Coronavirus

[Tiger]

Since this situation hasn't happened to anyone, including you, until now, there are no rows/studies looking at that scenario. Maybe ask that question in a year or two when it has happened and the protective effect in your setting can be measured, studied and published.

Again, your specific scenario can't have been looked at, yet. It's too early. So I am not sure why you would think that information is available.

The rarity is also an informative indicator. Let's revisit this at a later time.

 

[DrGriz]

The rarity is also an informative indicator. Let's revisit this at a later time.

Sure. I'm not sure what you mean by rarity. Death? Hospitalization rate? Post Covid symptoms are not rare. 15% is not great odds when you are talking about the risk of debilitating symptoms. If your risk of being injured in an accident in any given drive was 15%, would you get into your car every day?

 

[Tiger]

Sure. I'm not sure what you mean by rarity. Death? Hospitalization rate? Post Covid symptoms are not rare. 15% is not great odds when you are talking about the risk of debilitating symptoms. If your risk of being injured in an accident in any given drive was 15%, would you get into your car every day?

I mean "if there is no story to tell" with such combo, then probability might be low. Anyhow, let's revisit this in a year with more data and maybe AI can help mine it.

 

[Slipstream]

CDC recommends getting COVID-19 booster for the fall:

CDC Newsroom

Press releases, advisories, telebriefings, transcripts and archives.

www.cdc.gov

Looks like both Pfizer and Moderna are available now.

I'm curious which variants this new vaccine works against. I heard monovalent for Omicron and some of the newer variants, and I heard bivalent elsewhere. Any definitive info? Maybe I missed it on the CDC website.

 

[AlanSubie4Life]

I mean "if there is no story to tell" with such combo, then probability might be low. Anyhow, let's revisit this in a year with more data and maybe AI can help mine it.

No one has had a monovalent booster targeted at the current circulating variants, so we don’t know how well it will work.

Sadly, over the long-term, the bivalent booster had approximately zero efficacy at preventing in hospitalization in people 18-64. (Though 61% effective for the two months after.)

There was a bunch of data presented at the ACIP meeting. In retrospect the bivalent strategy was pretty dumb.

I’m getting my monovalent on Friday and hopefully it’s a better match and shifts imprinting momentum enough to actually provide some more substantial protection.

I'm curious which variants this new vaccine works against. I heard monovalent for Omicron and some of the newer variants, and I heard bivalent elsewhere.

It is monovalent and targeted to XBB1.5.

The clinical trials did not look at efficacy, unfortunately (really silly I think). However, the neutralizing titers for this vaccine to a wide range of the circulating variants look pretty good. So it looks better than the bivalent did for the time being.

So maybe it will work ok at actually preventing illness, like the original vaccine against the original variant. But we will see. Not super optimistic about anything but a few months of enhanced protection (with important longer lasting prevention of severe disease). I expect to be wearing a mask selectively for the foreseeable future.

This is a partial boost of the bivalent (the Omicron part) assuming you got it (or got Omicron) so it has the potential to work a bit better by making the body’s defenses more strongly retargeted to Omicron, as I understand it.

But still missing mucosal immunity, etc. It’s unfortunate there are not more efforts being put into a vaccine to prevent infection. I guess nearly everyone has had it, so there is little motivation.

 

[Tiger]

I expect to be wearing a mask selectively for the foreseeable future.

..

But still missing mucosal immunity, etc. It’s unfortunate there are not more efforts being put into a vaccine to prevent infection. I guess nearly everyone has had it, so there is little motivation.

Wasn't there one possible benefit of wearing mask that you can end up exposing yourself to the virus just enough to develop some antibodies but avoid getting sick? This was one of the strategies I was hoping for before the vaccines arrived.

 

[AlanSubie4Life]

Wasn't there one possible benefit of wearing mask that you can end up exposing yourself to the virus just enough to develop some antibodies but avoid getting sick? This was one of the strategies I was hoping for before the vaccines arrived.

As I understand it, that’s not clear in the totally unvaccinated scenario you propose. However, after vaccination, some virologists and immunologists definitely think that dramatically reducing your dose (which a N95 will do; I do not wear any other type of mask) can reduce disease severity and even prevent illness by allowing your body time to respond to the known pathogen before infection gets out of control. I am not sure there would be any significant boosting of antibodies though in the case of “no illness.” If there isn’t a huge infection, it makes intuitive sense that the body won’t expend energy on ramping up a bunch of immune defenses and remember the pathogen in detail - but I have no idea how it actually works.

Professor Iwasaki has covered this in detail on a few occasions (news articles, Tweets, etc.):

https://x.com/VirusesImmunity?s=20

 

[jerry33]

Wasn't there one possible benefit of wearing mask that you can end up exposing yourself to the virus just enough to develop some antibodies but avoid getting sick? This was one of the strategies I was hoping for before the vaccines arrived.

