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Coronamonomania Lives Forever, Part 50

By November 6, 2021Commentary

I believe I said earlier today that the employer mandate was illegal.  At least one federal appeals court has already concluded that this may indeed be the case, granting an order for an emergency stay.

Lot of interesting research today.  Let’s start with some studies supporting what I said in a post today regarding natural infection being more protective than vaccination.  Now this isn’t a direct comparison of previous infection to vaccination, but it is a comparison of whether people who are vaccinated and had a prior infection are less likely to have a breakthrough than those who were not infected before vax.  And we see that indeed breakthroughs are less likely in the infected first, then vaxed group, much less likely.  The study comes from Qatar and is a matched cohort design but likely understates the effect of prior infection since no antibody testing was done.  Being infected a longer period of time prior to vax added to the protective effect.  And the effectiveness of the vaccines did not wear off quickly in those persons who were both infected and vaxed.  (JAMA Article)

And this study helps explain why.  It finds that antibody levels after vax in persons with a prior infection were far higher than those in vaxed people who had not been infected.  (JAMA Article)

And now for a brief interlude of non-vaccine research.  Why do epidemic waves assume the shape they do–relatively sharply up, brief peak and sharply down.  This paper assesses that question.  The theory is based on extensive modeling of various contact patterns that might explain an epidemic curve shape.  They find that only a model in which a few people with a large number of contacts (and likely a high susceptibility to infection and large viral loads) get infected early on and become superspreaders can mimic the actual shape of curves in most geographies.  When the pool of superspreaders becomes significantly tapped, the epidemic wave collapses relatively quickly as well.  Not sure I completely agree with the model or conclusions and it doesn’t explain why a wave begins in different places at different times, but it does make sense that if a few people are both more susceptible and have large numbers of contacts, they are a driving factor in curve shape.  (Arxiv Paper)

Follow-up period is important when assessing vaccine effectiveness, as we know it lessens over time.  This study finds a significant protective effect of the mRNA vaccines against hospitalizations and deaths, but the follow-up is fairly short for many of the participants, and among those for whom it was longer, protection was lower.  (JAMA Article)

This study from the VA continues to indicate that vaccine effectiveness against infection does indeed lessen significantly after a few months, as does protection in those over age 65 against death, although that remains stronger than does protection against infection.  From February to October 2021, effectiveness against infection dropped to 58% for Moderna, 43% for Pfizer and a whopping 13% for J & J.  Effectiveness against death in those over 65 had dropped to 75.5% for Moderna, 70% for Pfizer and 52% for J & J.  For some bizarre reason, death here is all cause death, not CV-19 caused death, which introduces more opportunities for confounders.  And note that protection against death steadily dropped over time, so likely continues to fall.  All analyses were adjusted for age and other important factors.  (Science Paper)

This paper from Finland finds what every other study is noting, the vaccines lose effectiveness against infection rapidly after a few months, but in this study among health care workers, protection against death remained strong.  (Medrxiv Paper)

And this metareview and meta-analysis of studies on vaccine effectiveness comes to the usual conclusions about intitial effectiveness against infection, hospitalization, and death.  (Medrxiv Paper)

Identifying who may be at higher risk of infection can be helpful and researchers are still working on that.  This paper involved a number of infected, and not vaccinated persons, in the UK.  In addition to the well-understood risk posed by obesity and to some minorities, higher alcohol consumption and less physical exercise were also associated with greater risk of infection, likely due to the impact on the immune system.  (Medrxiv Paper)

Another benefit of closing schools and telling kids to stay home, average screen time doubled to 7 hours a day.  This has been repeatedly shown to not be good for their mental or physical health.  But don’t worry, we must have prevented at least 2 people in this age group from dying from CV-19.  Our public health experts don’t care at all about the public health.  (JAMA Article)

Join the discussion 7 Comments

  • rob says:

    What do you make of this story from NYT about all the deer in Iowa with Covid?

    • Kevin Roche says:

      Many animals are coronavirus reservoirs. I doubt there actually is much if any transmission from deer to humans or vice versa, especially if the deer are masked.

  • Abhijit Bakshi says:

    Actually it has repeatedly been shown that *double* masking is required for deer, especially when they’re outside.

  • Tim W says:

    It might be a bit over-blown. The study used ThermoFisher TaqPath kit; all PCR. Looking at their materials, it runs to 40 cycles.

    Remember the U of M Duluth study that detected traces of CV in Lake Superior water?

  • Wendy says:

    Another issue with the high screen time for our children is it affects their vision, I skimmed the JAMA article but didn’t see that as a consideration. Unfortunately for my son he inherited bad eye genes so his vision problems are not CV related but we spend a lot of time at his eye doctor’s office. Some things we do to help slow the progression of his degrading visions (1) outdoor time we try to hit 11-14 hours a week but in the north east it is difficult to do over the winter but we try. Additionally there is some mild benefit to sitting near windows so we have him place near the window in his classroom. (2) limit screen time no more than 2 hours at a time. This is not happening for many kids, as Kevin noted screen time is up, and for some the out door time the get is in elementary school for recess which may be 30 minutes.

    During one of our visits the eye doctor said his office is seeing a lot more kids needing glasses it started to tick up in the middle of 2020 and has continued.

  • J. Thomas says:

    AB, you are very tough competition for the ‘sarcasm’ award on this blog !! A+ for ‘double masked deer’ …

    I’ve ask a couple time about the direction of ‘testing’ with the PCR changes Jan 1, FDA home kit support and the OSHA ‘mandate’ opt out testing clause. Does anyone know what’s going on with future testing ?

  • Abhijit Bakshi says:

    Well the credit goes to Kevin as it was his joke. And to be honest, it made me laugh out loud. A subtle Rochean dig. I may not always agree with Kevin but I recognize a good joke when I see one!

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