Right off the bat, you may be looking at this and thinking, "wow this is way
too long for me to read, where's the summary?". Well, there isn't one.
Honestly, the whole point of why I'm writing this is to combat the habit of
reading a headline or a summary, and taking it at face value. So take a few
minutes, read the first bit of this, and just give me a chance to explain and
maybe you'll end up wanting to read through. This isn't my usual kind of post,
and it's not like your average news article. I didn't type this up like one
may write up a raging Facebook comment, but rather spent quite a number of
hours doing research in order to present you the most thorough information I
can. This is by no means extensive, nor is it near the calibre of the papers the experts write, but I do think it'll be a bit more accessible to some people than scouring through hundreds of scientific papers.
Media outlets are prevalent in the modern age, we have the internet and
we have social media, so it's easier than ever for news outlets to spread
their articles very quickly to a very large audience. However, due to how
massive the platform for sharing is, it's next to impossible to have a proper
filter to ensure those articles don't contain blatantly false information.
Sure we have fact checkers on some platforms, but nothing to a strong enough
extent to truly filter out "fake news", as it has been dubbed.
It's okay for people to have differing opinions and to share those,
that's the point of freedom of speech, however there is a significant
difference between sharing an opinion and sharing false information (e.g.
talking about whether or not it was the "right" decision for Biden to withdraw
US troops from Afghanistan vs saying that Trump wouldn't have withdrawn the
troops, when in fact Trump had pledged to withdraw troops back in
February 2020). Various media platforms are happily spreading false information, or
misrepresenting data, and I believe this is a major cause of why the COVID-19
pandemic has been dragging on this long.
The issue is, most people, including myself sometimes, will be scrolling
through social media, or flipping through the news, and will read articles and
just take it at face value. But instead we should stop, regardless of whether
we have an instinctively positive or negative reaction to what we read, and we
should ask ourselves, what are their sources? What data supports what this
article says? It is so easy to read something online and then share it around
and just believe that it's true. Since the media isn't taking it upon
themselves to do the work for us, we have to do it, and we need to verify what
we read.
So that's what this is. This is just me, an undergraduate biophysics
student, no Ph.D. in immunology or epidemiology, just as unqualified as most
of the journalists are to comment on COVID-19 and the vaccine, writing about
COVID-19 and the vaccine. There's one difference though: rather than just
saying what I believe and inviting you to share it around, I'm going to link
each and every source I use so that you can verify it for yourself. I'm going
to make sure the sources I use are peer-reviewed articles from experts in the
field, not statements made by politicians or teachers or anyone who hasn't had
an extensive education and has experience working in immunology, epidemiology,
and/or virology.
Is COVID-19 dangerous?
Short answer: yes, to a varying extent depending on your demographic.
Long answer: let us look at the numbers first. I often hear people proclaim
"it has a 99% survival rate, everyone is overreacting," so how true is that?
As of August 24th, at 19:17 UTC, there have been a total of 213.7 million
recorded cases worldwide of COVID-19, and 4.46 million deaths due to COVID-19
(worldometers.info, 2021a). That works out to be a 97.91% survival rate. It
does need to be taken into account that there are likely a number of cases and
deaths unaccounted for, since many cases may be asymptomatic (Nogrady, 2020;
Petersen & Phillips, 2020) and deaths may not always be appropriately
linked to the cause of death (worldometers.info, 2021b). However, asymptomatic
cases are less significant since they tend to be less infectious and for
shorter periods of time (Nogrady, 2020).
Framing information can make a large difference in how information is
perceived. Saying "COVID-19 has a 97.91% survival rate" likely makes you feel
like you have good chances and you don't want to go through restrictions and
lockdowns if your chances are that good at surviving. On the other hand,
saying "4.46 million people have died due to COVID-19, and that number may be
even higher" sounds a lot more harrowing. That's 4.46 million people's
families and friends who are heartbroken, and the number is so large that I
rounded to 4.46 million. I rounded a number where each count is a human
life.
To add to this, there is another major point which many people tend to neglect
mentioning, focusing on the death rate alone and not other consequences of
COVID-19. I'm not interested in economical arguments, since they are less
science-based and have a lot more opinion involved, and I do not have the
necessary background to form educated opinions about the matter, so economical
issues will be left out. However, there are more potential health effects
besides death. Let's ignore the period of COVID-19 infection, where your
symptoms may range from that of a simple cold to requiring hospitalization,
which racks up hospital bills for you, and look at what happens after you've
"recovered" and made it past that scary 2.09% death rate.
Fernández-de-las-Peñas et al. (2021) have reviewed the details of defining
long-COVID symptoms and where that barrier is between COVID and long-COVID. A
study by Blomberg et al. (2021) found that 52% of young adults that were not
hospitalized (i.e. had mild COVID-19 symptoms) still had lasting symptoms at 5
months, the most significant of which were loss of taste and smell and
fatigue. Another study by Graham et al. (2021) found that about 87% of
hospitalized COVID-19 cases have symptoms for longer than two months. Yet
another study by Petersen et al. (2020) found that even mild cases of COVID-19
often have long-lasting symptoms.
