It’s variant day at the Covid Cafe

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Welcome to the Covid Cafe, my friends. We have two variants on the menu today.

 

BA.5

Our first variant, BA.5, has gotten better than previous versions at evading both the vaccines and the immunity people acquired from earlier infections. But where previous omicron variants tended to stay in the upper respiratory tract, making it somewhat milder, BA.5 has picked up some mutations from the delta variant–that’s the most damaging variant to date–and it’s very pleased with them, thanks, and with itself for being so clever. 

They may be the reason it’s better at infecting cells than those respiratory-type omicron variants, and why it may be more serious. 

Seeing it circle back in this way doesn’t make me want to go out and celebrate. On the positive side, though, the current vaccines do still protect against its worst effects. But sensible people are recommending masks, ventilation, and distance–all those things governments and a lot of our fellow citizens have gotten bored with. 

 

Irrelevant photo: thistle with bee

BA.2.75

Are we having fun yet? 

Our second variant is BA.2.75. It seems to spread quickly and to evade immunity. How hard it hits people is yet to be determined. It’s also called Centaurus. I have no idea why and my brain isn’t willing to expend any bandwidth on it, but since it’s also possible that the thing has peaked, it has a second name: scariant. 

Come fall, updated vaccines are expected to target the omicron mutations. I’m in line already, and rolling my sleeve up.

 

However

Efforts to create a pan-coronavirus vaccine have slowed down for lack of funding, lack of any sense of pressure, and lack of even marginal good sense. The current vaccines are still keeping death and destruction to a minimum, and hey, that’s good enough. Let’s just stagger on.  I could toss in a quote or two here, but hell, you get the point. Follow the link if you like. It’s find-your-own-quote day here at the cafe.

In addition, testing candidate vaccines won’t be as easy it was at the beginning of the pandemic because Covid isn’t raging through populations the way it was. Pre-existing immunities make their effectiveness harder to measure.

 

Other mutations

A team that’s been analyzing millions of omicron samples in order to study its mutations reports that omicron alone has 130 sublineages. A member of the team, Kamlendra Singh, thinks vaccines might become less effective over time.  

“The ultimate solution,” he said, “will likely be the development of small molecule, antiviral drugs that target parts of the virus that do not mutate. While there is no vaccine for HIV, there are very effective antiviral drugs that help those infected live a healthy life, so hopefully the same can be true with COVID-19.” 

Singh helped develop CoroQuil-Zn, a supplement that infected people can take to help reduce their viral load. It’s currently being used in India, southeast Asia, and Great Britain and is waiting for FDA approval in the United States.

A virologist writing in the Conversation agrees, at least in part, saying that vaccines targeting recent variants will inevitably fall behind as the virus mutates. “Vaccines that generate antibodies against a broad range of SARS-CoV-2 variants and a cocktail of broad-ranging treatments, including monoclonal antibodies and antiviral drugs, will be critical in the fight against COVID-19.”

 

Long Covid news

Long Covid’s too stale for the cafe, but it’s not growing mold yet, so let’s have a nibble out here in the alley. 

The BMJ (formerly known as the British Medical Journal) has summarized 15 studies showing that the vaccinated are less likely than the unvaxxed to end up with long Covid. That’s most true of people over 60 and least true of people between 19 and 35. 

Long covid can range from annoying to life changing (in a bad way, in case that’s not already clear; it won’t make you grow wings or develop superpowers). It also ranges from transient to no-end-in-sight. In the UK, 2% of the population has reported having it and in the US, that’s 7.5%. 

Or by another count, 2 million people in the UK have it. That may or may not work out 2%. Don’t worry about it.  

Why is the percentage in the UK so different from the one in the US and why don’t I care if the UK numbers match? Because no one’s tracking long Covid systematically. It can get pretty weird out there.  

With that out of the way, let’s talk about the important stuff: “hy did the British Medical Journal change its name? I don’t know, but since my father did the same thing, I shouldn’t roll my eyes about it.

Which is unlikely to stop me. Especially since my father didn’t change his name to an abbreviation,but to the last name I use although I have no deep-rooted claim to it.

On the positive side, that bit of history means I know for a fact the Josh Hawley isn’t a relative–even a distant one.

*

In the absence of systematic tracking, a UK study compared a big whackin’ number of people’s medical records to see what they could learn about long Covid. 

