Covid: It ain’t over till it’s over…

…as the endlessly quotable Yogi Berra may or may not have said.

But forget Berra. The World Health Organization, a.k.a. WHO, isn’t as much fun to quote but it knows how to do footnotes, and that makes it more impressive. In its opinion, the pandemic isn’t over. Between the beginning of 2022 and late August, at least a million people around the world died of Covid. 

Or if you want to start counting at the beginning of the pandemic, that’s 6.45 million. Both numbers undercount the damage, but never mind that. Let’s work with what we’ve got.

”We have the tools that can actually prevent these deaths,” said Maria Van Kerkhove, WHO’s technical lead on Covid. “A lot of people are talking about living with COVID. But we need to live with this responsibly. A million deaths this year is not living with COVID. Having 15,000 deaths per week is not living with COVID-19 responsibly.”

In one recent week, more than 5.3 million new cases were reported worldwide, a number that doesn’t include people who registered positive only on a home test. Or who never tested.

“These are huge numbers, and that’s an underestimate,” said Van Kerkhove. “We do see this virus circulating really intensely around the world.”

Irrelevant photo: an orchid

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That brings me to the question of why I keep banging on about Covid. Apologies if I’ve gotten boring–Notes isn’t supposed to be mindless, but it is supposed to be a fun read. The problem is that scientists keep coming up with new information. What I’m saying here is, Blame the scientists. If they weren’t so damn good at this, it wouldn’t end up in your inbox.

And if that isn’t a good enough reason, it’s because it still matters. Living with Covid doesn’t have to mean pretending it’s no danger.

 

Long Covid 

Let’s talk about long Covid. Again. Sorry to keep coming back to it, but not long ago someone challenged me on the extent of the problem (my thanks; it was an interesting discussion) and since long Covid’s hard to define and at least as hard to measure, I didn’t have great statistics to offer. But I have started to see some lately, so let’s play with numbers. They all involve money, since it can be counted, and when you’re dealing with something as hazy as long Covid that’s useful. Besides, as we all know, money matters more than life itself.

So let’s talk money: A report from the US estimates that 4 million people are out of work with long Covid, which could mean $170 billion in lost wages. In a year. The report’s author,  Katie Bach, said, “If this looks like other post-viral illnesses, some people will recover, but there will be this big stock of people who don’t, and it will just continue to grow over time.”

She called it “a shocking number.” 

In mid-2021, the Federal Reserve Bank of Minneapolis estimated that 26% of people with long Covid were out of work or had cut their working hoursAn international survey found that 22% of people with long Covid weren’t working and 45% had cut their hours, and a U.K. survey found 16% had reduced their hours and 20% were on paid sick leave. That was between April and May 2021.

Australia’s treasury reports that the country’s lost 3 million working days to long Covid. Or to put that another way, 31,000 people have missed work every day because of it. 

 

So how many people have long Covid? I’m not sure anybody has a reliable count, but the U.S. Centers for Disease Control estimate that 19% of people who’ve had Covid get long Covid symptoms. Unfortunately, the number’s less helpful number than it sounds like, because long Covid’s symptoms range from relatively mild to completely hair-raising and the duration ranges from weeks to the possibility of a life sentence.  

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Are we having fun yet?

Evidence is growing that people who’ve had Covid face an increased risk of neurological and psychiatric problems as much as two years after their infection. That’s not the final word on the subject, but it comes from a study that followed 1.28 million cases over two years. It does seem to be a strong hint. 

The good news? Depression and anxiety are generally gone after two months and are no more common after Covid than after other respiratory infections. And kids are at the lowest risk for kids for later complications. 

End of good news.

Adults 64 and under showed an increased risk of brain fog–640 cases per 10,000 people vs 550 cases per. Over 65s? The number went up to 1,540 per compared to 1,230. For dementia (we’re still talking about the over 65s here) it was 450 instead of 330. Psychiatric disorders? That’s 85 instead of 60. 

Is there anything can we do about it? Hell yes. I’m going to petition the courts to lower my age.

Does the risk end after two years? We haven’t had enough time for anyone to find that out. 

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A theory that’s loose on social media holds microclots responsible for long Covid, and some evidence does back that up, but (as one article says) hematologists worry that enthusiasm for the theory has gotten ahead of the data.

Danny Altmann, an immunologist at Imperial College London, said, “We’ve now got little scattered of bits of evidence. We’re all scuttling to try and put it together in some kind of consensus. We’re so far away from that. It’s very unsatisfying.”

But that’s not stopping a few medical groups from offering treatment to remove the clots, and some people with long Covid are desperate enough to try anything, which I can understand. But at least some treatments to get rid of clots risk messing with the blood’s ability to clot, and that (she said, indulging in a mild understatement) would not be a good thing.

 

How Covid’s changing

Its incubation period—the time between when a person gets infected and when they’re shedding enough of the virus to infect other people—is getting shorter, and the shorter that time that period is, the harder it is for vaccines to keep the virus from spreading.  

Yeah, that was news to me too. Measles and rubella have a two-week incubation period, which allows time for a vaccinated person’s immune memory cells to crank out antibodies and keep the person from passing the bug to other people. So vaccines for those diseases stop the spread. In contrast, a Covid vaccine, although it protects the wearer, doesn’t protect the wearer’s friends. Or enemies. 

On the bright  side, the shorter incubation time means people who test positive might not have to isolate themselves for as long.

Every cloud has a silver lining, but the problem with that is that silver linings are too heavy to float. Watch out for falling silver linings.

 

Expired tests

You may (or may not) remember that a while back I wrote about the expiration dates on Covid tests. After they pass those dates, I led you to believe (if and only if you read it, of course), they start to call in sick and miss work. Well, I need to update that. The U.S. Food and Drug Administration set the expiration dates in the early days of the pandemic, on the basis of the limited information that was available at the time, but manufacturers are testing aging tests them and some turn out to be good beyond their expiration dates.

How do you know if yours still good?

“To check whether your test kit is still good beyond the printed expiration date, you can search on the FDA’s “At-Home OTC COVID-19 Diagnostic Tests” website.

“Type in the brand name on the FDA site, and a link will appear showing a list of updated expiration dates.

“You may have to check the lot number on your package. For instance, say you’re trying to look up an iHealth COVID-19 test kit with lot number 222CO20208. Scroll down the document to find your lot number, and you’ll find that the original expiration date of Aug. 7 has been extended to Feb. 7, 2023.”

Apologies.

 

An update on Hafiza Qasimi

In early August, I wrote about Hafiza Qasimi, a woman artist fleeing Afghanistan after the Taliban destroyed her paintings and left her unable to work. The campaign to raise the 10,000 euros she needed to apply for a German visa has reached its goal. This allows her to demonstrate that she can support herself for her first year in the country. (The amount will be raised to 11,208 in January.)

In the meantime, Qasimi has reached Tehran. I have no idea how she did that. In Afghanistan, women aren’t allowed to either travel or leave the country unless they’re with their husband or a male a relative. But she managed it, she’s safe, and she’s been offered a three-month residency at a German art gallery is she can get that visa.

The group supporting her is trying to raise more than the 10,000 euro minimum so that she can afford health insurance and other basics. They’re also working with her on a grant application that would allow her to study at art school.

“This,” they say, “will provide her with the space she needs, as a free woman, to renew and develop her artistic work. We are full of confidence and look forward with Hafiza to the future.”

Her brother, who lives in Germany, will be flying to Tehran to see her for the first time in eight years.

If you want to contribute to the fundraising campaign, any amount will be welcome. And if you don’t (or would love to but can’t), that’s okay. Do what you can where you can and wish her joy in her freedom.

It’s variant day at the Covid Cafe

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.

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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.

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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.

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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.

What causes long Covid?

A lot of clever people are chasing the cause of long Covid, but so far the virus is outrunning them–and we’re talking about a virus, remember, that doesn’t have a degree in either science or medicine and that’s rumored to be illiterate.

