Coronavirus

[AlanSubie4Life]

Wearing a mask (make it an N95, folks, it’s easy and they are more comfortable) might be good even if you get infected. Aside from the benefit of reducing infection. The minimum infectious dose model of infection seems to really be a thing…

Face masking and COVID-19: potential effects of variolation on transmission dynamics | Journal of The Royal Society Interface

Face masks do not completely prevent transmission of respiratory infections, but masked individuals are likely to inhale fewer infectious particles. If smaller infectious doses tend to yield milder infections, yet ultimately induce similar levels of ...

royalsocietypublishing.org

More recent strains are less severe.

Even if this is true (there seems to be a bit of debate, though I think Omicron is likely less virulent than Delta, even if experts largely agree Omicron is inherently similarly virulent to the Wuhan strain), it is not clear how exactly this difference would result in deviation of the ICU to death ratio from prior peaks (seemed to be a ratio of around 10). Maybe it can explain it somehow but to me it is not clear at all how that would follow.

Maybe it's just a very long tail,

I’m like 70% sure at this point that I am wrong about that. I just have no idea why.

 

[cwerdna]

Hundreds of MacBook Pro workers break through COVID barriers, battle guards :O

MacBook Pro workers breaking out of plant – three reasons - 9to5Mac

More details have emerged following eye-opening video footage of MacBook Pro workers breaking through barriers and fighting with guards ...

9to5mac.com

 

[heltok]

Yep. Not a surprise. On the other hand, it (in combination with other measures) did save a million lives or so, and therefore a significant number of lives of parents, particularly in disadvantaged communities (as the article points out, this is one major driver of the mental health issues!). So definitely a tradeoff. I’m sure the analysis will go on for years. It’s unfortunate we didn’t have the same inherent advantages and leadership as New Zealand (though I am not suggesting that outcome could have happened here - we just could not easily get to zero).

I’m in NZ right now, the country is open again. I have talked with some people here, people have mixed opinions on their government’s response. From the outside it might sound like Jacinda saved the country, lockdown to get rid of the virus, vaccinating everyone and then letting omicron rip. Well done president! But it did come at a price... Auckland was in lockdown for 160days of which 100 days nonstop before they surrendered, plus many days of level 1-2. No gyms, no schools, working from home etc. No tourists(tourism is a big industry here). No international students which is another big industry. Big increase in crime in the CBD area. Lots of small business went out of business. A huge deficit spending that will have to be repaid in the future. Heard people say that hospitals are still backlogged, but don’t quote me on that.

So yes, they did vaccinate 90% and then let it rip, saved tons of lives there. But there was a price to pay for it.

 

[Daniel in SD]

I’m in NZ right now, the country is open again. I have talked with some people here, people have mixed opinions on their government’s response. From the outside it might sound like Jacinda saved the country, lockdown to get rid of the virus, vaccinating everyone and then letting omicron rip. Well done president! But it did come at a price... Auckland was in lockdown for 160days of which 100 days nonstop before they surrendered, plus many days of level 1-2. No gyms, no schools, working from home etc. No tourists(tourism is a big industry here). No international students which is another big industry. Big increase in crime in the CBD area. Lots of small business went out of business. A huge deficit spending that will have to be repaid in the future. Heard people say that hospitals are still backlogged, but don’t quote me on that.

So yes, they did vaccinate 90% and then let it rip, saved tons of lives there. But there was a price to pay for it.

Should have bought vaccines. Crazy how governments tried to pinch pennies when it came to purchasing vaccines.
Now apparently my government hasn’t committed to buying fall boosters. I wish there was a way I could pay my $20 now to reserve mine…

 

[AlanSubie4Life]

But there was a price to pay for it.

They did do 3% better on GDP post virus than forecasts predicted prior to the virus. So I guess it just goes to show you can’t please everyone. I’m sure it was far from ideal but I feel like not having really any fear of your parents catching a deadly virus makes it more tolerable. Pretty frustrating after a year of that though.

