Lunchtime pandemic reading.
Standard disclaimer: this is a roundup of informative pieces I've read that interest me on the severity of the crisis and how to manage it. 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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Omicron BA.2 is different. "Soon after the emergence and global spread of a new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron lineage, BA.1, another Omicron lineage, BA.2, has initiated outcompeting BA.1. Statistical analysis shows that the effective reproduction number of BA.2 is 1.4-fold higher than that of BA.1. Neutralisation experiments show that the vaccine-induced humoral immunity fails to function against BA.2 like BA.1, and notably, the antigenicity of BA.2 is different from BA.1. Cell culture experiments show that BA.2 is more replicative in human nasal epithelial cells and more fusogenic than BA.1. Furthermore, infection experiments using hamsters show that BA.2 is more pathogenic than BA.1. Our multiscale investigations suggest that the risk of BA.2 for global health is potentially higher than that of BA.1."
Source: https://www.biorxiv.org/content/10.1101/2022.02.14.480335v1
Commentary: In the paper's details, it shows that Omicron BA.2 is able to override BA.1's humoral immunity. BA.2 is a juggernaut against existing immunity, which is why vaccination is not enough if we want to stop spread. We need to continue masking.
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Potential outcomes. "In this worrisome scenario, SARS-CoV-2 evolves to not only evade its human host’s immune response but to actively exploit it. The successive major variants of SARS-CoV-2 so far — Alpha through Omicron — show that the relentless evolution of the virus helps evade the immune system. But some coronaviruses, like the feline infectious peritonitis virus, take evasion to the next level: exploitation.
When a person — or in this case a cat — encounters a virus or receives a vaccine, immune cells begin making antibodies. These proteins bind to the virus and disable it. Paradoxically, antibodies against feline infectious peritonitis virus that are infused into non-immune cats render the animals more susceptible to peritonitis and severe disease than cats that have not been infused with anti-feline infectious peritonitis virus antibodies.
A similar perverse exploitation of the immune system can occur when humans are infected with dengue virus, which is not a coronavirus. A first infection with a dengue-type virus typically produces a self-limited, week-long illness with high fever and muscle and joint pain. The antibody immune response to that first infection renders a person immune to future exposures with that same type of dengue virus. But if the individual later becomes exposed to a dengue virus of a different type, the first infection increases the risk of severe disease instead of providing protection against it. How? In the human body, some cells have receptors for dengue viruses on their surface, while other cells have receptors for antibodies. Antibodies that bind to viruses normally prevent the virus from attaching to cells with dengue receptors. But these antibody-coated viruses can instead bind to, enter, and grow in the cells with antibody receptors on their surfaces. This process is called antibody dependent enhancement of virus growth.
Other coronaviruses that infect humans, such as SARS-CoV-1 and MERS-CoV, have been shown in laboratory studies to be able to exploit bound antibodies as a way to attach to cells and begin to replicate in them. SARS-CoV-2 viruses can also use antibody dependent enhancement to bind to cells with antibody receptors, with the virus having been shown to enter cells and begin to replicate. But in experiments so far, the full viral replication cycle wasn’t completed in test cells.
The worry here is that if SARS-CoV-2 evolves to use antibody dependent enhancement to increase virus growth and transmission, the new variant could explosively retrace its spread through immune populations."
Source: https://www.statnews.com/2022/02/16/coronaviruses-are-clever-evolutionary-scenarios-for-the-future-of-sars-cov-2/
Commentary: The worst case scenario for COVID-19 is that it mutates to become antibody exploitative. How likely is this? We don't know, but we do know that the probability of more concerning mutations is directly proportional to infections. The proportion of infections is inversely proportional to precautions people take such as masks and vaccination.
Thus, while everyone is tired of the pandemic, the only way it ends is through continued vigilance while medical research continues on pan-coronovirus vaccines.
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Vaccination reduces probability of long COVID. "Covid vaccination reduces the risk of developing long Covid, while current sufferers may experience an improvement in symptoms after getting jabbed, a comprehensive review by the UK Health Security Agency suggests.
