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. 

Will the pandemic ever end?

The pandemic, it turns out, is not a war. It won’t end in either complete victory or in a negotiated treaty. That leaves us with no clear line between pandemic and not-pandemic. 

The consensus among public health experts and epidemiologists is that Covid will, at best, turn into a background danger, something that pops up in localized and seasonal outbreaks that we have to live with and work around. 

But that’s the best outcome, not the guaranteed one. Everything depends on how many people get vaccinated and what variants develop. And because no variant can be contained in one country or region, one country’s problem is every other country’s problem.

According to Alessandro Vespignani, professor of physics, computer science, and health sciences, “Vaccination of the low- and middle-income countries is the most altruistic thought and at the same time, the most selfish. Because we have to protect those populations so that we can protect us.” 

Irrelevant photo: The Bude Canal

So that’s a definite maybe on the pandemic ending, not a resounding yes. Pack away the trumpets, the confetti, the Mission Accomplished banners. That banner stuff looked a little silly anyway, back when Bush Jr. tried it. And keep your eye on what’s happening in the worst prepared countries, because what happens there will be knocking on your door and mine in no time at all.

 

More on long Covid

First, the disclaimer: There’s no one definition of long Covid, so if this all seems a little murky, that’s because it is. Long Covid’s symptoms range from the annoying to the life-changingly disastrous, and at this point they all get lumped in together. Some of them go away after a while and others get milder. Some do neither–they set up housekeeping. 

If that sounds ominous, allow me to make the picture worse:

Almost a fifth of the people who caught Covid infections but had no symptoms show symptoms “consistent with long Covid” a month after they got infected. In other words, people who had no symptoms may be going on to develop long Covid. 

And 27.5% of non-hospitalized people with symptomatic Covid did the same thing, as did 50% of the people who were hospitalized. 

That comes from an analysis of medical insurance claims by 1.96 million people in the U.S. The weaknesses of the study are that it didn’t have a control group and that it only studied people who had certain kinds of insurance. In the U.S., what kind of insurance you have says a lot about your class, which in turn says a lot about how Covid hits you.

Did I say “class”? Sorry. Everyone in the U.S. is middle class. It’s just that a very few members of the middle class are obscenely rich, some are doing fine, some are just hanging on, and some are long-term broke.

I’ve been away so long. I sometimes forget. 

But back to the study. Its strength is that it’s huge. 

But you can’t look at it and say, “This group of people definitely had long Covid.” On the other hand, with no solid definition of long Covid, it’s hard to look at any group of people and say that. At the very least, it’s enough to make us stop and think about what we’re dealing with in the long term. The pandemic is likely to leave us with a long-term public health problem, something individuals, families, health systems, and governments will all have to deal with.

The report also “drives home the point that long Covid can affect nearly every organ system,” according to Dr. Ziyad Al-Aly, chief of the research and development service at the Veterans Administration St. Louis Health Care System. “Some of these manifestations are chronic conditions that will last a lifetime and will forever scar some individuals and families.”

Just to keep from scaring ourselves witless, let’s remember that some of the manifestations (that translates to symptoms) aren’t likely to leave scars forever. No one seems completely sure of how wide and how deep the problem of long Covid will go. It scares the hell out of me, but there’s no point in getting so scared we can’t function anymore.

If, in fact, we ever did function (she said cheerily).

 

So when do we go back to normal?

England–or its government, anyway–has put off lifting the last of its lockdown rules. That makes the prime minister very sad. He wanted to let us know that we all live in paradise, have enough money to live well, and are at our ideal body weight. 

Yea, every last lumpy one of us.

The postponement came because multiple experts have been warning of a possible third wave. Last I heard, England’s R number–the rate at which the virus is spreading–was estimated to be 1.4. Anything above 1 means the number of infections is growing. The numbers aren’t high yet, but the direction’s not good. 

If we do have a third wave, it’s expected to be caused by the more transmissible and possibly more dangerous Delta version of Covid. The hope is that keeping those last restrictions for a while means there’ll be time to vaccinate more people, preferably with two doses of a vaccine, not just one. 

 

Vaccine updatelets

In the region at the center of Britain’s outbreak, vaccination numbers have dropped in the last month. I’d love to give you more detail, but the article’s behind a paywall on a site I don’t want to subscribe to, so it’s headlines only on this. 

*

People working in care homes in England will have to get vaccinated in the next 16 weeks if they’re going to keep working with patients–or in some cases, keep working at all. The only exceptions will be people with a medical reason not to get the vaccine. No one knows how this will play out, but assorted organizations of medical professionals are opposing it.

The requirement may be extended to National Health Service staff.

“Compulsion is a blunt instrument that carries its own risks,” the British Medical Association said. An (unnamed) NHS boss said it was setting up a confrontation with staff “at a time when you’re denying them a decent pay rise but also saying how much you love them.”

Both fields already have staff recruitment problems. That have been made worse by Brexit. And low pay. And at least in the NHS, pandemic working conditions. 

In early June, 89% of NHS staff was at least half vaccinated and 82% fully vaccinated. In adult care homes, that was 83% and 68%. 

*

A new vaccine, this one made by Novavax, has come through stage 3 trials showing 90.4% effectiveness against mild and moderate Covid and 100% effectiveness against severe cases. It was tested against the Alpha, Beta, and Gamma variants. The Delta variant overslept and missed the test.

Delta will receive a failing grade but will be eligible to take the test the next time it’s scheduled. A spokesperson for the variant said, “Delta has other priorities at the moment and will be in touch when its schedule allows. It has no further comment at the present time and will not take questions.”

The Novavax is a two-dose vaccine. 

*

A small study dropped hints that a third Covid vaccine does might give transplant patients a better immune response. People with transplanted organs have to take drugs that suppress their immune systems in order to keep their transplants from being attacked by the aforesaid immune systems. Two doses don’t seem to be enough to rev up their Covid immunity.

A larger study is planned. In the meantime, the people who understand these things are feeling hopeful.

 

Why some folks who recovered from Covid keep testing positive

At some point during the pandemic, the good folks who comb through Covid tests noticed that a certain number of people who’d recovered from Covid kept testing positive, although further testing couldn’t find any live virus in their systems. Now a study offers us a theory about why that might be happening.

But before we go on, remember that this is a theory. Repeat after me: It’s a theory, it’s a theory, it’s a theory.

Ready? In simplified form, since that’s as much of it as I can handle, bits of Covid’s genetic sequence can embed themselves in human DNA, getting there by a process called reverse transcription. Don’t worry about what it’s called, though. I only mention it so it’ll have a name and we can call it when lunch is ready.

Irrelevant photo: Daffodils by a stream. Photo by Ida Swearingen.

Before you come unglued about the idea of Covid embedding itself in your DNA, understand that it doesn’t mean Bill Gates is embedding himself so he can send you instructions to buy his latest product or divorce your–or his–wife. Something like 8% of our DNA is made up of sequence fragments left there by ancient viruses. That sounds eek-ish, but they do nothing more than sit around looking ancient. And if you know how to read them, interesting. They’re not responsible for diseases or divorces or anything else beginning with D.

Now if they were retroviruses, they’d use a position in our DNA to replicate and make us sick, but Covid isn’t caused by a retrovirus, so if it’s there, it’s doing nothing.