While possible, it's luck of the draw. Depends on the mask/respirator and how many virus carrying particles are in a cubic metre of air. Bear in mind: Cloth masks 50% reduction at best. Surgical masks 60% at best (surgical masks are designed to protect the patient from the doctor's germs, not vice versa). N95 respirator 95% at best (80% is more typical). And the air can vary dramatically in the virus carrying particle density. To make this method work, you would need some kind of real time monitor to tell you the air's virus particle density with a wireless sensor between the mask and your nose to monitor the actual amount of virus you inhale. You would also need to know your threshold of how many virus you can acquire before getting sick.

 

[AlanSubie4Life]

N95 respirator 95% at best (80% is more typical).

I think this likely greatly understates the efficacy of a properly fitting respirator. If it's not leaking, it's likely to be very effective at capturing particles. And 95% is the minimum for a certain range of particle sizes, while large particles (the large droplets one would often be concerned with) will be even better. The key is to make sure all the air passes through the mask. Many of the quality masks out there fit very well (in the absence of significant facial hair) and ensure this happens.

Unfortunately, actually measuring efficacy of mask wearing is extremely difficult, and no one has done it (because there's no way to measure efficacy of mask wearing because no one wears them all the time). Of course it only makes sense to measure efficacy of N95 masks exclusively, since they are cheap, more comfortable than inferior masks, and there's really no reason to wear anything else. But I'm not aware of any studies of such things (actually measuring efficacy of mask wearing, excluding all periods of non-mask-wearing). No one cares about a study that includes periods of time when the masks were not used, and to my knowledge every study to date includes such periods.

The only evidence I have is that all the people I know who are serious about wearing masks still have not contracted COVID. It's not really evidence! I'll be the first if (when) I get COVID to come on here and say that I got it while wearing a mask, but I don't anticipate that will be the situation where I get it. It's much more likely to be in a situation where I am unmasked. If I get it through an unknown source, I will chalk it up to mask failure. I expect that I will know exactly where I got it, when I do get it.

Sadly, over the long-term, the bivalent booster had approximately zero efficacy at preventing in hospitalization in people 18-64. (Though 61% effective for the two months after.)

However, the neutralizing titers for this vaccine to a wide range of the circulating variants look pretty good. So it looks better than the bivalent did for the time being.

For the retrospective efficacy: This was for a test-negative case-control study, which I really don't understand even though I know how it works at a basic level, and I really have no idea how they remove the biases which might be involved. Just seems impossible to me.

Anyway. There are more slides there showing how the bivalent did, comparing VE measured via test-negative case-control, in various other scenarios, as well. And plenty more data on the new vaccine as well - but no efficacy measurements, of course.

ACIP September 12, 2023 Presentation Slides | Immunization Practices | CDC

www.cdc.gov

 

[jerry33]

I think this likely greatly understates the efficacy of a properly fitting respirator. If it's not leaking, it's likely to be very effective at capturing particles. And 95% is the minimum for a certain range of particle sizes, while large particles (the large droplets one would often be concerned with) will be even better. The key is to make sure all the air passes through the mask. Many of the quality masks out there fit very well (in the absence of significant facial hair) and ensure this happens.

Unfortunately, actually measuring efficacy of mask wearing is extremely difficult, and no one has done it (because there's no way to measure efficacy of mask wearing because no one wears them all the time). Of course it only makes sense to measure efficacy of N95 masks exclusively, since they are cheap, more comfortable than inferior masks, and there's really no reason to wear anything else. But I'm not aware of any studies of such things (actually measuring efficacy of mask wearing, excluding all periods of non-mask-wearing). No one cares about a study that includes periods of time when the masks were not used, and to my knowledge every study to date includes such periods.

The only evidence I have is that all the people I know who are serious about wearing masks still have not contracted COVID. It's not really evidence! I'll be the first if (when) I get COVID to come on here and say that I got it while wearing a mask, but I don't anticipate that will be the situation where I get it. It's much more likely to be in a situation where I am unmasked. If I get it through an unknown source, I will chalk it up to mask failure. I expect that I will know exactly where I got it, when I do get it.




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For the retrospective efficacy: This was for a test-negative case-control study, which I really don't understand even though I know how it works at a basic level, and I really have no idea how they remove the biases which might be involved. Just seems impossible to me.

Anyway. There are more slides there showing how the bivalent did, comparing VE measured via test-negative case-control, in various other scenarios, as well. And plenty more data on the new vaccine as well - but no efficacy measurements, of course.

ACIP September 12, 2023 Presentation Slides | Immunization Practices | CDC

www.cdc.gov

I haven’t contracted COVID and I’ve been wearing N95 ever since they became available. Initially they weren’t even remotely cheap. Of course being careful, going to the grocery store soon after it opens, etc., and frequent hand washing has likely helped.

 

[AlanSubie4Life]

Promises of availability by end of the week were premature! At least for Moderna.

Anyway, I have my appointment rescheduled for 8:30AM Monday.

