NEW WAVE:
1) Reported SARS-CoV-2 infections in the U.S. are rising again after a late winter and early spring dip. COVID-19 hospitalizations also are up (the 14-day average daily COVID-19 deaths rose over the past few weeks, peaking at 389, but it dropped to 326 a few days ago, per The New York Times). The latest wave of cases reflects the evolution and spread of two Omicron sub-variants called BA.5 and BA.4, both of which are considered highly contagious. Summertime gatherings, the near abandonment of mask-wearing and mandates, and low numbers of people getting first and second COVID-19 vaccine boosts likely are fueling this wave. What’s a sub-variant? OK, by last year, you probably heard of SARS-CoV-2 variants, versions of the virus that contain one or more mutations. Lately, U.S. public health experts and epidemiologists are focused on the sub-variants of the initial Omicron coronavirus variant—the variant that resulted in a large winter spike in severe and deadly cases of COVID-19 globally. The relatively new two Omicron subvariants have mutations in the virus’s surface molecule that enables cell entry (the spike protein) “that are different enough from earlier versions that they are able to dodge some antibodies,” writes Lauren Leatherby at The New York Times, 7/7/22. This phenomenon is known as “immune escape.” That short phrase necessarily skips a lot of detail. Here’s a reminder that people who have received mRNA vaccines and boosters against COVID-19 likely have immune cells that “remember” their vaccine-acquired exposure to the genetic instructions (mRNA) for a piece of the spike protein, and those cells can ramp up post-infection to help prevent severe COVID-19. Here are some graphics that illustrate the wave: https://www.nytimes.com/interactive/2022/07/07/us/ba5-covid-omicron-subvariant.html.
2) Subvariants BA.4 and BA.5 are the fastest spreading variants of SARS-CoV-2 currently circulating worldwide, reports Ewen Callaway at Nature (6/23/22). But they “seem to be causing fewer deaths and hospitalizations than their older cousins—a sign that growing population immunity is tempering the immediate consequences of COVID-19 surges,” Callaway writes. With earlier variants, people who already had had COVID-19 were protected from re-infection at least for some months. With these two relatively new Omicron sub-variants, any past infection with SARS-CoV-2 is less protective against re-infection. And that’s driving the rise in cases, the story describes computational epidemiologist Christian Althaus, of the University of Bern, as stating. Callaway continues: “With most of the world outside Asia doing little to control SARS-CoV-2, the rise—and inevitable fall—of BA.4 and BA.5 will be driven almost entirely by population immunity, Althaus adds, with cases increasing when protection lulls and falling only when enough people have been infected.” The COVID-19 vaccines might not be as protective against infection with BA.4 and BA.5 as they were against infection with earlier variants, the story suggests. “Lab studies consistently suggest that antibodies triggered by vaccination are less effective at blocking BA.4 and BA.5 than they are at blocking earlier Omicron strains,” the story states: https://www.nature.com/articles/d41586-022-01730-y.
VACCINE BOOSTERS:
3) Should you get a COVID-19 vaccine booster? A helpful graphic published in May at Dear Pandemic lays out the issues. [One out of date item in the post: the Pfizer-BioNTech and Moderna COVID-19 vaccines now are authorized on an emergency basis for U.S. children between the ages of six months and 5 or 6, respectively—here’s a 6/19/22 Q&A, by Yale Medicine, for some detail on that]:
4) Also, check out this second-boosters data point reported by Benjamin Mueller at The New York Times (7/4/22): “This spring, people age 50 and older who had received a single booster were dying from Covid at four times the rate of those with two booster doses, according to the Centers for Disease Control and Prevention.” The note is part of a larger story about a commitment by the U.S. government to update COVID-19 boosters for this autumn so they match the latest variants or subvariants of SARS-CoV-2 as closely as possible. It’s a gamble that also plays out with the U.S.’s seasonal flu vaccines, which are updated annually. Viruses evolve faster than vaccine-makers’ pace of production, so it’s impossible to know which versions of a virus will be circulating by the time vaccines are available: https://www.nytimes.com/2022/07/04/health/updated-covid-vaccines-omicron.html.