They definitely should have gotten vaccines sooner though; seems like a big misstep and not all that expensive.

https://twitter.com/x/status/1521540675174486016

 

[AlanSubie4Life]

A bit of a difficult read, but I think the summary is that there's reason to believe that the Omicron-targeted intramuscular vaccines will not likely be the solution to the breakthrough issue and cut transmission. This is consistent with the early macaque trials of the Omicron vaccine.

So at a minimum the boosters in the fall will likely be a multi-valent boost. Obviously infection (studied here) is not the same as vaccination, but this is the connection being made here. It's not even clear to me that there will be any significant advantage right now of the Omicron-targeted boost as compared to the original virus - though it may be better at protecting against future variation in Omicron so it still probably makes sense. It's just apparently not good at protecting (by itself) against other variants which is the reason it can't be relied on alone.

The cross-neutralization plots are pretty interesting. Shows that the boosted vaccine does quite well neutralizing Omicron, but an Omicron infection doesn't do a great job of neutralizing earlier variants. Fortunately an Omicron infection seems reasonably good at neutralizing BA.2 it looks like.

It'll be interesting to see the efficacy results of the Omicron-targeted vaccine trials. I hope they're better than expected based on this paper.

And it's possible that the best answer for preventing actual infection will be a nasal vaccine - might be needed in the case of Omicron. Not clear anything like that could be ready by the fall, especially since apparently funding vaccines is no longer important.

The good news is that it continues to appear that boosted individuals have quite mild courses of illness. Not a good time, but not serious.

https://twitter.com/x/status/1524086328173809664

 

[Jeff N]

Roughly 9% of triple-vaccinated in UK study self-reported “long covid” (continuing symptoms) 4 weeks into a symptomatic infection with BA.2.

I skimmed it quickly. It would be useful to know what the vaccination breakdown was between those who got Astrazenica vs Pfizer vs Moderna.

Self-reported long COVID after infection with the Omicron variant in the UK - Office for National Statistics

The likelihood of reporting long COVID symptoms four weeks after a first coronavirus (COVID-19) infection compatible with the Omicron BA.1 or BA.2 variants, compared with the Delta variant, using data from the COVID-19 Infection Survey.

www.ons.gov.uk

 

[NikolaACDC]

Opinion: Rebound after taking Paxlovid is the latest twist in the Covid-19 puzzle

A mostly opinion-piece with few hard numbers, but was still interesting to read (for me).

Also the linked FDA-update:
FDA Updates on Paxlovid for Health Care Providers

 

[madodel]

Our local TV news has given daily COVID numbers for each county in our area of the state for about 2 years now. Scared the crap out of me today as they showed 300 cases for my county, which is about 10-15 times normal. Then I noticed that was a weekly total. Still high for 7 days compared to the average of 10-15 cases a couple weeks ago.

 

[AlanSubie4Life]

Roughly 9% of triple-vaccinated in UK study self-reported “long covid” (continuing symptoms) 4 weeks into a symptomatic infection with BA.2.

I skimmed it quickly. It would be useful to know what the vaccination breakdown was between those who got Astrazenica vs Pfizer vs Moderna.

Self-reported long COVID after infection with the Omicron variant in the UK - Office for National Statistics

The likelihood of reporting long COVID symptoms four weeks after a first coronavirus (COVID-19) infection compatible with the Omicron BA.1 or BA.2 variants, compared with the Delta variant, using data from the COVID-19 Infection Survey.

www.ons.gov.uk

That's comfortingly low, given the self-reported nature of the study and the fairly short timeframe. It's certainly very common to have lingering congestion and cough from colds for weeks afterwards, so hopefully the more serious COVID is following a similar pattern in the triple vaccinated. Hopefully most of these responses are explained by that. But there is no data and the questions asked were very open-ended, so it's really hard to say whether it's something to worry about or perfectly normal post-infection sequelae.

