Coronavirus

[DrGriz]

Possibly Paywalled for some:

https://www.washingtonpost.com/wellness/2022/10/13/long-covid-exercise-symptoms/

Long covid can rob people of health, energy, employment and joy. It may also strip away the equivalent of a decades’ worth of aerobic fitness, according to a large-scale new scientific review of long covid patients and exercise.

For me personally, probably the biggest fear and the reason I still wear a mask in situations where >95% of the people around me do not.

The findings of this systematic review and meta-analysis study suggest that exercise capacity was reduced more than 3 months after SARS-CoV-2 infection among individuals with symptoms consistent with LC compared with individuals without LC symptoms, with low confidence. Potential mechanisms for exertional intolerance other than deconditioning include altered autonomic function (eg, chronotropic incompetence, dysfunctional breathing), endothelial dysfunction, and muscular or mitochondrial pathology.

Use of Cardiopulmonary Exercise Testing to Evaluate Long COVID-19 Symptoms in Adults

This systematic review and meta-analysis addresses whether adults with persistent COVID-19 symptoms more than 3 months after SARS-CoV-2 infection (long COVID-19 [LC]) have reduced exercise capacity compared with recovered individuals without symptoms and identifies potential mechanisms of LC.

jamanetwork.com

 

[Dave EV]

For me personally, probably the biggest fear and the reason I still wear a mask in situations where >95% of the people around me do not.

And that's about all you can do - fit yourself with the best masks you can.

I've also long stated that more work should be performed on indoor air quality (air exchange rates along with filtration) - not only would that reduce the risk of spreading COVID, but also a lot of other airborne diseases and pollution.

 

[AlanSubie4Life]

Pfizer announcement today about neutralizing data, but no data apparent.

Will have to wait for that, not thinking it will be incredibly impressive though…

I wonder when they will start testing the booster of the booster? Hopefully they have already started!

 

[scottf200]

Re: Wastewater Surveillance

https://twitter.com/x/status/1580706519909560320

 

[scottf200]

a) I know Eric is considered a "little" of a sensationalist [for lack of better words]. I guess we'll see if this turns out to be true.
I've mentioned BQ.1* recently in this thread. I've been puzzled why there has not been any tracking of BQ.1* if it is apparently highly transmissible.
For example ... it is not on "SARS-CoV-2 Variant Classifications and Definitions" site Coronavirus Disease 2019 (COVID-19)
where I thought it may be a VOI.

• Variants being monitored (VBM)– View current VBM in the United States that continue to be monitored and characterized by federal agencies
• Variant of interest (VOI)– Currently, no SARS-CoV-2 variants are designated as VOI
• Variant of Concern (VOC)– View current VOC in the United States that are being closely monitored and characterized by federal agencies
• Variant of high consequence (VOHC)– Currently, no SARS-CoV-2 variants are designated as VOHC

Just got this leak from CDC-insider source—it seems #COVID variants worse than CDC has been admitting. The new highly evasive #BQ1 & #BQ11 sub variants are surging over 11%—but CDC has not shared it yet!

https://twitter.com/x/status/1580751003485622272

Current chart: COVID Data Tracker
Supposed leaked new chart coming out (note 10/15/2022) date.

b) NY at 13.8% supposedly
"Status of the latest #COVID19 Wave in #NewYork #BellwetherState
Top Circulating Lineages (#15DAYTrends):
BQ* Lineages (13.8%) (of which 3.9% BQ.1.1)
..."

https://twitter.com/x/status/1580774664187498496

 

[AlanSubie4Life]

a) I know Eric is considered a "little" of a sensationalist [for lack of better words]. I guess we'll see if this turns out to be true.
I've mentioned BQ.1* recently in this thread. I've been puzzled why there has not been any tracking of BQ.1* if it is apparently highly transmissible.
For example ... it is not on "SARS-CoV-2 Variant Classifications and Definitions" site Coronavirus Disease 2019 (COVID-19)
where I thought it may be a VOI.

https://twitter.com/x/status/1580751003485622272

Current chart: COVID Data Tracker
Supposed leaked new chart coming out (note 10/15/2022) date.

b) NY at 13.8% supposedly
"Status of the latest #COVID19 Wave in #NewYork #BellwetherState
Top Circulating Lineages (#15DAYTrends):
BQ* Lineages (13.8%) (of which 3.9% BQ.1.1)
..."

https://twitter.com/x/status/1580774664187498496

EFD lost credibility a long time ago, several waves past that where he predicted sheer devastation each time.

