The Covid medical news roundup

First, a fragment of good news, since we’re all in need of one: The Pfizer vaccine has been declared safe for people with food and medication allergies. It’s only a hazard to people who are allergic to components of the vaccine itself–polyethylene glycol and polysorbate

People who have a history of anaphylaxis to an injectable drug or vaccine made with either of those, along with anyone who can pronounce the key words I’ve used so far, should talk to their allergists before getting a vaccination. Everyone else can relax. But people will still be monitored for fifteen minutes or so after they get vaccinated–just in case. So you can relax twice over.

Vaccines cause allergies in roughly 1.3 people out of a million, and the rate’s about the same for the Pfizer vaccine. 

Irrelevant photo: Snow on a camellia bud last February–or possibly the one before–when we had two or three inches. To celebrate, half of Cornwall jumped in their cars and ran off the road.

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Turkey reports that a vaccine developed by the Chinese firm Sinovac is 91.25% effective. 

Why is Turkey reporting on a Chinese vaccine? Because it was tested there. You have to test vaccines where the virus is plentiful and happy to infect people, and it’s not happy in China just now. 

Turkey’s signed a deal to buy 50 million doses.

 

Covid and the brain

Enough good news. It’ll only go to your head. 

Around the world, a handful of wild-ass psychiatric problems are turning up in post-Covid patients who have no history of mental illness. The numbers are small, but the problems aren’t and they can show up after weeks and even months in people who had only mild Covid symptoms.

The patients described in a New York Times article range from their thirties into their fifties–ages when people shouldn’t start having hallucinations, becoming paranoid, or, as an expert might put it, nutting out in these particular ways. And some of them had enough of a grasp on reality to know that something was wrong, which people with this kind of psychotic symptom usually don’t.

The best guess at the moment is that this is somehow linked to the body’s immune response to the virus–maybe to inflammation and maybe to vascular problems. There are records of psychosis and mania after the 1918 flu epidemic and after the SARS and MERS outbreaks. 

One psychiatrist, Dr. Hisam Goueli, said,  “We don’t know what the natural course of this is. Does this eventually go away? Do people get better? How long does that normally take? And are you then more prone to have other psychiatric issues as a result? There are just so many unanswered questions.”

I keep saying this, but younger people aren’t immune to Covid. They’re statistically less likely to have problems if they catch it, but that’s not the same as being immune. The problems it can cause are fucking terrifying. 

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The National Institutes of Health–they’re in the U.S., and I have yet to figure out why they’re plural–are seeing damage caused by thinning and leaky brain blood vessels in tissue samples from people who died shortly after contracting Covid. But they found no signs that Covid itself had invaded the brain, although earlier research did find small amounts of Covid in brain samples. 

The NIH findings may be caused by the body using inflammation to respond to the virus. And no, I don’t know what it means either. Eventually, I trust, someone will. In the meantime, it’s just one more piece of this giant jigsaw puzzle that’s all over the living room floor. If the cat would stop hiding pieces under the chair, we might complete it some day.

 

Controlling the spread–or not

A study of the effectiveness of measures to control Covid reports that you can’t drive the growth of the virus to below zero without paying a high social cost. Limiting gatherings, canceling public events, and suggesting that people stay at home? Nope, that won’t do it. You have to close schools, order people to stay at home, and close workplaces either fully or partially.

The British government will do most, and maybe all, of that eventually, but it wants to wait until the virus has a head start. That’s only sporting.

In fact, after Boris Johnson waffled over whether to reopen the schools on schedule and at the latest possible moment announced that he would, he now says there’s “no question” we’ll have to take tougher measures. But only in “due course.” 

On Sunday, Britain had more than 50,000 confirmed new cases for the sixth day running. But no, we’re not going to rush into this. 

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A Barcelona experiment held an indoor concert, complete with masks, dancing, and rapid Covid tests, to see if an event could be held safely in this pandemic age. Half the people who tried to go were tested and sent home to be a control group and half were tested and allowed in if they were negative. 

Preliminary reports are that eight days later no one in the group that attended had Covid and two people in the group that was sent home did. 

What does it all mean? I’m not sure. A photo from the concert shows dancers wearing masks but they weren’t all wearing them in the right places, so whether this speaks to the effectiveness of the testing, the inability to adult humans to identify the parts of their faces involved in breathing, or pure dumb luck I don’t know. 

