Fireflies and Covid vaccines meet conspiracy theories

If you’re vaccinated, you’ll be glad to know that the Covid vaccines will not make you glow in the dark. Or else you’ll be disappointed. How you feel about it is up to you, but the reality remains unchanged.

I mention this because Newsmax’s White House correspondent tweeted that “the vaccines contain a bioluminescent marker called LUCIFERASE so that you can be tracked. Read the last book of the New Testament to see how this ends.”

The last book of the New Testament? When’s it due out? I’ll pre-order it and get back to you with a spoiler as soon as I have it in my non-glowing paws. 

In the meantime, though, let’s talk about luciferase, which does exist, isn’t scary, and doesn’t need capital letters. It’s the stuff that makes fireflies glow at night. And (because we can’t take anything for granted anymore) they glowed well before Covid vaccines were created.

Irrelevant photo: Bindweed, also known as a morning glory

Is luciferase in any of the Covid vaccines? No, but it is used in labs–and again, and was well before any of us put the letters C, O, V, I, and D together in that order. 

Let’s turn to Axandra Becker for an explanation of what scientists at the Texas Medical Center did with the stuff earlier in the pandemic–and let’s switch to the past tense to do it: It was used to “develop faster and more accurate diagnostic tests for Covid-19 as well as to analyze potential therapies and gain a clearer understanding of the SARS-CoV-2 virus itself.” 

They inserted luciferase into the genomes of the Covid, Zika, and West Nile viruses. That produced light, which made it easier to track where they (I believe that’s the viruses we’re talking about) went in a cell culture, along with what they’re reading and what they do on social media.

Okay, I’m filling in a bit where the explanation of the tracking went wavery. All it said was that they could track what was happening in them.

Admit it, my version’s more fun.

What’s any of this got to do with Lucifer? Because we can’t take anything for granted, we’ll start on the ground up and work our way up. Lucifer’s the antagonist who makes sure that there’s a market for that forthcoming book of New Testament, because without tension, no one can keep a plot rolling for that many pages and through two testaments, and antagonists are a cheap and easy way to create tension. If you open with “And God created the world and everything was nice from there on,” you have a short book.

Lucifer’s name comes from the Latin for bringer or light, or morning star, so when scientists isolated the stuff that makes fireflies (and a few other lucky creatures) glow, some clever devil named it luciferase.

Okay, we’re done with the name, now let’s go back to the vaccines: There’s no luciferase in them. None. Zero. It was used in research only. I’m multiply vaccinated and even in this post-truth era of ours I still can’t see my arm after I turn off the light. No matter what religion you do or don’t adhere to, you can get your vaccine safe in the knowledge that Lucifer–whether you believe in him or not–is not in it.

And you’ll still need a light source other than your own lovely self if you want to read in bed.

 

“A disease of the unvaccinated”

A doctor who writes as the Secret Consultant (consultant is British for a senior hospital-based doctor) says that although some vaccinated people are hospitalized with Covid, they tend to be elderly or frail or have underlying health problems. In Britain, an unlucky few otherwise healthy people will be hospitalized briefly on the general wards, but in the intensive care unit, “The patient population consists of a few vulnerable people with severe underlying health problems and a majority of fit, healthy, younger people unvaccinated by choice.”

None of them glow in the dark. Do you have any idea how helpful it would be if they did?

 

An update on needleless vaccination

Assorted groups of scientists are working on ways to deliver vaccines without using needles. One group’s working on a Covid vaccine in pill form. A trial has been approved in South Africa and will start enrolling people any day now–if it hasn’t started already.

A second approach uses a patch with spikes so tiny you can’t actually see them. These deliver the vaccine into the skin, not the muscle, which turns out to be an advantage. Muscle tissue is–well, think of it as a semi-arid zone as far as immune cells are concerned. You won’t find many of them there. Skin, on the other hand, goes into high alert when you bother it with a bunch of teeny tiny needles. The immune system wakes up, asks, “Did you need something from me?” and sends out messengers, who quickly learn to fight what looks like an invading army.

But patches have other advantages as well: 

  • They use less vaccine than a needle.
  • Babies don’t scream when they’re vaccinated–or if they do it’s for some other reason. 
  • The vaccine in patches is stable at room temperature and keeps for longer than the stuff used for needles. 
  • Anyone who can find one arm with the other one could use them. That means you could stick the patches in the mail for people to use at home.

One version of the patch has been tried on mice. Other versions–well, I don’t know what stage they’re at. The problem at the moment seems to be how to produce them in large enough quantities. 

 

Antiviral news

Scientists working at assorted universities and institutes in India have found an antibiotic that also works as an antiviral by messing with Covid’s ability to replicate.

But let’s not pretend that I can explain how it works. The best I can do is try to scare you with phrases like “amino acids . . . present in the ‘finger’ subdomain of the nsp12 protein” and  “the viral protein’s ‘palm’ subdomain cavity and the linear form of Kannurin.”

What matters is that “this approach could help us address the pandemic threat when yet another novel coronavirus emerges and medicine needs new pharmaceutical treatments ahead of the development of a suitable and widely available vaccine.” 

It’s good to know that, however screwed up humanity is, we have people among us who can figure this stuff out. 

 

Why you should take candy from strangers

A test group of 3,000 people will be sent a piece of colorless hard candy every day for 90 days. They’ll sniff it and eat it and then log onto an app to report what flavor it is and how sweet or sour it is. If the app notices any drop in drop-off in their sense of smell or taste, it will tell them to quarantine and get a Covid test.

The goal is to see if this is a way to spot Covid in otherwise asymptomatic people. 

 

How does Britain fight Covid?

Why, by pissing money out the window, that’s how. 

Okay, that’s not entirely fair. It got a vaccination program rolling early and that’s been reasonably successful, although the government followed that up by encouraging us all to run out and infect each other, since, what the hell, we’re mostly vaccinated. 

Except for the people who aren’t. Or are too frail for the vaccines to spark a good immune response. But that’s okay, because compassion’s not a big thing lately so we don’ thave to care.

But let’s go back to the money: We’re in the midst of a sleaze-valanche, and every few days we get more news about conflicts of interest and politicians giving lucrative favors to friends and donors. 

Now comes the news that we’re spending roughly £1 million a day on consultants for the test and trace system.

Those aren’t consultants as in very senior doctors. Those are consultants as in the outsiders who fly into an organization, look important, and charge a lot of money for it. They may perform priceless services. They play Tetris all day. I wouldn’t know. Either way, they do charge lots of money. On average, test and trace is paying £1,000 a day (and in a pinch a person could probably live on that), but some are making as much as £6,000 a day. In September, test and trace had one consultant wandering the halls (or working from home–again, I wouldn’t know) for every civil servant doing the same.

A year ago, it was going to reduce the ratio to 60%, although I’m not sure which side of the balance was 60 and which was 40. It doesn’t matter, though, since it didn’t happen. 

What’s the country gotten for its money? Let’s fall back on the House of Commons spending watchdog, which said test and trace hadn’t achieved its main objective, which was to cut infection levels and help the country return to normal. 

So as of earlier this fall, it had spent £37 billion in the process of failing to meet its objective. I wouldn’t mention that–I mean, what’s a few billion pounds between friends?–except that I mention the government’s incompetence so much that I thought I’d give you a quick sample of what I’m talking about.  

Kids, Covid, and the Delta Variant

An article from the U.S. reports a sharp rise in the number of children hospitalized with Covid, especially in states with low vaccination rates. The article’s from September, although it’s still relevant. The U.S.–just to be clear–continues to exist even though September’s come and gone.  

The danger isn’t just that they’re at risk of dying, but that they’re also at risk of long Covid–the sometimes serious symptoms that drag on for no one knows how long after a percentage of people recover from Covid.. 

“These are children whose development and futures may be compromised,” said Dr. James Versalovic of Texas Children’s Hospital. “The collective impact when we look ahead is significant.”

In case anyone missed the point, he also said, “Children are our future adults.”

I’ve suspected that for a long time but I’m glad to have it confirmed by a medical professional. 

Irrelevant photo: Cut flowers at the village produce stall.

Are the numbers up because the Delta variant’s more dangerous to children? That’s not clear yet. Children are still less likely than adults to get severe Covid, even with Delta. But whatever we eventually learn about the percentages, the Delta variant is more contagious, so we’re dealing with a larger number of infections and from that a larger number of kids who draw the short straw in the great Covid lottery.  The doctors interviewed for the article called for more people to get vaccinated and for people to wear masks and maintain social distancing.

