OMICRON VARIANT:
1 - A SARS-CoV-2 “variant of concern” (B.1.1.529) first reported 11/24/21 to the World Health Organization (WHO) from South Africa has been dubbed Omicron. Preliminary evidence suggests that mutations in the variant could make it spread more quickly. The previous variant escalated to the variant-of-concern designation was Delta (before that: Alpha, Beta, and Gamma). In an 11/26/21 story by Carl Zimmer at The New York Times, Harvard Chan School of Public Health epidemiologist William Hanage is quoted as saying: “Epidemiologists are trying to say, ‘Easy, tiger.’ This could be bad. This could be very bad. But we don’t know enough to roll that tape forward.” There is no strong evidence available yet to show if COVID-19 vaccines are less effective against Omicron (nor whether the variant spreads more easily). More research is needed, some of which is under way. “Vaccines are expected to provide some protection against Omicron because they stimulate not only antibodies but immune cells that can attack infected cells,” the Zimmer story describes Rockefeller University virologist Theodora Hatziioannou as saying. Hanage is described in the story as saying, “It might turn out that the apparent spread of Omicron [in South Africa] was actually just a coincidence, as has been seen with some previous variants. If a new variant happens to get swept along during a surge of cases, it will look highly contagious when it isn’t”: https://www.nytimes.com/2021/11/26/health/omicron-variant-vaccines.html.
2 - Kai Kupferschmidt’s 11/27/21 story at Science provides more detail on why Omicron’s mutations concern infectious disease researchers and virologists. “Many of the changes in spike [which is the protein, or part of the virus, that latches onto our cells and then causes infection] are around the receptor binding domain, the part of the protein that makes contact with the human cell,” Kupferschmidt reports. Mutations alone do not “tell how infectious a virus is,” the story describes University of Oxford evolutionary biologist Aris Katzourakis as saying. “But if we were looking out for mutations that do affect transmissibility, it’s got all of them,” Katzourakis says. Jesse Bloom, an evolutionary biologist at the Fred Hutchinson Cancer Research Center in Seattle, Washington, “thinks people who recovered from COVID or were vaccinated are unlikely to completely lose their ability to neutralize the virus,” the story states. “But I would expect, based on this particular combination of mutations, that the drop in neutralization is larger than for all the other major variants,” the story quotes Bloom as saying: https://www.science.org/content/article/patience-crucial-why-we-won-t-know-weeks-how-dangerous-omicron.
VACCINES:
3 - COVID-19 boosters are now authorized for all U.S. adults 18 and older who received the Moderna, Pfizer-BioNTech, or Johnson & Johnson vaccines. Even young and healthy adults likely should get the booster, writes University of Oxford population health researcher Jennifer Beam Dowd at Dear Pandemic (11/23/21). Recent evidence from a randomized Pfizer study of 10,000 participants showed that those who got a third dose had “95.3% fewer COVID-19 infections compared to those with 2 doses,” Dowd writes. This added protection, atop the earlier protection against COVID-19 hospitalization and deaths conferred by two doses of the Moderna or Pfizer vaccines or one of the J&J, “is downright amazing,” she adds. The Dear Pandemic team of “bona fide nerdy girls” also anticipates that boosters will “eventually be extended to <18s,” Dowd writes: https://dearpandemic.org/do-i-really-need-a-covid-booster-dose-if-i-am-young-and-healthy/.
4 - Earlier this month, the U.S. Centers for Disease Control (CDC) recommended the Pfizer-BioNTech vaccine against SARS-CoV-2 for use in children ages 5 to 11, as many media outlets have reported. This recommendation, released on 11/2/21 – four days after the vaccine was authorized for this age group by the U.S. Food and Drug Administration, is bringing huge relief for millions of parents of children this age as well as immune-compromised household members. It also could prevent school closures due to coronavirus outbreaks, and could “buttress defenses against a possible surge as winter arrives,” wrote Apoorva Mandavilli at The New York Times (11/2/21). COVID-19 vaccination for children “will also help children emotionally and socially,” the 11/2/21 Times story quotes an American Academy of Family Physicians doc as saying. Dr. Pamela Rockwell served on the CDC panel that made the recommendation. The kids dose is one-third that of the vaccine dose for people ages 12 and up. This smaller dose “had the fewest side effects and yet produced at least as many antibodies as observed in young adults who had been given the larger dose,” Mandavilli reports. The risk of severe COVID-19 in children is lower than it is in adults, but children infected with SARS-CoV-2 are also at risk for Long Covid (like adults) and for Multi-System Inflammatory Syndrome in Children (MIS-C, unlike adults). “Results from the Pfizer vaccine’s trial in children under age 5 are not expected until the end of this year at the earliest,” the story states: https://www.nytimes.com/2021/11/02/health/covid-vaccine-children-cdc.html.