Take a deep breath. The situation isn’t any worse than it was a minute ago. 

From there on everything gets complicated, but I did escape away with this much information: 1, It’s not yet clear how common reverse transcription is with Covid; 2, if it’s happening at all, it might mean that some Covid immunity gets integrated at the cellular level (that would cause a good thing); and 3, it might also be responsible for the autoimmune responses that show up in long Covid (that would cause a bad one).

Warning: The study’s still controversial, with some scientists yelling–in a more academically appropriate way–”This is bullshit and it’s feeding into people’s fears.” Make of it what you will. I suggest tucking a sprig or two into your hat and waiting to see what it’s done in a month or six.

 

Covid and evolution

You’ve probably heard people say Covid will become less deadly over time. Didn’t the plague? Didn’t, after the Spanish flu epidemic, the flu?

Mmm, well, maybe. There are two problems with the argument. The first and biggest is that evolution’s random, driven by a combination of pure dumb chance and the pressures put on it by outside circumstances. So as any given disease evolves, it could become milder and it could become more deadly. Or could become neither and change in other ways–ones we care about less.

But that’s old news. The second problem with the argument is newer and more interesting. A group of necrophiliacs–

Sorry, a group of scientists studied the bodies of 36 sixteenth-century bubonic plague victims and compared their immune markers with those of people living in the area today. The modern residents showed a greater genetic resistance to the plague than the sixteenth-century bodies did.

“This suggests these markers might have evolved to resist the plague,” said Paul Norman of the Colorado School of Medicine. 

Because it’s not only diseases that evolve: So do we. And if the study’s correct, so did we. Or at least so did the people of that particular town.

If you want to get whacked with the full scientific verbiage, the article says, “Among the current inhabitants, the team found evidence that a pathogen, likely Yersinia pestis which causes bubonic plague, prompted changes in the allele distribution for two innate pattern-recognition receptors and four Human Leukocyte Antigen molecules, which help initiate and direct immune response to infection.”

Got it?

Me neither. That’s why quotation marks were invented.

The good news here is that humanity can adapt to massive medical threats. The bad news is that, even if some of us have genes that will protect us against Covid, we can’t know in advance who’s got ‘em and who doesn’t. And for those genes to spread through the population would take I’m not sure how many generations and many deaths, which would unsentimentally eliminate those of us who don’t have ‘em. 

In short, if you can get vaccinated, do. 

 

Does vaccination either stop or slow the spread of Covid?

A study that followed vaccinated and unvaccinated hospital employees found that vaccination dramatically reduces asymptomatic Covid infections. In fact, the change was enough that a pretty dry writeup of the study used the word dramatically. The word didn’t wander into this paragraph because I was struggling to keep us all awake.

So what? So it means that vaccinated people will be dramatically less likely to pass on infections. If you don’t get them, you can’t give them. 

How dramatic a change are we talking about? A week after getting their second shot (or jab if you speak British), vaccinated people were 90% less likely than their unvaccinated co-workers to have asymptomatic Covid.

In that case, how soon will the pandemic be over? 

Um, yeah.

A group of infectious disease modelers at Northwestern University are playing with the numbers and trying to figure that out for the U.S. alone. Their projections are lining up nicely with the numbers reported from the real world, so they’re worth listening to. Basically, the number of Covid deaths and the number of severe cases are going down. That’s the vaccination program at work. 

Rochelle Walensky, of the Centers for Disease Control, said, “The models forecasted some really good news, and an important reminder. The reality is it all depends on the actions we take now.”

Basically, she says, controlling the pandemic depends on people getting vaccinated–quickly.

Is forecasted a real word? Yup. To forecast has two past tenses, depending on what mood it’s in when it gets out of bed. Forecast is one and forecasted is the other.

You can’t always forecast which mood it’ll be in. 

I didn’t know that either.

“The results remind us that we have the path out of this,” she said, “and models once projecting really grim news now offer reasons to be quite hopeful for what the summer may bring.”

But the modelers warn that this doesn’t mean all restrictions should be lifted at once. Surges are still possible, and new variants are a threat. 

They don’t specifically mention this, though, so I will: Until vaccines get to the rest of the world, no country is safe. 

Which leads me to this: As of May 6, 44% of the US population and 51% of the UK population had been vaccinated. Compare that to 9.4% in India, 4.4% in all of Asia, and below 1% in all of Africa. Which is an elaborate way of saying even the safest of us is a long way from safe. 

Appeals to our higher nature are fine, but the desire for self-preservation’s a powerful force and always worth a mention. 

 

Long Covid

Long Covid has a new name: Post-Acute Sequelae of SARS-CoV-2–or PASC to its friends. 

Why does it need all that? Because in my experience, when the medical community can’t cure something, they rename it. 

Since I’m claiming to have experience, I’d better cite my qualifications. I lost four years of my life to some sort of post-viral exhaustion that was so vaguely defined it had to be diagnosed by picking two symptoms from List A and three from List B. Or maybe it was one and four. Either way, I watched the syndrome go through two or three name changes before I stopped keeping track. 

The experience means that I’m more afraid of long Covid than I am of the severe form of the disease, although I won’t argue that we should all feel that way. 

I’d like to think the new name’s a sign that long Covid’s being taken seriously, and if the number of articles about it are a measure of seriousness it just might be, but being taken seriously isn’t the same as anyone knowing how to cure it. Or even knowing what causes it. 

Long Covid lands on people who had severe Covid and on people who had nothing more than a mild case. And this next bit is news to me: It also shows up in people who had asymptomatic cases. It can range from mild to debilitating to horrific. In one study, less than a third of people with long Covid had fully recovered five months after they left the hospital, although that’s a skewed study because it only follows people who were hospitalized. 

A different study found that nearly half the people hospitalized with Covid felt they hadn’t fully recovered after seven months. Either that study or a different one (forgive me, I get dizzy when I’m around numbers for long) says one person in ten will have Covid symptoms months after recovering from the disease itself. 

This is all still new territory. Expect the numbers to be contradictory. No one even has a fixed definition of long Covid, so you’ll find the game being played by different rules in different studies. And the playing field keeps changing size. In fact, some studies are working with cards and others are convinced it involves a ball. 

It’s not clear yet who’ll get long Covid. Working-age women are the most likely, but men can get it, old people can get it. Young adults and kids can get it. No one seems to have a demographic Get Out of Long Covid Free card. 

An article from Yale University says we are “facing the prospect of a chronic condition without diagnostics or therapeutics. We are facing a post-viral condition of potentially historic proportions and are almost completely in the dark about the underlying mechanism.”

It goes on to talk about lives that are changed overnight, about long Covid’s disproportionate impact on minority communities, and “a health care system that can offer no substantive assistance.” Not to mention long Covid’s “financial toxicity”–and since the article comes from the U.S., people’s loss of health insurance.

Yeah. It scares the hell out of me. 

Home brew Covid research meets Goldilocks

When Vittorio Saggiomo, a scientist in the Netherlands, couldn’t work in his lab during lockdown, he invented a rapid Covid test using the materials he had at home: coffee pods. You know, those pretty, nonrecyclable things that–well, if you use them at all, you have plenty of them.