“What really protects children are the interventions directed at the rest of society,” said Dr. Thomas Tsai of the health policy department at Harvard University. 

If asked, I’m sure he would have confirmed that children are society’s future adults, but no one did him the courtesy of asking.

 

Long Covid and vaccination

The latest news on vaccination and long Covid–or at least the latest I’ve found–is that being doubly vaccinated slashes hell out of your odds of developing long Covid. 

First, vaccination makes you less likely to get infected. In a study of 2 million vaccinated people, 0.2% tested positive. What’s the comparison number for unvaccinated people? Um, yeah, I should have that, but the article I’m working from was making a different point, so it didn’t hand me a comparison group. But in a different study of a different group, vaccinated people were three times less likely to get infected than the unvaccinated. 

To point out the obvious, that means only that they test positive, not necessarily that they get sick. 

Second, if you take that first group of infected vaccinated people and compare it with a group of infected unvaccinated people, the vaccinated group are only half as likely to develop long Covid.

The vaccinated group is also 31% less likely to get acute Covid symptoms, 73% to end up in the hospital, and 16% less likely to have had liver for supper. 

Sorry. I wanted to see if anyone was still awake. That won’t be on the test.

The bad news is that older people and people from poorer areas (also known as poor people, but the study didn’t have income data for individuals so it extrapolated from where they lived)– 

Should we start that over? Those two groups aren’t as well protected by the vaccines, which argues that they should be priorities for booster shots. It also argues that raising people’s incomes would be a great public health measure. I’d recommend lowering peoples ages as well, but no one’s worked out the mechanics of that. 

If I hear that anyone’s making progress on that, I’ll let you know. Right after I inform my knees, which will be very excited about it. 

 

Scientists are being threatened

A poll of 321 scientists found that 15% had gotten death threats after speaking publicly about Covid, and 22% had been threatened with physical or sexual violence. 

Not that sexual violence isn’t physical, mind you, but I guess it’s best to be specific about how ugly things are getting.

The most common issues that triggered the threats were vaccination, masks, and the effectiveness of specific treatments.

It’s heartening that we’re handling a worldwide crisis like adults.

 

And speaking of specific treatments…

The Thai government gave an herb, green chiretta, known as the king of bitters, to 11,800 inmates with mild and asymptomatic Covid and claims that 99% of them recovered. 

Which sounds great, but the problem is that it doesn’t seem to have been a controlled study–you know, the kind with a control group that doesn’t get the treatment, so you can compare them.. 

If they reported how many of them were asymptomatic, I haven’t seen it. An asymptomatic person making a full recovery is hardly headline news.

The herb’s widely used in Thailand to treat colds and flu, 

Just to complicate the picture, it’s hard to calculate Covid recovery rates. Don’t ask–the article I’m working from just tossed that in and moved on, so let’s do the same. 

By way of comparison,” the article says, “the recovery rates announced by Thai officials are somewhat higher than overall Covid recovery rates in India (32%-83%) or Australia (96% recovered after 120 days).”

That doesn’t explain why they’re hard to calculate, but if we’re looking at a range from 32% to 83%, we might want to agree that it’s not an easy number to come up with.

Two controlled studies of green chiretta are underway, one in Thailand and the other in Georgia. That’s Georgia as in the country where you’ll find Tbilisi, not as in the state where you’ll find Atlanta. 

 

And a quick glance at Britain…

…since that’s what I allegedly write about here. Sorry. The pandemic’s taken me on a long side trip.

It’s done that to all of us, hasn’t it?

Covid infections in Britain went up by 60% in a month. Or to come at the numbers in a different way, we had almost 50,000 new cases in one recent day. That’s some 19,000 short of our all-time peak. 

Britain’s infection rates are higher than those of other European nations. Yay us! We’re winning!

No, wait. I got carried away. We don’t want to win this race. 

Why are we ahead? It’s not clear yet. The puzzle has a lot of pieces and it’ll take a while before anyone figures out where they go. How does testing compare to other countries? What about mask wearing, ventilation, vaccination, school rooms, work, transportation? But we can give a few of the pieces a good hard stare: Some of these bullet points will apply to Britain as a whole and some only to England. Apologies for putting them in the same bag and shaking them together before baking. It’s been that kind of week. 

  • The kids are back in school and not wearing masks.
  • Lots of people who were working from home are going back into–well, wherever it is they once worked. Whether they want to or not.
  • Not unrelated to that, the government has reopened everything it could get its hands on. 
  • Mask mandates have ended, although they’re recommended in public indoor spaces.
  • Kids between 12 and 15 are eligible for vaccination but it’s not happening quickly.
  • Booster shots for vulnerable adults aren’t happening quickly either.
  • Immunity from vaccines may be waning. Because Britain started its vaccination program earlier than most countries, waning immunity would show up earlier.
  • A new sub-variant of Delta has been spotted. That may well not be significant, but I thought I’d mention it. 

On top of that, one article I’ve seen brings the news that the unvaccinated could get reinfected an average of every 16 months, although reinfection doesn’t necessarily wait that long. It can happen soon after the first bout. So it’s not just the vaccines that (apparently) wane, so does natural immunity. Reports are coming in of people getting reinfected not just once but twice. 

People who’ve been vaccinated are also reporting reinfections. How often? I haven’t seen a number, and I’d be surprised if decisive numbers are in yet. What we can say is that the vaccinated will, at least, have some protection against the severest forms of the disease.

“We still don’t know much about the risk factors for reinfection,” Nisreen Alwan, associate professor of public health, said, “but the theoretical assumption that once all the young get it the pandemic will be over is becoming increasingly unlikely.” 

So much for herd immunity. 

Widespread vaccination has meant hospitalizations aren’t going up as quickly as infection rates, but even so we’ve got something like 869 admissions to hospital every day and some 8,000 people in hospital with Covid–around 10% of them on ventilators. So this increase in cases isn’t cost free. Leaders in the National Health Service are calling for mask mandates, working from home, and other restrictions to be brought back before we all find ourselves neck-deep in unpleasant brown stuff. And the health secretary, while refusing to do anything that useful, is at least asking Members of Parliament to set an example by wearing masks in crowded public places.

Should Christmas parties be canceled? Oh, hell no. Just take a lateral flow test first. 

The UK’s fairly highly vaccinated, and that’s keeping deaths and hospitalization rates from rising as quickly as they did in the early days of the pandemic, but they are rising and an already underfunded health care system is struggling. 

*

To underline how complicated the picture is, Japan’s had an unexpected downturn in the number of cases, and it’s not clear why that’s happened either. No one’s complaining, but understanding it would be useful.

*

A joint report from the House of Commons’ science and health committees rips into the British government’s early response to Covid, which amounted to, “Let’s all get sick, then we’ll have herd immunity. Yeah, som people will die, but doesn’t everyone die sooner or later?” 

The government caused thousands of deaths by delaying a lockdown, the report says.

“Decisions on lockdowns and social distancing during the early weeks of the pandemic–and the advice that led to them–rank as one of the most important public health failures the United Kingdom has ever experienced,” it says. 

Britain has had more than 137,000 recorded coronavirus deaths. That’s the second highest number in Europe. Only Russia has more–and it’s a hell of a lot bigger. 

We won’t get into how many unrecorded Covid deaths there were and are, or the varying ways a Covid death is defined, but let’s acknowledge that it’s not a number anyone can be accurate about. Still, the numbers we have give us a rough sketch of where things stand. 

 

The smoker’s paradox

Early in the pandemic, a small handful of studies reported that smokers seemed to be protected against Covid’s worst effects. Since that ran counter to everything we’d expect, it was reported widely as a man-bites-dog story.

You know about man-bites-dog stories? If a dog bites a man, it’s not news. If a man bites a dog, it is. This bit of wisdom came from the time before women were invented, hence their absence. 

I might as well admit that I don’t remember seeing articles about smokers being protected from Covid, but my memory’s more decorative than functional, so I may have known about it at the time.

Never mind. What was behind the stories? Less than meets the eye. A larger study has now shown more or less what we’d expect: that smokers are 80% more likely to be hospitalized with Covid than nonsmokers. 

If you’d like an interesting lesson on probability, do click through and read the article. It’s a great explanation of why science continually updates its conclusions. But I’m going to skip all that and tell you this instead: 

First, the initial studies were small and the more recent one is large, meaning it has a better chance of being accurate.

Second, some of the initial studies were funded by tobacco companies, which–oops–are still trying to sell cigarettes. So we might want to look for an element of bias. Which lead us to the next paragraph.

Third, the studies asked the wrong question. They looked at the number of people hospitalized with Covid and asked how many of them smoked.