Among other things, they were able to add 42 symptoms to the existing list. (Yeah, progress comes in some annoying colors.) The new ones include hair loss, reduced sex drive, erectile problems, swelling limbs, and bowel incontinence.

I did tell you it could be serious, didn’t I? You should listen to me. 

They also organized the symptoms into three categories: 80% of the people with long Covid symptoms had a broad spectrum of problems, from fatigue to pain; 15% had mental health and cognitive problems, from depression to brain fog; and 5% had respiratory problems.

*

A small study treated long Covid patients with cognitive symptoms by using hyperbaric oxygen therapy, and the results were enough to give a person hope. The group that got the real treatment had “significant improvement in their global cognitive function and more cognitive improvement related to their specific damaged brain regions responsible for attention and executive function,” along with improvement in their energy, sleep, and psychiatric symptoms.

The patients who got the placebo treatment didn’t, although they did get a simpler sentence with no fancy language or quotation marks.

The treatment, unfortunately, isn’t something you can set up in your garage. It involves five treatments a week for two months in a machine that looks like a mid-size submarine. 

 

Protective actions you never thought of

Covid is less likely to kill or hospitalize people who fast at least one day a month than it is to do either of those things to those of us who think eating should be a daily practice. This may be because fasting reduces inflammation or it may be attributable to a couple of other reasons that you can look up yourself by following the link.

The bad news? The study involved people who’d been fasting intermittently for decades. It offers no information on people who took it up twenty minutes before becoming infected.

 

A bit more about vaccines

I’ve found enough shreds of good news that I can spare you one more piece: Vaccination, although it doesn’t prevent Covid, does seem to reduce the odds of infection. Not by as much as we’d all like, but I don’t know about you, I’ll take any percentage I can get.

You want details, though, right? Fine: In the second wave of the pandemic, vaccinated National Health Service employees who worked face to face with patients were 10% less likely to get infected than unvaccinated ones. And I’ll remind the assorted anti-vaxxers who pop up here periodically that the primary value of the vaccines lies in preventing death and serious illness, which (do you really need to be reminded?) is not a bad thing. They haven’t turned out to create sterilizing immunity, and that’s a damn shame but doesn’t mean the people who recommend them should be burned at the stake. 

No one’s offered to do exactly that to me yet, but the conversations do have a way of turning hostile. Or starting out that way. A recent comment opened with, “Stop lying, Ellen.”

And I appreciated the suggestion, since hadn’t thought of that myself. I also appreciated the generous and high-minded approach to discussion. Let it be a model for us all.

*

But forget about me. Ben Neuman, a professor in the Department of Biology and chief virologist at the Texas A&M Global Health Research Complex, has another reason to get vaccinated: “to avoid the brain damage that often comes with COVID. During a natural infection, the immune response around your brain will starve cells of oxygen, and the effect is that you will lose a lot of gray matter—something like a stroke. Unlike a stroke, where usually only one part of the brain is affected, COVID seems to affect the entire brain, so you don’t necessarily lose one thing, like the ability to control nerves on one side of the face, you lose a bit from everywhere. COVID-associated brain damage only happens with infection, not with the vaccine, and having a strong set of white blood cells trained by the vaccine is likely to be helpful in preventing brain damage.” 

 

Okay, but what about monkeypox?

Let’s forget about whether monkeypox is a pandemic or an epidemic or just a damned nuisance. Those–especially damned nuisance–have technical definitions that, for a bunch of free-range blog readers, aren’t the most useful standards. The more pressing question is, How much of a problem is this likely to be?

After what sounds like a lot of internal argument, the World Health Organization declared it a global health emergency. The disagreement, as far as I understand it, comes from this: Diseases that spread on the air (think Covid or flu) are bigger worries. They’re easy to catch. Monkeypox is spreading through touch. That doesn’t make it fun and I don’t recommend rubbing up against anyone with a rash right now, but it does mean transmission’s slower and more difficult.

It’s also less deadly than Covid. 

If that’s not reassuring enough, existing vaccines can slow the spread–or they can once production catches up with the need.

On the other hand, it’s popping up in a wide range of countries and seems to have surprised the experts.

Monkeypox could (I’ve read) go in two directions: It could establish itself in many countries as a sexually (an also not-sexually) transmitted disease that people will have to deal with or it could be gotten under control. The first prospect isn’t fun, but it’s still not Covid all over again.