The reason he wanted to do this is because Covid tests give you a choice between a slow but accurate one and a fast but inaccurate one. The slow ones take time because–

Oh, hell, do you really want to know this? They take time because tiny scientists have to take the swab you jammed up your nose, extract the DNA you left on it, and multiply it until they have enough to work with. And it’s not easy to find tiny scientists–they have to be small enough to fit inside a test tube. 

The fast one is inaccurate because it bypasses the tiny scientists and works with just that bit of DNA you left on the swab. 

Irrelevant photo: These are either what you think they are–dandelions–or one of the half dozen or so flowers that look just like them but aren’t. Damned if I can tell them apart.

Listen, if you want a serious explanation, you should follow the link. I didn’t flunk high school science, but that was only because I was hiding behind the bunsen burner when they handed out grades.

Onward. There’s a third way of testing, a process called Lamp, which stands for, um, loop-mediated isothermal amplification.

You just had to ask, didn’t you?

It does the same thing as the PCR test, multiplying that stingy bit of DNA you sacrificed, but unlike the PCR test it doesn’t have to be done at a bunch of different temperatures. One will do.

So Saggiomo’s problem was how to create the right temperature at home. He found a wax that would melt at the right temperature, so that would keep the DNA at a constant temperature. Next he needed something to put it in. At this point, he turned to the coffee pods. 

The final problem was finding a way to heat the pods. In the dishwasher, they got lost. In the microwave, they overheated and the lids popped off. Cups of hot water didn’t control the temperature well enough and the porridge was too cold. Or possibly too hot. The bears got hungry. 

A pan of water simmering on the stove was perfect, though, and Goldilocks and the three bears sat at the table together and said, “Yeah, but where’s our coffee?”

“Shut up,” the scientist said. “I’m on the verge of a breakthrough and all you can think of is caffeine.”

They ate him.

The tests can be made for .20 euros each (don’t miss the decimal point on the left), but whether anyone’s actually going to produce it is up for grabs. 

Anyone ready for porridge?

[For anyone visiting from a culture with a different set of folk tales, the references are to Goldilocks and the Three Bears. If I have to explain them, they won’t be remotely funny, but Lord Google will be happy to help you find the tale if you’re interested.]

 

 

More at-home research

From the start of the pandemic, a professor’s thirteen-year-old son watched his father disinfect the groceries and afte a while he questioned whether it really needed to be done. 

“I just told Anand, ‘If you want to do a science project, this is a perfect one,'” the father, Vishal Shah, said.

They took the project seriously enough to quarantine for fourteen days so they wouldn’t contaminate the test subjects, then gathered produce from ten stores in the Philadelphia area, where high levels of community Covid spread were reported, and they went at peak times. They took produce that people touch a lot–apples, avocados, bananas, broccoli, carrots, potatoes, lettuce–and swabbed them five times.

“One of the first things I realized once I told my dad I wanted to do this project was that I had no means of testing for the virus on my own,” Anand said. “My dad’s lab was closed, so I contacted labs across the country and gave presentations that discussed what the project was.”

He found one  in Tennessee that would do his testing. Of the 140 pieces of produce it tested, only one apple had traces of the virus on its surface. 

The study has been published in ACS Food Science and Technology.

Not bad for a thirteen-year-old, even if he did have help.

 

A bit about long Covid

At the beginning of March, the Office for National Statistics estimated that 1.1 million people in Britain had long Covid.

So gets long Covid? It was most common among people between 35 and 49 and more common in women than men. It followed Covid’s pattern of hitting hardest in the poorest areas, and health and social care workers are the most likely occupational group to have it. That could be because they–like people who live in the poorest parts of the country–are more likely to be exposed to the virus. 

People with preexisting health conditions were also more likely to get long Covid.

In round numbers, out of seven people who test positive for Covid, one will still have symptoms three months later. 

But there’s still no official definition of long Covid, and that leaves a lot of questions about what happens to people who get it, financially speaking. If they use up their sick leave and lose their jobs, do they have a medically recognized condition so they can apply for support? How is long Covid diagnosed when there’s no definition and no diagnostic code? 

You’ll notice I’m asking more questions than I’m answering, so here’s one I can answer: What’s a diagnostic code? It’s something terribly important that you put into a little blank square. If you don’t have one, please apply to the Department of Diagnostic Codes. As soon as you get it, your life will become more fulfilling.

So are people who get long Covid disabled? In practical terms, some are and some aren’t. Some will be able to work full time, some only part time, and some not at all. Are they officially disabled, though? Gray zone. The short answer is that it’s too early to tell, and figuring it out is going to be messy. If they become officially disabled, an employer’s expected to make “reasonable adjustments” for them. If not–

Gray zone. 

Among those 1.1 million people in Britain with long Covid are 122,000 people who work for the NHS, 114,000 teachers, and 30,000 social workers. I didn’t find statistics on what percentage of teachers that is, but it’s close to 4% of the NHS staff, and their illness is hitting the NHS hard. 

It’s also hitting the people with long Covid hard. Some haven’t been able to go back to work and have lost their jobs. 

Or I think that’s what the article I read is saying. The exact quote is about losing their “roles.” Maybe they’re talking about being downgraded to other roles, but I wouldn’t count on that. If you take enough sick leave–even if it’s your job that exposed you to the sickness–most employers will find a way to show you where the door is. 

One MP is trying to get long Covid recognized as an occupational disease, and to compensate and support workers in health care, social care, and key public services who catch it. I wouldn’t hold your breath, but it would be the right thing to do.

I should also mention the thousands of people who caught Covid in less prestigious jobs in transportation and meat packing and supermarkets–all those people who used to be cheered as key workers and who’ve now been officially reclassified as Remind-me-why-we-cared-about-you.

 

How not to break lockdown rules

An unnamed man broke the Covid rules by traveling from England into Scotland for no better reason than to camp out on Inchtavannach, an island in Loch Lomond. Once there, he didn’t sing “By yon bonnie banks and by yon bonnie braes” (as far as anyone knows, anyway). Instead, he lost his paddle and got his silly self stranded. 

(Again, if you’ve visiting from a culture with a different set of overused songs, that’s from “Loch Lomond.”)

What happened to the unnamed man isn’t quite the same as, in the famous American phrase, up shit crick without a paddle, but it’s close enough. (That phrase, by the way, is said to date back to the 1860s. You can take it back half a century or so to the days of Admiral Nelson, but you might or might not have to sacrifice the word shit. You needed to know that.)  

It’s not clear what happened to the paddle. The man went for a walk and when he came back he discovered that it had gone for a walk of its own. He and his true love never met again, and someone called the cops–probably him but the article I found doesn’t commit itself. A rescue boat picked him up. I don’t know if he was fined, but I’m reasonably sure that he was teased within an inch of his life.

Some good news about Covid–and some bad

In some patients, vaccination can ease long Covid symptoms. A small study–44 patients–saw 23% of the participants showing some improvement compared to the unvaccinated group. But just so we don’t get too excited about this, 5.6% found that their symptoms got worse. It didn’t seem to matter whether they’d gotten the Pfizer or the AstraZeneca vaccine. 