It’d be more useful–if you want a scientifically useful answer, that is–to compare smokers and nonsmokers and ask how many in each group are hospitalized with Covid. 

If you approach the question the first way, you don’t take account of the people who die before being admitted or who are transferred to a hospice. 

My math’s terrible, but I suspect that if you have one category of people who die quickly and one of people who linger, the lingerers pile up, so there will be more of them when you count heads, making it look like the dead are protected. 

The larger, later study included a fuller range of the population, asked a better question, and got a more predictable result.

if COVID teaches us nothing else,” the article says, “it should teach us to hold extraordinary claims–about smoking, vitamin D, zinc, bleach, gargling iodine, or nebulising hydrogen peroxide–to high standards.”

The future of Covid, and some updates on the fight against it

A while back, I summarized a theory that the Covid virus is unlikely to pick up the number of mutations it would need if it’s going to evade the vaccines. I felt a lot better after reading that, but let’s look at an opposing theory so we can all get depressed together.

This theory raises the possibility that in addition to the virus picking up small mutations over time (that’s called antigenic drift), there’s the possibility of antigenic shift, which involves more dramatic changes caused by the virus recombining with other human coronaviruses. Viruses do that. Basically, they hold a swap meet. Or a bring and buy sale if you’re more used to them. They don’t actually use money–their evolution hasn’t brought them to that exalted stage–but they do trade strategies for making money-using creatures sick.

If they swap the right bits of knowledge, the current crop of vaccines will need to be re-engineered. We’ll all move back to Go and start the game over again.

It’s also possible that Covid will infect animals we share space with and then cross back to humans in some more powerful form. That’s reverse zoonosis.

Irrelevant photo: Japanese anemone, with a bite out of it. That’s to prove the beauty of imperfection and all that deep philosophical stuff.

As a general rule, long-term evolution favors viruses that don’t make their hosts too sick. The very sick tend to crawl away somewhere and keep their germs to themselves, which (seeing this from the germs’ point of view) isn’t an efficient use of a host. And the dead die, which also limits their opportunities to share. That’s even more inefficient. 

From that base, any number of people argue that (after a trail of death and destruction) epidemic diseases get milder over time. Everyone who doesn’t die lives happily ever after. They point to the 1918 flu epidemic (or the Black Death, or some other cheery moment in human history) and assure us that this is the natural order of things. 

According to this theory, that is indeed one possibility but it’s not the only one. 

The British government’s group of scientific advisors, SAGE, thinks the virus isn’t likely to become less virulent in the short term. (Virulence isn’t about a disease’s ability to spread–that’s transmissibility. It’s about how sick it makes a person.) SAGE considers that a long-term possibility, but it also considers it a realistic possibility that a more virulent strain will emerge. 

Sorry. I don’t create the possibilities, I just write about them.

So what direction will it evolve in? Basically, no one’s sure.  

However, all isn’t lost. A lot of work’s being done on how to cope with Covid.

 

The Covid-killing mask 

A group of researchers have created a surgical mask that deactivates not just the Covid virus but any enveloped virus (that includes the flu), plus some antibiotic-resistant bacteria like a couple of the staphylococci. 

What’s an enveloped virus? I’m so glad you asked, because I have an answer right here in my pocket. It’s “any virus in which a nucleoprotein core is surrounded by a lipoprotein envelope consisting of a closed bilayer of lipid derived from that of the host cell’s membrane(s), with glycoprotein.”

You’re welcome. I didn’t understand it either, but I’m glad to get it out of my pocket.

The masks are the first ones that don’t just protect both the rest of the world from the wearer but also protect the wearer from the rest of the world. 

Okay, not completely, but virus- and staphylococcuses-wise, it will. If someone’s trying to hit you on the head with a hammer, the masks are no help at all.

I’ve seen masks promoted as antiviral. Advertising copy for masks with a copper layer, for example, talks about copper’s antiviral properties without actually claiming that the masks will kill Covid. From what I’ve read, they don’t have enough copper to do more than provide carefully worded hype.

The new masks are called FFP Covid masks, they come in adult and child sizes, and according to the article I read they’re very affordable.

How affordable is very affordable? After bumping around the internet for a while, I found some on sale for one euro. That’s not bad, but whether it’s affordable depends on how much you have in your wallet, and how long it takes to renew itself once you pull some of it out to buy masks.

Not to mention how many other calls you have on it.

Are the masks reusable? That’ll affect people’s opinion of their affordability, and the definitive answer is, I’m not sure. They look disposable, but that’s strictly a guess. 

Another limiting factor for most of us–since this is an English-language site–is that the only place I could find them for sale is in Spain, which is where they were developed. Presumably they’ll make their way into the rest of the world at some point. 

Still, whatever the mask’s immediate impact, it’s an important step.

 

Quick updates

Multiple new Covid treatments and vaccines are in the works. Here’s a sampling:

An inhalable powder works against Covid, MERS, and one version of the flu. In animals. It has yet to be tried in  humans–at least in this form. As a pill, it’s used against leukemia, but when you turn it into a powder and inhale it, it becomes a whole ‘nother thing. In addition to landing in a different part of the body and possibly needing a different dose, it opens up the possibility of Covid treatment taking on some bad-boy chic: You roll up a hundred-dollar bill and snort your meds.  

*

Repurposing a drug that’s already in use to treat a new disease isn’t, it turns out, as simple as it sounds. You may have to shift from a pill to a powder. You may need a dose so high that it turns toxic, at which point you may need to rethink the whole idea.

*

Another drug that’s already in use, this one to treat fatty substances in the blood (no, don’t ask me), could reduce Covid infection by 70%. Could. So far, it’s worked only in human cells in the lab. Two clinical trials are underway, though.

*

An antiviral called molnupiravir halves the chances of an infected, high-risk person needing hospitalization or dying from Covid, and Merck will be asking for emergency approval in the U.S. Molnupiravir doesn’t seem to be as effective as monoclonal antibodies, but because it’s a pill it can be used outside of hospital settings, so it’s much easier to use.. 

Down sides? It costs $700 for a five-day course of treatment, which makes it cheaper than and easier to type than monoclonal antibodies, but it’s still expensive. And some experts are warning about potential side effects. Plus it doesn’t seem to help patients who are already sick enough to be hospitalized. So although it’s gotten a lot of press coverage and is, without question, important, it’s not the answer to all problems.

Other antiviral pills are also in the works. 

*

Vaccines? Why yes. A new vaccine in development uses only a single shot and can be stored at room temperature for up to a month. In trials with primates, it gave near-complete immunity that stayed at its peak level for eleven months.

It’s called an AAVCOVID vaccine, AAV being the vector the vaccine uses. 

What am I talking about? The vector’s the horse the vaccine rides in on. Or if you want to sound marginally more sensible, it’s the  strategy the developers use. I’m not going to try to explain this one, because I’m pretty sure I’ll get it wrong. Let’s just say that if this strategy works, it’ll help get the vaccine out to places where refrigeration’s a barrier. 

The team that’s developing it is also exploring needle-less delivery systems.

*

Another vaccine in the works is using a new model that I’d love to explain but I’m not even close to understanding it, so let me quote: It combines “the advantages of the two types of traditional vaccines—virus-based vaccines and protein-based vaccines—by preparing a bacterial protein that self-assembles into a virus-like particle. By displaying a COVID-19 protein on the surface of this virus-like particle, researchers produced a novel vaccine that is well recognized by the mammalian immune system, but yet does not have any viral infectivity.”

If I understand that correctly, it behaves like one of those transformers kids used to play with, and for all I know still do. You introduce it into a body as a motorcycle, it clicks a few of its own pieces, turns green, and suddenly it’s the Hulk, chasing down unsuspecting Covid viruses.

Early tests show it being effective against the Covid variants and setting up a strong immune response.

Come to me anytime you need a high-grade scientific explanation.

 

Long Covid numbers

I’ve found some numbers on long Covid, finally: About a third of the people who come down with Covid get at least one long Covid  symptom. 

First question, who are we talking about when we say people who get Covid? As far as I can tell, it’s people who actually got sick, because the article talks about them recovering. So I think we can rule out anyone who gets infected but stays asymptomatic. 

We need all the good news we can get, so let’s play nice and say thanks for that.

Second question, how are they defining long Covid? You get to pick from nine core symptoms, and they have (or it has, if you only get one) to last at least 90 days. The most common ones are breathing problems, abdominal symptoms, fatigue, pain, and anxiety and depression.They’re more common in people who’ve been hospitalized and slightly more common in women than in men. The same symptoms occur after the flu, but they’re 1.5 times more common after Covid.