Not that I’m making fun of those clever people. Long covid scares the bejeezus out of me and I’m grateful for the work they’re doing, but I’m also painfully aware that they haven’t even found all the puzzle pieces yet, never mind gotten them in the right place. 

Puzzle pieces? What happened to the chase metaphor? 

I couldn’t keep up with it and had to grab something else off the shelf where I store my cliches.

Irrelevant photos: Morning glories–or as the British call them, bindweed.

But back to our actual subject: The clever folk are at the stage where they have theories, but that’s not all bad. Theories open up possibilities and they’re a good place to start. Let’s check in with a few of them:

Pediatrician Danilo Buonsenso noticed that some of his patients–these are kids, remember, with their habit of showing up at pediatricians’ offices and licking their fingers before touching the toys–

Where were we? Some of his patients who’d had mild Covid cases were left short of breath, exhausted and sporting a variety of other symptoms. That’s not common in post-Covid kids, but what with him being a doctor and all, and one who specializes in infectious diseases (I know, I didn’t get around to mentioning that earlier)–well, the kids he’s most likely to see are the ones who are sick, which skews the sample.

As the article I stole this from explains it, “He now suspects that, in some of them, the cells and tissues that control blood flow are damaged and the blood’s tendency to clot is amplified. Minute blood clots, leftover from the viral assault or fueled by its aftermath, might be gumming up the body’s circulation, to disastrous effect from the brain to joints. ‘In some patients we have specific areas where no blood flow comes in’ or the flow is reduced, Buonsenso says. 

Another theory comes from  microbiologist Amy Proal: that the virus hangs on in the body after the acute stage of the infection is over. Studies show that “the virus is capable of persistence in a wide range of body sites,” she said. 

A third theory comes from Chansavath Phetsouphanh, who’s observed that the immune cells of long Covid patients are still on high alert as much as eight months after they first tested positive. 

A fourth theory comes from Nick Reynolds, who found amyloid clumps in the brains of people with the neurological symptoms of  long Covid. They’re similar to the clumps that cause Alzheimer’s disease and dementia. That doesn’t necessarily mean the patients will have lasting damage or that the drugs used to treat those diseases help in these different circumstances. On the other hand–well, who knows at this stage? It might.

Are any of the theories right? Are all of them showing us a small piece of a large picture? Tune in sometime later–possibly a lot later–for the next exciting episode of What’re We Going to Do to Get Out of This Mess? And keep in mind that once the clever people figure out what’s driving long Covid, they or some colleagues still need to figure out a treatment.

Don’t you just feel better after you hang around here? 

In the meantime, an assortment of studies are following up on the possibilities these theories raise. Wish them well, please. It won’t make any material difference, but it might make you feel like you contributed to the effort.

 

Numbers

How many people actually have long Covid? Answering that depends on how we define long Covid, but let’s set that aside. We’re not scientists–or most of us aren’t and anyone who is must be slumming. We can get away with being hazy when it suits us. 

In May, the U.S. Centers for Disease Control and Prevention rampaged through the medical records of some 2 million people and reported that at least 1 in 5 people who’d had Covid came away with long Covid symptoms. For some of them, that meant struggling but hanging onto their normal lives. For others, it meant struggling, only with nobut at the end of the sentence.  

In the UK, some 2 million people have long Covid according to the Office for National Statistics, which does have a definition of the thing but never mind what it is. We’re not scientists, remember? Or else we’re slumming and will have to put up with the way other people’s minds work. 

Proal (remember her?) said, “I consider Long Covid to be a massive emergency.”

 

Who’s most at risk of long Covid?

A small study from Japan found that being over 40 increased the odds. So did being over 60. Since I’m over both (it took a while, but I got there), this is not good news where I live. 

In contrast to other studies, it didn’t find sex to be a big factor, although long Covid seemed to have a harder psychological impact on women than on men. 

In contrast, a UK study found that being female, being in poor pre-pandemic mental and physical health, being obese, and having asthma all increased the odds of long Covid. 

Do the two studies contradict each other? Partially. The data they’re working from is sketchy, but the issue’s important enough to use it anyway. Take them for what they’re worth.

The UK study finds that between 7.8% and 17%of the people who reported having Covid also reported symptoms that lasted longer than longer than 12 weeks, and between 1.2% to 4.8% reported  that the symptoms were debilitating. 

Why the range? I haven’t a clue. I find numbers debilitating.

The numbers were lower when they worked from doctors’ records as opposed to self-reports, but that could be because doctors weren’t reporting long Covid before November 2020.

 

A shred of good news

The omicron variant may be less likely than delta to cause long Covid–20 to 50% lower. To put that another way, with omicron, 4.4% of cases turned into long Covid. With delta, that was 10.8%. But that’s still a shitload of people.

 

More numbers: What have vaccinations ever done for us?

Well, in the first year they were available, they prevented an estimated 19.8 million Covid deaths. That’s based on excess deaths in 185 countries and territories. 

Excess deaths? It’s the figure you use when you don’t have any other consistent or reliable way to count the pandemic’s impact. In rough terms, it compares deaths during the pandemic to deaths in some pre-pandemic year. It’s imperfect, but the other systems are even more so. If you don’t use it, you end up counting the number of people who (if they weren’t dead) could brag about having Covid listed on their death certificates. You miss a lot of people that way. You can also count the number who are known to have had Covid and who then went on to die, leaving you counting people who died because a brick fell on their head and missing some who died undiagnosed. Or you can count people who die within 28 days of a diagnosis and miss the ones who took too long to die as well as include a few who had unfortunate encounters with bricks.

The UK switched methods midway through the pandemic, probably because the government wanted it to look like fewer people had died and the new way yielded a lower number. 

Yeah, I have absolute faith in the people leading the country. They’ll do whatever works best for them and to hell with everything and everyone else.

Not only is none of the systems accurate, different countries rely on different definitions of a Covid death, raising hell with international studies. 

But let’s put death on the shelf for a minute and go back to vaccines and lives saved, which is what we’re pretending to talk about. The study estimates that 599,300 more lives would’ve been saved if the world, lower case, had met the World (upper case) Health Organization’s target of getting  two or more vaccine doses to 40% of the population of every country by the end of 2021

By now, 66% of the world’s population has received at least one dose of vaccine.

 

More numbers

In 2020 and 2021, Covid was the third leading cause of death in the United States, crossing the finish line after cancer and heart disease. So it gets a bronze medal and modest bragging rights, but not as much glory as it was hoping for. 

Are the expiration dates on Covid tests for real?

I raise this question because I’m an expiration date-denier, at least in most situations. I’ll bake with flour that’s older than I am. I don’t toss food out until it reeks or evolves new life forms. I don’t take orders from the small print on food packaging. 

To my lasting disappointment, though, test kits do get to boss us around. When they pass their use-by date, they start returning false negatives. And the worst of it is, they expect us to be at least a little sympathetic about it. Wouldn’t we get tired of sitting on a shelf and waiting for someone to decide they might have a use for us? And don’t we also turn a little negative with all that passivity and waiting? 

So apologies, but we really do need to pay attention. 

When do the ones on my shelf expire? Haven’t a clue. I should go look but I think I’ll wait and go into a panic about it when I need one.

Irrelevant photo: a poppy

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Remember everything hopeful I’ve written about the possibility of universal Covid vaccines? 

Of course you do. You memorize every word I write. Which is good, because I don’t.

I ask because we’ve got some new Omicron subvariants working their way into the pandemic pipeline, and although they don’t seem to be any more vicious than the old versions, they do seem to be better at immunities. 

The one spreading in the US is called BA.2.12.1, which as far as I can tell means it’s a variant on Omicron 2.0. The others were spotted in South Africa and are called BA.4 and BA.5, which are, at least, easier to remember.

Is it time to panic? Nah. There’s always time for that later. 

