How Covid mutates and why that might be a good thing

There’s good and bad news about the way Covid mutates, and it’s all wrapped around the same bit of information. 

Like most non-experts, I use the word mutate loosely. If something genomeish leads to change, I think it’s a mutation. Which goes to show you what I know.

Covid, it turns out, doesn’t just mutate, it also recombines, meaning it mixes large chunks of its genome, not just single genes. If a mutation’s a typo, recombination is a cut-and-paste error, dumping a largish chunk of text in the wrong place. And while the virus proofreads typos fairly well, it doesn’t catch cut-and-paste problems as effectively.

I’ve had that problem myself. I still wince at something quite horrible that I let go into print because the spelling was right and my eye didn’t pick up the change in meaning. And I’m larger and (I like to think) more complicated than a virus.

Most of those recombination errors, like most mutations, make a mess and that particular virus doesn’t get to leave little virette progeny behind. But some of them work and the virus changes.

Irrelevant photo: One of Janey’s crocuses.

Is recombination what’s happening with Covid? Possibly. The Kent variant has more than a dozen mutations and they seemed to appear all at once. Emphasis on seemed. A lot of what goes on happens in the kitchen while we’re out front cleaning the dining room. Feng Gao, a virologist from China, says we don’t yet have proof of recombination. “Diversity, no matter how much, does not mean recombination. It can well be caused by huge diversification during viral evolution.”

So let’s not get carried away with this. We’re dancing at the edges of what’s known. But (damn, that tune’s catchy, so I’ll do a few more steps) recombination may be how viruses that infect one species jump to another species: by swapping a bit of genetic code .

It’s possible that recombination means a more dangerous virus will appear–either a new one or a more dangerous form of Covid. So there’s our bad news. 

But the good news is that experiments with a mouse coronavirus show that blocking a single enzyme keeps the virus from correcting its typing errors and recombination events happen much less often. If this holds for Covid, the right drug might be able to block recombination and (or maybe that should be or) push the virus to mutate so badly that it ends up in something called error catastrophe–basically, the evolutionary equivalent of falling off a cliff. While dancing to that catchy little tune.

As a way to treat Covid, blocking the enzyme could make antiviral drugs more effective.

The enzyme goes by the name of nsp14-ExoN, which isn’t particularly catchy. If we’re going to be spending time with it, it needs a nickname. But whatever we call it, it’s common in coronaviruses, so if this works it opens up the possibility of curing other coronavirus diseases as well. 

 

Covid variants

If Britain didn’t end up with the world-beating test and trace system Boris Johnson promised us–and believe me, it didn’t–it may have come up with a world-beating strain of Covid instead: the Kent variant; the variant I mentioned that has all those mutations. Sharon Peacock, the director of the Covid-19 Genomics UK consortium tells us it looks likely to sweep the world.

And unlike the test and trace system, we didn’t pay a penny for it.

Go Britain!

The consortium is testing the genomes on a randomly selected 5% to 10% of all positive Covid samples in the country but aims to test them all in order to keep track of how the virus is mutating.

And speaking of variants, the World Health Organization says the small trial that found the AstraZeneca vaccine to be largely ineffective against the South African variant was inconclusive. They’re not saying the vaccine’s definitely effective against it, only that it isn’t definitely ineffective. 

Which is better than nothing. 

 

Covid and Coca Cola

How much space would all the Covid viruses in the world take up if they could be packed neatly for shipping? They’d fill a Coke can

They’d also fill a can of supermarket brand fizzy orange-flavored sugar water, but Covid’s a brand-name kind of virus. Coke it is. So in the scene where someone yells, “Don’t open the can!” for pete’s sake, don’t open the can. You know what happened when Pandora didn’t listen to the warnings?

I’m not telling. But I did give you a link.

 

Spreading the virus

More than half of all Covid cases are spread by people who have no symptoms. They may be less infectious than people who are sick, but they could well make up 80% of the total number of people carrying the disease. And they’re wandering through the world shedding viruses, not lying in bed at home.

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A study by the U.S. Centers for Disease Control found that wearing two masks can reduce the chance of getting Covid by 90% or more. Yes, not just transmitting but catching the damned thing. 

The study had its limits. It tested a tight-fitting cloth mask over a surgical mask, not two surgical masks and not two cloth ones, and it only looked at one type of cloth masks, although the world’s awash with different types just now. And as the article where I first read this put it, it also didn’t consider “men with beards or children.”

Does having children interfere with the fit of men’s masks more than women’s? Hard to say. The study didn’t test that. 

To keep everything in perspective, an engineering professor says that the only reason to wear two masks is to get a better fit. But the masks most of us wear do fit loosely, so double masking might be worthwhile, no matter who’s right.  