5 - Costa Rica will require COVID-19 vaccination of children under 18, making it “one of the first countries to implement such a mandate,” reported John Yoon at The New York Times (11/6/21). The country had already authorized the vaccine for children 12 and over, the story states. Costa Rica’s vaccination rate (55% of its population; 73% of youths ages 12 to 19) is higher than that of “several of its neighbors in Latin America, where vaccine access has been unequal,” Yoon writes: https://www.nytimes.com/2021/11/06/world/americas/costa-rica-covid-vaccine-children.html.
6 - Here’s a list of additional countries that have approved or are considering requirements for vaccinating children against COVID-19 (Reuters, 11/25/21): https://www.reuters.com/business/healthcare-pharmaceuticals/countries-vaccinating-children-against-covid-19-2021-06-29/.
7 - This essay by Georgetown University medical anthropologist Emily Mendenhall for Scientific American calls for public schools to require students to be vaccinated against COVID-19. The argument draws on Mendenhall’s research on “mask hesitancy” last year in Okoboji, Iowa, her hometown. Refusing to wear a mask or to get vaccinated against COVID-19 builds up social status among “certain groups of people,” she writes (11/24/21). “Based on my research…I do not believe many children in Okoboji and similar communities all over the U.S. will ever be vaccinated against COVID-19 if we leave it up to personal choice. To protect the most vulnerable children—and particularly those who cannot get vaccinated—we need to close this gap of vaccine refusals with a mandate,” she writes: https://www.scientificamerican.com/article/we-need-school-age-vaccine-mandates-to-end-the-covid-pandemic/.
8 - Montreal-based science journalist Pouria Nazemi let me know that he has written a compendium of answers to questions raised by people who are hesitant about COVID-19 vaccines (10/2/21). He gathered the questions from his followers on Twitter and Instagram. “I received more than 100 issues then categorized them and tried to give explanations,” he says. In Farsi/Persian: https://pourianazemi.com/?p=6727. Nazemi hopes to undertake a translation into English.
9 - Why get vaccinated if you have recovered from COVID-19? Because data consistently show “that immune responses from natural infections [with SARS-CoV-2] are extremely variable, thus unreliable” in protecting people from future infections with the virus, wrote Beth Mole in a 10/8/21 explainer for Ars Technica. For this reason, people who recover from COVID-19 nonetheless should get vaccinated against the disease to ensure a strong immune response to future exposures to the virus. And vaccines are safer than the risk of an infection that can cause severe disease or persistent symptoms that last for months, the story states, adding that the latter may occur in “up to half of people infected,” Mole writes. Recent studies show that three COVID-19 vaccines authorized (or approved in the case of the Pfizer vaccine) in the U.S. remain highly effective in preventing adult hospitalizations for the disease, the story states: https://arstechnica.com/science/2021/10/prior-infection-vs-vaccination-why-everyone-should-get-a-covid-19-shot/
TREATMENT:
10 - Earlier this fall, Pfizer and Merck each recently reported that their randomized experiments in adults at high risk for severe COVID-19 revealed that their pill treatments for the disease are highly effective at preventing severe COVID-19 and COVID-19 deaths. “The Pfizer and Merck pills, which can be dispensed at pharmacies and taken home, are expected to reach many more people than monoclonal antibody treatments, which are usually given by intravenous infusion at a clinic,” reported Rebecca Robbins at The New York Times (11/5/21). However, a more recent story by Robbins (11/26/21) reports that Merck now says that a final analysis of a larger number of study participants reveals that its antiviral pill (molnupiravir) only reduces “the risk of hospitalization and death among high-risk Covid patients by 30 percent, down from an earlier estimate of 50 percent.” A U.S. Food and Drug Administration panel is set to meet 11/30/21 to discuss whether to recommend authorizing the Merck anti-viral as a treatment for high-risk COVID-19 patients. A University of Minnesota infectious disease researcher thinks that Merck’s anti-viral pill will be authorized in the U.S., and the story states this could occur “as soon as next week,” Robbins reports: https://www.nytimes.com/2021/11/26/science/merck-molnupiravir-antiviral-covid-pill.html.
11 - Pfizer says its studies show that its antiviral treatment, a pill-form combination of an older retroviral called ritonavir with Pfizer’s new Paxlovid drug, cut the risk of hospitalization for severe COVID-19 in infected, unvaccinated adults at high risk of severe COVID-19 by 89%, various media have reported. Robbins’ story above states that the Pfizer treatment “could become available within weeks.”
