Coronamonomania Lives Forever, Part 173

We are seeing reports from around the country that there is a sharp uptick in various respiratory virus infections, particularly in schools.  This was the predictable result of keeping kids out of school and away from lots of other children and from the general decline in social contacts among everyone.  We need to swap germs frequently to keep out immune systems in top shape.  And people’s health has deteriorated as well–we gained weight, we got less exercise, we were stressed.  From early on I pointed out that this would be one of the clear stupid outcomes of the epidemic response and was part of the failure to consider the true public health.  So for some time we will all likely have a greater risk of serious illness from other bugs.

Two new articles from the principals at the Centre for Evidence-Based Medicine help understand the poor outcomes resulting from the epidemic response.  The first discusses the excessive infection fatality ratios which drove the extreme epidemic response.  As has now become apparent, the death rate from CV-19 is actually similar to that from influenza.  (IFR Article)

The second article discusses the epidemic in nursing or long-term care homes.  As we know, these facilities took a substantial hit early in the epidemic, with so many vulnerable people in close proximity.  But the response of isolating them also took a toll, worsening mental health and leading to deaths from that isolation.  Another example of failing to consider the overall public health.  (CEBM Article)

Japan has an excellent health care system, but even there during the epidemic cardiac arrest outcomes worsened, with delays in receiving care leading to greater mortality.  (Medrxiv Study)

This very large study from England has been cited by some for supposedly saying that vax effectiveness against hospitalization or death became negative; i.e. a vaxed person actually was more likely to be infected.  That is not what it says.  One dose of vaccine did lose effectiveness quickly, but two doses of Pfizer retained protection out beyond 3 months, although that protection had lessened.  The negative effectiveness of a single dose the authors attribute to behavior changes, but I would think is more likely due lack of ascertainment of prior infection status and to unidentified health issues.  Those who only received one dose of vaccine may have been more fragile and experienced health issues leading to failure to receive a second dose.  (JE Study)

The never-ending saga of attempting to disentangle the protection from vax versus prior infection in a population where the vast majority have both sources of potential immune response continues.  The study was done in a prison population and indicates that both sources of protection lessen pretty quickly and may be less effective against more recent variants.  But prior infection clearly offers good protection, although it is augmented by vaccination.  Being infected during Delta offered better protection than being infected with earlier strains.  (NEJM Study)

And this study from Qatar similarly finds that in regard to infection with the most recent Omicron variants, prior infection with a non-Omicron strain offered limited protection.  Prior infection with any Omicron strain offered fairly good protection.  Vaccination improved protection.  But in all cases it appears that the immune response lessens over time.  (Medrxiv Paper)

I have made it pretty clear I see no reason to vax children, because they are at extremely low risk of serious disease and at this point they have almost all been infected anyway.  But I also am dubious about claims of large numbers of safety issues in children.  This study uses large claims databases contracted by the FDA for pharmacovigilance, which I have written about before, to do real-time monitoring of vaccine receipt in 5 to 17 year-olds.  Sorry vax safety conspiracists, no significant number of adverse events, other than the now well-known uptick in heart inflammation cases, but limited to 12 to 17 year-olds.  Out of over 3 million children vaxed, there were a total of 153 heart inflammation cases by claim data, and on medical chart review of 37 of those cases, 27 were verified to actually be heart inflammation and 19 resulted in hospitalization, for a median of about 2 days.  But let me also repeat, I wouldn’t vax a child, simply no reason to do so.  (Medrxiv Paper)

Bell’s Palsy is a facial muscle disorder which is linked to both CV-19 infection and vax.  This meta-analysis concludes that while vaxed persons have a higher than background incidence of Bell’s Palsy, the rate among infected persons is even higher.  (Medrxiv Paper)

This study from Japan finds that recent Omicron variants result in infections with lower viral loads, meaning that the apparent greater infectivity of these variants must be due to factors like immune system evasion or other characteristics enhancing transmission.  (Medrxiv Paper)

The role of vitamin D in regard to susceptibility to infection and course of disease has been debated and studied.  This study from Spain suggests that persons with vitamin D deficiency may have worse outcomes, but there is a high likelihood of confounding, since these people likely also have other health issues.  (Medrxiv Paper)