Next shred of good news? If long Covid symptoms are more common in people who’ve been hospitalized, less than a third of people with milder symptoms are likely to come down with it. 

What will it mean if Covid stops being a pandemic?

The talk these days is that Covid will eventually lose its pandemic status and turn into an ordinary, house-trained endemic disease–the kind of disease that circulates in a population and gets us sick but doesn’t give us nightmares, overwhelm hospitals, or kill huge numbers of people. And (they say) this will happen because of two factors: vaccination and the natural immunity that people who’ve been exposed and survived gain. 

What are the odds, though, that Covid will pull a fast one and evade our immunities

Not that high, according to a study that tried to replicate Covid’s mutation pattern using a harmless virus. To completely outrun the immunity we gain from either exposure or vaccination, the virus would have to draw twenty of the right cards out of the mutation deck. 

How many cards are we playing with? I’m not sure. As far as I can figure out, the rules of the game keep shifting. But the scientists–the people who study this stuff, as opposed to the people who read one lone article and call themselves experts–say it would be one hell of a trick for it to pick all twenty.

Irrelevant photo: The north Cornish coast.

On top of that, the virus isn’t the only thing that evolves. So does the human immune system. After it’s met the virus, either in the form of an infection or a vaccine, it sits down and plays with its antibodies. Think of it as a kid with a Lego set. It spends months working out shapes that bind ever more tightly to Covid’s spike proteins. 

People who’ve gotten an mRNA vaccine and also have naturally occurring immunity to Covid have the strongest defense. It’s possible that booster shots will create the same flexible immunity, although that hasn’t been demonstrated yet.

So as surely as the virus doesn’t keep one single form, neither does the human immune system. We will, eventually, get through this mess, although the question is at what cost. 

 

How can we measure Covid’s impact?

In the US, Covid has now killed as many people as the 1918-19 flu epidemic. I’d love to give you comparisons for other countries, but that’s all I’ve found.

To put that into perspective, in 1918 the population of the US was a third of what it is now, so it killed a larger percentage of people. On the other hand, if we’re comparing the inherent danger of the two diseases, massive advances in medicine have kept the death toll lower than it would otherwise have been. 

There must be a dozen ways to measure Covid’s impact, but one of them is cold, hard cash. Again in the US, it’s cost almost $6 billion to hospitalize the unvaccianted in just three months, from June through August 2021

The study’s authors say that’s probably an underestimate.

Yet another study says that by March of 2021, Covid had taken 9 million years of life from the U.S. population. Instead of measuring excess deaths, it looked at the mortality burden of the pandemic. 

What the hell does that mean? You would have to ask, wouldn’t you? The study looked at QALYs, or quality adjusted life years, using them to measure the length of time people would have lived if they hadn’t, um, died. It says that people between 25 and 64 lost 4.67 million years of life, and Black and Hispanic communities were hit hardest, especially men in those groups who were 65 and older.

I know, I know, I’m supposed to be writing about Britain. What can I tell you? Bloggers are irresponsible cheats.

 

Question: If you’re not vaccinated against Covid, will gargling with iodine help? 

Answer: In a test tube, povidone-iodine kills the Covid virus. 

Further information about that answer: Humans aren’t test tubes. 

What happens in a human, then? There haven’t been many studies, but what few there are hint that iodine can inactivate Covid in the mouth for a time, but not for a long one. What happens after that? The same thing that was happening before. If you breathe in the virus, there’ll be nothing there to stop it. If you’re incubating the virus, it’ll move back into your throat and ditto–there’ll be nothing there to stop it. It’s like wiping your kitchen counters with antiseptic wipes. You kill 99 point something percent of the germs that are present in that moment. Then you and your antiseptic wipes go away and wherever the germs came from, they come back. 

In other words, unless you’re going to spend your days and nights gargling with whatsidone-iodine, this isn’t going to work. 

And have I mentioned that the stuff tastes disgusting and smells just as bad?

Other than that, is there any reason not to use it? Well, it can cause skin irritation–sometimes severe, although not necessarily. It can (rarely) cause your thyroid gland to become inactive, especially if you’re pregnant. And especially if you’re both pregnant and a woman.

The most likely side effect, though, is that it will make you think you’re done something to protect either yourself or the people around you when you haven’t. 

*

On Fridays I usually post something about English or British history or culture. This week I’m doing well to do post anything at all. I hope to be back to full speed eventually. In the meantime, bear with me.

What does it mean that a Covid vaccine is, say, 70% effective?

Let’s start by talking about what it doesn’t mean. If a vaccine is 70% effective against a virus it doesn’t mean that 30% of the people who’ve been vaccinated will get infected. That’s an assumption that only people whose math is as bad as mine would make. The kind of people who juggle the numbers 70, 30, and 100 and come up with an answer that’s as likely looking as it is meaningless.

It turns out that the number doesn’t compare the vaccinated people who stay well to the  vaccinated people who get sick. Nay, verily, it compares the vaccinated people who get sick (or who stay well) to the unvaccinated people who get sick (or who stay well). To put that a different way (because I don’t know about you, but I’m struggling with this), it compares the risk vaccinated people run in the presence of Covid to the risk unvaccinated people run.

This matters because it leaves us with a much smaller pool of people who are vulnerable.

If you’d care to read about that with actual numbers and sensible writers, follow the link. I have a severe allergy to math and I know better than to attempt a full explanation. 

Irrelevant photo: Red clover. I’ll come back with more kitten photos soon.

 

Who gets sick with the Delta variant and can the vaccinated spread it?

In the US, 95% to 98% of the people hospitalized with Covid are unvaccinated, and 99.5% of the deaths are of the unvaccinated. Even with the Delta variant circulating, that seems to be holding true.

But some numbers have changed since the initial vaccine studies, and they have to do with what Dr. Robert Schooley, from the Department of Medicine at UC San Diego’s School of Medicine, calls “the asymptomatic shedding rate among vaccinated individuals,” which in human speech means how much of the virus is spread by vaccinated people who get infected but don’t get sick.

Or to push that one step further, how dangerous they are to the unvaccinated.

When the vaccines were tested, the Delta variant wasn’t around yet. They were dealing with a less infectious beast. On top of which, no one thought to investigate the odd sniffles and colds that people in the study cooked up. They were allergies. They were colds. They were flu. 

Remember the old days, when people caught colds? 

So the study didn’t track them.

Now, though, they’re realizing that those mild symptoms could be nearly asymptomatic Covid, and what’s known so far is that some fully vaccinated people who get infected carry enough of the virus to spread it, even though it’s not making them sick.

How do they compare with unvaccinated people as far as spreading the thing goes? The numbers aren’t in yet. I mean, they’re out there. Numbers always are. But nobody’s assembled them yet. On average, though, Schooley says the infected vaccinated person will shed less virus for a shorter time. And the odds that they’ll become infected are lower, so whatever the eventual picture turns out to be, vaccinating people does slow the spread of the disease.

 

Are the vaccines losing their effectiveness? 

As has become usual since the pandemic started, we’re not likely to find a definitive answer yet, but it does look like the number of breakthrough cases in vaccinated people is growing.

What’s a breakthrough case? A Covid case in someone who’s vaccinated. Getting one doesn’t mean you’re dead, hospitalized, or even necessarily sick. It just means you’re carrying the infection, when if the vaccines were 100% effective (very few are and no one expected these to be), you wouldn’t be. 

So if you’re fully vaccinated, it’s not time to panic yet. You can always do that later. 

Why’s this happening? The experts are still debating that, but it doesn’t look like the Delta variant is evading either the vaccines or immunity from earlier infections. 

That’s another reason to wait before you panic.

If Delta hasn’t broken through the vaccines’ protective lines, that leaves us with two possibilities. One, the vaccines’ effectiveness is fading, or two, Delta’s high transmissibility is responsible.

Several studies show what could be a waning in vaccine effectiveness, but it’s hard to know if the numbers really mean that. They could also mean that vaccinated people are taking more risks–going to bars or gyms or other Covid exchange sites–and giving themselves more chances to meet the virus.

And protection against getting so sick that you need to be hospitalized, though, is holding steady, which may mean effectiveness isn’t waning. All this will be perfectly clear in hindsight, but for now we have to make do with what we can see from where we are.

So do booster shots make sense? 

On the side of saying no are the many countries that the vaccines have barely reached. How can rich countries be talking about booster shots when initial doses are desperately needed elsewhere?