Study participants were asked to respond to the following questions: "Would you describe yourself as having 'long COVID', that is, you are still experiencing symptoms more than 4 weeks after you first had COVID-19, that are not explained by something else?" and, if so: "Does this reduce your ability to carry-out day-to-day activities compared with the time before you had COVID-19?" and "Have you had any of the following symptoms as part of your experience of long COVID? Please include any pre-existing symptoms which long COVID has made worse." [Not clear what the following symptom list was or what the responses were to these questions]

Oh well. Some day we'll know.

 

[Dave EV]

That's comfortingly low, given the self-reported nature of the study and the fairly short timeframe.

I disagree, given the extremely high number of people getting infected...

 

[AlanSubie4Life]

I disagree, given the extremely high number of people getting infected...

Certainly if it is 9%, too high. But sounds like it COULD be 0.9%, steady state, or whatever. Hard to know. Frustrating!

I have no idea, and I was just surprised to see it this low for self reported in a short timeframe post infection. What would this rate have been before vaccination?

I’m not sure what to make of long COVID. Hopefully it is way less of a big deal for vaccinated people. Might be too much to hope for, but seems odd to see such a high rate for a coronavirus.

 

[AlanSubie4Life]

Case counts still concave up. Seems like any peak must be a couple weeks away at best.

Everyone I know recently who has gotten COVID has not been included in case counts, thanks to rapid tests (have to love anecdata!), so I figure ascertainment is half of what it used to be. 6:1?

It’s also all been mild (very bad sore throat though), though a couple of them are pushing 80. Boosted though (not double). Too small a sample to say whether vaccines work, lol. So far, they seem to be relieved to have finally gotten COVID; almost makes me want to get it, but I don’t like sore throats.

Still seems like this surge is largely consistent with people who have been careful finally letting down their defenses. And of course the continued burning through the unvaccinated, which is a substantial contributor and probably drives spread. Certainly was root cause in the cases I am aware of (transmitted by unvaccinated symptomatic individual who decided to attend crowded gathering and talk a lot).

I still don’t know anyone who has gotten COVID while wearing a mask. They’re amazing. I’m trying to become the first double-boosted individual to be infected while wearing an N95. I am maximizing indoor crowded exposures in that configuration. Threw in the towel on Omicron-specific vaccine, and went ahead and got the second booster which I don’t qualify for. Next up, international travel.

Not sure how much of recent growth is due to BA.2.12.1 vs. BA.2. Everyone has lost interest I guess. Anecdotally I haven’t heard evidence of waning immunity being the reason.

 

[Dave EV]

It’s also all been mild (very bad sore throat though), though a couple of them are pushing 80. Boosted though (not double). Too small a sample to say whether vaccines work, lol. So far, they seem to be relieved to have finally gotten COVID; almost makes me want to get it, but I don’t like sore throats.

Don't do it. I know two coworkers who have gotten it in the last week due to business related travel and lack of masking. Both are not having fun with it, but fortunately "mild". Still too soon to know what the long term effects are.

Not to mention that COVID today won't necessarily protect you from COVID in the fall. It's highly likely that by then, we'll have a new variant that escapes immunity from today's variant. After all the latest variants already escape most of the Omicron resistance, otherwise they wouldn't be spreading.

 

[AlanSubie4Life]

After all the latest variants already escape most of the Omicron resistance, otherwise they wouldn't be spreading.

Is this true? I haven’t seen definitive evidence that these variants (which are still Omicron) escape from boosted immunity plus prior infection. Prior infection alone is another issue (seems like protection is not great). Do we have any documented cases of people boosted who have been infected twice after boosting without immunocompromise? I would expect that to be pretty rare.

