The briefing yesterday was blah, blah, blah, more of the same. It is getting better, but still be frightened. Watch out for variants, cases are inching up. I would bet a lot of money that if we saw the actual test results we would identify many false and low positives, given the levels of testing among asymptomatic persons. So I don’t think cases are inching up, I think false and low positives are inching up and accounting for an increasing proportion of so-called cases. And the Director of Infectious Disease repeats the extremely dangerous and misleading notion that reducing transmission is good because it limits mutation opportunities. That is very wrong and unbalanced. Limiting transmission may sound good from a mutation perspective, but as I have noted before, the countervailing concern is that the more you try to suppress spread, the more you are creating an environment for favorable selection of more infectious variants. You want a little balance here.
I mentioned last week that the Federal Reserve, despite its best efforts, does not control interest rates and that they were headed higher, much higher, as the Treasury unloads massive amounts of new debt, which the Fed cannot take all of. And sure enough, after the Fed meeting, at which it sought to tell people that it would keep rates low for a long-time, rates are making a big move up. Stay tuned; the market knows bullshit about inflation and market debt capacity when it hears it. Eventually the rise in rates will sock the stock market and growth as well.
I will increasingly use these summaries to take on the key areas of terrorization and bad policy, like variants, vaccines, and masks and school closings.
More on schools to start. First a study from New York on school transmission. (Peds. Article) Over 230,000 people were tested; .4% were positive, a lower rate than in the community. Of over 36,000 contacts of a case, only .5% became infected, and of those almost 80% had an adult as the index case. Pretty clear students don’t play any significant role in transmission.
Next, a paper estimating the global damage we have done from school closures. (Note that people aren’t even pretending anymore that virtual schooling is a legitimate option.) (WB Observer) The article finds that across 174 countries, children could lose from a third to a year of schooling. Up to 11 million children may simply drop out of the education system. The poor and minorities get hurt worse. This results in a substantial drop in earnings for students and a drop in economic output.
Finally a study from the American Institute of Economic Research reminds us that CV-19 causes basically no deaths among children but suicide is a serious issue and suicides are up as a result of shutting down schools and social life for children. (AIER Study)
More evidence of mask problems. A study among health care workers, who obviously have to wear these virus collection devices for extended periods of time, finds that 80% experienced some symptom as a result. (Mask Study) The study was comparing medical masks and N95 ones and found no difference between the two.
How likely is reinfection with CV-19, which for a while last fall was a major point in the terror campaign. Here are a couple of studies on the topic. The first comes from Denmark and covers over 11,000 people who were positive in a first wave of testing and were retested during the second wave. Among people who had been positive in the first wave, a new infection was identified in .65%. Among people who were negative in the first wave, a new infection was identified in 3.3%. So prior infection was deemed protective 80% of the time. Significantly lower protection appeared to exist among the elderly. The level of protection is likely higher because some of the repeat positives may reflect lingering RNA from the first infection. And there was no information on severity of the second infection; it likely was much less severe. (Lancet Study)
And this study came from one large health system in Ohio and included over 150,000 patients who were tested. Again, those who had been infected were far less likely to be positive on a subsequent test. (Ohio Study) Protection against reinfection was estimated at over 80% and against symptomatic infection at almost 85%. These authors did note the likelihood that some apparent reinfections were due to lingering RNA.
This study on vaccine efficacy came from Tennessee and is similar to the work DD is attempting, with Minnesota’s much worse data. (Medrxiv Paper) Comparing case and outcome rates and trends based on vaccination levels in various age groups, the authors found a substantial decrease among the elderly who were being vaccinated first and that this decrease let to an overall decline in hospitalizations and deaths.
And this study on vaccine efficacy came from Israel. (Medrxiv Paper) Looking at the Pfizer vaccine, they found that effectiveness began around day 12 after injection and reached a plateau about 35 days after inoculation. This is a good reminder that adaptive immunity, by infection or by vaccine, takes a while to fully develop, so widespread vaccination may not have an immediate effect, but eventually it will. In this study, the vaccine was found to be 91% effect against any infection and 99% effective in preventing symptomatic ones. Pretty darn good. Unfortunately, there was a decline in effectiveness with age and in people with certain comorbidities, like diabetes. So less protection for the most vulnerable.
And yet another study buttresses the finding that we have a lasting and persistent adaptive immune response. While circulating antibodies may wane, the number of memory B cells tends to grow and is very persistent. Those memory B cells are far more important. So relying on antibody surveys without also looking at B memory cells gives a very misleading picture of immune response. (Cell Paper)
One more along those lines, I will soon stop mentioning these as it is pretty clear to me that the jury is in on adaptive immunity. (Medrxiv Paper) This study, importantly, followed hospitalized patients with moderate and severe disease for up to nine months. It found a very robust immune response, including memory B cells and T cells.