PUBLIC HEALTH:
1 – This 12/17/21 Twitter thread by Dr. Bob Wachter at the University of California, San Francisco makes more definitive claims & assertions about the Omicron variant of SARS-CoV-2 and infection risk-reduction than I have seen elsewhere. Here’s a cleaned-up, boiled-down summary: a) Omicron is more infectious/contagious and it is getting past immune-system defenses acquired from vaccination or from a past SARS-CoV-2 infection; b) Omicron infections might have peaked already in South Africa, so Wachter expects to see a similar surge-then-plunge pattern here; c) Pfizer’s oral anti-viral drug, Paxlovid, is “a very big deal and it won’t be available for 4-6 weeks, and even then it will be in short supply”; d) SARS-CoV-2 immunity these days can be ranked from highest to lowest in this order – 3 mRNA vaccine doses plus past SARS-CoV-2 infection = super-immune, 3 mRNA doses and no prior infection = very immune, 2 mRNA doses OR 1 J&J vaccine dose plus 1 mRNA dose = modestly immune, 1 mRNA vaccine dose OR 1 J&J dose OR prior infection alone = minimally immune, no shots and no prior infection = totally vulnerable; e) Wachter says he has received 3 Pfizer vaccine doses and he’s an overweight 64-year-old – he would travel for Christmas in the U.S. but not in Europe; f) he’s ruling out indoor-dining at restaurants, though outdoor-dining is fine; g) he is not attending crowded events; h) he is shopping indoors while wearing an N95 or equivalent mask; and i) he is getting tested before visiting older people or others at high-risk for severe COVID-19, unless he is sure that everybody who will be present is “3x vaxxed” – basically 3 mRNA vaccine doses: https://threadreaderapp.com/thread/1471980512503758853.html.
2 - “What seemed likely earlier this month is now quite certain. A big Omicron wave is coming, on top of an already substantial Delta wave,” writes Sarah Zhang at The Atlantic (12/17/21). Even if Omicron turns out to cause milder cases of COVID-19, it’s more contagious so it could sicken so many people that it increases COVID-19 hospitalizations and deaths “on the whole,” Zhang writes. She adds: “in South Africa, where Omicron is already dominant…nearly 20 percent of the health-care staff have COVID”: https://www.theatlantic.com/science/archive/2021/12/covid-cases-omicron-highly-contagious/621038/.
3 – Here’s a hopeful statement by Emory University infectious-disease physician, virologist and global-health expert Dr. Boghuma Kabisen Titanji in an interview about the Omicron variant (by Katherine Wu, The Atlantic, 11/27/21). “We are definitely not where we were two years ago, when SARS-CoV-2 emerged. We now have a better understanding of how the virus is transmitted from person to person. We have antivirals that are coming down the pike. We have a better understanding of how to manage and treat cases of people who do get infected. We have vaccines and incredible mRNA technology that allows us to adapt quickly to a changing virus, and we will have second-generation vaccines. It’s definitely not back to square one”: https://www.theatlantic.com/science/archive/2021/11/omicron-coronavirus-variant-what-we-know/620827/.
4 - In 12/16/21 tweet by infectious disease epidemiologist Billy Quilty at the Centre for Mathematical Modeling of Infectious Diseases in London and at the London School of Hygiene & Tropical Medicine, he advises that people take a rapid test *just* before visiting people indoors. He was testing himself 3 times daily and went from negative to positive for SARS-CoV-2 overnight. Tip: He uses the term LFT (lateral flow test) for what some in the U.S. call a “rapid test,” or “rapid antigen test,” or “antigen test”:
5 - As the Quilty tweet above illustrates, antigen tests (rapid tests) for SARS-CoV-2 are best administered repeatedly at frequent intervals, rather than relying on a single test result. This point also is made in this 10/12/21 piece about the best ways to use rapid at-home COVID tests, by Tara Santora for Scientific American: https://www.scientificamerican.com/article/the-smartest-way-to-use-rapid-at-home-covid-tests1/.
6 – Hospitals in parts of the U.S. and beyond are overwhelmed by COVID-19 cases, driven by infections with the Delta and Omicron variants of SARS-CoV-2. But one New York City-based physician says the mood in his health-care system is mixed, reports Kaitlyn Tiffany at The Atlantic (12/17/21). Dr. Brendan Carr, chair of emergency medicine for the Mount Sinai Health System, is quoted in the piece as saying that the mood “on the ground” is “frankly, hope and optimism”; and “The people that we’re seeing are mildly ill.” New York City’s vaccination rate is fairly high, and so far, “the vaccines are holding up against the Omicron variant” in terms of severe COVID-19, the story states. But the anticipated surge of SARS-CoV-2 infections resulting from holiday travel and visits is just getting started, Tiffany writes: https://www.theatlantic.com/technology/archive/2021/12/new-york-city-covid-apocalypse/621039/.
