1/3/22 - smart, useful science stuff about COVID-19
BOOSTERS
VACCINES:
1 - Booster shots of Pfizer-BioNTech’s COVID-19 vaccine could clear all regulatory hurdles this week for use in 12- to 15-year olds in the U.S., according to various reports. On 1/3/22, the U.S. Food and Drug Administration (FDA) authorized the age group for these boosters, advancing an emergency-use authorization decision down the conveyor belt to a U.S. Centers for Disease Control (CDC) vaccine advisory committee. If that committee gives the go-ahead, the CDC director is expected to quickly approve the recommendation. The FDA also authorized reducing the wait time between 2nd and 3rd doses of the Pfizer vaccine from six months to five months, for both adults and adolescents. And the FDA OK’d children ages 5-11 with some types of immune compromise to receive Pfizer boosters. “Because studies have shown that a Pfizer booster dose increases protection against the Omicron variant, a shorter interval might offer ‘better protection sooner,’ the [FDA] said,” report Noah Weiland and Sharon LaFraniere at The New York Times. (U.S. officials authorized Pfizer boosters for 16- and 17-year olds on Dec. 9, due to omicron). Virology and immunology specialist Dr. Paul Offit, a pediatrician at the Children’s Hospital of Philadelphia, is concerned that the COVID-19 booster push is sidelining efforts to vaccinate people who have yet to receive a single dose. “This is a disease of the unvaccinated, and I just think that boosting is largely a detour that is not going to have a big impact on this pandemic,” Offit is quoted saying in a 1/3/22 Politico story by Lauren Gardner: https://www.msn.com/en-us/news/us/fda-authorizes-covid-boosters-for-teens-12-15/ar-AASnQNp.
2 - Meanwhile, Israel now is offering a fourth dose of the Pfizer-BioNTech vaccine to health care workers and people over 60 and immune-compromised people, Reuters reports (1/3/22). The decision reportedly was made in the final days of December by an expert panel in Israel’s health ministry: https://www.medscape.com/viewarticle/965839.
3 - Boosters are important for maintaining the protection of AstraZeneca’s vaccine against COVID-19, says a pharmaceutical medicine researcher at King’s College London who is quoted in a 12/21/21 Fortune story in response to new findings on the vaccine. AstraZeneca’s vaccine, which relies on genetic instructions for SARS-CoV-2’s spike protein to prime the immune system to respond to infections with the virus, is approved for use in Brazil and authorized for use in dozens of other countries. The large study enrolled millions of people in Brazil and Scotland who had already received two doses of the AstraZeneca vaccine. Published 1/1/22 in The Lancet, the results suggest that “immunity against severe disease began to fade three months after people had received their second dose,” writes Jeremy Kahn. In the UK, the Pfizer-BioNTech and Moderna vaccines are being used as boosters to the AstraZeneca “primary series” (the first two doses), because research has shown that this provides stronger immunity than a third dose of the AstraZeneca, the story states. (Similarly, in the U.S., the Centers for Disease Control states in a 12/23/21 update that “in most situations, Pfizer-BioNTech or Moderna COVID-19 vaccines are preferred over the Janssen [J&J] COVID-19 vaccine for primary and booster vaccination.” Emphasis added by me): https://fortune.com/2021/12/21/astrazeneca-covid-19-vaccine-fast-waning-protection-against-severe-disease/.
SCIENCE:
4 - Immune protection – developed from COVID-19 vaccines and past SARS-CoV-2 infections – against the omicron variant of SARS-CoV-2 “seems to have been broadly maintained,” write Andrew Joseph and Helen Branswell at STAT (12/30/21). “While studies have repeatedly shown that our neutralizing antibodies don’t recognize and block omicron as well as earlier forms of the virus, our T cells haven’t lost much of a step against the variant,” they write. So even if infected with omicron, people with immunity are less likely to need hospitalization for COVID-19. The “connection between cases [infections] and severe outcomes is growing increasingly loose,” but it’s not completely severed,” the story states: https://www.statnews.com/2021/12/30/beyond-case-counts-what-omicron-is-teaching-us/.