As the paper I last referenced mentions, it seems true that Omicron is pretty consistent in regards to preservation of certain characteristics of the RBD, which seem consistently less vulnerable to neutralization (minimally neutralizing antibodies for this epitope), so perhaps protection from any prior immunity is less than for prior variants, due to this characteristic. However, in spite of this, there seems to be optimism about vaccines that elicit mucosal and broader immunity being successful. So I’d think boosted then infected people would be in pretty good shape for now.

Some detailed discussion here, previously posted here; anyway, to me it seems like increased transmissibility and human behavior changes are likely driving the spread right now, with very little impact of immune escape (though I expect more immune escape impact in unvaccinated populations):

https://twitter.com/x/status/1516147488587075584

Not to mention that COVID today won't necessarily protect you from COVID in the fall. It's highly likely that by then, we'll have a new variant that escapes immunity from today's variant

I don’t think I would describe it as “highly likely” - though I wouldn’t bet against it; maybe 30% chance; I’d call it “possible”:

https://twitter.com/x/status/1511871618443665408

 

[Dave EV]

Is this true? I haven’t seen definitive evidence that these variants (which are still Omicron) escape from boosted immunity plus prior infection. Prior infection alone is another issue (seems like protection is not great). Do we have any documented cases of people boosted who have been infected twice after boosting without immunocompromise? I would expect that to be pretty rare.

Well, as you say it's a combination of quickly waning antibody levels combined with rapidly evolving virus. I recall seeing some studies on Twitter, will link if I run into them again.

 

[AlanSubie4Life]

Well, as you say it's a combination of quickly waning antibody levels combined with rapidly evolving virus.

I am actually saying that at the current time, I would guess that very little of the increasing spread and millions of cases has to do with these factors, with the exception of the small changes in the virus leading to increased transmissibility, which does seem to be happening to an extent, and perhaps with the exception of waning immunity in the unvaccinated (though I suspect that is not that significant - in the past a single infection conferred excellent protection, usually better than two vaccine doses, but perhaps for Omicron it’s a bit different).

 

[heltok]

North Korea not doing too well. Went from 0, to 1 to 18000 to 350000 in 24h.

North Korea confirms first COVID death; 350,000 reporting ‘fever’

Experts worry North Korea’s health system will be unable to cope with spread of COVID in an unvaccinated population.

www.aljazeera.com

Zero vaccines there, omicron already widespread. Gonna be many cases at the same time, many severe cases at the same time, many people who will not get the healthcare they need, many who would have survived with healthcare who dies. Expect very high mortality rates there

 

[Dave EV]

I am actually saying that at the current time, I would guess that very little of the increasing spread and millions of cases has to do with these factors, with the exception of the small changes in the virus leading to increased transmissibility, which does seem to be happening to an extent, and perhaps with the exception of waning immunity in the unvaccinated (though I suspect that is not that significant - in the past a single infection conferred excellent protection, usually better than two vaccine doses, but perhaps for Omicron it’s a bit different).

It's probably due to both, but the data would tell us if it was out there. FWIW, here is some data in this thread comparing BA.1 (Original Omicron) to BA.4 and BA.5. Linking to the summary below, but click through to read the whole thread.

https://twitter.com/x/status/1520097459996966914

 

[AlanSubie4Life]

It's probably due to both, but the data would tell us if it was out there. FWIW, here is some data in this thread comparing BA.1 (Original Omicron) to BA.4 and BA.5. Linking to the summary below, but click through to read the whole thread.

https://twitter.com/x/status/1520097459996966914

Right. But BA.4 and BA.5 aren’t causing the wave here right now. Yet.

Anyway this is consistent with vaccinated Omicron-infected individuals having pretty good immunity against BA.4 and 5. And this is also consistent with BA.1 not being very immunogenic in immune naive people (particularly poor cross-immunity too).

In any case due to lower vaccination rates, the impact of BA.4/5 should be more substantial in South Africa than it is here. And by then BA.2.12.1 will have ripped through, which is similar in some respects to the BA.4/BA.5 variants, so there may be significant cross-immunity at least against those similar variants.