Long Covid? It’s a weird range of symptoms that some percentage of people are left with after they get rid of the infection itself. In some people, the symptoms clear up in weeks and in others–well, it’s not clear how long they’ll last because they’re still hanging around. The symptoms can range from mild to pretty damn awful and they can follow either a severe infection or a mild one. 

An infectious disease specialist at Columbia University said that about a fifth of the patients he’s treated get long Covid. So anything that helps a quarter of them? We like that. 

Irrelevant photo: hyacinth

 

The bad news

With a bit of good news out of the way, let’s drop in on its old friend Bad News: In Brazil, Covid’s sending younger people to intensive care units–people who aren’t just youngish but who have no pre-existing medical problems. Younger in this case means between 30 and 60, so they’re not young-young, but that’s still an important shift in a disease that’s been known for targeting people over 60. 

This doesn’t seem to be because of a change in the disease itself, though. (Put that on the good news side of the scales.) Part of the shift may be coming from younger people’s belief that they can shrug the disease off. They’re making themselves available to get infected. Or the Brazilian government’s Covid denialism is putting them in harm’s way. Public transportation is packed. On crowded sidewalks, it’s not unusual to see people going maskless. And older people are getting vaccinated while younger people aren’t. 

Even though younger people are more likely to shrug the disease off, enough of them need hospitalization that hospitals are overwhelmed. It’s a reminder that none of us can count on being immune to this thing. 

 

The news you can interpret as good if you want to

Researchers estimate that the Covid virus was probably circulating undetected for a couple of months before it popped its nasty little head up in Wuhan at the end of 2019. This is based on modeling and I’m not going to take you through it because, let’s face it, I don’t understand it, but the researchers played out a series of scenarios and concluded that new viruses jump from animals to humans regularly but that most of them die out before they get a chance to create pandemics. Or even epidemics. 

Remember when epidemic sounded extreme? Yeah, me too. Now it’s just some kindergarten-style disaster–the kind where someone called you a bad name and you went home in tears. 

They figure that some 70% of the infections that jump from animals die out within 8 days of finding their way into the human race. If they get into an urban area, though, the odds tip further in their favor. 

So is that good news or bad? Both, I guess. It reminds us that a whole line of viruses is out there, just waiting to set up housekeeping in our bodies’ cells. On the other hand, it means that most of them, even when they find an entry point, won’t spread around the planet.

 

And a bit more good news

The unalloyed good news is that while Covid’s evolving, so are our antibodies

Let’s say you get Covid and count your antibodies just after you recover. You’ll have lots of them. (I’m writing the script, so of course you recover. I apologize for giving you the disease to begin with, but the plot demanded it. The sad truth about fiction writing is that if you don’t let anything bad happen, you don’t have a story.)

Then you count those antibodies again in six months and you don’t have as many. 

Why’s that good news? 

Because they won’t be the same naive little antibodies you had when you first got sick: 83% of them will now recognize Covid variants and be ready to kill them on sight. (It’s a nasty old world at the cellular level. Sorry.) They’ll even be learning to recognize related viruses, such as SARS. They’re sadder but wiser antibodies. If they go into a bar wanting nothing more than a drink and some virus sits down beside them and tries to chat, they won’t be flattered that it’s paying attention to them. They’ll kill it. 

I haven’t done that in bars, but believe me, I understand its appeal. 

How did they get to the point where they understood the game before the first moves were even played out? 

Let’s go back to that case of Covid I assigned you. After you got rid of the infection, you were left with some non-infectious bits of the virus scampering around your body, and they worked as reminders to your immune system: This is what the virus looks like. If this sounds like an ex who won’t stop calling–

Well, yeah, it is, but this isn’t a relationship or a breakup and the virus isn’t your ex. It’s a virus. And you aren’t you anymore, you’re an immune system, because I moved us into a different story without thinking to warn you. So it’s good that bits of the virus still have your phone number, and use it. It’s not universally true that what doesn’t kill you makes you stronger, but in this case they really are making you stronger.

The immune system has an evolutionary advantage over viruses. They mutate randomly and the ones that work well survive, which is a way of saying that the ones that survive, survive. But antibodies don’t mutate randomly. I’d love to explain that to you, but the best I can do is tell you that it has to do with B cells and activation-induced deaminase and somatic hypermutation. Or to put that more simply, I don’t understand a word of it but if I could pronounce it I’d have one hell of a snappy comeback next time some virus tries to chat me up.

What I did follow is that the lymph nodes notice which B cells make better antibodies and which ones don’t. They give the best B cells good grades and send the worst ones back to repeat the year with the same teacher who couldn’t get the lessons across the first time. 

The ones who got the top grades get to mass produce their new, improved antibodies. Which recognize variants of the virus they fought off, bringing us back to our starting point, sadder but wiser and ready to fight. 

 

Finally, a bit of Zoom news

Humans aren’t the only ones using Zoom during the pandemic. Two zoos in the Czech Republic set up a Zoom connection to let their chimpanzees watch each other’s lives on big screens while the zoos are closed. The chimps get bored without humans to watch. 

There’s no sound in their meetings (that would improve some I’ve been in), but after initially approaching the screens defensively or aggressively, they settled in to watch the show and it seems to be a great success.

Art v. Covid: Round one goes to the opera singers

The English National Opera is becalmed in a windless pandemic sea (and beset by overcooked metaphors), but it’s putting its expertise to use by teaching breathing exercises to people struggling with long Covid. On Zoom, of course. Because nothing happens in person anymore. 

Jenny Mollica, who runs the opera company’s outreach program, started hearing about long Covid–the chest pains, the exhaustion, but above all the breathlessness– and thought, “Opera is rooted in breath. That’s our expertise.” Maybe, she thought, the company had something to offer.

She got hold of Dr. Sarah Elkin, a respiratory therapist in the National Health Service, who thought, Why not? 

Yes, I know. I’m claiming to know an awful lot about what people who aren’t me thought. But I’m stealing the information straight from what they said, so we’re on relatively safe ground.

Irrelevant photo: Primroses.

Elkin and her team had some drug treatments they could try patients on, but beyond that they didn’t have a lot to offer. And Elkin used to sing jazz, so she understood first hand what vocal training could do.

They recruited a dozen participants, and one of them said in an interview that in everything he’d done since recovering from Covid, “I was struggling for air.” Even a few of the simple breathing exercises made a huge difference. “The program really does help. Physically, mentally, in terms of anxiety.”

In addition to exercises, they sing, working with lullabies from around the world. They’re easy to learn and they’re soothing, since anxiety is as much an issue for the participants as breath.

Just reading about it, I feel better. If you’ll excuse me, I’m going to go hum a lullaby to the cat. 

 

Ultraviolet light and Covid

A reader and frequent comment-leaver, Peter Wetherill, has been telling me about UV-C light as a way to battle Covid, and I got intrigued enough to see what I could learn about it. The internet isn’t exactly awash in information on the subject, but it does have a bit, so here’s what I’ve been able to sort out. 

Ultraviolet radiation–let’s call it UV, since we’re friends–comes in three flavors: A, B, and C. They’re not the most exciting flavors nature ever created,and that’s probably why you don’t hear about them on cooking shows and why no one’s given them more exciting names. But they’re what we’ve got to work with, so will you pipe down so we can get some work done?

