive test) and death within 28 days of a positive test and did supplementary genomic analyses in a cohort of chronically shedding patients and in a cohort of remdesivir-treated patients. Viral load was compared by proxy, using PCR cycle threshold values and sequencing read depths.

Findings:

Of 496 patients with samples positive for SARS-CoV-2 on PCR and who met inclusion criteria, 341 had samples that could be sequenced. 198 (58%) of 341 had B.1.1.7 infection and 143 (42%) had non-B.1.1.7 infection. We found no evidence of an association between severe disease and death and lineage (B.1.1.7 vs non-B.1.1.7) in unadjusted analyses (prevalence ratio [PR] 0·97 [95% CI 0·72–1·31]), or in analyses adjusted for hospital, sex, age, comorbidities, and ethnicity (adjusted PR 1·02 [0·76–1·38]). We detected no B.1.1.7 VOC-defining mutations in 123 chronically shedding immunocompromised patients or in 32 remdesivir-treated patients. Viral load by proxy was higher in B.1.1.7 samples than in non-B.1.1.7 samples, as measured by cycle threshold value (mean 28·8 [SD 4·7] vs 32·0 [4·8]; p=0·0085) and genomic read depth (1280 [1004] vs 831 [682]; p=0·0011).

Charts and Graphics

International News

U.K. variant isn’t linked to more severe disease or death, study finds

https://www.nbcnews.com/science/science-news/uk-variant-isnt-linked-severe-disease-death-study-finds-rcna658

People infected with the more contagious coronavirus variant first identified in the United Kingdom did not experience more severe symptoms and were not at higher risk of death, according to a new study published Monday.

Scientists are struggling to pin down the nature of the U.K. variant, which has become the dominant strain across Europe and, as of last week, in the United States. Chief among the questions: Is the variant more deadly?

The study, published in The Lancet Infectious Diseases, looked at data from last fall in the U.K., shortly after the variant was first detected. It soon spread rapidly, eventually becoming the dominant strain circulating in the country.

The new findings add to scientists’ ever-evolving understanding of the U.K. variant, known as B.1.1.7, at a crucial time in the pandemic, as it and other variants are circulating widely in other countries.

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