The new subvariants are able to infect people who had the first version of Omicron–the one that came out before Elon Musk bought the entire genome. They can also infect people who’ve been vaccinated. But the picture isn’t simple. A lot of vaccines are out there and the study couldn’t cover them all. They may provide greater protection. And in case that doesn’t introduce enough unknown quantities, the variants’ ability to slither past people’s immunities could be, in part, because people’s immunity was starting to wane. It could also be because so many people spell Musk’s first name wrong. So don’t jump to conclusions.

What does it all mean for the fight against Covid? A lot of experts are asking that, including the vaccine makers, who could tweak their vaccines to target Omicron and find themselves, yet again, three steps behind a virus that knows the Greek alphabet better than they do. Translation: We don’t know what the next variants will look like (never mind what letter it will be named after), but we do know that a new variant will appear. And experience tells us that Covid’s good at finding ways to dodge our immune systems.

The obvious solution is a vaccine that targets all forms of Covid, and possibly its coronavirus friends and relations as well, and any number of scientists are chasing after that. But they haven’t caught it yet. It’s fast, it’s clever, and it’s small enough to hide in the undergrowth.

Another possibility is to use a mix of monoclonal antibodies that target various strains of Covid. 

A mix of what? A brew made from antibodies created in response to assorted forms of Covid. Pour the mix into an infected person’s system and it can get to work on whatever it finds.

The problem is cost. One dose currently costs $1,000 per patient, so at best it would have to be limited to the most vulnerable people, and only in countries that can afford it. Or if you’re in the US, it would be limited to individuals who can afford it.But if the brew could be gotten down to $50 or $100 per dose, it would be cheaper than constantly updating vaccines.

What does seem to be certain–at least to observers who haven’t drunk the KoolAid labeled “What the Hell, Let’s Say It’s Endemic and Move On”–is that letting the virus spread and mutate while we shrug our shoulders and tell ourselves to live with it is a recipe for trouble.

Sorry–make that more trouble than we already have, since we’re hardly trouble-free just now.

 

Studies, updates, and patent pools on the spread of Covid

According to one study, you’re a thousand times less likely to catch Covid from touching stuff than you are from breathing in its presence. That’s true not only of you, but also of your friends, your relatives, and your enemies (if you have any, and if you don’t please substitute a few people you never managed to like. And also of me. So if you’re still trying to find that pack of disinfectant wipes you lost at the back of your cupboard (or your neighbors’ cupboard–who knows how these things happen?), relax. You may not need them.

Emphasis, as usual, on may.

Details? Oh, you fussy people. The study was done when lots of antibacterial cleaning was going on and crowds were nonexistent, so let’s not go off the deep end and decide it translates completely to the world we’re living in now. Still, it’s information and it’s worth reading:

The riskiest places, in terms of both air and surface samples, were gyms, with gym drinking fountains rating high on the list of things to avoid. The exercise equipment itself didn’t turn up any positive samples. 

In offices, the study found few positive samples on keyboards, light switches, tables, microwaves, or refrigerator handles. In schools, the same was true of desks.

The survey estimates that the chances of getting Covid after airborne exposure are one in a hundred. From a contaminated surface, it’s one in a hundred thousand–factoring in, of course, that a lot of cleaning was going on at the time, so you might want to move a zero or a decimal point in some random direction to make up for that.

The study didn’t look at the surfaces in people’s homes, dorms, or other places where people live together. I’m not sure how useful any of it is, but I thought I’d mention it.

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A different study looked at the effect of what it called layered controls–basically, masks, distance, and ventilation–and found that the three used together would reduce Covid transmission by 98% in 95% of the scenarios it studied. The study involved the gloriously named atmospheric scientist Laura Fierce. She gets a mention solely on the basis of her last name. 

Ventilation alone doesn’t do much to reduce transmission, although if you add in a distance of six feet it does, and masks reduce the safe distance from six feet to three. 

This is all wonderfully sensible, but are we going to do it? Hell no. The pandemic’s over, hadn’t you heard? If you get sick, it’s your own silly fault.

It’s infuriating. Allow me to refer you to the scientist mentioned above. We need to clone her. 

*

A research team in Japan is developing a decoy virus receptor that promises to keep the virus so entranced that it never finds the human cells it set out to infect.This is in the early stages yet, so we don’t know if it’ll keep its promises, but if it does it should stand up to Covid’s shape-shifting ways, at least for a decent interval. 

It doesn’t sound like the decoy would completely neutralize the virus. They’re still talking about less severe infection and increased chances of survival. But staying a step ahead of the virus’s evolution would be good.

*

And finally, a bit of good news: The US has put the licenses for eleven Covid-related technologies into a patent pool so that low- and middle-income countries can access them. 

I gather that we don’t have poor countries anymore. We have low-income ones. 

Never mind. The patents include vaccines, drugs, research tools, and diagnostic whatsits. 

The bad news? In some cases, this only gets rid of one roadblock. Countries that want to work with these technologies would still need to negotiate with other patent holders, since nothing about this disease is simple, including who owns what. Nonetheless, it could help pressure companies to do the decent thing, and it could also increase the odds of the World Health Organization making medicines and vaccines available more quickly in the future.

Or so I read. It’s not as if I actually know this stuff.

“It’s a pretty big deal,” according to James Love, director of Knowledge Ecology International, which pushes (reckless radicals that they are) for intellectual property to be shared so it benefits the public. 

Shreds of hope in the pandemic

A Covid vaccine that’s in development could, potentially, create sterilizing immunity.

Sterilizing immunity? That’s the kind that prevents infection, which means a disease not only can’t get you sick, it also can’t use you to pass itself along to anyone else. If we could get enough people vaccinated with a sterilizing vaccine, we could stop this sumbitch in its tracks.

The snag, of course, is hidden in that word potentially. The thing’s still in development. But if all goes well, it could work on both the existing variants and any new ones and could create immunity even in people whose immune systems sleep through the current vaccines, through bouts of Covid itself, and through math class.

How does it work

The SARS-CoV-2 subunit vaccine (PreS-RBD) developed at MedUni Vienna is based on a structurally folded fusion protein consisting of two receptor binding domains (RBD) of the SARS-CoV-2 virus and the PreS antigen from hepatitis B, which serve as immunological carriers for each other, thereby strengthening the immune response.”

Allow me to translate that for you: It’s magic. Don’t worry about it. Although you might want to know that it involves a series of shots to build up to full immunity, and the first trials could start this year. But that depends on funding. 

Irrelevant photo: an ornamental cherry tree. Or I think it’s a cherry.

What doesn’t depend on funding?

Hmm. Dunno. As society’s organized, not much.

Why do I ask so many questions? They’re a cheap and easy way to organize a piece of writing. 

See? Even that depends on funding.

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A second shred of hope is that researchers have found a monoclonal antibody that could potentially be a treatment for all Covid variants as well as for SARS and MERS (if they reappear), and for some versions of the common cold. But there’s that word potentially again. So far, it’s gone through animal studies. Next they have to capture some humans and test it on them.

It’s being combined with another monoclonal antibody, and the two together are going by the name AR-701 cocktail right now, but before they’re released into the wild someone will have to give them a less pronounceable name to make them sound more scientific. 

The plan is for people to inhale it, and it could–again, that word–potentially last for a year. 

Covid and male fertility

A very (very) small study raises the possibility that catching Covid could have long-term effects on male fertility. 

Long-term effects? When someone says that,they’re never talking about  good long-term effects. In this case, it means that men who had recovered from Covid had lower sperm counts, more misshapen sperm, and sperm with lower motility than the comparison group. 

Again, it was a small study, so don’t go off the deep end with it. But I can’t help thinking that if you want to discombobulate someone who’s pounding the table about vaccines messing with women’s fertility–

Nah. I’m not going to suggest that. I’ll leave it to you to sink that low.  

News about Covid tests

Two rapid, accurate Covid tests are in development. I’ve written that sentence so many times before, changing only the number at the beginning, that I’m not even going to give you the details. But testing’s another area where–out of sight of the general public–work’s going on that could have an impact on the way this mess plays out.