We’re used to A and B, even if we don’t know it. If you use sunscreen, they’re what you’re blocking. Give them enough time and opportunity and they’ll damage the skin, no matter how dark skinned you are, and they don’t do the eyes any favors either. But it takes them a good long while to do their damage. Basically, our bodies have learned to live with them.

C, though, gets blocked by the earth’s ozone layer, so we and our many germs have all evolved without protection to it. It kills germs. It’ll also damage the hell out of people. So that’s the promise and that’s the problem, all neatly wrapped around each other. Can you separate one from the other to clear our public spaces of Covid?

Answer, yes-but.

Robots have been armed with UV-C so they can disinfect the surfaces of empty planes and subway cars. That’s useful but only up to a point. Problem one, Covid doesn’t spread primarily through surface deposits. As far as they’ve been able to trace the beast, airborne transmission’s the main culprit. And problem two, the minute you let people back into the space, it’s no longer clean. Because you know what we’re like. 

UV-C can also be adapted to clean N-95 masks, but its ability to sanitize depends on (problem three) the light hitting the virus directly. If some of the viruses are covered by a fiber or by dirt, the virus wins a round. If some bit of the mask is shadowed, any virus living there wins a round. In an experiment with Staphylococcus aureus, the kill rate varied as much as 500-fold depending on the angle of the light. So it generally takes three UV systems to disinfect a hospital room, and they won’t get everything. The surfaces still need to be cleaned the old-fashioned way.

Why bother? Because they’ll kill viruses and bacteria that the old-fashioned cleaning would have missed.

All of this, remember, has to be done away from human skin and eyes, because we never evolved any protection against it. So you have to clear people out before you can do it. 

What about cleaning the air? It can do that. 

One approach is to install UV-C units in the air ducts of ventilation systems, where no one goes unless they’re in some movie, there’s tense music in the background, and everyone watching suspends what little they know about reality. Using it this way could prevent, for example, what may have happened in a quarantine hotel in New Zealand where the ventilation system (may have; it’s not certain) helpfully moved the virus from one room to another. 

Another way to use UV-C is to install the units close to the ceiling, carefully calculating what it’ll take to miss even the tallest people and being careful not to let the light scatter downwards. Fixtures of that sort cost a couple of thousand dollars each and can be used in waiting rooms, in corridors, and in other badly ventilated places where people gather or pass through and breathe. It sounds like they’ll reliably kill off any germs in their line of sight–but only in their line of sigh. So they clear the upper reaches of the room but not the lower ones.

We’re almost done here. Stay with me, because there’s another possibility, called far UV-C, which is on a different wavelength and don’t ask me about that, please. For reasons best known to itself and to people who actually understand this stuff, it hardly penetrates the outer layer of human skin and, at least in albino rats, doesn’t cause eye damage. If you’re an albino rat, this is good news. But it does still kill viruses and bacteria. So you could use it in a room full of people without worrying about how tall people are or how much of the aerosols they breasted out hang in the lower air. 

David Sliney, retired manager of the U.S. Army’s Laser and Optical Radiation Program said, “There is some evidence that it may even be more effective against airborne viruses” than other UV light. 

This is still in the range of may and some evidence, remember. And again, it only cleans what it can directly hit. The virus underneath your book? It’s safe. The virus hiding in your shadow? It’s safe until you move your shadow. But since most aerosols (and as it happens, the ones we need to worry about) will be floating around somewhere in the room’s air, it can reasonably be expected to unleash a wholesale viral slaughter.

If you’re planning to try this, you need a krypton-chlorine excimer lamp, but they have built-in problems, because they also generate light on a different wavelength–a damaging wavelength.

Back to the drawing board. 

You could filter the lamp–we’ll come back to that–or you could use a far UV-C LED lamp, which is a great idea except that they don’t exist yet, and that’s a problem. It all has to do with wavelengths and efficiency. Get the wavelength right and the efficiency falls off a cliff. Get the efficiency right and the wavelength’s wrong.

That drives us back to excimer lamps. The article I’m linking to expects them to be on the market by early 2021.

Hang on. This is early 2021. You could even argue that it’s late-early 2021. So–as my brother used to ask on car trips–are we there yet? 

Sort of. I asked Lord Google about filtered excimer lamps, and after leading me through some odd corners of the internet, including one involving fishpond sterilizers, I did find some. I think. But first I found some box-like gizmos that draw air in, sterilize it, and breathe it back out so that humans aren’t exposed to UV-C but the virus is.  

I also found a “far UV-C excimer lamp module for microbial reduction applications.” It cleans surfaces and air, it can be used in occupied and unoccupied rooms, and I’m sure the website says how much it costs somewhere but believe me, they’re not leading with that information. Let’s assume it’s expensive, but then so’s death.

In spite of the limited offerings on the internet, the article I’ve drawn most of my information from (it’s published by the IEEE Spectrum) says that “the current pandemic may yet come and go before the world has rolled out germicidal UV broadly enough to make a big impact. And so experts are already planning for the next dangerous pathogen, and when it comes, they hope to greet it with a phalanx of UV air purifiers and surface sterilizers in hospitals, airports, public transit, offices, schools, nursing homes, stores, restaurants, elevators, and elsewhere. The ubiquity of UV technology should make it much harder for an outbreak to spread, perhaps preventing a lethal contagion from ever becoming a pandemic.”

If–like me–you’re wondering what IEEE stands for, it stands for IEEE. You may have to join before they’ll tell you anything more than name, rank, and serial number. It’s a technical professional organization that’s interested in technology. And professionalism. And sounds like the scream of someone falling off a cliff: I-EEEEEEEEEEEEEeeee.

Oh, hell, I don’t know what it does, but it’s big. At least compared to other technical professional organizations. 

By way of a second source, you can find a fairly small bit about it from the FDA–the U.S. Food and Drug Administration.

How long Covid immunity lasts, and other pandemic news from Britain

Since the start of the pandemic, 63 million of our battered planet’s inhabitants have been infected with Covid. So are they immune and can they run around bareback?

No one knows, although the occasional data-free politician says (loudly and proudly) that they are. Only a couple of reinfections have been documented, and signs of an immune response can be spotted for months after an infection, but that doesn’t exactly answer the question. We still don’t know if they could catch it a second time once their immune responses die back. We don’t know how long the immune response lasts. And we don’t know whether in spite of being able to fight off the virus they could go on to be a-symptomatic carriers, infecting other people.

Covid’s a coronavirus. So’s the common cold, and immunity to a cold doesn’t last long. On the other hand, SARS is also a coronavirus, and seventeen years after a person caught it their immune system will be ready to fight it off all over again. Covid could be in either camp or somewhere in between. Or it may have set up its camp in a whole different country than either of its relatives. No one knows what to expect from this particular coronavirus, and people who’ve had the disease are being advised to get vaccinated.

Irrelevant photo: Hydrangea–our neighbors’. Photo by Ida Swearingen.

And people who get vaccinated are advised to wear a mask and keep their distance, because even with a vaccine-induced immunity, they could be carriers. No one knows yet.

We’re not likely to see what we so quaintly call normal for a while yet.

*

I saw a summary recently of what the Great British Public asked Lord Google during the lockdown. It’s–

Excuse me while I look under the furniture and inside the microwave for a neutral word.

–it’s informative.