7 - Any mask is better than none when it comes to SARS-CoV-2. And for many months, I only wore cloth masks. Not any more. These days, I want to nudge more people to upgrade their masks to well-fitted, high-filtration KN95s, KF94s, or N95 masks, or even a surgical mask if necessary, all of which typically are made of spun (not woven), molded synthetic plastic fibers. Read Tanya Lewis’s piece at Scientific American (9/30/21) for details about why such an upgrade is a good idea: https://www.scientificamerican.com/article/why-we-need-to-upgrade-our-face-masks-and-where-to-get-them/.
SCIENCE:
8 - It’s too early to be sure whether Omicron causes less severe cases of COVID-19 than previous SARS-CoV-2 variants did, reports Heidi Ledford at Nature (12/17/21). Yes, an unpublished report out of South Africa indicates that the risk of hospitalization among people with an Omicron infection is down 29% compared with the hospitalization risk among people infected with a previous variant, the story notes. But many of those cases were among younger people, per various reports, and among people previously exposed to SARS-CoV-2, Ledford writes. In Denmark and in the UK, recently released data on relatively few cases suggest that the Omicron hospitalization risk is the same as it was among people infected with a previous variant, Ledford reports: https://www.nature.com/articles/d41586-021-03794-8.
9 - “Scientists feel increasingly confident that …Omicron is likely to dramatically alter the trajectory of the pandemic—and not for the better,” writes Kai Kupferschmidt at Science (12/14/21). It’s spreading faster and more easily than the Delta variant did earlier this year, and infecting the vaccinated, the unvaccinated, and people who have had a past SARS-CoV-2 infection. “The good news is that boosters appear to bring protection against disease back to about 75%, and probably even higher against hospitalization,” Kupferschmidt writes: https://www.science.org/content/article/scientists-see-really-really-tough-winter-omicron.
10 - If you like stunning interactive simulations, check out “The Coronavirus in a Tiny Drop,” at The New York Times (12/1/21), based on research, data, and modeling from biologist Rommie Amaro and members of her lab at the University of California, San Diego. The piece shows the movements of more than a billion atoms in a model of the Delta variant of SARS-CoV-2 inside an airborne drop of water expelled from the lungs. An Omicron model is in the works, the piece states. The researchers modeled the atoms’ movements at time intervals of less than a millionth of a second. I like the color illustration of the virus’s spike proteins, long mucins (proteins from mucus lining the lungs), surfactants (something to do with either keeping things sticky or not), and deep lung fluid (by Carl Zimmer and Jonathan Corum): https://www.nytimes.com/interactive/2021/12/01/science/coronavirus-aerosol-simulation.html
VACCINES:
11 – A series of graphic slides by “those nerdy girls” at Dear Pandemic explains some data released 12/8/21 by Pfizer on its COVID-19 vaccine’s effectiveness against the Omicron variant of SARS-CoV-2. According to the post, the company states that its data show “strong neutralization of Omicron after 3 doses of its vaccine, but a significant reduction for 2 doses” (12/11/21): https://www.instagram.com/dear_pandemic/p/CXWHXQTrIfi/.
12 - There is little consensus among scientists on the best vaccination strategy for society against the Omicron variant, reports Jon Cohen at Science (12/16/21). The range of strategies being considered include: a) staying the course and promoting just two doses of one of the mRNA vaccines (Pfizer/BioNTech or Moderna); b) promoting boosters, which are currently authorized for U.S. adults 18 and older; c) pursuing a booster tailored to Omicron (both Moderna and Pfizer/BioNTech says theirs could be available as soon as March 2022, Cohen reports); or d) a universal coronavirus vaccine “that would aim to protect against every new mutant of SARS-CoV-2, as well as other coronaviruses that nature might throw at humans in the future,” Cohen writes. The story quotes virology and immunology specialist Dr. Paul Offit, a pediatrician at the Children’s Hospital of Philadelphia, as saying it is “extremely unlikely” that Omicron will result in severe COVID-19 among healthy, vaccinated people under age 65: https://www.science.org/content/article/what-does-omicron-mean-future-covid-19-vaccinations.
ENTERTAINMENT:
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Love/In friendship, Robin