Monthly Archives: October 2021

Randomized control trial using masks.

Economists and perhaps others will benefit from seeing the results of this large-scale randomized controlled trial on wearing masks, in Bangledesh, which studied N=342,126 adults with three study arms: cluster randomized Villages and households with no intervention, with free cloth masks, and with free surgical masks. Participants also received information and local  reminders.

 

Here is the Yale research paper by economist Jason Abaluck et al describing the experiment.

The Impact of Community Masking on COVID-19: A Cluster Randomized Trial in Bangladesh. https://elischolar.library.yale.edu/cowles-discussion-paper-series/2642/

August, 2021

 

Here is a popular summary in the Atlantic from September 4, 2021

https://www.theatlantic.com/ideas/archive/2021/09/masks-were-working-all-along/619989/

 

The study shows the superiority of surgical masks over cloth masks, and the both sets of masks achieved a roughly ten percent reduction in symptomatic seroprevalence. This is less than perfect, but the study interventions were only able to increase the wearing of masks from 13% to 42% and raise social distancing from 24% to 29%. Recall that the study was done in Bangladesh.

Three sources on COVID-19

This BUHealth blog contains clips on practical advice about COVID-19 from a Harvard School of Public Health email, links to the The Vaccine Confidence Project, and an except from the CDC advisory on pregnancy and COVID-19

From: Harvard Executive Director Mark Dorgan <oer_info@hsph.harvard.edu>

While globally new cases are trending downward, the virus continues to spread. Half the world’s population still has not had a single shot, many people remain extremely vulnerable, and we continue to learn about the best ways to protect ourselves. For those who have access, medical masks far surpass cloth masks, mRNA vaccines (Pfizer and Moderna) are proving most effective, and rapid tests can help make real-time decisions. In all cases, any protection is better than none.

Bill Hanage, associate professor of epidemiology, said in a recent interview, “You cannot tell where the virus is, or if somebody is infected with it, unless you test for it. Once testing becomes available, you suddenly turn on the lights and you see that there’s a huge problem. And by that stage, it’s a little bit too late to be able to control that problem.” Pardis Sabeti, professor of immunology and infectious diseases, added, “To do it right in the future, whenever a new viral threat emerges, we have to position…clinical labs to be able to set up testing right away.”

Michael Mina, assistant professor of epidemiology, advocates for at-home tests over PCR tests to help stem spread. “If you want to keep businesses running, or to be able to host a safe dinner at home, don’t ask people to get a PCR test two days before. Ask them to use a rapid test within two hours of coming over.” If it’s negative, he said, “It’s extremely unlikely that person is infectious and a risk to other people. It’s an extraordinarily effective way to keep dinner, concerts, workplaces, and schools safe. Will it keep them 100% safe? No, but it will likely be 100% effective in stopping super spreaders from entering gatherings.”

Regarding vaccines, Sarah Fortune, John LaPorte Given Professor of Immunology and Infectious Diseases and chair of the Department of Immunology and Infectious Diseases, explained in a We’re Better Off podcast that mRNA vaccines were not rushed despite the quick rollout. “There were decades of work involved in mRNA vaccine platforms, and in fact, in testing different kinds of vaccines for different coronaviruses. When SARS-CoV-2 first appeared at the end of 2019, actually we had a huge foundational knowledge that accelerated that vaccine development.”

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RE: The main battles being fought in developed countries like the US is over the acceptance of science and acceptance of the key importance of the social determinant of health. I highly recommend the series of articles in The Vaccine Confidence Project from the London School of Hygiene and Tropical Medicine. Here is the direct link.

https://www.vaccineconfidence.org/

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This September 29, 2021 posting on the CDC website has the new recommendations for related to pregnancy, which is a big change.

CDC Statement on Pregnancy Health Advisory

https://www.cdc.gov/media/releases/2021/s0929-pregnancy-health-advisory.html

Here are the key paragraphs from this report.

“Today, CDC issued an urgent health advisory to increase COVID-19 vaccination among people who are pregnant, recently pregnant (including those who are lactating), who are trying to become pregnant now, or who might become pregnant in the future to prevent serious illness, deaths, and adverse pregnancy outcomes.”

“Through September 27th, there were more than 125,000 confirmed cases of COVID-19 in pregnant people including more than 22,000 hospitalized and 161 deaths; of which, 22 deaths occurred in the month of August alone. Cases of COVID-19 in symptomatic, pregnant people have a two-fold risk of admission into intensive care and a 70 percent increased risk of death. Pregnant people with COVID-19 are at increased risk of adverse pregnancy outcomes that could include preterm birth, stillbirth, and admission into the ICU of a newborn also infected with COVID-19.”

RE: If you trust your obstetrician’s advice to have your baby in a hospital, then you should also trust their advice to get a COVID-19 vaccine, regardless of what stage of pregnancy you are in: before, during, or after.