People asked how to cut their own hair, how to bake bread, how to make face masks and hand sanitizer, and how to cook Swedish meatballs, katsu curry, KFC-style chicken, and eels. 

Now, I’ll be the first vegetarian to admit that eating eels is no creepier than eating meatballs, but that doesn’t keep it from sounding creepier. People got interested in them, apparently, because I’m a Celebrity contestants were fed eels, presumably to gross out the participants, the viewers, and the crew. That doesn’t explain why it set off a rush on the poor damn creatures, but it seems to have.

People watch too much TV. And take it too seriously.

People also wanted to find someone who’d deliver afternoon tea. Or wine. Or compost. Or possibly all three together. 

They wanted song lyrics. 

Somewhere in all that you’ll find an insight into the soul of lockdown Britain. It was drunk, it had a bad haircut, it was on a do-it-yourself kick, and it watched too much TV, but it didn’t forget the beauty of afternoon tea. If only someone could bring it to the door, because after all that wine the eels got mixed up with the meatballs and the hand sanitizer got into the flour and no, we’re in no shape to make our own. 

And that reminds me of a song. The first word was I. Want to bet Lord Google can find it for us? 

*

From the Joseph Rowntree Foundation comes news that the pandemic’s likely to push two million families into destitution. The foundation defines destitution as not being able to afford two or more of the following over the past month: shelter, food, heat, light, clothing that matches the season, or basic toiletries.

I’d have thought that not having one of those would be plenty, thanks, but I guess they’re making a distinction between garden variety poverty and complete destitution. Either way, we’re looking at a problem. 

This isn’t entirely the pandemic’s doing. It follows years of cuts to government benefits, and I bet we all know the justification for that without googling it: People who rely on government handouts are shiftless and lazy and cheats and worse than that they’re somebody other than us and they should all be out there working. If we just make living on benefits uncomfortable enough, they’ll get off their backsides, put their kids or their dying parents in the deep freeze and their disabilities in their back pockets and accept whatever underpaid job comes along, assuming one is out there to be found–or two or three three of them if need be. Then they can make ends meet as best they can. Or wrestle the ends until they’re as close as possible, anyway. Just like our grandparents so mythically did.

Truth in advertising: On one side of the family, my grandparents did do something along those lines. It’s one of the reasons they were socialists, since you ask. It doesn’t make an argument for someone else having to live that way.

I don’t want to rant about this–or I do, but not here. I also don’t want to ignore it. I’ts part of what’s happening in the country, so let’s acknowledge it. Some of us get to google Swedish meatballs and eels–and neither of them are luxuries–while other people line up at the food bank and if that sort of solves one problem for the moment they still don’t know what they’ll do about the rent and the electricity. 

Meanwhile, some of the people who financed the Brexit campaign are making money because the pound fell in response to the threat of a no-deal Brexit.

*

Depressed? Oh, good. Then this is the time to look at a study from the University of Montreal on how the pandemic’s affected ordinary life. 

Do I know how to throw a party or what?

The study found that if people thought governmental messages about how to respond to the crisis were clear and coherent, then they assumed other people were following them. And the more they assumed other people were following them, the more likely they were to follow them. 

That led the researchers to recommend that government messages be clear and coherent. That may seem obvious, but it’ll surprise the inhabitants of 10 Downing Street and all the people who work there. Except possibly Larry the Cat, who is clear, coherent, and almost universally popular. He also kills mice.

The researchers also recommended that governments target their communications at the majority of people–the ones who follow the recommendations, not at the ones who don’t.

They didn’t say that government ministers and advisors should follow their own recommendations–silly people, they probably take that as a given–but it’s not something you can take for granted, can you, Mr. Cummings?

*

A Geneva study of 700 Covid patients who weren’t hospitalized found that a third of them went on to develop long Covid–which they defined as still having symptoms (fatigue, loss of smell or taste, shortness of breath, coughs . . .) six weeks after they were diagnosed.

The group’s mean age was 43. That’s mean as in one form of an average, not mean as in 43 being inherently any nastier than any other age.

The researchers plan a follow-up at 7 and 12 months to see how the study participants are doing. At this point, no one seems to know how long long Covid is. 

*

A study that followed over 100,000 British people reported that healthcare workers were seven times as likely to get a severe COVID-19 infection as people in other types of work. People working in social care and transportation were twice as likely. 

Black and Asian workers in what are being called non-essential jobs were more than 3 times as likely to develop a severe COVID infection as white non-essential workers, and Black and Asian essential workers were more than eight times as likely.

*

Could we find some good news, please? 

You only had to ask. Researchers from the Open Bioeconomy Lab at the University of Cambridge, the Lab de Tecnología Libre at iBio/PUC Chile, the FreeGenes Project at Stanford University, and the synthetic biology company Ginkgo Bioworks collaborated on a free online toolkit that will let labs in developing countries create their own Covid diagnostic and research tools.

According to John Nkengasong, director of the Africa Centres for Disease Control and Prevention, “The collapse of global cooperation [has] shoved Africa out of the diagnostics market. . . . African countries have funds to pay for reagents but cannot buy them.”

Or, as the article I lifted this information from put it, the supply chain is broken.

The open-source toolkit will allow scientists to develop tests that are fast, cheap, adapted to needs of local health systems, and easy to manufacture.

*

A 91-year-old who got one of the earliest vaccine doses was interviewed by CNN and, inevitably, the reporter asked how he felt about it. 

Reporters always ask members of the public how they feel about something or other. Your entire block was destroyed by flying saucers? Well, how do you feel about that? We the Public are, apparently, no more than ambulatory masses of feelings, so what else can they ask?

May all the gods I don’t believe in help any reporter who asks me that.

“I don’t think I feel much at all,” Martin Kenyon said, “except that I hope that I’m not going to have the bloody bug now.”

It went viral. 

And how does he feel about that?

“Have people not got better things to talk about?” he wants to know.

Long Covid, vaccine safety, and ferrets: it’s the pandemic news from Britain

A drug that’s still in the experimental stage promises to stop Covid transmission. So far, we know it works in ferrets. If you’re a ferret, you probably don’t care about this because ferrets are like young adults: They have fur and like to eat raw meat.

The similarity’s struck you before now, hasn’t it?

They also become infected with Covid and can pass the infection on, but they don’t get sick. 

Strictly and importantly speaking, that’s true of ferrets but not true of young adults (see below), because some young adults get mildly sick and then get long Covid, which is a particularly nasty kick in the head. And some are hospitalized. In fact, some die, although nowhere near as many as older adults, which is where the myth of young adult immunity comes from. 

Irrelevant photo: Tintagel Castle. Or part of it. This bit was left on the mainland when the land bridge to the island collapsed. 

So let’s say that most young adults are like ferrets, and I’m told they make excellent pets and can be quite affectionate. They’re intelligent, energetic, and shouldn’t be left in cages.

If I’ve driven that joke into the ground, we’ll move on. 

How long will it be before the drug is available for humans? Well, they’ll probably want to test it in something furless before it gets to the market. I’ve read, and I’ve often written here, about all sorts of promising drugs. And that’s the last we hear about most of them. Or at least the last I hear of them. I don’t really know what you hear, do I?