5 - The omicron variant of SARS-CoV-2 is an “upper-airway specialist,” research by a University of Cambridge virologist and others suggests, report Carl Zimmer and Azeen Ghorayshi at The New York Times (12/31/21). That is, the viral variant tends to infect our noses, throats, windpipe (trachea), and the large bronchi that then lead to the lungs rather than the lungs themselves. In the lungs, “previous variants would often cause scarring and serious breathing difficulty,” but this is not usually the case with omicron, per the story. The findings could explain why “omicron is milder,” that is, why omicron – despite its large number of mutations – seems to cause less severe disease compared with the delta variant of the virus and earlier versions, “especially in vaccinated people,” the story states. A photo caption in the story quotes Ravindra Gupta, the University of Cambridge virologist, saying, “I’ve always been struck by the fact that you can’t predict the behavior of virus from just the mutations.” The mechanism behind milder omicron illness could be a protein (a complex molecule) found in lung cells that “does a worse job” of grabbing onto omicron than it did with delta, but that’s just one hypothesis, Zimmer and Ghorayshi report: https://www.nytimes.com/2021/12/31/health/covid-omicron-lung-cells.html.
6 – The emerging trend of less severe illness associated with the omicron variant of SARS-CoV-2 (although even a moderate case can feel awful and I read of someone whose COVID-19 in late December tragically turned from recovery-seems-imminent to fatal) is raising the question of whether the virus will evolve over time to cause less illness. Probably, writes microbiologist and immunologist Andrew Pekosz at the Johns Hopkins University Bloomberg School of Public Health. But it’s not inevitable. Our growing immunity as a population – due to vaccination primarily as well as prior infections – is what will bring about milder COVID-19 over time, the essay states (The New York Times, 12/10/21): https://www.nytimes.com/2021/12/10/opinion/covid-evolve-milder.html.
PUBLIC HEALTH:
7 - This informative piece by Katherine J. Wu at The Atlantic will sharpen your understanding and use of “nine pandemic words,” including quarantine, isolation, asymptomatic, presymptomatic, mild COVID-19, fully vaccinated, immunized, vaccine effectiveness, breakthrough infections, and natural immunity (10/8/21): https://www.theatlantic.com/science/archive/2021/10/covid-vocabulary-pandemic-words/620351/.
8 - This 12/20/21 Twitter thread by atmospheric chemist atmospheric chemist Jose-Luis Jimenez, of the University of Colorado lists several recent erroneous and potentially deadly SARS-CoV-2 safety messages circulated by governments worldwide. I share it here not to provoke ire and undue skepticism of government messages during the pandemic. What’s most useful here is that each error in the thread clarified or solidified my understanding of evidence-based guidance on reducing the risk of SARS-CoV-2. For instance, Jimenez writes that there “are ZERO proven cases of surface transmission & we have known for a year that it is unlikely”. So, guidance that emphasizes hand-washing to prevent the spread of SARS-CoV2 is misinformation or disinformation, as Jimenez puts it. Failing to mention the importance of wearing a mask, especially a well-fitted, high-filtration mask like an N95 or KN95 is also mis/dis-information, he suggests: https://threadreaderapp.com/thread/1471160707794276353.html.
9 - In “A Message From Britain on Using Rapid Tests,” University of Birmingham microbial genomicist Alan McNally writes that this is how to think about or interpret a negative rapid test result (12/23/21): “You may not be infectious in that moment, but you may still have an infection and could be contagious later. It means you should still exercise caution to prevent spreading the coronavirus”: https://nyti.ms/3suLF3C.
10 - Among infectious diseases reporter Helen Branswell’s top 10 lessons from the COVID-19 pandemic (STAT, 12/28/21) are: a) simplicity rules (that is, some of our protection strategies and policies have been “too complex to operationalize”; b) “the calculus for kids is just different”; c) “downplaying what lies ahead helps no one”; and d) “winning the vaccine race really does matter”: https://www.statnews.com/2021/12/28/10-lessons-ive-learned-from-the-covid-19-pandemic/.
HEALTH CARE:
11 - Check out this “circuit breaker status” map of U.S. counties designed to indicate which are at high risk for hospitals being overwhelmed in the next 1 to 10 days by SARS-CoV-2 infection counts (“cases”) and hospital capacity. It was created by Dr. Jeremy Faust, an emergency room doc and health policy researcher at Brigham and Women’s Hospital, and Benjy Renton, of Ariadne Labs at Brigham and Women’s and the Harvard Chan School of Public Health: https://alexanderjxchen.github.io/circuitbreaker/. For more details, see this 12/30/21 Twitter thread by Faust: https://t.co/QmPNCyu1tL
ENTERTAINMENT:
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Love/In friendship, Robin