It's hard to compare Pfizer and Moderna responses. Moderna appears to have been tested in humans while Pfizer data shows mouse studies. Anyway I'll stick with Moderna I guess.

Looks like there is an enormous rush for these vaccines, for the first two days. Then lots of openings.

 

[DrGriz]

Promises of availability by end of the week were premature! At least for Moderna.

Anyway, I have my appointment rescheduled for 8:30AM Monday.

It's hard to compare Pfizer and Moderna responses. Moderna appears to have been tested in humans while Pfizer data shows mouse studies. Anyway I'll stick with Moderna I guess.

Looks like there is an enormous rush for these vaccines, for the first two days. Then lots of openings.

That's what I would expect. The high risk, the attentive, and the anxious will hit it hard the first few days, then people will get it done at their convenience. Except for fans of {I won't name him, but you all can read headlines}, who is saying don't do it unless you are over 65. Like your birthday is magical.

 

[dhanson865]

That's what I would expect. The high risk, the attentive, and the anxious will hit it hard the first few days, then people will get it done at their convenience. Except for fans of {I won't name him, but you all can read headlines}, who is saying don't do it unless you are over 65. Like your birthday is magical.

I saw a Nurse Practitioner like that when I had an infection once. She prescribed an antibiotic that has a history of major side affects for people over a certain age. I declined to take it because I was that age minus 2.

She was like "but you are under age X" and I'm like "but I'm near age X" and she couldn't see my concern. I had to flat out say I wasn't going to fill the prescription, give me something else and then she did.

She was probably still in the "I'm immortal" phase of life and had no fear.

 

[Tiger]

She was probably still in the "I'm immortal" phase of life and had no fear.

Oh, those were the days!!!

 

[scottf200]

Wife and I got the Fall updated vaccine (and flu shot) a couple days ago. First day/evening I was achy and had the chills. Sleep almost 9 hrs. Second day had a 1.5 hr nap and long nights sleep. Feel normal on the 3rd day.

Our BCBS covered the cost as shown below. We pay a lot monthly tho. It is more than what I've read. Someones making some moola. Hey, I'm happy to get it before our foliage viewing road trip at the end of the month.

 

[bkp_duke]

I saw a Nurse Practitioner like that when I had an infection once. She prescribed an antibiotic that has a history of major side affects for people over a certain age. I declined to take it because I was that age minus 2.

She was like "but you are under age X" and I'm like "but I'm near age X" and she couldn't see my concern. I had to flat out say I wasn't going to fill the prescription, give me something else and then she did.

She was probably still in the "I'm immortal" phase of life and had no fear.

It's more a problem of training. MDs/DOs are trained to understand things are shades of grey and would not have argued with you. NPs are "protocol" trained. Most really have trouble thinking outside of the box, as in this case.

 

[DrGriz]

It's more a problem of training. MDs/DOs are trained to understand things are shades of grey and would not have argued with you. NPs are "protocol" trained. Most really have trouble thinking outside of the box, as in this case.

You would hope that MD/DOs are capable of gray. My younger colleagues don't always follow that. They practice with EMRs that push them to follow the 80/20 algorithm, which neglects the 20. Also, I found out that they aren't necessarily taught to do the "physical" part of a history and physical when I visited one of them the other day.

 

[bkp_duke]

You would hope that MD/DOs are capable of gray. My younger colleagues don't always follow that. They practice with EMRs that push them to follow the 80/20 algorithm, which neglects the 20. Also, I found out that they aren't necessarily taught to do the "physical" part of a history and physical when I visited one of them the other day.

I hated that when practicing. I flunked so many residents when I caught them cuting/pasting their physicals from the prior day.

Protocol medicine is only as good as those people that built the protocol, and that's often . . . lacking.

 

[Tiger]

Some scrutiny on adverse effect reporting COVID vaccine vs others and differences between countries:

 

[DrGriz]

Some scrutiny on adverse effect reporting COVID vaccine vs others and differences between countries:

You need to use better sources of information than this guy. Why do you persist?

He has an agenda that includes misinforming you.

Anyone can submit a report to VAERS. The presence of a report in VAERS does not mean it is vaccine-caused. As noted in the Annenberg report, the CDC says VAERS reports “may contain information that is incomplete, inaccurate, coincidental, or unverifiable.”

To illustrate this point, one doctor famously reported to VAERS that after getting a flu shot, “his skin turned green, his muscles grew and he started having rage problems,” signs that he may have been turning into the Marvel Comics superhero the Incredible Hulk. That report was flagged for its unusual nature, investigated, and removed with the doctor’s consent.

Confusion Over VAERS: Why the Vaccine Safety Reporting System Should Be Renamed | The Annenberg Public Policy Center of the University of Pennsylvania

A report by the Annenberg Public Policy Center explains why the federal vaccine safety reporting system, VAERS, should be renamed.

www.annenbergpublicpolicycenter.org