PUBLIC HEALTH:
5) This Dear Pandemic post explains why it is still makes sense for us as individuals to try to prevent catching and spreading SARS-CoV-2 (7/1/22). Public health measures such as “isolating when ill, physically distancing, improving ventilation, and wearing masks” help to “break a chain of transmission” and reduce the number of people that each infected individual will infect (the “effective R-value”), which is good for us collectively and individually. A lower effective R keeps waves small, staving off big spikes in infections, hospitalizations and deaths due to COVID-19, as well as Long Covid cases. And here’s a hopeful note: “While population immunity waxes and wanes, we are unlikely to get a variant that sets us back to immunity ground zero,” the post states:
6) At least five pandemic-related numbers are out of date and/or no longer hold meaning at this point in the pandemic, writes Katherine J. Wu at The Atlantic (6/23/22). They include: 1) the advice that only 2 doses of a COVID-19 vaccine are needed to be “fully vaccinated”; 2) the advice that 15 minutes in the presence of someone who is within 6 feet of us is the definition of “close contact”; in fact, the virus doesn’t keep at bay for 14 minutes and 59 seconds before charging at our faces, for example; 3) the idea that it’s safe to stop isolating five days after testing positive for SARS-CoV-2, regardless of whether you test negative, if you have a mild case of COVID-19 or no symptoms at all (constraints included advice to wear a mask and not travel through day 10); 4) the idea that there’s no need to re-test for SARS-CoV-2 after an exposure to someone who tests positive if you are within 90 days of a prior infection with the virus. In fact, you should re-test. For details on why these numbers no longer make sense and the fifth number to abandon, see the story: https://www.theatlantic.com/health/archive/2022/06/covid-numbers-outdated-two-doses-six-feet/661366/.
7) This short 7/8/22 Twitter thread by Dr. Eric Topol at the Scripps Research Translational Institute touches on some of the same fallacies (with some added direct criticism of the U.S. Centers for Disease Control)—the problems with stating that 2 doses = fully vaccinated and 5 days isolation is enough. Topol here also illustrates how graphic choices are painting an overly rosy picture of current SARS-CoV-2 transmission in U.S. counties:
8) If you still wear a mask indoors in public, I salute you. It’s a healthy and caring choice, but it can feel like a daring choice too if you live around anti-maskers. At the Daily Kos, Laura Clawson rounds up some pointed comebacks posted to Twitter. A sample, lightly edited by me: “Because if I’m going to catch COVID it’s going to be from spending time with people I love and care about, not an airplane full of people who don’t mind their own business”; “I have contagious critical race theory”; and “how much of my medical history will it take for you to shut up and leave me alone?” Some candidate replies are specific to one’s situation such as being a health care worker for people with COVID: “I treat people who have COVID and other contagious diseases, so I have been exposed. But if you feel comfortable, I’ll take it off.” (5/26/22): https://www.dailykos.com/stories/2022/4/26/2093919/-Anti-maskers-just-can-t-stand-people-still-caring-about-public-health-Get-your-responses-ready.
LONG COVID:
9) It is now commonplace to have been infected with SARS-CoV-2. In New York City, at least one in three people has been infected (and at least 1 in 204 people have died of COVID-19), according to the latest figures from The New York Times. In the U.S. overall, at least one in four people has been infected. In this context, more attention is turning to the long-term consequences of one or multiple infections with SARS-CoV-2 and the risk of Long Covid. For beautiful illustrations and explanations of how Long Covid affects the body (text available in English and in Spanish), see this 2/19/22 guide at The New York Times (by Josh Keller, with illustration by Violet Frances for Bryan Christie Design). Near the end of the piece, find several resources for people with Long Covid: https://nyti.ms/3oWAFJO.
ENTERTAINMENT:
10) SOUND UP!
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[Yes, I accept baklava, and only baklava.]
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16) dummy hypnotizes ventriloquist:
WHERE HAVE I BEEN? “Out.” OK, seriously, I had a lot of other work, including a reporting assignment that rented most of the space in my brain. I’ve been running as much as my body can stand (which is not as much as I’d like). Nothing felt concrete for a while. I got sick. I quit some gigs. Then I got a new one. Perhaps a break was a good idea. But please know that I missed the heck out of you all and wished thousands of times that I could return to this newsletter.
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Love/In friendship, Robin