30 thoughts on “It’s variant day at the Covid Cafe”

  1. Thanks for the info. As the media & the government (or whats left of it) seems to have decided covid is over I find it hard to come by proper information. Unlike the “Stop Lying, Ellen Contingent” I trust that you did some reasonable research and I appreciate that highly. 👍

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    • I rely heavily on a couple of newsletters that summarize medical studies. My science (not to mention my patience) isn’t up to reading the studies myself. I do try to make sure my sources are sane, and I’m old enough to remember a day when I wouldn’t have thought that was necessary.

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      • Those were the days… sigh … I was listening to James O’brien’s podcast the other day where he said he learned one thing as he got older: progress doesn’t stay. Life falls back into the old ways as soon as we give up being vigilant and fight for a better life. And while it might be good to get back to the old days when it comes to where and how we get our information some other things might not 🙄

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  2. Thank you Ellen for your fine interpretation of Covid information. I always come away with good information and a little smile. The smile is badly needed these days when reading the news. I look forward to your weekly offerings.

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    • One, a runner, died of heart failure while running. (It does happen.) Two died of cancer. A fourth had been seriously ill for some time, although the cause of death has not been disclosed. I’m not sure about the fifth. The rumor on social media is that they were caused by vaccines, but there’s no evidence that any of them got Covid boosters before their deaths.

      They weren’t all young. One was 49. One had worked at Trillium Health for 40 years, which would put him safely north of 60. I don’t have ages on the others.

      https://www.techarp.com/facts/toronto-doctors-die-4th-vaccine/
      https://globalnews.ca/news/9020642/trillium-health-partners-3-doctors-obit/

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        • Hi Ellen, regarding the extensive flap set off by a troll, I’d also be happy if you want to delete my case of mistaken identity response and anything else related to it as well (and this comment too!)…just if it helps declutter, I’m fine either way. I enjoyed our discussion on the actual topic of covid, and would like to continue with a few other thoughts.

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          • When I cut comments I’d been asked to delete, nothing else made sense so I took down the whole cluster, which was kind of a shame because I’d enjoyed the mistaken identity emails and thought even the trolling was interesting. So having already done that (oops), I’m grateful that you agree to it.

            I’m happy to continue the discussion if you like.

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  4. Wow. I have not abandoned my N95 mask and now certainly have no plans to. This is some seriously scary stuff.(I don;t understand all of it either…but over here we have been lied to so much lately – and not about COVID -that I am not worried about you fibbing to me. Better safe than sorry!) Thank you for this information, which, admittedly, I will be rereading just because I can’t take it all in. This is not Covid brain damage- I was the same way when I took Philosophy 101 in college. My roomate saw me underlining the text and said “Gish 0 is there that much important ?” and I said “No – this is to let me know I already read this.”
    Stay safe !

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    • It is interesting to see the varying ways people estimate the danger of this thing–and I’m not talking about people who think it’s the flu, but people who see its dangers but still think we’re past the dangerous part. I wear an N95 mask in enclosed spaces, but I see that fewer and fewer people bother, and I confess my definition of enclosed is getting vaguer and vaguer. It’s the herd instinct, I think.

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  5. Well, I should perhaps offer my apologies to you and Emma Cownie – I’ve not worn a mask for a long time, and I don’t know how “insane” that is or how much I’m taking the lead from our so-called Government. Should I be? It’s not that I think it’s all over and no problem anymore, it’s more that I think we have had rounds and rounds of vaccinations available to those who aren’t hypnotized by conspiracy theory nonsense, and my own small circle of friends, colleagues and family aren’t seriously ill, as they have been. They’ll say, “I’ve got Covid. Yeah, I’ve been wiped out for a few days, but I’m feeling better now,” and they go back to work when they test negative, if they’re even bothering to test. I have therefore been a bit surprised by your (Ellen) repeated focus on Covid on here, and my sense that you are much more concerned than I am.

    I can understand that, for someone who’s had repeated infections and suffered badly, the current lack of mask-wearing will be annoying, frightening and seem stupid, and I am genuinely sorry about that. But we do – in this country – seem to have broken the back of this thing (notwithstanding the possibility of further variants causing mayhem, of course) and a balance has to be found between taking every precaution possible and maintaining life as normal. Everyone constantly wearing masks wasn’t just a minor inconvenience – they contribute large amounts of plastic waste, for one thing, strewn about in streets or dumped in landfill, and we are supposed to be trying to save the planet.

