Coronavirus Tidbits #155 8/29/21

Announcements:

First, there is now a Resources Page here for the most commonly asked questions I'm getting.

Happy to continue to answer your questions/concerns as best I can, so don't be shy about that.

New posts:

Covid-19 Vaccine Boosters - What You Should Know

https://www.forbes.com/sites/judystone/2021/08/23/covid-19-vaccine-boosterswhat-you-should-know/?sh=1be85e1a1b86

EpiPen: Price-Gouging of Essential Medicine

https://www.medscape.com/viewarticle/957169

News 

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New SARS-CoV-2 variants have changed the pandemic. What will the virus do next?

Science By Kai Kupferschmidt

...The Delta strain circulating now—one of four “variants of concern” identified by the World Health Organization, along with four “variants of interest”—is so radically different from the virus that appeared in Wuhan, China, in late 2019 that many countries have been forced to change their pandemic planning. Governments are scrambling to accelerate vaccination programs while prolonging or even reintroducing mask wearing and other public health measures. As to the goal of reaching herd immunity—vaccinating so many people that the virus simply has nowhere to go—“With the emergence of Delta, I realized that it’s just impossible to reach that,” says Müge Çevik, an infectious disease specialist at the University of St. Andrews.

Yet the most tumultuous period in SARS-CoV-2’s evolution may still be ahead of us, says Aris Katzourakis, an evolutionary biologist at the University of Oxford. There’s now enough immunity in the human population to ratchet up an evolutionary competition, pressuring the virus to adapt further. At the same time, much of the world is still overwhelmed with infections, giving the virus plenty of chances to replicate and throw up new mutations.

https://www.sciencemag.org/news/2021/08/new-sars-cov-2-variants-have-changed-pandemic-what-will-virus-do-next

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The mutation that helps Delta spread like wildfire

A key amino-acid change might underlie the coronavirus variant’s ferocious infectivity.

Pre-activated virus

To penetrate cells, the SARS-CoV-2 spike protein must be cut twice by host proteins. In the SARS-CoV-1 virus that causes severe acute respiratory syndrome (SARS), both incisions occur after the virus has locked on to a cell. But with SARS-CoV-2, the presence of the furin cleavage site means that host enzymes (including one called furin) can make the first cut as newly formed viral particles emerge from an infected cell. These pre-activated viral particles can then go on to infect cells more efficiently than do particles requiring two cuts, says Whittaker.

Delta wasn’t the first SARS-CoV-2 variant to gain a mutation that alters the furin cleavage site. The Alpha variant has a different amino-acid change at the same location as Delta. But the available evidence suggests that the mutation’s effect has been especially profound in Delta.

https://www.nature.com/articles/d41586-021-02275-2

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Calling dissent the "foundation of democracy,"

Reddit rejected a request by moderators of a pro-vaccine forum to do more to combat COVID-19 disinformation. (CNN)

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Vaccines effective even without post-shot symptoms or prior infection

Vaccination with the two messenger RNA (mRNA) vaccines for SARS-CoV-2, the virus that causes COVID-19, yields a robust antibody response, even if a person did not develop significant symptoms following vaccination or did not have a prior SARS-CoV-2 infection. That's the key finding from a recent study of nearly 1,000 health care workers in the Johns Hopkins Health System who received two doses of either the vaccine manufactured by Pfizer/BioNTech or the one produced by Moderna.

https://medicalxpress.com/news/2021-08-vaccines-effective-post-shot-symptoms-prior.html?

Diagnostics:

still an incredible, negligent last of testing.

Drugs and Vaccines:

FDA gives full approval to Pfizer-BioNTech vaccine

Watch the goalposts move for why people won't want it now.

https://www.fda.gov/news-events/press-announcements/fda-approves-first-covid-19-vaccine

The vaccine is also available under an emergency use authorization for children aged 12 to 15 years.

