Coronamonomania Lives Forever, Part 36

That Biden economy is just humming along, creating tons of inflation and little growth.  I was early in my stagflation prediction this spring, but it is getting here.  The Fed has done yeoman’s work keeping interest rates low, but nobody believes the “temporary” inflation bullshit anymore so rates are headed up.  And true growth is non-existent.  Just a debt-fueled spending binge.  Ten-year Treasuries are back over 1.5% and I don’t think they will retreat this time.  We are in for some misery, price increases outpacing wage gains and a cycle of people demanding more pay increases, which only fuels inflation further.  And nincompoops in charge of the economy who don’t understand how to create growth, productivity or real standard of living gains.  Yippee, hang on tight.

A couple of non-vaccine studies first.  This one purported to study relative transmissibility of Delta and Alpha in New England.  The study purports to find that Delta results in higher viral loads and greater rates of transmission but the authors note the host of limitations which cast doubt on the accuracy of these comparisons.  In particular there was enormous variability in the supposed advantage in transmission across the six states included in the study, which strongly suggests that population and testing characteristics not viral characteristics are responsible for the apparent difference.  (Medrxiv Paper)

Next a study from Norway on school-related transmission.  There was limited transmission in schools, with slightly more staff to staff transmission than student to student spread.  Most schools with an index case reported no transmission.  It would appear likely that many of these index cases were false positives to begin with, given the low prevalence.  Please also note that masking was not used in primary schools and was only introduced late in the epidemic in secondary ones.    (Medrxiv Paper)

Next up, rural America, despite low population density, has been hit fairly hard by the epidemic.  According to this study, hospitalizations and deaths, even on an adjusted basis, have been significantly higher in the rural population.  But since this group is whiter and older than the general population, no need to worry about equity or inclusion or disparities.  (Medrxiv Paper)

Here is the latest release on variants of concern from the UK public health authorities.  I am most interested in viral load and transmissibility differences from previous strains.  A separate report on vaccine surveillance indicates that rates of infection between vaxed and unvaxed groups in Delta seem to be catching up, although again, this data does not adjust for prior infection.  In regard to transmissibility, this report notes that the household contact rates in particular seem to vary over time, which variance itself suggests that the population and other factors account for the apparent difference in transmissibility, not characteristics of the virus itself.  See Figure 10.  Most notably, for both Alpha and Delta, rates of household transmission, which appeared high at the start of their respective waves, declined over time.  What we very, very clearly see, is no difference in transmission rate between Delta and Alpha.  See Table 4.   (UK Data)

This is a very vaccine heavy day.  First up in this category a study on boosters, the latest thing that will save us all.  This one again is from Israel, the canary in the coal mine for vaccine effectiveness concerns and early booster adopter.  According to this study, the boosters boosted effectiveness substantially, both against infection and against serious disease, but we thought the vaccines looked great early on too.  I am withholding judgment til we are 6 months out on the boosters.  (Medrxiv Study)

Comparisons of antibody response following vaccination or infection are appearing rapidly.  In this one, the basic finding is that infection creates a broader response, one that is less likely to be evaded by new variants.  (Medrxiv Paper)

And this is a similar study, with a focus on the differential response to mRNA vaccination in infected versus uninfected persons.  The followup period was short.  The Moderna vaccine induced a stronger antibody response, in general, probably because it is a higher dose.  The previously infected group had a stronger antibody response, consistent with all the research I have seen.  (Medrxiv Paper)

Another variant of this research, again assessing response in elderly versus middle-aged vaccinees.  The very old were once more found to have muted antibody responses, but the presence of T helper cells reactive to spike protein prior to infection aided in a much stronger response even among this group.  The authors claim that vaccination induced stronger response than did prior infection, but the timing differences make this assertion not as credible.  Notable also is that response appeared stronger in blood antibodies than those in the mucosal system of the upper respiratory tract.   (Medrxiv Paper)

And nursing home resident responses to vax are also intensely studied, given that this is such an at-risk group.  In this research, antibody and T cell levels were assessed and the follow-up period averaged 6 months.  A subset of the residents had been infected prior to vaccination.  The lessening of anitbody levels over time was notable, but was far less frequent or intense in those with prior infection.  A similar trend was observed in regard to T cells.  Nonetheless, most residents had a detectable response at the 6 month follow-up.   (Medrxiv Study)

Healthcare workers received the vaccines early on, so longer follow-up periods are available.  This is more research into infectons following vaccination in this group.  The authors conducted a meta-review and analysis, concluding that there was significant protection against both infection and hospitalization, but there also was wide variation across the studies and the authors did nothing to assess the now well-established finding that protection lessened over time.  (Medrxiv Paper)

This retrospective cohort study assessed infection rates following vaccination by comparing the vaccinated with an unvaccinated cohort.  Breakthroughs were more likely with Pfizer than with Moderna, but effectiveness against infection lessened with time (how many times have we heard that now).  Overall, 16% of the vaccinated experienced an infection, and the rate rose most rapidly at around 4 months following vaccination.  Effectiveness against death remained high.