On the side of saying yes is that in people with weakened immune systems, because of either age or disease, they can make a difference, although the evidence on that is still preliminary.

 

Testing news

A new study shows that testing saliva for Covid is as reliable as testing nasal swabs. So at some point we may be able to stop puncturing our brain pans with sticks that are allegedly softened with cotton wool–or something that looks vaguely like cotton wool.

If Covid tests shift to using saliva, they won’t have to rely on patents’ willingness to make themselves uncomfortable, which will make them more reliable. And we won’t have to worry about a shortage of swabs.

If, in fact, worrying about that is one of the things that’s keeping you up at night.

*

Several times now, I’ve sworn off writing about newer, faster, cheaper Covid tests because although I keep reading about them, they never seem to be adopted–at least not anywhere I read about, and certainly not where I live. But you know how it is when you swear off something multiple times: It’s a sign that you keep breaking your word. So here we go again:

A newer, faster, cheaper Covid test has been developed. And it uses the same stuff that pencil lead is made from, which isn’t lead at all, it’s graphite. It cuts the cost to $1.50 per test, takes six and a half minutes, and is 100% accurate using a saliva sample and 88% using one of those evil nasal thingies.

The system can be adapted to test for other transmissible diseases. Now all we have to do is wait and see whether we hear of it again.

Younger, sicker, quicker: does the Delta variant target young people?

An article in the New York Times considers why the Covid Delta variant is hospitalizing more young people than the beginning-of-the-alphabet variants did. The answers are still a bit iffy, since the numbers involved haven’t had the time or money to hold a convention yet, but the phrase front-line doctors are whispering to each other, at least in the US, is younger, sicker, quicker: The patients are younger and sicker and they’re deteriorating faster. Or quicker. Or more quickly. Or possibly in a greater hurry.

The article’s talking about patients in their twenties and thirties. And these aren’t people with risk factors like diabetes or obesity. What they are is unvaccinated.

Some doctors think the Delta variant is what’s making the difference. It’s suspected of causing more severe disease, although that’s still educated guesswork. See above about the numbers. It may also be hitting an age group that was thought to have a Get out of Covid Free card. But as the Times puts it, “There is no definitive data showing that the new variant is somehow worse for young adults.”

I don’t often get to correct the Times, but technically that should be “definitive data…are.” It sounds awful, but it’s right.

Irrelevant photo: a begonia

So we don’t have solid data. It could be that the high percentage of younger patients is a result of older people being vaccinated in higher numbers than younger people. Take, say, 90% of old people out of your hospital emergency rooms and your patients’ average age falls dramatically. 

It’s also possible that the numbers are a result of people mixing more just when a more contagious variant is circulating, a significant pool of people remain unvaccinated, and many people aren’t wearing masks.

However.

According to an internal Centers for Disease Control document that somehow wandered into the Times newsroom with a sign saying, “Read me,” the Delta variant is as contagious as chicken pox and “may cause more severe disease than Alpha or ancestral strains.” If that turns out to be true, it would account for those hospitalized patients who are sicker and deteriorating more quickly.

According to  Dr. Catherine O’Neal, of Our Lady of the Lake Regional Medical Center in Baton Rouge, “Something about this virus is different in this age group. We always saw some people who we just said, ‘Why the heck did this get them?’ But that was rare. Now we’re seeing it more commonly.

“I think it is a new Covid.”

Dr. Cam Patterson, chancellor of the University of Arkansas for Medical Sciences, said, “Our sense is that younger, healthier people are more susceptible to the Delta variant than those that were circulating earlier. . . .

“The transition we saw toward younger patients and toward people getting sick more quickly coincided almost precisely with the emergence of Delta here in Arkansas. This to us feels like an entirely different disease.”

 

Meanwhile back in Downing Street 

Boris Johnson, Britain’s alleged prime minister, was exposed to Covid last week. Or else he wasn’t exposed. Either way, he’s not going to go into isolation because, basically, he doesn’t want to. He went into isolation before (under protest) and he’s bored with it.

Besides, what’s the point of being the prime minister if you have to follow the same rules as everyone else?

The exposure happened when one of his aides tested positive on a political visit to Scotland. The aide dutifully went into isolation. A Downing Street spokesperson informed us, with a straight face, that he and Johnson weren’t in close contact. Yes, they were in a plane together, but Johnson didn’t inhale. And neither did anyone else on the plane.

The rules on isolation are set to change on August 16. After that, vaccinated people will be exempt. Before Johnson was exposed himself, he’d resisted calls to move the date forward, saying it was important that everyone follow the rules.

Unless they happen to be him. 

 

Vaccine news

Of the 100 Covid vaccines now in development, 7 of them are nasal sprays, and nasal sprays have advantages and disadvantages.

On the plus side, they act more quickly and if you’re twitchy about needles they won’t make you twitch. Since Covid tends to enter the body through the nose, nasal sprays deliver the vaccine to the site of the infection. They act faster than injected vaccines. And “ they can elicit mucosal immunity in the lungs.”

You might want to notice that, for fear of screwing it up, I’m not rewording that. I think I understand it but I don’t want to find out I’m wrong. You’re on your own.

On the down side, the immunity created by nasal spray vaccines doesn’t last as long. And they use live viruses that have had the hell kicked out of them so that they won’t make most people sick, but with a very, very few they will.

Using both forms of vaccine isn’t out of the question–one for its fast action, the other for its long life.

One trial gave infected animals the AstraZeneca vaccine as a nasal spray, and it decreased their viral load, which doesn’t prove–but does suggest–that it decreases the amount of virus they shed.

To translate that, they might be less likely to infect anyone else. 

*

Let’s end on a hopeful note. Scientists are working on a vaccine that targets a huge category of coronaviruses known for jumping from animals to humans. They’re called sarbecoviruses, and Covid’s one of them. The idea is that this would work not just against whatever variant Covid can cook up but against whatever coronavirus the world might throw at us next. 

So far, the vaccine’s been effective in mice. The hope is that after more animal testing it’ll be tried in humans next year.

By the numbers: how to help Covid outrun the vaccines

In Europe, a group of experts who model disease spread plugged as assortment of variables into their computers–things like vaccination, transmission, and mutation rates–and asked about the odds, under various conditions, of the virus mutating into something that would escape the vaccines.

It turns out that that highest risk comes when a large proportion of the population has been vaccinated but when it’s still not a high enough proportion to create herd immunity. In other words, exactly the situation in Europe right now. And in the US. 

Britain has a higher percentage of vaccinated adults, but I think I could safely add “and Britain” to that paragraph.

This sounds counter-intuitive, but when a large proportion of the population’s been vaccinated, a vaccine-resistant strain of the virus will have an advantage. So what countries need to do at that stage is control the spread.

Irrelevant photo: The north Cornish coast

“Of course we hope that vaccine-resistance does not evolve over the course of this pandemic, but we urge caution,” one of the study’s co-authors said. “Evolution is a very powerful force and maintaining some reasonable precautions throughout the whole vaccination period may actually be a good tool to control this evolution.”

I mention that just in case anybody’s listening. In Britain, they’re  not. Masks are now optional in most situations, although many people are still wearing them. (Thanks, folks. You’re wonderful.) Nightclubs are reopening. (Thanks, Boris. You’re a fool.) Vaccinated people wearing blue, who say please and thank you, and who come into the country from Covid-safe countries or from countries that might or might not be Covid-safe no longer have to go into isolation, never mind quarantine. 

Why? Because the government’s thrown up its hands and said, “This is making us confused and we’re not going to bother anymore.”

So yes, we’re being perfectly sensible here. Wish us luck.

Thank you.

 

Breakthrough infections and the Delta variant

When vaccinated people get infected with the Delta variant, as some small percentage of them will inevitably, they’re very likely to get mild or asymptomatic cases of Covid, but that doesn’t tell us whether they’ll be as infectious as an unvaccinated person who gets infected. 

Stop the presses, though. For the first time, we have a gesture toward a move in the direction of an answer: They will have as high a viral load as an unvaccinated person. That seems to mean that they’re every bit as likely to transmit the virus, although no one seems willing to say that without a plugging in some sort of word that creates wiggle room in the sentence.. 

As the US Centers for Disease Control director put it, they “have the potential to spread the virus to others.”

That’s a large part of the reason that the CDC reversed its throw-away-your-mask-if-you’re-vaccinated policy and now recommends masks for all students, teachers, visitors, and school staff when they’re indoors. And all includes people who’ve been vaccinated. 

The CDC also recommends masks in indoor public places in parts of the country that have had at least 50 new cases per 100,000 people in the last week. That’s something like 60% of the counties in the US. 

