Lunchtime pandemic reading.
Standard disclaimer: this is a roundup of informative pieces I've read that interest me on the severity of the crises and how to manage them. I am not a qualified medical expert in ANY sense; at best I am reasonably well-read laity. ALWAYS prioritize advice from a qualified healthcare provider who knows your specific medical situation over advice from people on the Internet.
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It's been a minute, but some new research has come out that's worth sharing.
"There is little evidence available about the risk of post-acute sequelae of COVID-19 (PASC or long COVID) with regard to COVID-19 reinfection. This is largely because reinfection was substantially less common during the pre-Omicron era, and PASC outcomes appeared to be less common on an epidemiological level after Omicron (compared to pre-Omicron) infection (Fernández-de-las-Peñas, December 2022). However, an analysis of adults 50 years and older identified that PASC outcomes were more common in individuals with Omicron reinfections, compared to Omicron primary infections. This finding was supported by a recent report from the National COVID-19 Cohort Collaborative, which identified an increased risk of PASC after Omicron BA reinfection compared to Omicron BA primary infection. Additionally, the absolute number of PASC outcomes has risen substantially in the Omicron era due to much higher numbers of infections, compared to the pre-Omicron era (Boufidou, August 2023). As reinfections continue to occur in the Omicron era, clinicians and patients should be aware of the potential risk of PASC outcomes after COVID-19 reinfection.
Research also suggests that individuals with PASC outcomes after a primary COVID-19 infection may have reduced levels of neutralizing antibody, compared to individuals without PASC outcomes after their primary infection (Su, March 2022). This could predispose some individuals with a history of PASC to reinfection."
Commentary: There are two key takeaways. First, if you've had long COVID, you may be predisposed to reinfection. Thus it's important to keep up with boosters as well as mask as often as you can in public indoor places. Second, long COVID seems to become more probable the more times you are reinfected. The more you can prevent reinfection, the healthier you will be in the long run.
"One in ten severe acute respiratory syndrome coronavirus 2 infections result in prolonged symptoms termed long coronavirus disease (COVID), yet disease phenotypes and mechanisms are poorly understood1. Here we profiled 368 plasma proteins in 657 participants ≥3 months following hospitalization. Of these, 426 had at least one long COVID symptom and 233 had fully recovered. Elevated markers of myeloid inflammation and complement activation were associated with long COVID. IL-1R2, MATN2 and COLEC12 were associated with cardiorespiratory symptoms, fatigue and anxiety/depression; MATN2, CSF3 and C1QA were elevated in gastrointestinal symptoms and C1QA was elevated in cognitive impairment. Additional markers of alterations in nerve tissue repair (SPON-1 and NFASC) were elevated in those with cognitive impairment and SCG3, suggestive of brain–gut axis disturbance, was elevated in gastrointestinal symptoms. Severe acute respiratory syndrome coronavirus 2-specific immunoglobulin G (IgG) was persistently elevated in some individuals with long COVID, but virus was not detected in sputum. Analysis of inflammatory markers in nasal fluids showed no association with symptoms. Our study aimed to understand inflammatory processes that underlie long COVID and was not designed for biomarker discovery. Our findings suggest that specific inflammatory pathways related to tissue damage are implicated in subtypes of long COVID, which might be targeted in future therapeutic trials."
Source: https://www.nature.com/articles/s41590-024-01778-0
Commentary: What's important here is that long COVID seems to be hinting at not just one condition, but a series of conditions that affect different parts of the body. Thus, one person's long COVID may not resemble another person's. This is critically important as doctors try to diagnose it, because there isn't one uniform "long COVID condition" that is easy to diagnose. It's more complicated. You might have cardiorespiratory long COVID, or you might have gastrointestinal long COVID, or neurological long COVID. Like so much of this disease, its after effects are confounding. Prevent it as much as you can, and if you're suffering from SOME of the symptoms of long COVID but not the majority, you'll still probably want to ask your healthcare provider about it.
A reminder of the simple daily habits we should all be taking.