 

The great vaccine rollout

Now that Britain has two vaccines going, how long will it take to get everyone vaccinated? 

A while. In the first three weeks, three-quarters of a million people were vaccinated, so (even I can work this out) that’s a quarter of a million people per week. At that rate, it’ll be the end of 2021 before the vaccine reaches everyone in the official list of vulnerable people (anyone over 50 plus a narrow definition of front-line workers and people with underlying medical conditions). Someone else worked that out, so you can probably trust it. 

The health secretary is aiming for 2 million people a week. And I’m still hoping to be a full 6 feet tall, but at 73 I suspect I’ve stopped growing. 

And that’s just the first shot. For the followup, we’re counting on King Arthur to rise from–remind me, where’s he supposed to return from when his country needs him? Avalon? Anyway, he’s traded his now rusty sword for a rust-proof needle and will be helping out with the vaccination effort as soon as he finishes the required online module in identifying and countering radicalization and gets his certificate. 

And the good news is . . . 

. . . that astronomers in Australia have found a radio wave that (important missing word: apparently) comes from a nearby star. It was picked up for thirty hours during April and May of, um, 2019 I think. They’ve been analyzing it ever since and so far haven’t found anything earth-based that would account for it.

What’s more, It’s apparently shifted frequency in a way that’s consistent with the movement of a planet, and the star it seems to come from, Proxima Centauri, has a rocky planet in the habitable zone, where water doesn’t freeze permanently or sizzle itself into something not helpful to the creation of life.

No one’s ruling out some really boring explanation for the signal, but at the moment it’s called the Wow! Signal because an astronomer wrote “Wow!” in the margin next to the data. 

Why is this good news and what’s it got to do with Covid? You know the concept of deus ex machina? That’s when a writer traps her- or himself in a corner and can’t resolve the plot problem in an even vaguely credible way, so–let’s shift to the plural; it’s not as clunky–they bring in some unexpected power or event to save the day, the play, and the paycheck. 

Well, I try to include something hopeful in these posts, but my shipment of hopeful material got stuck at the Brexit border with the wrong paperwork and will be delayed for several days. Or months. So this is a deus ex machina ending. These folks, whoever they are, are radioing us instructions that, as soon as we translate them, will save us from our silly selves.

And if you believe that, I heard about a bridge in Brooklyn that’s going at a knockdown price.

Deus ex machina literally means “god from the machine” and it comes from ancient Greek drama (even though the words are Latin; don’t ask). They’d use a crane to lower a god onto the stage at the end of the play and nothing would have to make sense after that. If god said the undeserving character got the full bowl of Cheerios, the deserving one got yesterday’s cold toast, and the important Greek phrase got to be in Latin, who could argue? 

The vulnerabilities of younger people: It’s the pandemic update from Britain

England’s world-beating Covid test and trace system has people beating their heads against the wall. Anyone can mistake a wall for the world. It’s natural enough. Even in pandemic hot spots, symptomatic people are being turned away. The government’s labs had a backlog of 185,000 tests that were sent abroad over the weekend. But if test samples sit around too long, they’re useless. So, um, yeah. I’m not sure how that’s going to work. But let’s not be silly and hold out for competence.

English schools are warning that they’ll grind to a halt if students and staff can’t get tested, because people who might test negative will have to isolate.

Wales says it’s going to process its own tests. Scotland accused England of trying to limit its access to tests. Northern Ireland doesn’t seem to be taking part in the conversation, and nobody ever listens to Cornwall.  

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Screamingly irrelevant flowers. Whatsit flowers–probably osteospermum. In bloom. In our yard. They’re wonderful–the slugs don’t eat them.

Meanwhile, Doug Jaquier sent me a bit of wisdom from a Facebook site called Puns, One Liners & Clever Wordplay

“Due to the success of Covid testing the Government has taken over pregnancy testing too. The waiting list is currently 10 months.”

The capitalization is not mine. Neither, sadly, is the inventive mind that thought of that. If they’d waited another lifetime, I would’ve come up with it. I just know I would’ve.