In a statement, the AAP said that although physicians are legally permitted to give the vaccine off-label to children younger than age 12 years, it is advising against the practice, with AAP President Lee Savio Beers, MD, citing a need for more data from clinical trials to properly determine a dose.

https://www.healio.com/news/primary-care/20210823/pediatricians-urge-patience-in-giving-vaccines-to-children-aged-younger-than-12-years

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Covid-19 Vaccine Boosters - What You Should Know

https://www.forbes.com/sites/judystone/2021/08/23/covid-19-vaccine-boosterswhat-you-should-know/?sh=1be85e1a1b86

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Do Delta ‘breakthroughs’ really mean vaccine protection is waning, and are boosters the answer?

https://www.sciencemag.org/news/2021/08/do-delta-breakthroughs-really-mean-vaccine-protection-waning-and-are-boosters-answer

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Loss of antibodies after Pfizer vax vs natural infection

In vaccinated subjects, antibody titers decreased by up to 40% each subsequent month while in convalescents they decreased by less than 5% per month. Six months after BNT162b2 vaccination 16.1% subjects had antibody levels below the seropositivity threshold of <50 AU/mL, while only 10.8% of convalescent patients were below <50 AU/mL threshold after 9 months from SARS-CoV-2 infection.

Conclusions:

This study demonstrates individuals who received the Pfizer-BioNTech mRNA vaccine have different kinetics of antibody levels compared to patients who had been infected with the SARS-CoV-2 virus, with higher initial levels but a much faster exponential decrease in the first group.

https://www.medrxiv.org/content/10.1101/2021.08.19.21262111v1?%253fcollection=

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Having SARSCoV2 once confers much greater immunity than a vaccine—but no infection parties, please

The natural immune protection that develops after a SARS-CoV-2 infection offers considerably more of a shield against the Delta variant of the pandemic coronavirus than two doses of the Pfizer-BioNTech vaccine, according to a large Israeli study that some scientists wish came with a “Don’t try this at home” label. The newly released data show people who once had a SARS-CoV-2 infection were much less likely than vaccinated people to get Delta, develop symptoms from it, or become hospitalized with serious COVID-19.

The study demonstrates the power of the human immune system, but infectious disease experts emphasized that this vaccine and others for COVID-19 nonetheless remain highly protective against severe disease and death. And they caution that intentional infection among unvaccinated people would be extremely risky. “What we don’t want people to say is: ‘All right, I should go out and get infected, I should have an infection party.’” says Michel Nussenzweig, an immunologist at Rockefeller University who researches the immune response to SARS-CoV-2 and was not involved in the study. “Because somebody could die.”

The researchers also found that people who had SARS-CoV-2 previously and then received one dose of the Pfizer-BioNTech messenger RNA (mRNA) vaccine were more highly protected against reinfection than those who once had the virus and were still unvaccinated. The new work could inform discussion of whether previously infected people need to receive both doses of the Pfizer-BioNTech vaccine or the similar mRNA vaccine from Moderna. Vaccine mandates don’t necessarily exempt those who had a SARS-CoV-2 infection already and the current U.S. recommendation is that they be fully vaccinated, which means two mRNA doses or one of the J&J adenovirus-based vaccine. Yet one mRNA dose might be enough, some scientists argue. And other countries including Germany, France, Italy, and Israel administer just one vaccine dose to previously infected people.

https://bit.ly/3mHjLOI

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Medicaid Vaccination Rates Founder as States Struggle to Immunize Their Poorest Residents

https://khn.org/news/article/medicaid-vaccination-rates-founder-as-states-struggle-to-immunize-their-poorest-residents/?utm_source=

Devices:

Temperature screenings confirmed as security theater:

J Occup Environ Med. 2021 Aug; 63(8): 638–641.

Survey: More than 15 million screenings were performed by 14 companies. Fewer than 700 episodes of fever were identified. Of these, only about 53 cases of COVID-19 were detected. By contrast about 2000 workers with diagnosed COVID-19 were in the workplace and not detected by screening.

One case of COVID-19 was identified by screening for approximately every 40 cases that were missed. Worksite temperature screening was ineffective for detecting workers with COVID-19 and is not recommended.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8327760/

Epidemiology/Infection control:

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COVID-19 is most transmissible 2 days before and 3 days after symptoms appear

Each wave of the pandemic has underscored just how gravely contagious COVID-19 is, but there is less clarity among experts on exactly when—and to what extent—infected individuals are most likely to spread the virus.

https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2783099

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Holes in reporting of breakthrough Covid cases hamper CDC response

The agency originally tried to track all infections in vaccinated people, from mild to severe. But in May it decided to focus on the most severe cases.