 

Covid and the sense of smell 

Omicron’s less likely than the Delta variant to mess up the senses of smell and taste, but a failed attempt to lower people’s viral load–that’s how much Covid they carry around–turned out to protect patients’ sense of smell and taste. It also left them less tired than the patients who got a placebo.

They were using a drug called camostat mesylate, and it’s not clear yet whether it would help restore smell and taste to people who’ve lost them. You can live without both of them, but taste and smell are not minor losses.

The drug will need more testing–which in turn means more time, not to mention more money–before it can be used this way. 

An update on Covid in Africa

One of the mysteries of an already pretty weird disease has been its impact on Africa. According to a World Health Organization’s estimate, 65% of people in Africa have been infected by Covid. That’s something like 100 times more cases than have been reported. Covid cases are undercounted everywhere, and more so in Africa, because so many people have no symptoms. 

When they say “estimated,” they’re not talking about an educated hunch. They’re basing it on blood samples from around the continent. It’s not as accurate as counting every head, but it’s not pulling numbers out of thin air either. 

Earlier in the pandemic, the fear was that Covid would devastate Africa, but it’s turned out to be one of the least affected parts of the world. Multiple explanations are on offer. It has a low percentage of people with risk factors like diabetes, high blood pressure, and heart disease. It has a relatively young population. And some studies suggest that having been infected with other diseases, including malaria, may be protective, but that hasn’t been confirmed and rushing out to buy yourself a case of malaria is not recommended.

But being one of the least affected parts of the world doesn’t mean Africa’s unaffected. It’s had 250,000 Covid deaths. Or known Covid deaths–they also tend to be underreported worldwide. Only 15% of Africa’s population has been vaccinated, and that may mean only one vaccination, since the article doesn’t say “fully vaccinated,” which is the phrase that usually pops up.

Updates on the fight against Covid: from far-UVC to nasal sprays

Studies showing that far-UVC light kills coronaviruses started circulating fairly early in the pandemic, but they were small studies and the whole project seemed marginal–one of those promising possibilities doomed to be ignored by the folks who know best. A new study might be changing that. 

Might, mind you. As Yogi Berra might or might not have said, “It’s tough to make predictions. Especially about the future.” *

But first, let’s talk about UVC light: It’s short for ultraviolet light, and it kills germs, which (you may remember) we have reason to think is a good idea these days. But UVC has some bad habits. Basically, it doesn’t like people. It can burn the skin and damage the eyes, so if you want to disinfect a room with it, you have to figure out how to keep the light and the people apart. 

That’s awkward, what with Covid’s habit of circulating through the people’s lungs.

Far-UVC, though, doesn’t have those bad habits. It has a shorter wavelength, so it doesn’t penetrate skin or eye cells. But it still slaughters viruses and bacteria, since they’re smaller than the cells humans are interested in protecting.

Irrelevant photo: primroses with violet

So we now have UVC, far-UVC, and a bunch of dead viruses. 

The earlier studies demonstrating far-UVC’s usefulness and safety were conducted in small experimental chambers, and that left open the question of whether it would work in less controlled situations. Now someone’s done a demonstration in real-world conditions–a fairly ordinary room with roughly the same ventilation as a home or office, which is about three air changes per hour.

Does your home change air three times an hour? Does mine? Haven’t a clue, so let’s take their word for it. 

Under those conditions, far-UVC slaughtered 98% of the test microbes within five minutes. Compared to other ways of cleaning air, that’s–to quote someone involved in the project–spectacular. 

I know that, gentle vegetarian that I am, I’m not supposed to be cheering mass slaughter, but nobody ever accused the human race of consistency, and I am, to the best of my knowledge, predominantly human. 

If you want more detail of the experiment, you’ll have to follow the link. It involves numbers, although not many of them. But it doesn’t take many to send me running. Before I left, I did take in that the approach works with viruses, bacteria, and any additional infectious beasties that I’ve forgotten, none of which can mutate to develop a resistance to it.

So in the interest of public health, will far-UVC be coming to all indoor spaces near you? I’d love to think so; it only makes sense. The problem is that it not only makes sense, it costs money. Granted, it would also save money by making indoor air 98% safe, keeping us healthy, and quite possibly getting the pandemic (and assorted other diseases) under control, but we’ve all lived long enough to know that logic doesn’t necessarily apply. It’ll depend on who would be saving the money, who would be spending, and who would be making it it–not to mention who can see half an inch in front of their nose.

In the UK, I predict far-UVC will be adopted only if someone with strong ties to the Conservative Party–preferably a huge fuckin’ donor–goes into the business. At that point, it will become the savior of the nation and we’ll have a world-beating promise to install it everywhere. Some huge amount of money will then be spent and it will be installed in nowhere near as many places as we were promised.

But it’s hard to make predictions. Especially about the future.

*

UV can also be used to clean N95 masks, a new study demonstrates. Early in the pandemic, when protective gear was in short supply, people in medical settings tried pretty much everything to make the gear they had last longer, including disinfecting it with UV, since they had the equipment on hand for other uses. The masks were only meant for a single use, but they were desperate enough to stretch that.

Dianne Poster, a co-author of the study, said, “Right now, UV technologies are really in their infancy with respect to the healthcare environment.” And I’m quoting that because it strikes me as relevant–at least vaguely–to the use of far-UVC as well.

*

And while we’re in UVC mode, researchers have come up with a system that can alternate between plain ol’ white LED light to, you know, see by and UVC light to decontaminate an indoor space. The drawback is that it depends on motion-sensors to let it know when the room’s empty. So you wouldn’t want to fall asleep at your desk or be in the sensors’ blind spot.

The lights work in standard lighting fixtures, which should keep the cost down.

 

Other new developments

A nasal spray that promises to prevent Covid infection for 12 hours or treat the early stages of infection has passed mouse studies with flying colors and a company is trying to raise money for human studies, development, marketing, and all the uproar necessary (or at least expected) to get a product to market. 

Is this the same anti-Covid nasal spray I wrote about a few weeks ago? Possibly. At the moment, this one’s called N-0385, so you can see why the name didn’t stay in my mind. But who cares? I want this stuff badly enough to risk writing about it twice.

*

For the first time, doctors have used a vaccine to clear Covid from the body of an immune-suppressed patient who tested positive for seven months after first catching the virus.

This wasn’t long Covid, where symptoms keep dancing long after the viral band has packed up its instruments and gone home.The patient tested positive through that whole time. 

*

Assorted other tests and treatments and vaccines are also in the works. The new tests are faster and more accurate than what we’re currently using. Some of the treatments hold the promise of working against mutated forms of Covid by targeting a part of the virus that can’t mutate–the virus dies if it plays around with that spot. One vaccine would be highly tweakable when not just new variants but new diseases emerge, and I think we’ve learned by now that new diseases will emerge, although whether we’ll act on that knowledge is a whole ‘nother question.

I mention all this to say, Hang in there, folks. We will get through this.

 

Omicron BA.2

How dangerous is the new omicron variant, omicron point two? (It’s actually called BA.2, but never mind that.) For starters–and forgive me if you already know this–it’s no tougher than omicron point one. It can’t lift heavier weights, can’t run faster, and to date hasn’t stolen lunch money from any more kids than point one has. 

It is more contagious, but according to one measurement not by that much. You can tell that by how long it’s taking to become the dominant strain.

So if this study’s right, it kind of fooled us there. Early reports were that it was much more contagious.

The bad news–isn’t there always bad news?–-is that the people studying it expect people to get reinfected. You already knew that too, right? It’s a coronavirus. People do tend to get reinfected by them. So you have my encouragement to deck the next person who mentions herd immunity to you. Or you can ask me to do it if you’re not in the mood. I’m five foot not very much, 75 years old, and terrifying in a fight. 

And I need the exercise.

The article I stole all this from reminds us that “we’re entering a different phase of the pandemic,” and “need to now assess whether [a new variant is] a risk to the general population, . . . a risk to an individual person” or a risk to a specific group such as the elderly or the immune compromised.