12 - Meanwhile, on 11/4/21, the UK became the first country to approve the Merck antiviral pill treatment for COVID-19. The pill “has been authorized for use in people who have mild to moderate Covid and at least one risk factor for developing severe illness, such as obesity, diabetes mellitus, or heart disease and anyone over the age of 60,” writes Holly Ellyatt at CNBC (11/4/21): https://www.cnbc.com/2021/11/04/merck-oral-covid-pill-approved-by-uk-in-world-first.html.
SCIENCE:
13 - For the latest on the origins of SARS-CoV-2, see Beijing-based freelance science journalist Jane Qiu’s 11/19/21 story for MIT Technology Review. The story features an 11/18/21 analysis in Science by a University of Arizona evolutionary biologist who had signed a 5/14/21 letter in Science calling for a probe of the lab-leak theory. Michael Worobey now thinks that a scenario in which SARS-CoV-2 jumped from an animal to a human at the Huanan wet market in Wudan is “vastly more likely.” For a summary, see Jane’s twitter thread:
14 - A cartoon illustration by Chia C. Wang of National Sun Yet-sen University in Taiwan and of the Scripps Institution of Oceanography in California illustrates how viruses that we inhale, such as SARS-CoV-2, are transmitted. Atmospheric chemist atmospheric chemist Jose-Luis Jimenez, of the University of Colorado tweeted the cartoons, compiled at this thread (9/9/21). Wang prepared the cartoons as part of a 8/27/21 review study of how respiratory viruses travel through air and infect people. The study: https://www.science.org/content/article/covid-19-vaccines-may-trigger-superimmunity-people-who-had-sars-long-ago. Twitter thread: https://threadreaderapp.com/thread/1435977594302713858.html.
PUBLIC HEALTH:
15 - A 10/6/21 story in Nature covering a 9/22/21 study on portable air filters’ effectiveness at removing SARS-CoV-2 particles (as well as Staphylococcus aureus, Escherichia coli and Streptococcus pyogenes) from air increased my confidence in these devices. Tosin Thompson’s story reports that the study at a hospital “swamped by people with COVID-19 has confirmed” that portable air cleaners/purifiers/filters are effective at removing SARS-CoV-2 particles from the air in a real-world setting, she writes. Previous experiments were performed in carefully controlled environments, the story states, so questions had lingered about the effectiveness of portable air filters in real-world settings: https://www.nature.com/articles/d41586-021-02669-2.
16 - A mild case of COVID-19 can range from “a day of feeling crummy to being completely laid up in bed for a week, all of your bones hurt and your brain isn’t working well,” a 9/12/21 story by Will Stone for NPR quotes Dr. Robert Wachter of the University of California, San Francisco, as saying. Some data suggest that COVID-19 symptoms do not last as long in people who get infected after vaccination compared with getting infected before vaccination, the story states. And vaccinated people may have fewer symptoms (“notably absent: fever and persistent cough”) than do unvaccinated people, a recent study reveals, Stone writes. If you do get infected, being vaccinated also cuts the odds of Long Covid in half compared with the risk among unvaccinated people, according to a study Stone cites: https://www.npr.org/sections/health-shots/2021/09/12/1036356773/i-got-a-mild-breakthrough-case-heres-what-i-wish-id-known.
17 - An 8/22/21 piece by Dr. Dhruv Khullar, a contributing writer at The New Yorker and an assistant professor Weill Cornell Medical College, included some helpful thinking about “breakthrough infections” – infections among people vaccinated against COVID-19. These should not be thought of as “binary events: the virus either breached the gates, or it didn’t,” Khullar writes. The meaning of a positive PCR test for SARS-CoV-2 is vague, the story quotes virologist Angela Rasmussen of the Vaccine and infectious Disease Organization as saying. The positive test “doesn’t mean there’s a robust viral infection raging in your body. Even if some cells do get infected, other parts of the immune system spring into action and stop it from spreading. Is that an infection? That’s a philosophical question.” The term “breakthrough infection” is somewhat misleading when applied to vaccinated people who get infected and have mild or no symptoms, Khullar describes Rasmussen as thinking. In those cases, the vaccines actually worked well, tamping down infections such that they don’t break through in a meaningful sense, she is described as saying. Overall, “a breakthrough infection could be an illness that knocks you flat, a tickle in your nose, or nothing”: https://www.newyorker.com/science/medical-dispatch/have-you-already-had-a-breakthrough-covid-infection.
ENTERTAINMENT:
18 - Just before 1 min., this video achieves cuteness overload: https://laughingsquid.com/baby-monkey-becomes-friends-with-piglet/.
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24 – Small Business Saturday: I just ordered a bunch of my colleague Michelle Wright’s beautiful holiday cards: https://aticardsgifts.com/.
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Love/In friendship, Robin