Suddenly you don't just need to worry about a 2.09% chance of death, you also
need to worry about a chance of hospitalization and then either an 87% chance
for long lasting symptoms if your case was severe, or a 52% chance if your
case was mild. Consider being unable to taste your food for months on end, or
being unable to smell a gas leak, or being unable to walk up the stairs to
your bedroom without needing to sit down to catch your breath,
even if you are an Olympic athlete.
Do masks and social distancing work?
First let us mention that COVID-19 measures (mask-wearing, washing hands, and
avoiding crowds) in Taiwan caused a significant decrease in severe influenza
cases and a notable decrease in overall influenza cases (Hsu et al., 2020).
Note that there was no significant effect on the data by the influenza
vaccine, since there wasn't a significant change in how many people received
the flu shot in the years the data were taken from.
Rahimi & Abadi (2020) created a short summary of the effectiveness of
social distancing, hand washing, and wearing masks in preventing transmission
of COVID-19, concluding that these measures are effective. An older study
using avian influenza to mimic COVID-19 showed that various forms of hand
washing and masks were extremely effective at reducing the risk of infection
(Ma et al., 2020). Another study using various particle sizes showed that
various kinds of cloth masks can provide high rates of filtration provided the
mask is worn to fit with no gaps and correct fabrics are used (Konda et al.,
2020). A report of two healthcare workers who both had mild cases of COVID-19
and were working before they showed symptoms showed that the worker who wore a
KF94 mask consistently did not infect any of their close contacts, while the
worker who wore a surgical mask but frequently pulled it down or removed it
infected 37.1% of their close contacts (Lee et al., 2021). A more detailed
study on different kinds of masks and inhalation vs exhalation protection
showed that wearing any kind of mask can significantly reduce chances of
transmission, especially considering that 2 meter social distancing is not
fully effective since COVID-19 particles can travel much further (Wang et al.,
2021). They claim the combination of 1.8 meter social distancing and proper
mask protection would be effective protection.
The combination of social distancing and mask-wearing create an environment
where transmission of COVID-19 is significantly reduced.
Are the COVID-19 vaccines safe and effective? What about the Delta variant?
Reasoning I've often heard for not getting vaccinated is that the vaccines
only had emergency FDA approval. So to start off, let's note that Pfizer's
vaccine now has
full FDA approval. For clarity, the difference between
emergency and full approval is mostly logistical hoops, extra testing, and whether or not mandates
for that substance are legal. For both kinds of approval, the substance in
question needs to undergo rigorous testing and clinical trials, heavy analysis
on whether the benefits outweigh the risks must occur, meetings between
unbiased experts occur to discuss these benefits and risks, and so forth.
Another concern is how quickly the vaccines were developed, but to that all I
can say is that that is the beauty of how brilliant these experts are and how
much we can accomplish if we provide the funding for it. It was similar
reasoning for how we managed to make such technological leaps during the
world wars
and how we got to the
moon in the 1960s: there was major government support, the funding was readily given, and so
it happened quickly.
As for how safe and effective the vaccine is, if the FDA's approval isn't
enough or you're curious about the other brands of vaccines, or what this mRNA
thing is, here's some more information. A study by Henry et al. (2021) using
community-based data (as opposed to a clinical trial) showed that the Pfizer,
Moderna, and Oxford-AstraZeneca vaccines are all effective at preventing
severe cases and deaths from the Alpha variant (which means healthcare systems
won't be overloaded), as well as providing significant protection from the
Delta variant. A review of various studies and real-world data concluded that
while protection rates that numerous vaccines provide are incredibly high,
especially for severe and fatal cases, variants emerging are a serious concern
since they are evolving to become more and more vaccine-resistant (Brüssow,
2021a; Callaway, 2021). This is even more reason for the global population to
get vaccinated, since reducing transmission of COVID-19 reduces opportunities
for it to mutate, slowing down its advance and giving us the chance to avoid
extremely dangerous variants.
A thorough paper detailing all the mild and severe side effects of the
vaccines, as well as some logistical and economical concerns (which I'm not
covering here), shows that although severe side effects are possible, they are
negligible in comparison to the risk that COVID-19 poses (Brüssow, 2021b). One
effect is anaphylaxis, but this is usually due to an allergy to PEG or
polysorbate 80, which are rare but vaccine clinics generally have epinephrine
available in case of allergic reactions, and deaths have not been recorded due
to this in the USA as of yet. Another major point is that with many of the
severe side effects, such as cerebral thrombosis, the rate of incidence
amongst vaccinated individuals isn't significantly higher than the rate of
incidence in the general population pre-COVID.