Wear the best mask available to you when you'll be around people you don't live with, even after you've been vaccinated. P100 respirators are back in stock at online retailers, too and start around US$40 for a reusable respirator. Wear an N95/FFP2/KN95 that's NIOSH-approved or better mask if you can obtain it. If you can't get an N95 mask, wear a surgical mask with a cloth mask over it.
Verify your mask's NIOSH certification here: https://www.cdc.gov/niosh/npptl/usernotices/counterfeitResp.html
Get vaccinated as soon as you're eligible to, and fulfill the full vaccine regimen, including boosters. Remember that you are not vaccinated until everyone you live with is vaccinated. There are new vaccines available now in addition to the boosters we already know that may be more efficacious and tolerated better, so talk to your healthcare provider about which vaccine or booster is the best choice for you.
Check COVID dashboards to see how prevalent it is in your region. Focus especially on wastewater reporting. A couple of useful dashboards:
In areas of above-average prevalence, stay out of indoor spaces that aren't your home and away from people you don't live with as much as practical. Minimize your contact with others and avoid indoor places as much as you can; indoor spaces spread disease through aerosols and distance is less effective at mitigating your risks.
Aim to have 3-6 months of living expenses on hand in case the pandemics give another crazy plot twist to the economy, or you know, a global war breaks out.
Replenish your supplies as you use them. Avoid reducing your stores to pre-pandemic levels in case an outbreak causes unexpected supply chain disruptions.
Ventilate your home as frequently as weather and circumstances permit, except when you share close airspaces with other residences (like a window less than a meter away from a neighboring window).
Masks must fit properly to work. Here's how to properly fit a mask:
If you think you may have been exposed to COVID, purchase several rapid antigen tests and/or acquire them from your healthcare provider or government. This will detect COVID only when you're contagious, so follow the directions clearly. https://amzn.to/3fLAoor
Remember, you are not clear until you take 2 tests that are negative, 24 hours apart.
Common misinformation debunked!
There is no basis in fact that COVID vaccines can shed or otherwise harm people around you.
Source: https://www.reuters.com/article/factcheck-covid19vaccine-reproductivepro-idUSL1N2MG256
There is no mercury or other heavy metals in the Pfizer mRNA vaccine.
Source: https://www.technologyreview.com/2020/12/09/1013538/what-are-the-ingredients-of-pfizers-covid-19-vaccine/
There is no basis in fact that COVID vaccines pose additional risks to pregnant women.
Source: https://www.nejm.org/doi/full/10.1056/NEJMoa2104983
There is no genomic evidence at all that COVID arrived before 2020 in the United States and therefore no hidden herd immunity:
Source:
https://twitter.com/trvrb/status/1249414291297464321
There is no evidence SARS-CoV-2 was engineered, nor that it escaped a lab somewhere.
Source: https://www.washingtonpost.com/world/2020/01/29/experts-debunk-fringe-theory-linking-chinas-coronavirus-weapons-research/
Source: https://www.nature.com/articles/s41591-020-0820-9
Source: https://www.nationalgeographic.com/science/2020/05/anthony-fauci-no-scientific-evidence-the-coronavirus-was-made-in-a-chinese-lab-cvd/
Source: https://www.smh.com.au/national/are-we-ignoring-the-hard-truths-about-the-most-likely-cause-of-covid-19-20210601-p57x4r.html
There is no evidence a flu shot increases your COVID risk.
Source: https://www.factcheck.org/2020/04/no-evidence-that-flu-shot-increases-risk-of-covid-19/
Source: https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciaa626/5842161
Disclosures and Disclaimers
I declare no competing interests on anything I share related to COVID or other communicable diseases. I am employed by and am a co-owner in TrustInsights.ai, an analytics and management consulting firm. I have no clients and no business interests in anything related to COVID or other communicable diseases, nor do I financially benefit in any way from sharing information about COVID or other communicable diseases.
I am not a qualified healthcare provider and I do not provide medical advice. Only take medical advice from your qualified healthcare provider who knows your specific details and can provide customized recommendations for you.