Which is an interesting way of seeing the problem and I can’t help wondering if it’s an invitation to write off a few inconvenient groups in the presumed interest of the general population and to stop looking at Covid as a public health issue and start looking at it as a personal problem. 

But maybe that’s just me being cynical. 

The article ends with a call for people to wear masks when they’re sick, even if what they have isn’t Covid, because they’ll protect other people from whatever they have. It’s a radical thought: inconvenience yourself marginally to help other people significantly. 

There’s got to be something wrong with that.

*

In the meantime, the World Health Organization says omicron point 2 is 30% more transmissible than omicron point one. I can’t compare that estimate to the one above since their measuring tapes are marked differently. Make what you can of it.

WHO also says the European countries that have dismantled their anti-~Covid measures have done it too “brutally,” going from too many restrictions to too few. It reminds us that cases are rising.

In Britain, they’re rising significantly, and deaths are also going up. Not the way they did at the start of the pandemic, but the trend is up all the same, and the people who are dying of it are still dead. We don’t seem to be treating Covid as a public health problem anymore, just a personal one. If we see a coronavirus coming at us, we’re advised to either duck or dodge to the left. 

It’s a fantastically effective strategy.

 

* Yogi Berra is also supposed to have said, “I never said half the things I said.” So you want to approach his quotes with caution. They’re likely to explode on contact with a human brain.

Finding Covid’s weak spot

Researchers have found a vulnerable spot at the base of Covid’s spike protein. This is the medical equivalent of the moment when you found that spot right by your older sister or brother’s knee. You know the one: All you had to do was squeeze it and they were helpless. Instantly. Whatever they were doing to you (unless they were homicidal, in which case you needed something more than this trick), they stopped.

The problem–then and now–is how to reach that spot and (the knee image breaks down here) what to do when you get there.

The good part is that most beta coronaviruses, not just on Covid, have that same weak spot.

What’s a beta coronavirus? It’s a category of virus that causes everything from a cold to Covid. It includes diseases that could jump from animals to humans at some point in the future, starting the next pandemic.

Why is this a weak spot? Because it either doesn’t mutate or mutates slowly. I’m going out on a limb here (put that saw away, please), but I seem to remember reading that when a site doesn’t mutate it’s because the virus can’t function without it. Random mutations will change it, but those versions don’t survive.  

So let’s go back to the question of what to do once we find that spot. We create either a vaccine that targets it or an antiviral that does the same. And by we, of course, I mean scientists. People who–unlike me–actually know how to do this stuff. 

It won’t happen next week, but knowing where the weak spot is? It’s a step.

Irrelevant photo: “Allow me to explain why we need to keep this box.”

Speaking of antivirals 

The bark of the neem tree seems to hold promise as a Covid treatment. 

The tree’s native to India and it’s been used as a treatment for parasites, viruses, and bacteria for much longer than those categories were around to sort diseases into. 

Scientists fooling around in their labs see the bark extract as promising. The next step is to isolate the useful components, then figure out dosage and test the stuff.

Here’s wishing them–and us–luck. In the meantime, it’s probably not wise to test neem bark on yourself, although it is for sale on the internet and recommended for an assortment of ills by the (I’m guessing here) deeply alternative. 

It’s not the only antiviral being explored, just the one I happen to have landed on this week. 

I also found articles on a few new testing methods that are, or promise to be, cheaper and faster than the current ones. Now that so many countries are abandoning testing, though, I’m not sure whether they’ll be commercially viable, no matter how useful they might be.

 

Remember social distancing?

You remember the advice we got from the start of the pandemic that six feet (or two meters if your mind’s metric) is enough distance to keep you from catching (or spreading) Covid? It turns out to have been based on a 1934 model (by  William Firth Wells, if anybody asks) of how respiratory infections spread.

Just how dated is the model? Well, two meters hasn’t changed its length, and neither has two feet–at least to the best of my knowledge, although when you leave the metric system measurements can be unreliable, and if you want to take a side trip into non-metric mayhem, allow me to push you in this direction. It’s not at all relevant, but if you have nothing better to do with yourself and you enjoy a mess, it should be fun.

Back to social distancing, though: A recent study says the 1934 model was oversimplified. The new study looks not just at distance but also at temperature, humidity, viral load, and whether people were coughing, sneezing, or talking. A person talking without a mask can project droplets for one meter. If they cough, make that three meters. If they sneeze? Seven meters. 

Add a surgical, FFP2, or N95 mask, though, and ” ”the risk of infection is reduced to such an extent that it is practically negligible—even if you’re only standing one meter away from an infected person,” according to Gaetano Sardina, one of the researchers behind the study.

 

Vaccines in Africa

Six African countries–Egypt, Kenya, Nigeria, Senegal, South Africa, and Tunisia–will be getting the technology to produce Covid vaccines through a World Health Organization program

Only 11% of Africa’s population is fully vaccinated. That compares with a global average of around 50%. And Africa  currently produces just 1% of coronavirus vaccines. An earlier program to get vaccines to poorer countries, COVAX, has missed target after target and only 10% of people in its targeted countries have received at least one dose. 

The current program replicates commercially available vaccines, somehow dodging the patent issues. Don’t ask me. I know roughly as much about patent law as I do about science. Maybe they’re just producing the stuff anyway and daring the companies to sue.

Although Doctors Without Borders welcomed the program, it pointed out that it’ll be a lot of work to recreate the vaccines and called instead on the original producers to help.

“The fastest way to start vaccine production in African countries and other regions with limited vaccine production is still through full and transparent transfer of vaccine know-how of already-approved mRNA technologies to able companies,” a spokesperson said.

 

A Report from the Department of Shell Games

A research company that Pfizer contracted with to test its vaccine has been accused of messing with the data. According to the BMJ, a whistleblower reported that “the company falsified data, unblinded patients, employed inadequately trained vaccinators, and was slow to follow up on adverse events reported in Pfizer’s pivotal phase III trial. Staff who conducted quality control checks were overwhelmed by the volume of problems they were finding.”

After more than once notifying the company, Ventavia, of the problems, the whistleblower got hold of the FDA–the US Food and Drug Administration.

She was promptly fired.

Other former employees that the BMJ talked to generally backed her claims. 

I’m printing this not in support of anti-vax arguments but because it’s from a legitimate source and seems to be true. The vaccine’s been widely used with minimal problems. But if you had any faith left in for-profit medicine, this might rattle it a bit.

 

A quick feel-good story

The Mask Nerd of Minneapolis has set up a lab in his bathroom and for the past 18 months has been testing masks there to see which ones are most effective. He’s got an air compressor on the bathroom sink and an I-don’t-know-what-but-it’s-impressive on the windowsill. 

Aaron Collins is a mechanical engineer with a background in aerosol science. 

“I just want better masks on more faces,” he said. “If you know the secret—if you know a piece of information that could help people—it’s your moral obligation to make sure that people are aware of that.”

You can find him on Twitter under the handle @masknerd. He also posts videos on YouTube.

“This is why we’re scientists,” he said. “This is why we’re engineers. We’re not in it for the money. … We’re in it because we have a passion for changing the world in positive ways.”

 

And on an unrelated topic

An unimportant and bizarre effect of the invasion of Ukraine is that a post of mine, “Is Berwick on Tweed at War with Russia?” is getting an absurd number of hits, going from 3 on a day at the end of January to 249 on a day in the first week of March, and then 74 the next day.

To be clear, I’m all for people educating themselves on the background of this war, but the Berwick on Tweed story? This is the kind of research that convinces people that Hilary Clinton was the head of a pedophile ring operating out of the basement of a pizza parlor that didn’t even have a basement.

But never mind the pizza. Berwick is not at war with Russia. It has no connection to Ukraine. 

Go study some real history.

I’m happy to report that, on the third day, hits on the post settled back to 3. 

What do we know about the new Omicron variant?

Well, on its wanted poster, it’s called BA.2, so let’s call it that. We don’t know what it calls itself. It’s estimated to be 1½ times as infectious as its relative BA.1.