It's also important to understand how the vaccines work. Since the mRNA
vaccines are widely administered, I'll focus on them. The contents of the
vaccine disintegrate and are eliminated from the body within a few days, so
there isn't actually anything new in you for that long. mRNA is messenger RNA,
it's essentially instructions to create DNA. Instructions cannot hurt you,
they cannot change your DNA, and they cannot make you sick with COVID-19. Your
immune system sees these instructions, and there's this really glaring
landmark called a spike protein which makes it memorable. Since this is a
foreign thing, your immune system builds an attack against it to destroy it,
your body doesn't like abnormal things floating about! That's the fever,
chills, soreness, etc that you may experience following the administration of
a vaccine dosage, you're feeling your body fight off a foreign thing but you
aren't actually sick. When your body is done with the mRNA, it settles down
and you feel fine again and all is fine and dandy. One day, you pass by
someone with COVID-19 who infects you. This is where things get pretty cool,
and where my admiration of the human body shines. Your immune system sees that
same spike protein, since that's present on both the instructions (mRNA) and
actual virus (DNA), so it says "hey, I've seen that before, let's get rid of
it" and knows exactly how to destroy it quickly since it's done so before. So
oftentimes the virus will be destroyed before you were even aware that you
were infected, and even if you do show symptoms they end up being milder
because your body knows what it's doing. de Varona (2020) has an
article
containing five explanations using metaphors of how the mRNA vaccines work,
all written by experts.
Now you may be thinking, if you've been previously infected by COVID-19 then
why bother getting vaccinated since you have "natural immunity"? That's the
thing, natural immunity isn't true immunity, and isn't as effective as mRNA
vaccination, because the vaccination stimulates a different, stronger immune
system response (Harvard Health, 2020).
If I don't get vaccinated, will it affect anyone around me?
I've already previously mentioned the issue of variants, but I will reiterate
it here because it's important. The more unvaccinated people there are, the
more COVID-19 spreads, we've established that in the previous section. The
more COVID-19 spreads, the more chances it has to mutate. The more it mutates,
the larger the chance it'll mutate to become vaccine-resistant, and suddenly
the vaccines that people made the choice to receive to protect themselves are
no longer effective (Kupferschmidt, 2021). In effect, the decision of millions
to not get vaccinated will lead to nullifying the decision millions others
have made to get vaccinated, taking away the protection those people had. Your
decision to remain unvaccinated can end up affecting others around you.
Herd immunity is a term buzzing around often. Getting herd immunity through
vaccinations is much better than getting it through mass infection (WHO,
2020), and without herd immunity the unvaccinated are indeed affecting those
around them. Since unvaccinated people spread the virus more easily, they are
infecting other people more often, especially other unvaccinated individuals.
Some of these unvaccinated individuals may not be unvaccinated by choice --
perhaps they are under 12 years of age, and your decision to remain
unvaccinated puts them at higher risk. Not reaching herd immunity puts
communities at higher risk of outbreaks.
Percentages are also important to note. The vaccines are all highly effective,
but none are 100% effective since that's next to impossible. Even a 99%
efficacy rate means 1% of vaccinated individuals will get sick. We know they
won't die, and likely won't get critically ill, but being unvaccinated and
continuing to spread COVID-19 increases the risk that a vaccinated individual
will end up being part of that 1% who do fall ill, or may even end up falling
in the incredibly small percentage of vaccinated individuals who end up
critically ill. These are called breakthrough infections.
Unvaccinated people are far more likely to be hospitalized, we've covered that
and you can confirm for yourself by checking out the breakdown of hospitalized
cases in nearly any city. The issue here is the lack of resources for other
patients. With too many unvaccinated people, the hospitals end up overwhelmed
(Tangcharoensathien et al., 2021), and every bed taken up by someone severely
ill from COVID-19 is a bed that can't be used for someone else, such as
someone who needs a surgery to remove a tumour, or someone who needs an organ
transplant (Bodilsen et al., 2021).
How do I know this information isn't skewed?
You do your own research. Not the kind where you watch videos on YouTube or
read journalist articles or listen to politicians. The kind where you find
peer-reviewed scientific journals, articles written by well-respected and
experienced scientists, where you verify the sources and make sure the authors
have credentials attesting to the level of qualification you need to seriously
comment on the scientific aspects of the pandemic.
I did come across a few articles here and there that claimed opposite things
to what I'm writing about here, but there are four key reasons I did not
include them (and did not include some articles that did support what I'm
writing about) and did not use them as trusted sources: either the authors did
not have proper and relevant credentials, there were no sources for their
information, the information was blatantly false (such as claiming 50% of
vaccine recipients develop disabilities, which is false based on countless
other sources saying otherwise and numerical data simply not agreeing), or the
content was opinion-based rather than scientific in nature.
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