I hate the Minnesota coronavirus briefings. On Wednesday we just got more of the same. The emails revealed in the youth sports lawsuit show exactly how messaging-driven these people are. They don’t care about data or science, they just care about terrifying people and justifying actions they already decided to take, regardless of any data or science to support it. Guilt people about getting vaccinated, while making no changes in their freedom to engage in activities. Lie about supposedly more severe illness rates among younger groups. Spend an inordinate amount of time talking about “equity” in vaccination, pretending that it is about access, when the truth is that among minority populations failure to get vaccinated is a reflection of some of the same individual lack of responsibility we see across health care, where there is a failure to engage in healthy behaviors. The campaign to get people vaccinated needs to focus on those behavioral issues. You could have vaccine dealers standing on every corner in minority-heavy neighborhoods and you wouldn’t get much more uptake if you don’t change behavior. You can talk about equity til you are blue in the face, but that won’t change behavior.
I know people are freaking out about India and there clearly is a seasonal case surge there. But this country is almost as large as China, almost 1.4 billion people live there. On a per capita basis, and that is the only way to track things, it isn’t that bad, even compared to other countries. You always have to frame data the right way to understand what it is telling you.
Kind of an immune system heavy set of summaries today. The first is another study on the immune response to infection. (Medrxiv Paper) 48 infected individuals were included in the study and tracked for six months. All had antibodies within two months of infection, and those antibodies persisted for the full six months. Spike protein elicited the strongest antibodies, and most people had antibodies in their nasal cells.
And here is another study analyzing adaptive immune responses to infection. (Medrxiv Paper) This research covered over 250 patients with 8 months of followup. While some antibodies waned, memory B cells strengthened early on and remained strong. Strong T cell responses were also noted, with the helper T cells tending to target spike protein, and killer T cells the nucleoprotein.
And this study focused on the immune response to vaccination. (Medrxiv Paper) Development of spike protein antibodies following two doses of the Pfizer vaccine was tracked in 118 persons. Antibodies spiked after the first and second dose, but waned slightly at 6 weeks after the second dose, although remaining higher than in people who had recovered from an infection. The waning was more pronounced in older men. Older persons had fewer side effects from vaccination, which may reflect their less active immune systems.
The next study attempts to ascertain why certain people remain asymptomatic and others develop disease. (Medrxiv Paper) The authors sought to identify gene expression differences between the two groups. Those who remained asymptomatic actually appeared to have lower expression of certain innate immunity biochemicals, particularly interferon signaling molecules, suggesting that over-active immune responses may actually facilitate disease.
And here is one paper not relating to immune response, but about modeling. (Medrxiv Paper) Acknowledging the poor performance of most models, the authors sought to figure out why. The looked at data from Brazil, India and Sweden. Their analysis suggested that the most plausible explanation for the epidemic course was that around 45% to 60% of the population may have some immune response that limits their ability to be infected.
And a study from Italy notes that it had lots of excess deaths, many of which appear unrelated to CV-19. (BMJ Paper) The study was done in Italy in a region very hard hit by CV-19 last spring. It compared mortality the first half of 2020 with the prior five years. The region experienced excess mortality beginning in March of 2020, peaking at a high rate in April, declining to actually go below historical averages in June, before beginning to swing back up in July. The excess mortality was almost all in the over 75 age group. About one-third of the excess mortality was not related to CV-19 deaths, which the authors suggest was due to potential under-reporting of CV-19, but I suspect is more related to lockdowns, missed health care, etc.
Obesity is clearly linked to worse outcomes for CV-19 infections. This paper confirms that finding. (Lancet Article) This was a large study in the UK which showed that increasing weight was associated with more hospitalizations and deaths and that the effect was strongest among young people and minorities.