What kind of relatives are they? They’re being called sister viruses, since .2 isn’t a descendant of .1, although why it’s a sister instead of a brother I don’t know. Viruses never allow themselves to be shoved into little pink or blue baby suits.

Never mind. If they want to be sisters, they can be sisters. Kids, you can be anything you want to be. 

Within limits. We’ll discuss the fine print when you’re older.

Let’s set that aside, okay? We’ve got some good news for a change: BA.2 doesn’t seem to be any more dangerous as BA.1, and the vaccines seem to be as effective against .2 as they are against BA.1.

Irrelevant photo: The first celandine are out. They’re looking a little bruised, as if they’ve gone nine rounds with King Winter, which they have, but they’re in bloom.

End of good news. Dr. Gregory Poland, of the Mayo Clinic’s Vaccine Research Group, said that variants will “continue to happen and infect every unvaccinated person until people are vaccinated and until they’re wearing a mask. You can choose to ignore these facts―these clear data―but the virus could care less what we think. The virus is going to find people who do not have protective immunity and infect them.”

That should be “couldn’t care less,” but you know what he means.

 

So what should we be doing?

According to WHO Director-General Tedros Adhanom Ghebreyeus, “We are concerned that a narrative has taken hold in some countries that because of vaccines—and because of omicron’s high transmissibility and lower severity—preventing transmission is no longer possible and no longer necessary. Nothing could be further from the truth. It’s premature for any country either to surrender or to declare victory. This virus is dangerous and it continues to evolve before our very eyes.”

That quote’s a few weeks old, but we’re not listening. Many countries are undoing their Covid restrictions because, hey, they know better. And it’s over. 

Meanwhile, Covid’s overwhelming Hong Kong and desperate hospitals were setting up beds outside.

How much of Hong Kong’s population’s vaccinated? The closest I could come to an answer is this: If you compare the number of doses delivered to the population, 78.9% of the people could have had two doses. 

 

Vaccine news

Scientists at the Wistar Institute are working on a vaccine that, at least in animal studies, creates a stronger, broader, and more durable protection than the current vaccines, and does it with a single, low dose that can be stored at room temperature. If that’s not enough, it can also be adjusted quickly as new variants arise.

And it makes a decent cup of tea if you ask politely.

It uses three technologies: immune focusing, self-assembling nanoparticles, and DNA delivery. Now let’s see if I can explain what those are.

Well, no, I can’t quite, but I can throw some language at you to make it sound like I understand a bit of this. 

The vaccine shoots you some naturally self-assembling proteins (whatever they may be), and they then form nanoparticles that arrange themselves–oh, hell, I’m lost, so I’ll quote: “By arranging themselves into structures that resemble an actual virus, the nanoparticles are more easily recognized by the immune system and transported to the germinal centers, where they activate B cells which produce protective antibodies.”

To translate that, they use long words to activate your immune system, creating “stronger levels of protective, neutralizing antibodies.” 

If I understand this correctly, all this convinces the body to produce things that would normally be produced in high-tech factories.

They’re at the animal-test stage, and so far it’s producing a stronger, longer-lasting immune response than the existing vaccines. With that data in their pockets, they’re scrambling around, trying to raise the money for human trials. 

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Another set of trials is using a nasal spray to deliver a booster vaccine, focusing the immune system on the areas Covid attacks first, the nose and lungs. It depends on the recipient having already had an mRNA vaccine or possibly a previous infection.

The idea, since this focuses the protection on the nose and lungs, that it would prevent both infection and transmission. 

They’ve run tests on mice and will test the approach on larger animals, then hope to start human trials.

*

Researchers at the Massachusetts Institute of Technology have worked out a way to inject RNA and DNA into the stomach lining by way of a capsule the size of a blueberry, allowing it to reach the digestive tract directly. 

Other than driving anti-vaxxers nuts, what’s the purpose? It would let you–or, ideally, someone who knows what they’re doing if you’re no more skilled at this than I am–deliver medicine for gastrointestinal problems directly to the gastrointestinal work site. It might (or might not–it hasn’t been fully tested yet) also let you deliver an RNA vaccine in a new and interesting way, one that would be easy on needlephobes and wouldn’t make small children scream, although that last possibility depends on someone getting them to swallow the blueberry. 

And, of course, it would drive the anti-vaxxers nuts. 

 

Do masks work?

A California study reports that wearing an N95 mask or its equivalent reduces the chances of becoming infected with Covid. In Europe, the N95 is called an FFP2; both are also called KN95 masks or just plain ol’ respirators.

These aren’t the blue disposable masks that blow around the parking lots of this and many other fair lands. They’re also not your average cloth masks. They’re the more expensive ones made of I have no idea what but designed not just to keep you-the-wearer from sharing your germs but also to protect you-the-wearer from stealing other people’s.

That’s other people’s germs, not their masks, and that’s a huge and important difference. As mask mandates are reduced and as some people insist on their right to breathe in other people’s faces, they become a form of self-defense. 

Some N95s are disposable. Others are reusable–up to a point, estimated at about 40 hours of use. 

The study involved 3,000 Californians, and it’s a less than perfect study. For one thing, it relies on what people say they’ve done, with no reality check built in. That’s always dicey. You know what humans are like. It was also limited to people who chose to get tested for Covid. Still, it might give us a hint or two about what’s happening out there.

So with all that out of the way, would I please tell you what the damn thing said?

Why yes, I’d be glad to: 

People who said they always wore masks (any kind of masks) in public indoor settings were 56% less likely to test positive for Covid than people who didn’t wear masks. That went up to 83% for people who wore N95 masks. People who wore surgical masks were 66 percent less likely to test positive.

A more controlled study, published in the Proceedings of the National Academy of Sciences, tested the rate of transmission when an infected person talked for an hour to an uninfected person. When the person who wasn’t infected wore a well-fitting mask N95 or its European equivalent, the FFP2 mask, the risk of infection was 20 percent. 

If both people wore surgical masks, the risk of infection went up to just under 30 percent. When both N95 masks or their equivalent, though, it dropped to 0.4 percent. 

The two studies reported their findings differently, so we can’t compare the results–or I can’t anyway–but the second one does tell us that two people wearing good masks present less of a risk than one person doing the same. 

Should we do the howevers now?

To work most effectively, the N95 mask has to be fit tested, which is something they do at hospitals and in hazardous workplaces. It’s complicated enough that no one does it at home. Or in the supermarket, or on the bus. Most people who put them on without fit testing them don’t get a complete seal between the mask and their face, even if it feels like a good fit. 

So they’re less than perfect protection, but even if they’re not fit tested they’re still decent.

How decent? Sorry, I sank, but you’re welcome to dig around in here and figure it out yourself. I warn you, it involves numbers. Also words. Don’t say you weren’t warned. In layperson’s terms, I think the answer would be not enough to make someone with a compromised immune system safe but more decent than a cloth or disposable mask. 

I haven’t looked into how the second study was set up, but I did wonder. Did they actually use an infected person, putting the uninfected person at risk? Dunno. How many of the people being talked at expired from sheer desperation before the hour was up? Dunno that either. I’m sure it depended on the talker. With some people I’ve known, I wilt after fifteen minutes of listening.

Is the pandemic over?

Can I be the bearer of bad news? 

You’re not here to answer and the news won’t surprise you anyway, so I’ll just go ahead: The World Health Organization tells us that the pandemic’s not over. 

How do I know? Because Tedros Adhanom Ghebreyesus, WHO’s director general said, “This pandemic is nowhere near over.”

That’s a subtle way of putting it, but if you pay close attention you can tease out the message.

He also said, “Omicron may be less severe, on average, but the narrative that it is a mild disease is misleading. Make no mistake: Omicron is causing hospitalisations and deaths, and even the less severe cases are inundating health facilities.”

And if that’s not enough, “While Omicron causes less severe disease than Delta, it remains a dangerous virus—particularly for those who are unvaccinated. We mustn’t allow this virus a free ride or wave the white flag, especially when so many people around the world remain unvaccinated.”

