So much nonsense, so little time.
Here is a funny, funny story from Oregon. Doctors there are puzzled because, shockingly, the mask mandate–indoors, outdoors, by yourself, when you sleep, when you eat, and please stop breathing altogether–and other measures don’t seem to be having any impact on cases. Hmmm, you are supposedly smart people, all that medical education, I wonder if the appropriate conclusion to draw might be that they don’t make any difference in spread. Naaahhhh, that would be too obvious. (Oregon Story) Oh, and a physician notes that one of the reasons the hospitals are so full is that they are seeing seriously ill people who deferred needed care during the epidemic. Victims of the terror campaign.
As usual, any signs of sanity come from Europe. Here is a story, obtained off Twitter because I don’t read German, that the German government will no longer test and send children home from school just because they may have been exposed, but only test them if they have symptoms and send them home if they are positive. In the US we are going the other way. (Twitter Thread)
Here is another really good thing we did for our children–helped them all gain weight, as if we needed more of that. Excess weight in children is especially bad, it sets up a lifelong pattern of fighting against it and as in adults, creates a predisposition to diabetes, heart disease, hypertension and other problems. And of course, obesity appears to be the primary risk factor for more severe CV-19 disease. Even before the epidemic, an alarming 39% of children were overweight or obese. Among 5 to 11 year olds, this rose from 36% to 46% during the epidemic and older children saw an increase as well. (JAMA Article)
A number of people actually get CV-19 in a hospital, of course, we don’t know how many because the state of Minnesota and governments in general won’t tell us, although they have the data. This study from the UK found that a few patients were responsible for most of the spread within a facility, and that patients infecting other patients was more common that staff spreading the virus in a hospital, although about a fourth of infections were from health care workers to other health care workers or to patients. Cycle numbers were not noticeably different in superspreaders versus those with less transmission. In an impressive demonstration of the 80/20 rule, around 20% of patients accounted for 80% of cases within a hospital. And the study demonstrates that cases arising in a health care setting are not uncommon. This should be broken out in the data. (eLife Study)
One question about vaccines is whether they prompt a significant adaptive immune response in the mucosal tissues of the upper respiratory tract, since that is where most people are initially exposed to the virus. This study reports on a vaccine in the form of a nasal spray, which did appear to prompt a strong adaptive immune response in those tissues in an animal study. The next generation of vaccines is likely to be better in a variety of aspects, and a nasal spray would help those who are needle-phobic. (Medrxiv Paper)
How do vaccines perform in the elderly, particularly against the dreaded Delta variant. This study compared older vaccinees to younger health care workers. Neutralization of Delta was lower in the elderly, which is what you would expect from general experience with vaccines in the older population. But still at 6 months after vax, around 60% were capable of neutralization, compared to 95% of the health care workers. T cell reactivity was also reduced in the older vaccinees. (Medrxiv Paper)
This large trial in Israel examined the safety profile of the Pfizer vaccine. (NEJM Article) In addition to examining rate events in vaccinated persons, they performed a similar analysis in regard to infected patients. Vaccination was associated with an increased risk of myocarditis and had a very slight association with some other adverse events. Being infected, however, had a far stronger association with myocarditis and was associated with many more serious complications. So stick in that in your risk/benefit analysis on getting vaccinated.
Some people were infected over a year and a half ago, so we should have a better sense of how long antibodies and other immune responses to that infection last. According to this study, in a small cohort of health care workers, measurable antibodies often disappeared by 6 months after infection, although most people retained them. No examination of other immune cell types. (Medrxiv Paper)
And why do we get such mixed research findings on antibody prevalence. As we have noted before, it likely is because the diagnostic tests used to find antibodies are wildly variable and probably not all that accurate. This study examined the performance of multiple assays and found substantial differences in measurement. The authors recommended greater standardization of output measures. (Medrxiv Paper)
People are still trying to sort out the impact of prior seasonal coronavirus infection on likelihood of infection and severe disease with CV-19. This research compared persons who were not infected, persons who were not infected although they cared for family members who were infected, persons with mild disease and people with severe disease. It is a small study, but the presence of seasonal coronavirus antibodies was associated with less likelihood of severe disease. (JID Study)