We are going to have a winter wave. It’ll probably look a little worse than the last wave. But not like last year. Just my guess.

Hopefully the boosters provide some coverage. With any luck we’ll stick with this Omicron and not have a major shift (30% chance per year is one estimate).

 

[scottf200]

EFD lost credibility a long time ago, several waves past that where he predicted sheer devastation each time.
We are going to have a winter wave. It’ll probably look a little worse than the last wave. But not like last year. Just my guess.
Hopefully the boosters provide some coverage. With any luck we’ll stick with this Omicron and not have a major shift (30% chance per year is one estimate).

I guess my emphasis was on him "scoping" the missing BQ.1* data.
It is apparently highly transmissible by various sources and not him in particular. It is in various other countries already and they are showing it spreading faster than others.

Re: booster provides some coverage.
If you are talking about the new bivalent COVID booster, then everything I'm seeing is how slow the uptake is (people getting it).
Good news is that very recently (few days) it became available for 5-11 year olds (ie. younger school going kids)

Today, CDC’s Director Rochelle P. Walensky, M.D., M.P.H., signed a decision memo expanding the use of updated (bivalent) COVID-19 vaccines to children ages 5 through 11 years.

Coronavirus Disease 2019

CDC provides credible COVID-19 health information to the U.S.

www.cdc.gov

 

[AlanSubie4Life]

It is apparently highly transmissible by various sources and not him in particular. It is in various other countries already and they are showing it spreading faster than others.

Yes, that is what you would expect. We will notice the variants that have a growth advantage by definition. Doesn’t seem to be a crazy takeover like Omicron so far.

But is it MORE CONTAGIOUS THAN MEASLES , lol?
(No, COVID is nowhere near as infectious as measles.) It may be as infectious as measles is when 80% of the people are vaccinated against measles. Maybe that’s what he meant!

https://twitter.com/x/status/1472442949246070785

I guess we’ll see on this wave. The one thing the US has excelled on is getting people infected, so hopefully we’ll have an easier time of this wave than any prior one, and do better than Europe. We’ve done the hard work of infecting everyone already.

We just have to hope we just stick with Omicron. It’s going to suck and excess mortality will remain elevated indefinitely it appears. Very curious when that dynamic will change! The steady state sucks so far!

It does look like there’s a small chance we will drop to the lowest mortality levels of the pandemic in a month or so. ICU levels aren’t quite low enough yet though.

Good news is that very recently (few days) it became available for 5-11 year olds (ie. younger school going kids)

68% of them aren’t eligible since they haven’t got their primary series. Misinformation and sh**talking the excellent vaccine really works!

 

[Jeff N]

EFD lost credibility a long time ago, several waves past that where he predicted sheer devastation each time.

We are going to have a winter wave. It’ll probably look a little worse than the last wave. But not like last year. Just my guess.

Hopefully the boosters provide some coverage. With any luck we’ll stick with this Omicron and not have a major shift (30% chance per year is one estimate).

I’m more concerned about a bad flu year combined with a moderate Covid wave. There was concern in prior years about getting hit with both Covid and flu waves at the same time but this time it may actually happen. I also hear talk about hospitals being less prepared now due to many health professionals dropping out of the job market.

I suspect we will muddle through.

 

[DrGriz]

I’m more concerned about a bad flu year combined with a moderate Covid wave. There was concern in prior years about getting hit with both Covid and flu waves at the same time but this time it may actually happen. I also hear talk about hospitals being less prepared now due to many health professionals dropping out of the job market.

I suspect we will muddle through.

Yes they are already seeing more than normal flu. And the antivaccination movement has spread to flu vaccine.

I got both vaccines last week. No symptoms.

Yes, a severe shortage of healthcare workers nation wide.

 

[JRP3]

The fun never stops with Covid.

A new subvariant of the novel-coronavirus called XBB dramatically announced itself earlier this week, in Singapore. New COVID-19 cases more than doubled in a day, from 4,700 on Monday to 11,700 on Tuesday—and XBB is almost certainly why. The same subvariant just appeared in Hong Kong, too.