The “overwhelming majority” of people admitted to hospitals are unvaccinated, he said.

 

Irrelevant photo: The first daffodils are out.

Has Covid gone endemic?

But what about the idea that Covid’s changing from a pandemic to an endemic disease and that we need to stop whining and learn to live with it? 

Let’s start by figuring out what that means: An endemic disease is “consistently present but limited to a particular region. This makes the disease spread and rates predictable.” 

Sorry, but I need to step in here. That last sentence doesn’t mean that being consistently present and limited to one region makes the disease spread. It means those things make the disease’s spread predictable.

Which was probably already clear, but I couldn’t help myself. I used to misunderstand people for a living, and old habits are hard to break.

So how do we measure up to that definition? We’ve blown it on the “limited to a particular region” part, but let’s not be fussy. Are the spread and rate predictable? 

Nope. Not only do we have sharp spikes, we have no idea when a new variant will come along or how dangerous or benign it’ll be. We do know that the climate’s right for creating new variants.

Another defines an endemic disease as constantly present but not causing the upheaval or massive number of infections that an epidemic does. Covid hasn’t become endemic by that definition either.

But again, let’s not be fussy. Even if Covid doesn’t fit either definition, couldn’t we pretend it does, get over our fear, and learn to live with it?

Well, it depends on how we want to live. Or die. Being endemic doesn’t mean it’s no threat. Before penicillin, tuberculosis was endemic. [Late correction: Penicillin has nothing to do with tuberculosis. See the comments below. It’s the things you think you know that trip you up.] So was syphilis. They wrecked a lot of lives. They killed a lot of people. People learned to live with them because they had no choice, but I wouldn’t make a virtue of it. 

It would be interesting to look at how much resistance measures to control their spread met. But that’s another post.

Learning to live with Covid is one of those phrases that, when you look at it, means nothing. Does it mean we tear off our masks, join a germ exchange, and relearn the lyrics to that Country Joe and the Fish song with the line “Whoopee, we’re all going to die”? Or does it mean we wear masks religiously, invest in some serious ventilation, and pass vaccine mandates? They’re both ways of living with a virus.

Does it mean learning to live with a constant threat, not just of death but of disability from long Covid–a threat that no one’s been able to quantify yet? If so, how will we decide to live with it?

Michael Ryan, the head of emergencies at WHO, said, “Endemic malaria kills hundreds of thousands of people; endemic HIV; endemic violence in our inner cities. Endemic in itself does not mean good. Endemic just means it’s here forever.”

Okay, he skipped the predictable part, but we did say we weren’t going to be fussy.

“What we need to do is get to low levels of disease incidence with maximum vaccination of our populations, so nobody has to die,” Ryan said. “The issue is: It’s the death. It’s the hospitalizations. It’s the disruption of our social, economic, political systems that’s caused the tragedy—not the virus.”

And in case you’re betting on the next variant being milder than Omicron, mutation isn’t a one-way street. The direction of travel is random. 

 

Could you scrape up some good news, please?

Possibly, but let’s whisper so we don’t spook it: Some experts say that once the Omicron wave recedes we may get a period of quiet. The theory is that we’ve built up widespread immunity that could keep future waves from hitting as hard as they have in the past. 

Do waves hit? Is that a mixed metaphor? Do we care?

Probably, but let’s focus on the important stuff.

That’s not a unanimous opinion and other experts are more cautious, reminding us that it’s not clear how long Omicron immunity will last or whether a new variant will evade it. Omicron has demonstrated that even a relatively mild version of Covid can put a huge strain on health systems–and on the people who work in them. 

And as Boghuma Titanji, a virologist at Emory University School of Medicine, put it, “Wealthy countries moving on, I fear, will push the issues of access to vaccines and therapeutics access down the global priority list.” Which would mean not only more deaths in poor countries but (self-interest alert here) more variants loose in the world.

On the other hand, data suggests that the human immune response becomes better and broader every time it’s exposed to Covid’s spike protein. 

On the third hand, however, Leif Erik Sander, an immunologist at the Charité University Hospital, says that Omicron’s spike is so different from the spike in earlier variants that it’s not clear just how much immunity the Omicron wave will leave us with.

At which point we’re out of hands and it’s time to talk about what the next variant might look like. One possibility is that Delta could stage a comeback tour. Omicron was able to spread so quickly in part because the earlier versions hadn’t left us immune to it. Once that advantage fades, it may die back, leaving Delta room to work. Or they could work out their disagreements, move in together, and have babies, which could easily be uglier than either parent.

And, since a handful of antibodies does not an immune system make, what happens if a new variant evades not just our antibodies but our T cell response? (Reminder: T cells are an essential part of your immune system. Don’t leave home without them.) Well, if that happens “we’re dealing with another pandemic,” Shabir Madhi, a vaccinologist at the University of the Witwatersrand, said. But “the likelihood of that happening, I believe, is quite slim.”

 

Let’s try that good news thing again . . .

. . . because my last try didn’t go well.

Researchers in Finland are working on something they call a biological mask–a spray that could (assuming the tests go well) protect a person against Covid for 8 hours. 

It’s not meant to replace vaccines but to supplement them. If a person’s immune system doesn’t respond well to the vaccines, this spray is their friend. Or if they’re faced with a combination of a vaccine-evading variant and too many human beings in a risky setting, then ditto. 

The active molecule in the spray is called TriSb92, a name I forgot as soon as I got past the comma. Never mind. It’s a clever little beast that targets a part of Covid’s spike protein that’s common to all variants–at least so far–and once it makes contact it keeps the virus from going to work. You know what that’s like. It calls in sick and loses its job because spike proteins have no union and therefore no sick leave and no job security. 

If it was anything other than the Covid virus I’d feel bad about that, but it’s got it in for us. Have no mercy.

The developers think the spray might also be effective against new coronaviruses that emerge. Keep your fingers crossed. This sounds promising.

Can a vaccine protect against all Covid variants?

A vaccine designed to fight off all the current and future Covid variants has gotten through a small early trial and is ready to test on a larger group. 

Instead of targeting only Covid’s spike protein, which has been mutating madly, it backs that attack up with–um, yeah, something else. 

You want details? Fine: It drives “broad CD8+ T cell immunity.” I drive a little Toyota Aygo and the mileage isn’t bad but I bet the vaccine’s is better, because it also “enables inclusion of a wide array of highly conserved viral epitopes.”

Never mind. I didn’t understand it either. That’s why it’s in quotation marks: to keep it safe from sticky little editorial hands.

The vaccine’s designed as a booster shot, and it works at a much lower dose than the current ones. 

Irrelevant photo: A neighbor’s camellias just came into bloom. In January.

*

The U.S. Army is also working on a vaccine that could be effective against all Covid variants, although I don’t think it’s progressed as far. A press release quotes Dr. Kayvon Modjarrad as saying, “Our strategy has been to develop a ‘pan-coronavirus’ vaccine technology that could potentially offer safe, effective and durable protection against multiple coronavirus strains and species.”

Notice that they’re talking about not just Covid but coronaviruses in general. And also that they’re talking about long-lasting protection, so we wouldn’t need repeated boosters. But the key word in the quote is potentially. Don’t bet a large sum of money on this one yet, or even on the first one I mentioned, but do allow yourself a nice jolt of hope. And maybe a little ice cream to wash it down. 

This may or may not be the universal vaccine that gets to the finish line, either first or at all, but like the one above, it’s a reminder: These aren’t the only efforts to find a vaccine that puts us ahead of a mutating virus instead of always running to keep up. The article I stole this from is oriented to the U.S. and mentions that major figures in the National Institutes of Health are behind the effort, indicating the government’s willingness to fork out some cash.

*

Meanwhile, researchers from the University of Hong Kong are working on a vaccine that will–assuming everything works out as planned (and as the saying goes, the crick don’t rise)–keep Covid from setting up a home in people’s noses. 