The “rapid evidence briefing” drew together data from 15 UK and international studies, about half of which examined whether Covid vaccination protected against developing long Covid if someone had never been infected, while the rest looked at the impact of vaccination among people who already had long Covid.
It found that, as well as any benefit obtained by not catching the virus in the first place, those who do catch it are less likely to develop long Covid if they have received one or two doses of vaccine compared with unvaccinated individuals.
According to the two studies that measured individual long Covid symptoms, the fully vaccinated were less likely than unvaccinated people to develop medium- or long-term symptoms such as fatigue, headache, weakness in the arms and legs, persistent muscle pain, hair loss, dizziness, shortness of breath, loss of smell or scarring of the lungs.
“There is also evidence that unvaccinated people with long Covid who were subsequently vaccinated had, on average, reduced long Covid symptoms, or fewer long Covid symptoms than those who remained unvaccinated,” the review said.
There were, however, some people who reported worsened symptoms after vaccination, it added.
Deborah Dunn-Walters, chair of the British Society for Immunology Covid-19 taskforce and a professor of immunology at the University of Surrey, said there was not yet enough information to explain why vaccination should lead to an improvement in people’s symptoms. “The term ‘long Covid’ covers a wide range of post-Covid conditions and so we don’t yet fully understand all the processes involved,” she said.
One theory is that it may help clear up remaining reservoirs of virus in the body, or fragments of virus that are triggering ongoing inflammation. Another possibility is that vaccination rebalances the immune response in individuals whose symptoms are being driven by autoimmune-like processes – this may also explain why a few people report worse symptoms after vaccination, Dunn-Walters added."
Source: https://www.theguardian.com/world/2022/feb/15/vaccination-reduces-chance-of-getting-long-covid-studies-find
Commentary: More reasons to get vaccinated, even if you've had COVID.
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A reminder of the simple daily habits we should all be taking.
1. Wear the best mask available to you when you'll be around people you don't live with, even after you've been vaccinated. Respirators are back in stock at online retailers, too. 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.
2. Verify your mask's NIOSH certification here: https://www.cdc.gov/niosh/npptl/usernotices/counterfeitResp.html
3. Get vaccinated as soon as you're able to, and fulfill the full vaccine regimen, including boosters. Remember that you are not vaccinated until everyone you live with is vaccinated. If you received an adenovirus vaccine (J&J/AstraZeneca), consider getting an mRNA single shot booster (Pfizer/Moderna) if available. If it's available, choose Moderna as your first choice for both vaccine and booster, Pfizer as your second choice. However, remember than any vaccine is better than no vaccine.
4. Wash/sanitize your hands every time you are in or out of your home.
5. 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 the disease through aerosols and distance is less effective at mitigating your risks.
6. Aim to have 3-6 months of living expenses on hand in case the pandemic gives another crazy plot twist to the economy.
7. Replenish your supplies as you use them. Avoid reducing your stores to pre-pandemic levels in case an outbreak causes unexpected supply chain disruptions.
8. 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).
9. Masks must fit properly to work. Here's how to properly fit a mask:
10. If you think you may have been exposed to COVID-19, purchase a rapid antigen test. This will detect COVID-19 only when you're contagious, so follow the directions clearly. https://amzn.to/3fLAoor
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Common misinformation debunked!
There is no basis in fact that COVID-19 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-19 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-19 arrived before 2020 in the United States and therefore no hidden herd immunity:
Source:
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-19 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
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Disclosures and Disclaimers
I declare no competing interests on anything I share related to COVID-19. 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-19, nor do I financially benefit in any way from sharing information about COVID-19.
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A common request I'm asked is who I follow. Here's a public Twitter list of many of the sources I read.
https://twitter.com/i/lists/1260956929205112834
This list is biased by design. It is limited to authors who predominantly post in the English language. It is heavily biased towards individual researchers and away from institutions. It is biased towards those who publish or share research, data, papers, etc. I have made an attempt to follow researchers from different countries, and also to make the list reasonably gender-balanced, because multiple, diverse perspectives on research data are essential.
This is also available as an email newsletter at https://lunchtimepandemic.substack.com if you prefer the update in your inbox.