And it says that vaccinated people should be tested for Covid after they come into contact with an infected person. Even if they don’t develop symptoms. 

In a couple of months, we may get definitive news on just how infectious fully vaccinated people who have mild or symptomless Covid are. In the meantime, we’ll have to go with seems and as high a viral load. Common sense might indicate caution.

 

Covid and public policy

A paper from the Commission for Pandemic Research of the Deutsche Forschungsgemeinschaft–a group whose name is almost as long as the paper itself–makes a heroic effort to talk sense to people (and more to the point, governments) who are still recommending hand washing to combat the spread of Covid. 

Okay, that interpretation is strictly my own. What the article I stole this information from says is that they “aim to contribute to establishing a reliable information base that is broadly coordinated among specialists as well as offering concrete advice on how to guard against infection.” 

So to be objective and reliable and not at all snarky about this, they’re aiming to contribute to establishing a coordinated effort to offer the world an extended string of verbs with the intervention of a few nouns. And they’re damn good at it. 

The article’s headline is an even better source of fun: “Prevention of coronavirus infection spread through aerosols.” I spent an unconscionable amount of time wondering how to spread the prevention of infection before I worked out that prevention isn’t being spread; spread has taken a part-time job as a noun.

To be fair, the committee with the long name probably didn’t write the headline.

Are you following any of this? I’ll get to the information any minute now.

For all its oddity, the headline doesn’t approach the genius of a newspaper headline published during the Falklands War that said, “British left waffles on Falkland Islands.” I had a carton of maple syrup all packed up and ready to send to the Falklands before I realized that left was the noun (political leftists, presumably in Parliament) and waffles the verb. 

Maybe this is only funny if you’ve worked as an editor.

But to go back to our article: It breaks infections into two categories, direct and indirect. 

Direct infection happens when one generous soul is close to someone else and passes the virus on to them. That usually happens indoors. 

Indirect infection happens when infectious aerosols accumulate indoors. The first person–the one with the virus–doesn’t have to stay in the room to make sure the second person breathes the germs in. If they’ve spent time in the room, exhaling, when they leave, unless the room’s well ventilated, their germs will not follow them out.They’ll stay there, available for the second person to inhale and take home.

And all of this is free. Just imagine! No one has to pay a red cent for it.

Indirect infections are what make it pretty much pointless when people put on their masks only when another person comes into the room, the shop, the wherever. They’ve been in there breathing. They can’t unbreathe those aerosols. 

Indirect infection is somewhere between hard and impossible to accomplish outdoors, although direct infection is possible if the people are in close enough contact for a longish time. So if you’re spending time in a bus shelter, at a demonstration, at a football game, or in a brawl, you might want to wear a mask, even though you’re outdoors. And you might want to ask the people you’re brawling with to also wear masks. 

In closed rooms, though, they (that’s the experts, not the people in the brawl) suggest using–well, pretty much every breath-related protective measure you can think of: avoiding contact, keeping a distance, wearing masks, using protective panels, and ventilating the hell out of the room.

Yes, “ventilating the hell out of” is a thoroughly scientific term. It means opening windows and using permanent ventilation systems as well as mobile air purifiers.  

“Only regulations that are as consistent and uniform as possible guarantee a high level of safety with as few restrictions as possible,” the article says, paraphrasing the experts, something that becomes necessary when the nouns and verbs grow exhausted from holding down two jobs. 

I’d love to think that the world’s governments will get their heads around the idea that consistent regulation is the way to live (relatively) safely with Covid, and that ventilation and masks are essential parts of that. But then I’d love to think all kinds of things, including that our problematic species will still be around in, oh, say seven generations, and that it will have gained some wisdom. Those aren’t impossible, but I’m unable at this time to issue the money-back guarantee that we inadvertently advertised. 

Can fermented soybeans destroy Covid?

It’s too early to celebrate this, but from Japan comes the news that an extract made from natto–a sticky food involving fermented soybeans–inactivates Covid’s spike protein by digesting the receptor binding domain.

What’s a receptor binding domain? No idea, but Covid’s spike protein needs it, so anything that digests it has got to be good–at least from our point of view.

The extract of natto works on all the existing variants.

The reason it’s not time to celebrate is that so far it’s only worked in a lab. No one’s gotten the natto and the virus together inside the body. Eating natto won’t help. Neither will sending the virus invitations to a party and serving natto hor d’oeuvres. No matter how much it mutates, the virus will continue to be illiterate, so it won’t show up.

Irrelevant photo: a wild orchid.

The next stage is to isolate the molecular mechanism that’s destroying the–what was that called?–the receptor binding domain. Figure that out and you could well have a treatment for Covid. 

Possibly. At some time in the indistinct future. But c’mon, we need all the hope we can find.

 

England’s world-beating experiment in irresponsible government

On July 19, England took what little common sense it had forgotten in the drawers of 10 Downing Street’s desks and set it on fire. It’s been dry lately, but there wasn’t enough common sense to burn for long, so we didn’t get the second Great Fire of London, just another round of Covid stupidity.

To be clearer about this, nightclubs are now open. So are bars, restaurants, and pretty much everything else you can think of. It’s up to you whether to throw your mask away and sit nose to nose, indoors, and sing loudly with six of your favorite strangers and no ventilation. Or with thirty of them if you can get your noses close enough. Crowd limits are out of fashion, along with distancing. 

The first day of that was called Freedom Day. Those of us currently cowering under the covers are free to cower under the covers. Unless of course we have to go to work or in other ways mix with the rest of humanity.

The official justification for this is that vaccination has severed the link between infection and hospitalization. Or weakened it, depending on when you listen to the explanations and who gives it. We have to return to normal life. We have to live with Covid. The economy needs us. And if not now, when? 

Maybe when it’s safe, that’s when. Because the link between infection and hospitalization hasn’t been severed, it’s only been weakened, and that’s not enough. The number of infections is going up, and so is the number of deaths. Not as sharply as it once would have, but more than it would if we kept to a marginally sensible policy.

And the thing about deaths is that once people are dead, they’re gone. It’s kind of irreversible.

The government’s Scientific Advisory Group warns that the combination of a large number of vaccinated people and a high number of infections creates the perfect conditions to create a variant that will escape the vaccines. No one can know whether that will happen–vaccines mutate randomly–but the likelihood increases as the number of infections increases.

And while all this is shoving us in one direction, Boris Johnson says vaccine passports will be required for nightclubs etc.–but not until the end of September. Between now and then, let Covid rip.

What are they thinking? One of the government’s scientific advisors, Robert West, says it’s “a decision by the government to get as many people infected as possible as quickly as possible, while using rhetoric about caution as a way of putting the blame on the public for the consequences.” 

That wave of infections would combine with the number of vaccinated people to push the country toward herd immunity and the virus would no longer spread.

What are the problems with the strategy? Well, in addition to opening the doors to a variant that evades the vaccines, no one knows what level of immunity is needed for herd immunity to Covid. The best guess is 85%. And then there’s long Covid–the long-term damage that some people live with for no one knows how long, after even asymptomatic infections. 

The government says that’s not its strategy. You’re welcome to believe it if you like. 

And a unicorn just pranced down the street outside my window. You’re welcome to believe that as well. It was wearing a tutu and singing a Mozart aria.

Not long ago, the Netherlands opened everything up and Covid infections rose sevenfold. They’ve since closed bars, restaurants, and nightclubs.

England’s reopening has caused the Covid tracing app to warn an annoying number of people that they’ve been exposed to Covid and should self-isolate–more than 600,000 last week–and that in turn has led to a lot of people being off work.

So what’s a responsible government to do about that? 

We don’t have one of those, so who cares? Instead of deciding that too many people are being exposed to Covid because we took all our restrictions out and burned them, the government’s decided that too many people are being notified, so it’s created a list of crucial occupations whose employees can ignore the app if they’re double vaccinated–although they will at least have to test themselves. 

Can people who are doubly vaccinated spread Covid? Why look! It must be time to talk about breakthrough infections! Because buried in that segment somewhere is the news that we don’t have a clear answer to that question yet.

 

Breakthrough infections

First we need a definition of a breakthrough infection, even if you already know it: A breakthrough infection happens when a vaccinated person gets Covid–or (it can happen with any matched pair of disease and vaccination) whatever else they were vaccinated against. When that happens, it doesn’t mean the vaccine isn’t effective. It means the vaccine isn’t 100% effective, much as we wish the Covid ones were. 

That leaves us–or me anyway–wondering why one person will get a breakthrough infection and another won’t. The definitive answer is that it’s hard to say.