    Roughly one in 15 of us have the infection, and yet hospital admissions with it are at about one in 6,250. That should tell us something. And, of course, the vast majority of those get better in days and are discharged. I dare say some test positive and have a panic attack, and that’s about all that’s wrong with them.

    From the start, the claim that Covid is “just the ‘flu” was nonsense – it was a plague – but there is a sense in which the purpose of all our counter-measures is to turn it into just another coronavirus, like the common cold, and we’ve made enormous strides in that direction. It seems rates of death are running at about the same numbers as people dying of heart attacks, the same as those dying of obesity, or a whole range of things people die from, including influenza. Figures for cancer are way more, and Alzheimers is off the chart. There are things we can do to load the dice with every one of those risks, and everyone will have particular susceptibilities.

    Incidentally, hyperbaric oxygen therapy seems to be good for just about everything!

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    • I agree that great strides have been made and that the waste problem from masks is real, but I’d estimate the continuing danger from Covid higher than you do, for several reasons. One, the risk of long Covid, which can come even after a mild infection. For some people, this will reduce the scale on which they can live their lives. It will interfere with their ability to work and generally to live full lives. Researchers are finally addressing this, but governments, I think, are generally underestimating the effect it will have. Two, the more the disease circulates, the more chances it has to mutate. The more it mutates, the more chances it has to evade immunity. That’s not good for our side. Three, although I know many people who’ve had Covid and recovered, I’m conscious that it’s more of a risk for people who for any reason have weakened immune systems. On a balance of things, I think wearing masks (many are now reusable, even the high-grade ones that promise 95% protection) is a small sacrifice that’s worth the effort.

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      • Hi Ellen,
        After the big muddle, I thought I’d continue the thread on our different assessments of the risk from Covid and, in particular, the wisdom of more widespread mask-wearing. I’ll respond to your earlier points:

        “I agree that great strides have been made and that the waste problem from masks is real, but I’d estimate the continuing danger from Covid higher than you do, for several reasons. One, the risk of long Covid, which can come even after a mild infection. For some people, this will reduce the scale on which they can live their lives. It will interfere with their ability to work and generally to live full lives. Researchers are finally addressing this, but governments, I think, are generally underestimating the effect it will have.”

        I’m not sure how you come to that conclusion (that governments are generally underestimating the effect of long covid), since you say researchers are only now “finally addressing” it. You’re right that “some people” are suffering serious consequences from the infection, but the importance of acting on that depends on how many are suffering what level of difficulty and for how long. I am sorry if I have missed any statistics on that, but again it relates to the issue of a lack of research so far, which means a lack of reliable evidence.

        It’s likely that confirmation bias will play a part in reports of long covid for a number of reasons, not least that getting covid has been one of the most traumatic events psychologically as well as physically (indeed, even when physically not impactful at all) and the fear of not recovering (especially after “long covid” became talked about) could induce incorrect attribution of cause to all manner of symptoms. Another reason might be that following the lockdowns and fear and delayed medical appointments, people might be going to their doctor and reporting various ailments that become associated with their infection with covid whilst not related. Another is that the stress of living through this pandemic will indeed cause actual ailments, as stress does, while again not being clinically directly caused by the virus.

        I’ll comment on two and three together:

        “Two, the more the disease circulates, the more chances it has to mutate. The more it mutates, the more chances it has to evade immunity. That’s not good for our side. Three, although I know many people who’ve had Covid and recovered, I’m conscious that it’s more of a risk for people who for any reason have weakened immune systems. On a balance of things, I think wearing masks (many are now reusable, even the high-grade ones that promise 95% protection) is a small sacrifice that’s worth the effort.”

        That’s just one side of the evolutionary equation, though – “the more it circulates, the more chance it has to mutate.” The experts, right from the start, told us this wasn’t going to go away, but we’d have to learn to live with it, partly through medical means and partly through developing “herd immunity,” and that’s the other side of the equation. If we aren’t exposed to a pathogen as a group or as a species we don’t develop herd immunity. Letting it wash over us, as Boris and co first recommended, would have been disastrous, but the measures taken (for us lucky ones in rich countries) have given us a very high degree of safety, and there’s a point at which more protection becomes counter-productive, and we have instead to acclimatize.