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China has announced that it may have a vaccine ready for use by the public in November or December. It’s currently in phase 3 trials–the ones where they test it on a large number of people to see if it’s both safe and effective.

Britain’s Oxford vaccine phase 3 trials were interrupted when one of the test subjects got sick. They’ve resumed now. Presumably her illness was unrelated. Not that anyone’s actually said that. Confidentiality and discretion absolutely ruin a good bit of gossip. 

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An advisor to the British government said that details of the new rules limiting how many people can gather in what circumstances are irrational–you can get a larger group of people together for a sports event but a family of five can’t have two grandparents visit them at home. 

“It is on the other hand very simple,” he said.

And it is simple until you try to sort through the who, what, when, where, and how.

In case you were worried, you can gather in groups of up to thirty to shoot grouse. So don’t feel too bad about the grandparents. At least no one (that we know of) is hunting them.

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A lot of Britain’s recent Covid cases are among younger people, so let’s talk about the people who it’s hitting like a sledgehammer. The reason I want to focus on them is that we have the illusion that Covid’s only a danger to people over sixty. Or seventy. Or eighty. Younger people are immune. 

Okay, most of us have that illusion. You probably know better, but the rest of us can be pretty dumb sometimes.

At Mount Sinai Health System, in New York, doctors treated five Covid stroke patients in two weeks, all under fifty. Normally they’d see one every three weeks. Four of them were relatively healthy beforehand. Two were in their thirties and had no risk factors. 

That’s a lot of numbers in one paragraph. Five in two weeks instead of one every three. Hold onto that. It’s not a huge number, but it reminds us that the danger to younger people is real. If you have to draw a card out of the Covid deck, you have no way to know what card it’ll be. 

Dr. Adam Dmytriw, a University of Toronto radiologist, says, “We’re seeing a startling number of young people who had a minor cough, or no recollection of viral symptoms at all . . . and they have a sudden stroke.” 

How many is a startling number? Enough to startle a doctor. That’s the best I can do, because the article didn’t say. Some of them had underlying medical conditions, but none had risks that should have increased their chance of having a stroke. For some, the stroke was the first sign that they had the coronavirus because they had the mild cases we all expect them to have.

In the U.S., the number of hospitalizations among 18- to 29-year-olds quadrupled in just a couple months. From the week ending April 18 to the one ending June 27, it went from just under 9 for every 100,000 to roughly 35 per 100,000. It’s not a huge number, but it’s a big jump for a short stretch of time.

One study, again of Americans, says a third of all younger people have at least one risk factor for severe Covid. 

Other younger people end up with some version of post-Covid syndrome, which can include exhaustion, chest pains, migraines, breathlessness, dizziness. About 600,000 people (I think that’s in Britain, and it seems to include all ages, but don’t take my word for that) have some version of post-Covid syndrome as measured by the app Covid Tracker. Around 12% of them have had it for more than a month and one in two hundred for more than 90 days.

Something close to 100% of British publications (at least the ones I read) don’t bother to translate their statistics into comparable categories. I think that would be .5%, but I’m not going to crawl too far out on that limb.

The initial belief that Covid risk rises with age still seems to hold true, but even so the evidence is increasing that younger people aren’t immune. A retrospective Chinese study of Covid in children counts 2,143 cases. More than 90% of them were mild or moderate, but 6% of pediatric cases were severe and even critical, compared to 19% of adult cases. 

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Isn’t it just fun to spend time with me? Doom, gloom, and after that I’m out of relevant rhymes.

Zoom.

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A paper published in the New England Journal of Medicine floated an unproven theory about Covid: that mask wearing may be immunizing people. The idea is that masks may cut down on the number of viruses that a person breathes in, so the body’s able to mount an immune response instead of getting overwhelmed. 

It’s the same process that made variolation–the early form of inoculation against smallpox–work. A person was deliberately exposed to a small amount of the disease and the body probably mounted an immune response. Emphasis on probably. You couldn’t be sure who would become immune and who would get sick and quite possibly die. 

The mask theory rests on two unproven assumptions: that exposure to a lower dose results in a milder case and that mild or asymptomatic cases confer some immunity. More than that, the only way to directly prove it is through clinical trials that would expose people, some wearing masks and some not, to the coronavirus. Which is unethical. So at this point it’s basically an interesting thought.