I keep promising myself that I won’t write about any more early-stage drugs, but then I read about one that I can’t pass up and I break my promise. You should know better than to trust me with promises, so you have no one to blame but yourself. 

This one, I think, is worth breaking a promise for. It not only stops Covid transmission, it also stops the progression of the disease. And works against the flu.

Let us all become ferrets, friends, and put an end to this plague. 

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The news about the Moderna vaccine is that it gives people (at least the 94% it works in) an immune response that lasts at least three months. That’s from a study run by NIAID, which is not a Greek goddess of springs, rivers, fountains, and lakes (you’ll need change the vowels a bit if you’re calling the goddess) but (more helpfully at this moment in history) the National Institute for Allergies and Infectious Diseases. 

Immunity may last longer, but that’s as many pages as they’ve had time to read.

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How has it been possible to develop the Covid vaccines so fast? Several factors came together.

Once the virus’s genome was decoded, it was shared immediately with the world’s scientific community. Chinese scientists published a draft of the genome of January 11. No one had to waste time repeating work that had already been done. 

After that, the world’s bad luck was put to good use: With the hounds of hell nipping at their heels, governments were willing to pour immense amounts of money into research. That translated to equipment and researchers. 

Next, it was easy for researchers to recruit participants for both the early and the later tests. That usually takes time, but people were motivated and anxious to sign up.

It usually takes a good long time before enough of the test subjects become infected to prove or disprove the vaccine’s effectiveness. But because Covid was so widespread, people got sick quickly. That comes to us compliments of the Department of Silver Linings.

On top of that, the pandemic hit just as scientists worked the kinks out of the mRNA vaccine process. I’m not going to try to explain that, but if you follow the link a few paragraphs back, someone who knows what they’re talking about will. 

Finally, a good bit of research that had already been done gave Covid research a running start: into creating  new flu vaccine; into SARS and MERS, both of which threatened to turn epidemic but didn’t; and into Zika.

Experts say no steps were missed in checking the safety and effectiveness of the Covid vaccines. I respect the well-honed skepticism that develops in a population that’s been lied to a lot, but I haven’t read any solid evidence that would lead me to wait when I’m offered a vaccine. I’m running around with one sleeve already rolled up.

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The Serum Institute of India has asked for fast-track approval of the Oxford/Astra-Zeneca vaccine, which doesn’t need refrigeration and which–if it gets approval–it will sell in India for something in the neighborhood of $3 a dose.

India is the second hardest hit country in the world’s Covid disaster race. Or the third. I’ve seen it listed both ways. It probably depends on what you count and how.

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A British trial will play around with mixing Covid vaccines to see if a mix creates a stronger immune response than two doses of a single vaccine. It’s due to start in January.

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Less encouragingly (but entirely realistically), the World Health Organization warns that the introduction of vaccines doesn’t mean an end to the Covid crisis. The logistics and economics of getting the world’s population vaccinated are massive, especially since two of the early vaccines need super-cold storage. 

And that doesn’t touch on the issue of how many people will be willing to accept vaccination or whether the vaccine will continue to circulated in spite of vaccinations.

In the meantime:

  • Wear a mask
  • Be careful
  • Grow fur 

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A small study (40 people, with a control group of 58) from the University of Dayton shows that 51% of young adults who are diagnosed with mild to moderate Covid had complications (chest pain, breathing difficulty, headaches, exhaustion, brain fog, diarrhea, loss of smell or taste, etc.) for more than 28 days afterward, and 30% had complications for more than 50 days.

The lead researcher, Julie Walsh-Messinger, said, “The common belief in the U.S. is that COVID-19 is benign or short-lived in young adults. Our study, which we believe is the first to report on post-COVID syndrome in college students, almost exclusively between 18 and 21 years of age, suggests otherwise. More research needs to be done to confirm these findings, but until then, we urge the medical and scientific community to consider young adults vulnerable to post-COVID syndrome.”

For a brief description of what long Covid is like, this is a good place to start, although from what I’ve read it can get far worse. 

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Like ferrets, cars don’t contract Covid. Unlike ferrets, they’re inanimate. But they can spread it. They’re like schoolrooms, like bars, like supermarkets: They depend on breathing humans to help them with their work.

A study at Brown University shows that opening car windows reduces Covid transmission. This probably won’t surprise you, given what’s known about air, breath, wind, cars, and Covid. But scientists have this pesky habit of wanting to prove things instead of just asserting them. They’re the kind of people who want to know how cold it is and how long it’s been how cold before they drive the car out on the frozen lake. They’ll want to calculate the depth of the ice and find out if the lake has currents where the ice will be thinner. They can be absolute mood-killers, but if you’re driving across a frozen lake they’re the people you want to ride with. 

Speaking just for myself (as if I had a choice), I appreciate them.

Asimanshu Das, co-lead author of the car window research, said, “Driving around with the windows up and the air conditioning or heat on is definitely the worst scenario, according to our computer simulations. The best scenario we found was having all four windows open, but even having one or two open was far better than having them all closed.”

But even with all the windows open and the roof sawed off, everybody should wear masks.

The article’s full of drawings and arrows. I’m not sure what they demonstrate, but they impressed the hell out of me.

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Semi-relevantly, researchers at Mount Sinai Hospital are working on a vaccine for a wide range of influenza strains. Early-stage clinical trials indicate that it could give a long-lasting immunity, eliminating the need for yearly updates. 

But it’s in the early stages. In the meantime, we’re all supposed to keep downloading our yearly flu shots. Or, in British, jabs.

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And, completely irrelevantly, an experimental drug can reverse age-related memory loss within days. So far, unfortunately, that only applies to mice, but it may work its way up to ferrets and eventually to us. 

It’s called ISRIB and it also works on traumatic injuries, noise-related hearing loss, and cognitive impairment in Down Syndrome. Yes, mice can have Down syndrome-like characteristics. I didn’t know either.

It also fights certain kinds of prostate cancer and enhances cognition in healthy animals.

And it makes coffee, but it’s pretty bad. I wouldn’t recommend drinking it.  

Reform UK, Covid, and the definition of freedom: It’s the news from Britain

Nigel Farage, who was pivotal in convincing Britain that Brexit would be as much fun as a pint in a pub on a Tuesday afternoon, has rebranded the Brexit Party now that Brexit’s about to happen and there’s no more fun to be had from it. 

It might be relevant that Farage was in the US for a while, pumping up Donald Trump’s balloon, and a lot of the fun’s gone out of that as well. He had a £10,000 bet riding on Trump winning. A rebranded party might be just the thing to cheer him up.

The party is now called Reform UK, and it advocates letting Covid circulate freely among young people while the old and the vulnerable dig holes in the ground and hide.

Okay, what they actually said was that in response to the pandemic, “The Government has dug itself into a hole and rather than admit its mistakes, it keeps on digging.” But hey, I’m certifiably old. I’ve been around long enough to know that if you identify a hole and the digger won’t jump in, someone else is likely to be pushed. For all the rhetoric about protecting the vulnerable, someone’s going to end up in there. 

The party’s argument is a simple one: Not that many people die from Covid and “the new national lockdown will result in more life-years lost than it hopes to save, as non-Covid patients with cancer, cardiac, lung and other illnesses have treatments delayed or cancelled again.”