That would close a gap left by the current vaccines: They’re good at reducing serious disease, hospitalization, and death, but they’re not as good at keeping Covid from spreading. This one, if it works out, could stop the spread, because in spite of what people who wear masks under their noses think, the nose has an active role in both catching and spreading Covid.

The vaccine’s at the human-trials stage of development.

You remember humans. A two-legged, furless species, and a problematic one.  

Professor Chen Zhiwei, who co-leads the research, said, “The biggest challenge for our COVID-19 vaccine development is that we do not have a vaccine manufacturing plant in Hong Kong, which has delayed the translation of scientific discovery into clinical use.”

*

This next item isn’t about a vaccine, but since we’re talking about Covid and noses, let’s slip it in here: Researchers in Australia are playing with a nasal spray that they hope will stop the progression and spread of Covid. It involves heparin, which is used widely to treat and prevent blood clots and which can be kept at room temperature.

I never knew how friendly the phrase room temperature would come to sound.

Professor Gary Anderson explained how it works: “Covid-19 first infects cells in the nose, and to do that the virus must bind to Heparan Sulfate on the surface of nasal cells lining the nose.

“Heparin—the active ingredient in our spray—has a structure that is very similar to Heparan Sulfate, so it behaves as a ‘decoy’ and can rapidly wrap around the virus’s spike protein like a python, preventing it from infecting you or spreading the virus to others.

“Importantly, this nasal spray should prove effective for all Coivd-19 variants because the Heparan Sulfate binding site is essential for infection, and is likely to be preserved in new variants. Heparin binds avidly to the Omicron variant currently sweeping through the country.”

They expect to start clinical trials in the first quarter of this year. If it works out and promises to bring back what we so nostalgically call normality, some troll farm will unearth that python image and convince 24% of the population that they’d be spraying python eggs up their noses.

*

In 2020, Amazon’s charitable arm, Amazon Smile, donated more than $40,000 to anti-vax groups. That’s a small proportion of Amazon Smile’s donations, but it can be a hefty amount for a small organization. 

Smile, everyone. The python eggs you ordered will be at your door tomorrow.

 

Antiviral pills

Meanwhile, Covid cases are still climbing, and even though the Omicron variant seems to be less fierce than the earlier ones, a hell of a lot of people are hospitalized with it. 

But “hospitalized with it” doesn’t mean that Omicron, or any other Covid variant, drove all of them to the hospital. Some of them were hospitalized for other reasons but also turned out to have Covid. So the good news is that not everyone included in that statistic is so sick from Covid that it’s driving them to the hospital, but the bad news is that since they have it coincidentally, the hospital has to turn itself inside out to keep them from spreading the damn thing. 

Okay, I admit, “a hell of a lot of people” isn’t, strictly speaking, a statistic.

But never mind that. How helpful are the new antiviral pills?

It turns out that they’re not a magic wand. And they won’t be given to everyone. They’re for people with mild to moderate Covid who have risk factors of one sort or another–people with chronic illnesses, compromised immune systems, a history of having celebrated too many birthdays. That sort of person. The sort of people Covid’s most likely to hospitalize. 

And the pills come with a list of thou-shalt-nots. One of them isn’t okay for kids under twelve or pregnant women. (It hasn’t been tested on pregnant men yet.) The other isn’t safe for people with kidney or liver problems. Both interact with other medications, which will rule them out for some people. 

According to William Schaffner of the National Foundation for Infectious Diseases, “It’s not like going to a machine, putting in a quarter and getting out a candy bar. It’s a serious prescription of a medication, and the health care professionals need to do some screening and education.” 

That’s me you hear out in the hallway, pounding on the vending machine and yelling that I want my candy bar. You know how much good it does.

The pills have other limitations: If they’re going to work, they have to be taken within five days of the first symptoms, so people in high-risk categories will need to get tested quickly. The Covid symptoms that the article lists (again, this is a U.S.-oriented article) are: fever or chills, cough, headache, difficulty breathing, loss of taste or smell, sore throat, fatigue, runny nose, and muscle or body aches.

But Britain, in its wisdom, is still listing only the original Covid symptoms: a high temperature, a new continuous cough, or changes in your sense of smell or taste. In other words, they’re not listing the new variant’s symptoms, and last time I looked if you’re  in Britain and want to book a PCR test–the slower, more accurate Covid test–you have to swear that you have one of the three symptoms or have been exposed to someone who et cetera. So if you have the newer symptoms and want to do the responsible thing and get tested, your best course of action is to lie through your teeth and claim the old ones.

You’re dealing with an algorithm. There’s no point in arguing. 

 

Shortages

So we’ve established that you need to get tested as soon as possible, right? Well, guess what both Britain and the U.S. are short of: No, it’s not irony, it’s Covid tests

They’re not the only countries where they’re running short, but I can barely keep up with two. Let’s focus on Britain, since that’s where I live.

In Britain, pharmacies–those things that Americans call drug stores–sent out a warning in December that they were going to run short of home test kits. Guess what the government did: zilch. It didn’t even answer the letter. So pharmacies are running out, and you can’t necessarily get home tests from the government website either. 

But the Department of Good Planning did offer to shorten the quarantine period for anyone with two negative tests on day whatever and whatever plus something, and it also urged people to test themselves before going to a New Year’s Eve Germ Exchange, thus increasing the demand for tests. And now that the schools have reopened, students are urged to test themselves more often. Somehow.

And to complete the picture, the country’s lone distributor of the home test kits received 2.5 million of the things, then shut for Christmas. It reopened on the 29th. 

Pharmacies can order 55 packs per day. Each pack has seven tests. 

It reminds me of an old rhyme: As I was going to St. Ives, I met a man with seven wives. Each wife had seven bags, each bag had seven cats, each cat had seven kits. How many were going to St. Ives?

One. No doubt someone high up in the government who thought it was a good time for a vacation.

In the meantime, health care workers haven’t been able to get tests, many hospitals are short-staffed, and the government’s talking about building temporary hospitals in parking lots to deal with any overflow.

If they’re talking about how to staff them, the word hasn’t filtered down to me.

It may be a coincidence that international travelers no longer have to isolate or take a PCR test after–or before–they arrive in Britain. (Those are the slower, more expensive tests. They’re in short supply too.) Instead, they can take the cheaper, faster test no later than two days after they arrive.

If they can find one. 

To quote PoliticsHome, on January 4, “the UK recorded 218,724 new Covid cases, the first time a daily rate has exceeded 200,000. The Omicron variant now accounts for the majority of infections and it is no longer believed that the travel restrictions will curb the spread of infection.” 

I believe that translates to, “This thing’s so far out of control that, what the fuck, we give up.”

The Foreign Office said it would get back to me about joining the diplomatic corps.

 

So how serious is Covid?

In 2020, Covid decreased in life expectancy in 29 countries. For a number of Western European countries, it was the biggest decrease since World War II. 

Why 29 countries? They had statistics available in a form the study could use, so the study covers the U.S., Chile, and most of Europe. That leaves out a fair number of countries that had severe outbreaks, so can we agree that the study underestimates the decrease?

Thanks. I thought we could.

The largest loss was among males in the U.S., whose life expectancy at birth decreased 2.2 years compared to 2019 levels.

One of the study’s lead authors, Dr. José Manuel Aburto,, said, “To contextualize, it took on average 5.6 years for these countries to achieve a one-year increase in life expectancy recently: progress wiped out over the course of 2020 by Covid-19.”

It might be tempting to think, hell, if we’re talking about one year at the end of a long life, how much difference does it make? But it takes a lot of deaths to lower the average–deaths of real people, with real lives. With real friends and real families, who feel real grief at their loss and whose lives may well have been torn apart by it, emotionally, economically, or both. 

And those deaths don’t necessarily come only to the elderly. 

That’s worth thinking about the next time someone implies that learning to live with Covid means we should all tear off our masks, unvaccinate ourselves, enter into germ exchanges, and go out and play in traffic.