The Nightmare COVID Variant That Beats Our Immunity Is Finally Here

Photo Illustration by Erin O'Flynn/The Daily Beast/GettyA new subvariant of the novel-coronavirus called XBB dramatically announced itself earlier this week, in Singapore. New COVID-19 cases more than doubled in a day, from 4,700 on Monday to 11,700 on Tuesday—and XBB is almost certainly why...

www.yahoo.com

 

[DrGriz]

The fun never stops with Covid.

The Nightmare COVID Variant That Beats Our Immunity Is Finally Here

Photo Illustration by Erin O'Flynn/The Daily Beast/GettyA new subvariant of the novel-coronavirus called XBB dramatically announced itself earlier this week, in Singapore. New COVID-19 cases more than doubled in a day, from 4,700 on Monday to 11,700 on Tuesday—and XBB is almost certainly why...

www.yahoo.com

The gift that keeps on giving. We never had a chance.

At least the bivalent vaccine works against XXB for hospitalizations and deaths. Unfortunately there are plenty of vaccine deniers and skeptics to keep the ICUs busy. Reminds me that 10%+ of our heathcare workers fell into that category.

 

[scottf200]

The fun never stops with Covid.

The Nightmare COVID Variant That Beats Our Immunity Is Finally Here

Photo Illustration by Erin O'Flynn/The Daily Beast/GettyA new subvariant of the novel-coronavirus called XBB dramatically announced itself earlier this week, in Singapore. New COVID-19 cases more than doubled in a day, from 4,700 on Monday to 11,700 on Tuesday—and XBB is almost certainly why...

www.yahoo.com

a) I had forgot/missed that XBB was a descendant from BA.2

https://twitter.com/x/status/1580334138380328961

[partial image here since embedded tweet above didn't show it all ... for folks that didn't want to go to twitter]

b) Saw Laurie's post via this summary from the well known Vaccine Scientist Prof Peter Hotez. He provided some thoughts on Covid thru the end of the year.

https://twitter.com/x/status/1581616475097661442

 

[AlanSubie4Life]

The fun never stops with Covid.

The Nightmare COVID Variant That Beats Our Immunity Is Finally Here

Photo Illustration by Erin O'Flynn/The Daily Beast/GettyA new subvariant of the novel-coronavirus called XBB dramatically announced itself earlier this week, in Singapore. New COVID-19 cases more than doubled in a day, from 4,700 on Monday to 11,700 on Tuesday—and XBB is almost certainly why...

www.yahoo.com

I don’t think we have much to worry about from this, though of course it is of some concern. Not even clear whether it will become dominant!

At this point it is extremely difficult to predict whether what happens in one country will happen in another, due to very different immune landscapes.

In any case, the bivalent booster will nearly certainly work great on this one (will certainly not always prevent infection, but that is ok!).

Anyway get boosted and reduce transmission via any number of extremely effective measures, and you’ll be fine. Getting boosted has massive effects on reducing transmission itself, of course.

Remember, we don’t even know yet what will comprise our most (potentially) dangerous wave this winter. It was not until Thanksgiving a year ago that Omicron was identified.

What we have to hope for is that we keep just getting Omicron without any other major variant emerging in the next 3 months or so! Right now that’s holding true. Reducing transmission will help make that more likely to stay that way.

 

[JRP3]

Anyway get boosted and reduce transmission via any number of extremely effective measures, and you’ll be fine. Getting boosted has massive effects on reducing transmission itself, of course.

I'm afraid the take rate for the new booster will be very low.

 

[AlanSubie4Life]

I'm afraid the take rate for the new booster will be very low.

5% so far! (Of population, not of eligible.)

Herd immunity here we come.

 

[AlanSubie4Life]

Protection of prior infection (perhaps a good proxy for bivalent booster protection - wonder when we will have actual data?), and other discussion of variants.

Doesn’t look to me like a major escape variant (as expected). It just has fitness advantages and has some escape. That is my quick impression anyway.

https://twitter.com/x/status/1581786439838158848

 

[scottf200]

Another great non-nonsense summary of other countries and the USA.