Thanks, Ellen. That was really helpful.

Sorry, but I can only pass on what I find. The direct quote is, “It’s difficult to determine why any particular breakthrough case happens.” 

How large a dose of the virus you’re exposed to might make a difference–with the emphasis on might. Our individual immune systems will make a difference. They can be affected by health problems and by medications that make an immune system respond to the vaccine less enthusiastically.

And new variants can make a difference. The vaccines were developed for the Covid 1.0, or 2.0. We’re now onto–

Hang on a minute. I have to go look up the Greek alphabet and figure out where Delta comes. 

We’re now at Covid 4.0.

It’s also possible for a person to have gotten a vaccine dose that wasn’t administered correctly, although that’s a lot less likely. And no, I’m not sure how you administer a vaccine the wrong way either. Maybe you let the stuff get too warm. Maybe you let it expire. Maybe you miss the arm entirely and inject it into the hat. That last one is the reason they don’t let me do vaccinations anymore.

People who are (fortunately) better than I am at figuring this stuff out are tracking the number of breakthrough infections, looking for evidence that the vaccines’ are wearing thin and booster shots are needed. So far, they haven’t seen it. 

*

We can break breakthrough infections into a few categories, and in order of decreasing likelihood they are: 1, testing positive, 2, having a mild infection, 3, having a serious infection, and 4, dying.

Patients are strongly advised to keep themselves out of category 4. 

If you’ve absorbed that advice–and it is important–we’ll move on to the question of whether fully vaccinated people who’ve been exposed to the virus should have to go into isolation. In the US, the Centers for Disease Control (citing “limited evidence” according to the article I found) says they not only don’t need to go into isolation, they don’t need to get tested unless they develop symptoms. The theory is that they’re less likely to infect other people than unvaccinated people with asymptomatic infections.

Other countries are making different rules.The evidence is limited, the lights are off, and we’re all bumping into the furniture. 

What percentage of fully vaccinated people test positive after being exposed to Covid? If anyone has numbers on that, I haven’t found them.

What does seem to be well established is that breakthrough infections are rare, and we do have statistics (sort of) for categories 3 and 4–the one you want to stay out of and the other one you want to stay out of. In the US, 5,492 vaccinated people were either hospitalized or died and also tested positive for coronavirus. That doesn’t exactly say they were hospitalized for or died of Covid, but it’s as close as we’re going to get. That’s 5,492 out of the 159 million people who’ve been fully vaccinated. I’ll leave someone else to figure out what percent that is and just say it’s small.

Most breakthrough infections are mild, and the number of mild or asymptomatic infections will be larger, but again if numbers are available for that I haven’t found them.

 

A different way to live with Covid

Is it possible to return to normal life in some sane and safe way? A study from Barcelona points us toward a possibility. It followed the 5,000 people who attended a carefully controlled indoor concert. 

People were screened on the way into the concert, using an antigen-detecting rapid diagnostic test (it’s called an Ag-RDT if you want to sound like you know what you’re talking about), and the test was done by nurses. At least with other rapid Covid tests, that makes it more reliable than when people do it themselves, probably because they maneuver those nasty swabs into the right spots.

Everyone wore masks–specifically, filtering facepiece 2 masks–the whole time. Presumably over their noses and mouths, not their chins or back pockets. They look like this.  (I’m conducting a one-person boycott of Amazon, but I’m not above using them as a link if I don’t have to give them money.) They’re a kind of mask that offers more protection than your average cloth mask, but they’re disposable, which if everyone used them everywhere would create its own set of problems. Especially since a few of us out there hate throwing things away when they still look usable. 

But enough of that. Let’s move on.

The event’s described as a concert but people danced. People sang (presumably along with the music but it shouldn’t really matter from a medical point of view.) No one was asked to keep 6 feet away from anyone, at least by the organizers, although some predictable number of individuals will have told some predictable other number of individuals to back off. 

I don’t have details on the ventilation except for a passing mention of improved ventilation. Ventilation’s probably the most overlooked way to make work and public spaces safe. 

The event was held in an area that at the time had a moderate rate of Covid and a low number of vaccinated people. 

What happened? The followup found 6 cases of Covid two weeks after the event. Three of those were traced to sources other than the concert. Another person may have been in the incubation stage when she attended the event and could’ve been missed by the test. No one’s figured out where the other two cases came from. 

Which isn’t bad for 5,000 people. So it can be done if we have the will to do it.

 

. . . and in the schools

In the US, the American Academy of Pediatrics is calling for all students, teachers, and staff to wear masks in school, whether they’ve been vaccinated or not. That runs counter to Centers for Disease Control advice, which exempts the vaccinated and says the unvaccinated should wear masks in school to protect themselves.

Even though–apologies, CDC–your average mask is better at protecting people around the wearer than at protecting the person sporting one.

The article I got this from has the first statistics I’ve seen on how many kids get multi-system inflammatory condition (called MIS-C, in case you have any need to address it directly): It’s 1 out of every 600 infected children and teenagers. That’s not the same as 1 out of every 600 kids, only out of the ones who get infected.

MIS-C is seriously serious and more often than not will land a kid in intensive care. It comes several weeks after the primary infection.

Has anything like long Covid happened before?

Well, yes or I wouldn’t ask the question. Let’s start with the Russian flu, which ran from 1889 to 1892, and its after effects.

 

The Russian flu

Geographical names for pandemics have gone out of fashion, since they’re generally wrong and lead people to blame entire countries for things they suffered from themselves, but the Russian flu was at least first spotted in Russia and to date no one seems to have gotten around to renaming it. So, Russian flu it is. 

Извините, Россия.

That doesn’t make the name correct, though. The Russian flu might not have been a flu at all but a coronavirus. And just to confuse the issue a bit more, the flu was also called the grippe at the time. That becomes relevant in a few paragraphs.

Whatever we call it, the Russian flu seems to have been highly infectious. Half the population of St. Petersburg got it, and it (that’s the disease, not half the population of St. Petersburg) moved across Europe, arriving eventually in Britain. Not because it had been watching Downton Abby and wanted to tour the great houses. Diseases don’t have destinations or intentions or TV sets, and Britain wasn’t its final destination anyway, just a stopover. I give Britain special mention because it’s what I allegedly write about here, although the pandemic’s led me off in other, less predictable directions. 

The Russian flu is now considered the first modern pandemic (no, we’re not going to stop and define that), spreading worldwide along the paths so helpfully laid out by train lines, roads, navigable rivers, and steamships, and demonstrating that it was spread by human contact and by the wonderful ways that humans could now travel.

The Black Death was green with envy. 

Irrelevant photo: roses

In a nifty preview of what would happen with Covid, public health officials in the US watched the virus cross Europe and played it down. It was a particularly mild strain of flu, they said. And when it inevitably disembarked, without passport or visa, on American soil, they swore the first cases were either common colds or just a seasonal flu. 

Nothing to worry about, folks. It’s all under control.

The New York Evening World wrote, “It is not deadly, not even necessarily dangerous. . . . But it will afford a grand opportunity for the dealers to work off their surplus of bandanas.” 

Yeah, I’m having flashbacks to the beginning of the Covid pandemic myself.

This wasn’t a mild disease. Worldwide, an estimated 1 million people died. A survivor said, “I felt as if I had been beaten with clubs for about an hour and then plunged into a bath of ice. My teeth chattered like castanets, and I consider myself lucky now to have gotten off with a whole tongue.”

It also had serious after effects and some uncounted but substantial number of people had them. More than three months after having been ill, the English women’s rights campaigner Josephine Butler wrote, “I am so weak that if I read or write for half an hour I become so tired and faint that I have to lie down.” 

If exhaustion wasn’t bad enough, some people had the added insult of insomnia. 

A Victorian doctor, Morell Mackenzie, said the flu seemed to, “run up and down the nervous keyboard stirring up disorder and pain in different parts of the body with what almost seems malicious caprice.” 

That sounds like he’s describing the flu itself, not the after effects, but the Lancet, which is a medical journal and can be assumed to know what it’s talking about, put that quote and the next one inside a discussion of the after effects. 

Another doctor, Julius Althaus, wrote, “There are few disorders or diseases of the nervous system which are not liable to occur as consequences of grip”.

The collection of symptoms went by an assortment of names: neuralgia, neurasthenia, neuritis, nerve exhaustion, grippe catalepsy, post-grippal numbness, psychoses, prostration, inertia, anxiety, and paranoia. The range on offer backs up my theory that when you can’t cure a disease it helps to change its name from time to time. 