...those states rely on hospital administrators to report breakthrough infections. The resulting data is often aggregated, inaccurate and omits critical details for teasing out trends, such as which vaccine a person received and whether they have been fully vaccinated, a dozen state officials said.

The gaps in this crucial data stream raise questions about the Biden administration’s ability to spot and respond to changes in the virus’s behavior — such as the rapid spread of the Delta variant, which crowded out other strains — or vaccines’ performance. It also underscores the extent to which the CDC and public health departments across the country are still struggling to collect and study critical Covid-19 information 18 months after the pandemic began.

https://www.politico.com/news/2021/08/25/cdc-pandemic-limited-data-breakthroughs-506823?utm_source=

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How long does COVID-19 take to spread through one household?

Researchers from the University of North Carolina are showcasing just how quickly COVID-19 can spread from person to person under one roof. Additionally, the study is providing some much-needed information as to how and why communities of color have suffered more than other demographics throughout the pandemic.

This work took place long before the even-more-contagious Delta variant emerged. With this in mind, study authors hypothesize current rates of infection among housemates is quite higher right now.

Viral loads determine infection speed

Most secondary housemate infections occurred quickly, taking place within the first week of the initial positive COVID-19 test. Moreover, such cases shared a similar nasopharyngeal viral loadwhich refers to just how much of the virus an infected individual carries in their nose and throat.

“This means the viral load of the index case matters,” Prof. Lin adds. “A higher viral load means it’s more likely that there will be secondary transmission in a household, and viral load is also an indication of how sick a person could get from the virus.”

Researchers also investigated how much living density, or the amount of people living within a given household, played into infection rates. Well, 44 percent of examined participants were Hispanic or non-white, and researchers discovered that minority households tend to have greater living density and thus a higher risk of secondary infection.

https://www.studyfinds.org/covid-19-spread-one-household/

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COVID-related deaths in the U.S. increased by 317% over the past 7 weeks.

(ABC News) https://abcnews.go.com/Health/live-updates/coronavirus-delta-variant/?id=79597020#79665927

Without a change in behavior -- increased use of facemasks, staying home when sick, vaccination -- another 100,000 COVID deaths could occur by December 1. (AP)

As of about 8 a.m. EDT, the unofficial COVID-19 toll in the U.S. reached 38,387,116 cases and 633,591 deaths, increases of 161,267 and 1,308, respectively, from the same time yesterday.

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Simple techniques on near-capacity school buses prevent spread of SARS-CoV-2

Universal testing and contact tracing failed to find evidence that near-capacity school buses were the source of SARS-CoV-2 transmission at a school in Virginia, researchers reported.

“We realized early on that data were showing that schools are safe when simple techniques are used to stop disease spread, even when community disease spread is high,” Dana Ramirez, MD, an associate professor of pediatrics and pediatric emergency medicine at the Eastern Virginia Medical School and Children’s Hospital of The King’s Daughters in Virginia, told Healio Primary Care.

Reference: Ramirez DWE, et al. J Sch Health. 2021;doi:10.1111/josh.1305.

https://www.healio.com/news/primary-care/20210827/simple-techniques-on-nearcapacity-school-buses-prevent-spread-of-sarscov2

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Tips, general reading for public:

StayAtHome

Wash your hands.

Rinse and repeat.

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Politics:

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Parents get coached on how to escape mask and vaccine rules

https://apnews.com/article/health-religion-education-coronavirus-pandemic-5abb8a7505515f8b3248f2f71914728b?utm_source=

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A Nebraska state senator is criticizing the state's governor and the Department of Veterans Affairs for advertising job openings for unvaccinated nurses to work with "sick and aging" veterans. (KETV.com)

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Feel good du jour:

https://twitter.com/buitengebieden_/status/1429365255449239559?s=20

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Comic relief:

https://twitter.com/buitengebieden_/status/1428007049380696065?s=20

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Perspective/Poem

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Bits of beauty:

 

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