        It is more of a risk for people with weakened immune systems, as you say, but we know that one of the things that weakens our immune system is keeping it free from biological stresses. It’s infection that keeps our immune systems strong. Again, it’s a balance, and I appreciate some people have to be more protected than others – just that at some point we (in general) have to actually begin to live with covid, not in a bubble trying to avoid it. If not now, when are we going to start on that road?

        I believe that balance is very different when we look at other countries, and therefore the world in general, which is why we should be sharing vaccines with the world much more. Globally, perhaps, your first argument is more pertinent – there are too many infections globally allowing too many new variants that are potentially new serious risks to all.

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        • First, appreciation for your thoughtful comments. Forgive me if I’m skimming over the surface. I put off responding until I had more time, then didn’t have the time and–hell, I just need to get this done.

          A recent (5 August) newspaper article tells me that 1 in 20 “economically inactive” Britons has long Covid. That’s people who aren’t employed or looking for work. (That doesn’t include students or retirees.) If we’re talking only about economic impact, I expect that’s enough people knocked out of the labor market to be worth counting, although from what I’ve read governments aren’t reckoning with the economic impact yet. Assorted other statistics are available, but many don’t–or can’t–separate the various levels and lengths of long Covid. I’m not sure that’s enough statistical evidence to satisfy you, but it’s what I have on hand. The next question is how many have to suffer serious long-term impacts for action to be justified. I don’t have an answer for that I would say that to answer it we’d have to balance the action (masks; ventilation; vaccination, measured both in money and in intrusiveness) against the damage that no action causes. My sense is that you and I would see the scales tipping at somewhat different points.

          Does the increase in research mean governments are taking long Covid seriously. In one sense, yes, you’re right, at least some parts of the government machinery are. Research is being funded; treatments (however effective they may or may not be) are becoming available, although not, I think, widely. What I meant, but may not have said clearly, is when governments say that we just have to live with Covid–vaccination makes it manageable–they don’t seem to be weighing the risk of long Covid into the equation.

          How much of long Covid is stress, etc.? It’ll be a long time before anyone can untangle that and I’m not going to try, but I do know that medicine has a long history of attributing problems it can’t effectively treat or diagnose to stress, neurosis, or personal problems.

          Will exposure eventually mean Covid poses less of a threat and we should therefore not try to cocoon ourselves? Quite possibly, but at I’m constantly reminded by the articles I read, no one knows what the next mutation will look like. No law of nature dictates that over time diseases become less threatening. Living with it could be like living with malaria was for many years (it may be more treatable now–I’ve lost track): You want to be under that mosquito net. We are going to have to live with this beast, but I’ll be inclined to take more risks when the vaccines and the treatments have had time to improve.

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  9. Three good sources for information include Medscape for headline summaries if you do not have the time to read papers or even abstracts. (https://www.medscape.com/resource/coronavirus), Gov.uk (https://www.gov.uk/coronavirus), National Institute for Clinical Excellence Guidelines (https://www.nice.org.uk/guidance/conditions-and-diseases/respiratory-conditions/covid19).

    The Gold Standard for evidence amongst medical and clinical professionals is widely accepted to be Cochrane’s Systematic Reviews. I would urge anyone to read this (https://www.cochrane.org/our-evidence/what-are-systematic-reviews) before cherry-picking selected evidence from papers with small numbers of participants.

    The evidence keeps changing, so a changed message does not mean that previous advice was wrong. Unfortunately, in a world where people crave certainty and a simple message, a complex situation is always going to contain nuanced advice that some people will choose to interpret as being contradictory.

    Happily though, my own experience of wearing a mask, frequent handwashing between patients, and vaccinations helped me to dodge picking Covid up from known Covid-positive patients through the worst of the pandemic. Not all of my colleagues were as fortunate. Stay safe!

    Regards, Chris.

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  10. I came back again to see if you were just as funny when I wasn’t sleep deprived. You are. I love your style and I picked the covid one to read on purpose. I am so “not over Covid” and remain quite vigilant even though our government has decided covid doesn’t exist. Latest numbers here show less patients needing ICU but still death rates aren’t where you could laugh them off. Bernie

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    • Hi Bernie. That’s a tough test and I’m glad I sneaked past it. Or snuck. Whichever version I use, it sounds wrong. I’m not over it either, although I do find myself getting less careful when all around me people are acting as if it’s all fine and, what’s more, gravity’s on hiatus because we held a referendum and it lost. Oh, hell, we might as well laugh. It gives us something to do while the world around us goes insane. Anyway, welcome back.

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