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Two weeks after U.S. states introduced mask mandates (they haven’t all), the weekly growth in hospitalization rates dropped by 2.9% among people who are 40 to 64. After three weeks it dropped 5.5% among people 18 to 64.

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Every so often, you’ll find someone saying that Covid’s no more dangerous than a bad outbreak of the flu. So do we have any figures on how much more dangerous it is? 

Yup, some. The risk of death is 3.5 times higher. That number comes from comparing people who are hospitalized with the Covid against those hospitalized with flu. It ignores whatever long- term effects Covid has on the unhospitalized, so I’d say it’s undercounting. Still, it’s a number, and numbers help. 

At least they help most people. 

Covid patients also had one and a half times greater use of the intensive care unit and one and a half times longer hospital stays. And they were more likely to need a ventilator.

In case you think Covid’s only a problem for the old and the ill, not many of the hospitalized Covid patients had other illnesses and 21% were younger than 50. People under 50 made up 24% of the intensive care admissions.

As far as I can see, that doesn’t address the problem of how easily Covid spreads compared to flu. It only compares hospitalized patients.

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Worldwide, the number of reported Covid cases is down for the fourth week in a row. Take a deep breath. The drop is uneven, it doesn’t count unreported cases, and we forgot to get a guarantee that it won’t go back up, but we have to take our good news where we can get it. This is good news.

 

Is there any news on curing the thing?

In a small study, a common asthma treatment, budesonide, cut the need for hospitalization and urgent care by 90%, and people who took it within seven days of showing symptoms recovered more quickly than the control group. Better yet, it cut the number of people with symptoms that lingered after twenty-eight days. 

As usual, it was a small study–146 people–so it’s preliminary, but budesonide is a well-known and well-studied drug, which would speed the process if it’s adopted.

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The U.S. Food and Drug Administration has approved a combination of two monoclonal antibodies that can keep high-risk patients from developing Covid that’s severe enough to hospitalize them. A similar drug had already been approved. Both take Covid antibodies and synthesize them so they can be given to patients as a drip. 

And it’s that drip business that’s causing trouble. Initially, getting them from vial (or whatever they come in) into human took an hour. It can now be done in sixteen minutes. But some hospitals have been so overwhelmed they haven’t had time to deal with it. 

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A team of researchers in China has identified six drugs that the FDA has already approved for other uses that could be repurposed to treat Covid. They whittled that down from 3,769. They still need to be tested in the real world, but already having FDA approval for other purposes means that if they work they could be put to use quickly.

After that, the article went over my head, but it has to do with proteases and substrates, not to mention clades. Have fun.

 

Your feelgood story

New York software developer Huge Ma tried to make his mother a Covid vaccination appointment and discovered that not only did the city and state have different systems that weren’t talking to each other but that there were dozens of separate websites, each one demanding that you sign up a different way.

So he took a couple of weeks and made a free website, TurboVax, that compiles information from the three main city and state sites and sends information on available appointments to Twitter.

It cost him $50 to make.

The difficulty of booking an appointment is one reason–although far from the only one–that vaccines are going disproportionately to white New Yorkers. 

“It’s sort of become a challenge to myself, to prove what one person with time and a little motivation can do,” he said. “This wasn’t a priority for governments, which was unfortunate. But everyone has a role to play in the pandemic, and I’m just doing the very little that I can to make it a little bit easier.”

Lockdown in a hall of mirrors

If the Nobel committee ever gives a prize for incompetence, please, someone, can I nominate Britain’s current government?

It’s hard to know where to start, but let’s jump in with the government deciding to go off-label and give people their second dose of the Covid vaccines later than the manufacturers recommend. That set off a good bit of screaming by doctors and scientists, not because they know it’ll be a problem but because no one knows how it’ll work. 

But that’s serious stuff, so forget about it. What about the people who’d already gotten their first dose and were given appointments for the second one? 

Well, on the same day that the minister for Covid vaccine deployment (no, I didn’t know we had one either) said it was doctors could let patients keep their second-dose appointments, National Health Service England said the appointments needed to be “cancelled and rearranged.”

So that’s clear.

Irrelevant photo: skimmia japonica, I believe. 

Meanwhile, a Labour peer is suing the government over its decision to delay the second dose of the Pfizer vaccine.

Not the Oxford vaccine as well? 

Nope. Its clinical trials offer some evidence that getting the second dose later might not be a problem. Might. Some. Pfizer, though, has said there’s no evidence to support delaying its second dose. So that’s the stronger case.

Her argument is that the decision is unlawful and potentially unsafe.

Two notes before I go on: One, a Labour peer is, in normal language, a member of the House of Lords who’s a Labour Party member. If you live in the real world that sounds like a contradiction in terms, but if you follow British politics long enough it starts to sound frighteningly normal. 