Wait, though. Are those cancellations really a result of the lockdown or are they a result of Covid itself? 

Oh, stop fussing. If we move fast enough, no one will ask. Let’s move on:

Irrelevant photo: Orange berries. What would you do without me to explain these thing to you?

“Focused protection is its key, targeting resources at those most at risk, whether it is the elderly, vulnerable or those with other medical conditions. The rest of the population should, with simple hygiene measures and a dose of common sense, get on with life—this way we build immunity in the population. We must learn to live with the virus not hide in fear of it.”

You know to saying that for every complicated question, there is an answer that is simple, appealing, and wrong? 

Farage’s argument against lockdowns–or his party’s; it’s hard to know where the line between them is, since his ventures are strongly personality driven–is based on the Great Barrington Declaration. So, sigh, let’s talk about the GBD. (Great Barrington, by the way, is a town in Massachusetts where the declaration, for some reason, started.)

The GBD was written by three public health experts and signed by 15,000 public health experts and medical practitioners, some of whose expertise is questionable, especially that of Johnny Bananas and Professor Cominic Dummings. Another signer’s name is the entire first verse of “La Macarena.” About a hundred were therapists whose fields of expertise included massage, hypnotherapy, and Mongolian khoomii singing. Nothing against Mongolian khoomii singing, but it doesn’t make you an expert in public health. So I think it’s fair to say that this isn’t a highly selective group. 

The last time I checked, 160,000 members of the public had also signed. And some uncounted number of scientists have jumped in to criticize the declaration, which argues that lockdowns cause all sorts of harm, both physical and mental. 

The statement was sponsored by the American Institute for Economic Research, a libertarian, free-market think tank that’s part of a network of organizations funded by Charles Koch, a right-wing American billionaire who promotes climate change denial and opposes regulations on business. He’s one of two brothers who have something in the neighborhood of $40 billion to play with, who donate lots of money to the Republican Party, and who funded the Tea Party. To quote Rolling Stone, they’re using their money “to buy up our political system.”

Why one of them went out to play without the other I don’t know.

But let’s not throw out the declaration because of the company it keeps, however much we might not want to have Thanksgiving dinner with them. The question is, does it make sense?

Mmmm, no. First, let’s think about the difficulty of separating out the elders from the youngers. About the mulit-generational families who live together; the isolated elderly whose lives are held together by the visits of younger carers, either paid or unpaid; the institutionalized elders cared for by younger people; and any other intergenerational border that functions without a checkpoint and barbed wire.

Think about the vulnerable people who aren’t elderly. The ones with asthma, the ones with medical conditions of various sorts, the ones who are pregnant, the ones who are obese. Forget the smokers, the vapers. Also the people who are Black or from other minority ethnic groups, who are dying at higher rates than whites. Or (and there’s some overlap here) the people in low-paid jobs, who are in contact with wide swathes of the public and all the viruses they carry. 

Think about the medical professionals and non-professional medical staff who as an occupational hazard are in contact with the sick. 

 In a study of 106 Covid deaths among health-care workers, 8% were 30 or younger, 26% were between 31 and 50, and 38% were between 51 and 60. That doesn’t add up to a free pass for younger people. 

But even younger people with less exposure don’t get a Get out of Covid Free card. In an article in the Medical Express (I think it was a reprint), an imaging cardiologist, Partho Sengupta, reports “heart abnormalities in over one-third of student athletes who tested positive for COVID-19 and underwent cardiac screening at West Virginia University this fall.”

That’s not damage to the heart itself. It’s ”evidence of inflammation and excess fluid in the pericardium, the sac around the heart. Almost all of the 54 students tested had either mild COVID-19 or were asymptomatic.”

It could cause myocarditis, pericarditis, heart failure, or arrhythmia in athletes.

“There is still a lot we don’t know about COVID-19 and its lingering effects on the human body,” Sengupta writes. 

“We didn’t find convincing signs of ongoing myocarditis, but we did see a lot of evidence of pericarditis. Among the student athletes screened, 40% had pericardial enhancement, suggesting resolving inflammation in the sac that protects the heart, and 58% had pericardial effusion, meaning excess fluid had built up.

“Usually, this kind of inflammation heals within a few weeks with no residual effects. However, in some cases, there can be long-term effects, like pericardial inflammation recurring. It can lead to scarring of the pericardial sac, which in rare cases can be severe, and the pericardium can constrict around the heart. This can lead to symptoms similar to heart failure and cause congestion in the lungs and liver.

“It’s difficult to predict if a patient will develop any of these rare long-term complications, and it’s too soon to tell if it’s happening.

“. . . COVID-19 is no joke. The best way for athletes to stay healthy so they can keep playing sports is to avoid getting the coronavirus in the first place. Teams should test student athletes for the virus and make sure those who test positive see a doctor to determine if screening tests for heart damage are needed.”

I mention that particular study because it wandered into my inbox recently, not because it’s the only evidence of younger people being vulnerable to Covid. When I consulted Lord Google, he pointed me to a Johns Hopkins Medicine article with statistics from last March, when 38% of the people hospitalized with Covid in the US were between 20 and 54. Half of the people who ended up in intensive care were under 60,

The trend in Europe was the same. 

I could point out that Farage is getting on toward sixty and shrugging off a case of Covid might not be as easy as shrugging off last night’s pints, but it wouldn’t be wise to position myself between Mr. F. and the spotlight. 

An article in the Lancet says that “no population group is completely safe from COVID-19 at the present time, and there is no room for complacency.”

In Britain, patients admitted to hospital with COVID-19 after Aug 1 tended to be younger than the ones at the start of the pandemic, although they were less likely to end up on ventilators. A lot of them were women. This probably has to do with what jobs they do: A lot of people working in service jobs and what’s dismally called the hospitality industry are women. A lot of their customers breathe. The higher the dose of the virus a person takes in, the more likely they are to get a severe case.

It’s not just about your age.

One study estimates that one in seven people who gets ill with Covid is sick for at least four weeks, one in twenty for at least eight weeks, and one in forty-five for at least 12 weeks.

How long does “at least” go on? No one knows. 

If anyone wants to risk exposing themselves in the name of freedom and living their lives to the full, that’s their call. But as someone or other said, My rights end where the other fellow’s nose begins. You can find the quote in a variety of formats and attributed to a variety of people (Abraham Lincoln, John Stuart Mill, Oliver Wendell Holmes; not Yogi Berra, although he said almost everything else worth quoting), but the sense still holds: You have the right to judge your own level of risk but at the point where you’re risking other people’s health, your rights end. 

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Can we end with some good news, please? This should come with trumpets blaring at the top of the post, but odd are that you’ve heard it by now anyway: A preliminary analysis of the Pfizer and BioNTech Covid vaccine says it protects 90% of people from the virus.  It’s been tested on 43,500 people in six countries and so far no safety concerns have popped up. It involves two doses given three weeks apart and that magical 90% protection was calculated seven days after the second dose. 

The data hasn’t been peer reviewed yet, and the vaccine has to be kept in ultra-cold storage–below minus 80 C–so it won’t be easy to work with. Still, let’s enjoy a shred of hope when we can. If it works, it could take the fun out of the Reform UK party. What ever will Farage find to do with himself next?