COVID-19 State of Affairs: Oct 18
Katelyn Jetelina 1 hr ago

COVID-19 State of Affairs: Oct 18

SARS-CoV-2 is having a mixed impact across the globe. The WHO is tracking more than 100 subvariants of Omicron, and each country has a different makeup of “subvariant soup,” but two are winning the race: XBB and BQ.1.1. Couple this with changing behaviors and different immune histories (which...

yourlocalepidemiologist.substack.com

 

[wdolson]

The fun never stops with Covid.

The Nightmare COVID Variant That Beats Our Immunity Is Finally Here

Photo Illustration by Erin O'Flynn/The Daily Beast/GettyA new subvariant of the novel-coronavirus called XBB dramatically announced itself earlier this week, in Singapore. New COVID-19 cases more than doubled in a day, from 4,700 on Monday to 11,700 on Tuesday—and XBB is almost certainly why...

www.yahoo.com

One thing these hair on fire articles don't mention is that Omicron and its descendants so far are much less deadly than the variants we were seeing in 2020 and early 2021. There are a lot of hair on fire articles out there that hype the level of contagiousness of new variants, but don't mention that Omicron and its descendants being an upper respiratory virus lead to far fewer complications. People with underlying conditions may still have bad side effects, but so far for most of the population the severity of infection is no worse than a mild case of the flu. Unpleasant, but no lasting problems.

The common trajectory for viruses like this is to mutate into more contagious but less dangerous variants over time. However we do have the example of the 1918 Spanish Flu that appears to be a mutation of a milder flu that went around in the early 1890s that was less dangerous, though I believe the 1918 flu came from pigs.

Immunologists believe it was related to a milder flu from the early 1890s because people over about age 27-30 got the Spanish Flu in smaller numbers and tended to fight it off easier if they did. Especially people in more urban areas where the earlier flu probably traveled more. Rural areas which were more isolated in the 1890s had less herd immunity and some small communities were almost wiped out by the 1918 flu.

I wouldn't completely rule out a more deadly variant coming along, but the trend line so far tends to be along the lines of other pandemics that its getting more contagious but less deadly.

 

[DrGriz]

One thing these hair on fire articles don't mention is that Omicron and its descendants so far are much less deadly than the variants we were seeing in 2020 and early 2021. There are a lot of hair on fire articles out there that hype the level of contagiousness of new variants, but don't mention that Omicron and its descendants being an upper respiratory virus lead to far fewer complications. People with underlying conditions may still have bad side effects, but so far for most of the population the severity of infection is no worse than a mild case of the flu. Unpleasant, but no lasting problems.

The common trajectory for viruses like this is to mutate into more contagious but less dangerous variants over time. However we do have the example of the 1918 Spanish Flu that appears to be a mutation of a milder flu that went around in the early 1890s that was less dangerous, though I believe the 1918 flu came from pigs.

Immunologists believe it was related to a milder flu from the early 1890s because people over about age 27-30 got the Spanish Flu in smaller numbers and tended to fight it off easier if they did. Especially people in more urban areas where the earlier flu probably traveled more. Rural areas which were more isolated in the 1890s had less herd immunity and some small communities were almost wiped out by the 1918 flu.

I wouldn't completely rule out a more deadly variant coming along, but the trend line so far tends to be along the lines of other pandemics that its getting more contagious but less deadly.

I am not sure that it is clear that to the "uninitiated" Omicron is far less deadly. While with other viruses for which we have an historical record, as you describe well, this is often the case, that doesn't mean it is going to be that way this time.

We are dealing with a different population now on the whole. Many people have been vaccinated, have had Covid at least once, or both. And 1 million of the most susceptible Americans are gone. And we have treatments.

I think it remains to be seen whether for the uninitiated, previously unexposed, demographic Omicron is less lethal.

Firstly, it is still unclear why the risk of death is lower. Is this due to omicron’s increased capacity to avoid immune recall leading to lower immune activation, altered viral tropism, changes in anatomical localisation, improvements in clinical care, or a combination of these and other factors? Understanding the causes is critical for assessing risks as variants continue to emerge.

Covid-19: is omicron less lethal than delta?

Death certification data support an intrinsically lower case fatality rate for omicron Soon after the omicron SARS-CoV-2 variant of concern was first reported to the World Health Organization on 24 November 2021, preliminary observational studies in South Africa suggested this highly...

www.bmj.com