Two, something I read the other day objected to calling the Oxford AstraZeneca vaccine simply the Oxford vaccine. I’m sure they’re right, and it’s annoying as hell. I really should do it right.

 

Lockdown in a hall of mirrors

The government has changed the lockdown rules sixty-four times since the pandemic started, according to a human rights lawyer who sat down and counted them. That’s an average of one change every four and a half days–and that’s just the actual laws, not advice or guidelines. So basically no one knows what we’re supposed to be doing.

That’s led to cops, lawyers, and government ministers not knowing law from advice or their ass from an apple. 

A lot of the information on lockdown that filters out to the public doesn’t reflect the actual law, and the average cops on the beat get their information from the same not-necessarily-accurate sources as members of the public. They’re not lawyers and they don’t read the new laws every four and a half days. 

What the ministers’ excuses are, I don’t know, but Boris Johnson’s recent bike ride reminds us that they’re as muddled as we are.  

What I’m talking about is that Boris Johnson, allegedly our prime minister, although I’m not sure how much of his time or attention the job claims, took a bike ride and a member of the public spotted him seven miles from home. That was after two women were fined £200 (each) for meeting five miles from their homes to take a walk. Because, after all, we’re in lockdown.

They were supposed to stay local, the cop who fined them told said.

The fines–after lots of embarrassing publicity–were withdrawn, but the incident did set a context. Was Johnson staying local? What does local mean?

The policing minister (I didn’t know we had one of those either) said, helpfully, that whether seven miles is local “depends on where you are.” 

And while we were all chewing our way through that, syllable by unhelpful syllable, he added, “Seven miles will be local in different areas.”

I hope that clarifies the issue. 

 

Deaths and other serious stuff 

On January 13, the UK had 1,564 Covid deaths–more than we saw on any day of the first pandemic wave. The best estimates are that those were people who’d been infected before the great Christmas germ exchange, so we can expect the daily number of deaths to rise when the Christmas cases start rolling in.

The situation in some hospitals is serious enough that to free up beds for Covid patients they’ve started discharging some patients to their homes, where they can at least theoretically be cared for by family, and others to hotels, where they’ll be cared for by volunteer organizations, medical people from the military, and (less realistically, since they’re already overstretched) NHS personnel. 

These are patients who they’d otherwise keep in the hospital. 

The NHS has also asked care homes to start accepting Covid patients who don’t have a recent negative test as long as they’ve been in isolation for 14 days and have no new symptoms. I don’t know about you, but I see trouble coming there.

No one sounds happy about any of this. It’s a measure of how bad things look right now. 

 

The vaccine in Britain and around the world

London is getting fewer doses of vaccine per person than other parts of the country, and it’s not being quiet about it. But the country as a whole is getting fewer doses than it was promised. We were told we’d have 10 million doses of the Pfizer vaccine in our eager (and very cold) little paws as soon as it was approved. By Christmas, half that amount had made its presence known.

For the Oxford vaccine that I now have to call the AstraZeneca vaccine, 30 million doses were supposed to materialize immediately. By Christmas, 4 million were available.

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That hapless minister in charge of vaccine deployment said the government would absolutely switch the mass vaccination centers to 24-hour-a-day operations if that became necessary or possible. Then the prime minister’s press secretary said there hadn’t been any clamor for the centers to stay open overnight. 

I hate to side with Johnson’s office, but people do need to sleep–especially overstretched medical people. 

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While many countries are vaccinating their oldest people first, Indonesia is prioritizing people who are between eighteen and fifty-nine. Professor Amin Soebandrio said, “We are targeting those that are likely to spread the virus”–people who “go out of the house and all over the place and then at night come back home to their families.”

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The first reports on the Sinovac vaccine (it’s called CoronaVac–Sinovac’s the maker) said it was 78% effective, but new reports say it’s more like 50% effective at preventing the disease but 78% effective at keeping people from needing medical treatment. That makes it a perfectly workable vaccine but the first vaccines reported such high numbers that we’ve started to expect fantastic instead of just workable. 

SinoVac was tested in Brazil, where it’s become a political football, with the president, Jair Bolsonaro, feeding into an antivaccination movement and the governor of Sao Paolo, João Doria (who hopes to run for president), championing the vaccine.

 

And a bit of research that doesn’t fit anywhere else

Researchers are reporting that double-masking–wearing one on top of another–can protect not just the person on the outside of the mask but you, the person on the inside, especially if the masks are thin. You don’t want to get so crazy with this that it’s hard to breathe, but two relatively flimsy masks can approach the effectiveness of the N95 masks that medical workers wear. 

The researchers also say you can get a better fit out of a mask with add-ons: ties from ear loop to ear loop or nose bridges to keep it in place. And you’ll be in the height of fashion. I felt like a bit of an idiot, but I did wear two masks yesterday and it wasn’t much different than wearing one.