We’d be on shaky ground if we tried to sort the after effects of the Russian flu from–well, everything else that might’ve been available, including psychosomatic problems, tight corsets, and zombies, but observers in the mid-1890s blamed it for everything from a high suicide rate to general malaise. According to the Lancet article, the image of England at the time was “of a nation of convalescents, too debilitated to work or return to daily routines.” 

I would have assumed that the description applied only to the upper class, who could afford not to return to work or daily routines, but what happened in Tanzania (called Tanganyika at the time) shows that I’d be underestimating what post-viral syndromes can do to a person.

 

The 1918 flu

Let’s back up briefly. 

The 1918 flu epidemic used to be called the Spanish flu and sometimes still is. It didn’t originate in Spain, it’s just that Spain put up the first Instagram post. But it was at least genuinely influenza.

How serious was it? Worldwide, at least 50 million people died. About half a billion people—that was a third of the world’s population–were infected. So no, this is not the pandemic you’d want to challenge to a wrestling match. 

Like the Russian flu, its after effects were fierce. They included apathy, depression, tremors, restlessness, and sleeplessness. 

A New Zealand book collecting people’s experiences includes references to “loss of muscular energy” and “nervous complications.” Along similar lines, a South African collection includes this: “We were leaden-footed for weeks, to the point where each step meant a determined effort. . . . It also was very difficult to remember any simple thing, even for five minutes.”

But they got off lightly compared to people in Tanzania, where the flu was followed by a wave of exhaustion so severe that in some parts of the country people couldn’t plant when the rains came and in others couldn’t harvest when the crops were ripe. The result was a two-year famine, called the famine of corms, named after a part of the banana plant that people ate in desperation. 

One strand of post-epidemic symptoms was called encephalitis lethargica–EL for short–or sleepy sickness. It left people not fully asleep but not what you’d call awake either. They were aware of their surroundings but not functioning in anything like a normal way. 

Worldwide, an estimated 500,000 people had EL. A third died, a third recovered, and in the final third the symptoms went on.

Unborn children were also affected. A 2009 study looked at people who, based on when they were born, could have been exposed to in the womb to the 1918 flu. Compared to people born either slightly before or slightly after them, they were 25% more likely to have heart disease after the age of 60. They were more likely to have diabetes. They were, on average, shorter. They had less education and their “economic productivity” was lower. I think that means they made less money. I can’t think how else anyone would measure it. 

 

What does that mean for the Covid pandemic?

No one knows yet how many people have long Covid, which is of several names for Covid’s after effects. No one knows how many people will recover and how many will carry at least some of the effects with them through life. 

No one has a clue what the effects will be on children born during or just after the pandemic, or if there’ll be any, and I’d be surprised if many people are worrying about that yet. They’re kind of busy with more immediate problems.

No one’s even agreed on a definition of long Covid.

It is known that people who have mild or even asymptomatic cases can get long Covid, and that children can. 

It is, as one researcher put it, “One of the reasons I worry so much for people with long-Covid is the . . . uncharted aspect of it. . . . It’s one of the reasons why I do worry when I see people being laissez faire, saying ‘Well, if we’ve got [to] the stage where people aren’t dying, and aren’t filling up the intensive care units, do we need to care?’ And the answer is, I think, until we’ve got more data, we don’t know how much we need to care.

 

A recent study identified 203 symptoms in 10 organ systems. After seven months, many people in the study still hadn’t gotten back to their earlier levels of functioning. When the study was conducted, 45% had to work a reduced schedule and 22% weren’t able to work at all. 

And in a peripherally related seam of worries, a study has called attention to the estimated 1.5 million children around the world who’ve lost a parent or a grandparent who was either raising them or lived with them. It’s an overlooked side effect of the pandemic.

We don’t need zombies, folks. This is scary enough.

Are the fully vaccinated likely to get long Covid?

A bit of scientific brooding over Covid’s statistical tea leaves tells us that the chances of getting long Covid if you’re fully vaccinated are probably small. 

But with the emphasis on probably.

Was anyone other than me worried? After all, the statistics tell us that a vaccinated person who does catch Covid will probably have a mild case. Unfortunately, though, mild cases fairly often leave people with long Covid. 

So far, the information that’s coming in is anecdotal, and the experts say that it’s too early to be certain. In six months, it’s possible that a significant number of vaccinated people will start showing up with long Covid. It’s also possible that they won’t. 

So stay tuned. That’s not the reassurance I was hoping for but it’s the best we’ve got. 

Irrelevant photo: traveler’s joy

 

Do young people have Get out of Covid Free cards?

By now, we all know that young people are unlikely to get seriously frightening cases of Covid, at least when compared with old coots. 

But that doesn’t mean they’re immune. Like anyone else, they’re liable to come down with long Covid even after a mild case of the virus, and the small number who are sick enough to be hospitalized are almost as likely to have organ damage as the old coots are–almost 4 out of 10 of them. 

The message here is that Covid is not the flu. And that young people don’t have a free pass on this.

Young, by the way, is defined as anywhere between 19 and 50. Which from where I stand looks younger all the time. 

 

Taking quarantine seriously

Australia and China have decided that the new Covid variants are too contagious for hotel quarantine to be safe. They’re planning special quarantine centers

Compare that with the way Britain’s treated quarantine, which ranges on the strict end from hotel quarantine after sharing air with passengers who won’t be quarantining to, on the loose end, go home and look in the other direction when you pass other people on your way there.

 

The Covid news from Britain

Over twelve hundred scientists from around the world have signed a letter objecting to Boris Johnson’s policy of lifting all Covid restrictions on July 19. It will, they say, help spread the Delta variant around the world.

As professor Christina Pagel put it, “Because of our position as a global travel hub, any variant that becomes dominant in the UK will likely spread to the rest of the world. . . . UK policy doesn’t just affect us–it affects everybody. . . .

“What I’m most worried about is the potential for a new variant to emerge this summer. When you have incredibly high levels of Covid, which we have now in England–and it’s not going to go away any time soon–and a partially vaccinated population, any mutation that can infect vaccinated people better has a big selection advantage and can spread.”

Some of the experts described the policy as “murderous” and “herd immunity by mass infection.” The words unscientific and unethical also came up. If you pay careful attention, you’ll come away with the impression that they’re pretty pissed off. Not to mention scared. 

In the meantime, the number of people hospitalized with Covid in Britain is doubling about every three weeks and could reach what England’s chief medical officer, Chris Whitty, called “quite scary numbers.” Soon.

The government’s been telling us that vaccination has uncoupled the train car of hospitalizations from the accelerating engine of Covid cases. The problem is that they watched too many westerns when they were young, and uncoupling the cars from a runaway engine solved any problem involving railroads. 

Unfortunately, this is a pandemic, not a train. Or a western.

More cautious voices say they’ve weakened the link between Covid cases and hospitalization, but not uncoupled it. 

On Friday of last week, we had 50,000 cases, which is the highest  number since January. And 49 Covid deaths. 

Office for National Statistics data suggests that 1 in 95 people in England had Covid last week. I’m not sure why it only suggests that, but I’ve learned not to mess with the wording of things I don’t understand. 

The health secretary, Sajid Javid, is one of those new cases. He just came down with Covid. After having visited a care home earlier in the week–a visit that I’d guess was more pr and photo op than anything necessary. 

He’s fully vaccinated and says his symptoms are mild. He’s now self-isolating. No word on how things are going at the care home.

 

So what about Britain’s world-beating Covid tracing app?

Well, it’s been pinging a lot of people and telling them they’ve been exposed to Covid. That means they should self-isolate. Which means they should miss work. Which means the places they work, a lot fo which are already short on staff, are shorter on staff.

Which means no one’s in a good mood.

There was talk–quite definite-sounding talk–about dialing down the app’s sensitivity. People were uninstallling it, the government said, so as not to be bothered by its nagging. It was too sensitive, they said. The number of people pinged had grown by almost 50% in a week, to over 500,000. Transportation, trash collection, and health care were being affected, along with meat processing and car manufacturing. 

Then there was talk about not dialing down its sensitivity. It wasn’t too sensitive. The number of cases had grown, so of course the number of people exposed to Covid had grown right along with it.

So, the government mumbled to itself, what if we say that people who’ve had both their vaccinations are exempt from having to isolate themselves? They’ll get pinged, but they’ll be able to work? 

Last I heard, it hadn’t answered the question and was still mumbling. In other words, it’s taken the worst elements of both choices: It’s changed nothing but called the usefulness of the app into question and by saying lots of people are uninstalling it, it’s encouraged people to uninstall it.