I keep watching for signs that the world is leaving coronamonomania behind, but it isn’t clear that is happening. Here is an excellent overview article looking at the suppression efforts and lockdowns in particular. This truly was an unprecedented and unjustified approach. (Tablet Article)
Even the NYTimes is allowing op-eds wondering what the heck our goals really are. (NYTimes Article)
I am extremely concerned about the public communication, as usual, because in the next few weeks, breakthrough infections are going to become the majority of cases, and the proportion of hospitalizations and deaths will get higher as well. The public has not been properly prepared for this and it has not been put in context for the public, so there will be freaking out, which will likely be exacerbated by the media terror-lovers. There needs to be an exit plan and the biggest part of that plan needs to be stopping the endless reporting of meaningless data, like case numbers, and a far better education of the public on what to expect.
I am dubious about the entire booster idea, because it is not clear to me what the purpose is or that there is any data that a booster will have a longer impact than the original vaccination. Israel is the first country to really push the boosters, and this study looks at that effort. (Medrxiv Paper) The researchers created comparative cohorts of people with two doses but no booster and those who received the booster. The booster cohort had a much lower rate of infection, but this could be due to such a short follow-up period. And there may be some selection factor at work in who got the boosters that exaggerates effectiveness.
This study also examined a third shot of Pfizer in Israel. (Medrxiv Paper) According to this paper, in the short term there was a 70% to 85% effectiveness in preventing infection after a booster.
And why is Israel pressing for boosters? Because of the perception that the protection from the vaccines is lessening within a relatively short time. This study examined that effect and found that over 6 months, the protection against infection did decline significantly. (Medrxiv Paper)
More bad news for vaccine effectiveness over the long haul in this study from a large medical school in California. 83% of the staff had been vaccinated. From March 1 to July 31 there were 227 infections. 130 of these were in the fully faxed and 84% were symptomatic, but they used a really liberal (it is California) definition of a symptom. 88% of the unvaxed cases were symptomatic. These were largely Delta cases, the terrifying variant, so look all of one case was hospitalized, in an unvaxed person, with no deaths. So let’s see if my math is right, that is a 0% hospitalization rate and a 0% death rate in the vaxed group. The efficacy of the vaccine was calculated at 90% until June and then plunged to 65.5%, which seems a little unbelievable. People with prior infection were excluded from the study, but only if they had a PCR test, so could be a number in the unvaxed group that had been infected. Here is my big takeaway–if you geniuses are going to do these studies, why are you leaving out the PCR test cycle numbers, which would help us ascertain if any of these cases were actually infections. (NEJM Article)
This article in Nature also deals with the durability of antibody response stemming from infection and/or vaccination. The researchers found a decline in levels after three months and reduced effectiveness against variants. Again one weakness here is only looking at antibody levels. The study was also small, only 27 people, half of whom had an infection prior to vaccination and half who did not. Only four of the people who were found to have existing antibodies from infection had had a positive PCR test, giving you a sense of the number of undetected cases. The antibody levels after vax were about 4 times higher among those with a prior positive PCR test, indicating likely symptomatic infection, than those with a prior asymptomatic infection and those with no prior infection. (Nature Study)
Another study examining the potential effect of prior seasonal coronavirus infections on CV-19. (Science Article) The researchers found that a significant part of the population had helper T cells that derived from seasonal coronavirus infections and that reacted and prompted an immune response to CV-19. The authors say this likely explains why so many people have mild and asymptomatic infections. They further found that these cross-reactive T cells were activated by vaccination. The primary target of these T cells was the spike protein. The presence of thse cross-reactive T cells declined by age, which is also consistent with more severe illness in older age groups.
READ THIS: People keep calling the Delta variant much more transmissible. That is very likely untrue. This article gives as good an explanation as you will get about why. I will stick by my projection that ultimately Delta will be shown to be only marginally more transmissible. (CPSI Article)
And today I will finish up with the bad news. A study from Kaiser in California on mental health and suicide issues among teenagers. They were up significantly, especially among females, and were more prevalent among youths who did not have prior mental health issues. (JAMA Study)