Coronavirus Tidbits #156 9/4/21

Quick links

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.

Malaria Vaccine + Antimalarial = 70% Reduction in Disease, Death

Very well done study with dramatically better results than expected.

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GOP Governors’ Hypocrisy on COVID Endangers Their Citizens

News 

Simple safety measures reduce musical COVID-19 transmission

As the COVID-19 pandemic swept the globe in 2020, musicians around the world were desperate for the answers to two pressing questions: Can playing musical instruments transmit COVID-19? And if so, what can be done?

Now, halfway through 2021, the first official research results are in-and it’s good news: The show can go on.

Published today in the journal ACS Environmental Au, University of Colorado Boulder and University of Maryland researchers have found that while playing musical instruments can emit the same levels of potentially COVID-laden airborne particles as singing, simple safety measures, such as masking instruments (the bell of the wind instrument), social distancing and implementing time limits, significantly reduce this risk.

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Diagnostics:

Free access to all Washington Post Covid articles.

Antigen tests search for protein pieces of the virus while molecular tests, such as the “gold standard” PCR tests, detect RNA, the virus’s genetic material.

In general, antigen tests are less sensitive than molecular tests. A scientific review published by the Cochrane Library found that in people with confirmed covid-19, antigen tests correctly identified infections in an average of 72 percent of people with symptoms, compared with 58 percent of infected people without symptoms.

“what this test is probably not good at, especially for the asymptomatic,” is accurately ruling out an infection. In other words, at-home antigen tests are more likely to give you a false negative,

Testing negative can provide some reassurance that you’re not infectious at the point that you take the test, but it doesn’t give people “a free pass to go and do whatever they want to do,” Binnicker said. A single negative result “basically tells you, ‘I’m probably not shedding really high amounts of SARS-CoV-2 right now,’ ” he said. But that might not be the case in as little as six or eight hours,

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Typically, the sensitivity of antigen tests is 30% to 40% lower than for RT-PCR, depending on whether tested subjects were symptomatic or asymptomatic (Cochrane Library, March 2021)

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Antibody Tests Should Not Be Your Go-To for Checking COVID Immunity

On an individual level, antibody tests can be useful for picking up evidence of a past SARS-CoV-2 infection. They’re also helpful to researchers studying the prevalence of the virus across a population or tracking the degree to which antibody levels wane over time. And the decline in antibody levels against the coronavirus among some people who got vaccinated late last year were cited as part of the scientific case for why millions of Americans need booster shots.

But scientists in the field say there’s still considerable uncertainty about what these levels of detectable antibodies really mean when it comes to protection. And a lack of standardization among the commercially available tests for antibodies makes it even harder to decipher the results.

“There is no test that will give you that [degree of certainty] at this point,” says Gigi Gronvall, a senior scholar at the Johns Hopkins Center for Health Security who has studied serology testing and COVID-19. “There are tests that would show that you’ve been vaccinated or not, but is that going to be the kind of information you need?”

Maybe not, she suggests. Why?

Drugs and Vaccines:

NIH launches study of extra COVID-19 vaccine dose in people with autoimmune disease

Trial also will test pausing immunosuppressive medication to improve antibody response

The National Institutes of Health has begun a clinical trial to assess the antibody response to an extra dose of an authorized or approved COVID-19 vaccine in people with autoimmune disease who did not respond to an original COVID-19 vaccine regimen. The trial also will investigate whether pausing immunosuppressive therapy for autoimmune disease improves the antibody response to an extra dose of a COVID-19 vaccine in this population. The Phase 2 trial is sponsored and funded by the National Institute of Allergy and Infectious Diseases (NIAID), part of NIH, and is being conducted by the NIAID-funded Autoimmunity Centers of Excellence.

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COVID-19 vaccine elicits antibodies in 90% taking immunosuppressants

However, people treated for autoimmune conditions produce weaker responses than healthy people

COVID-19 vaccination elicited antibody responses in nearly nine out of 10 people with weakened immune systems, although their responses were only about one-third as strong as those mounted by healthy people, according to a study by researchers at Washington University School of Medicine in St. Louis.

The study, published Aug. 30 in the Annals of Internal Medicine, looked at people taking immunosuppressive medications to treat chronic inflammatory diseases such as inflammatory bowel disease and rheumatoid arthritis. Since a minimum level of antibodies needed for protection hasn’t been established, it has been difficult to say whether the levels achieved by people on immune suppressing drugs are high enough to protect them from severe COVID-19, the researchers said. The Centers for Disease Control and Prevention (CDC) recently recommended that people taking immunosuppressants receive a third dose of the vaccine to strengthen their immune responses.

Nonetheless, the discovery that COVID-19 vaccination elicits a response in people with compromised immune systems – even if not quite as strong a response – is encouraging news for a population that faces a high risk of serious illness.

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New Guidance for People with Cancer and 3rd mRNA COVID-19 Vaccination

The National Comprehensive Cancer Network® (NCCN®) announced significant updates to the NCCN: Cancer and COVID-19 Vaccination guidance today. This is the fourth version of NCCN’s COVID-19 vaccination guide.

Published on August 30, 2021, the new version incorporates the latest data plus recent approvals from the U.S. FDA and CDC regarding a third mRNA vaccine dose for immunocompromised people.

The update highlights timing recommendations from the CDC that people wait at least four weeks between second and third doses. In addition, cancer patients who develop COVID-19 despite initial vaccination should wait until they have documented clearance of the virus before their third vaccination.

According to the NCCN clinical recommendations, the following groups of people should be considered eligible for a third dose of the mRNA COVID-19 vaccine:

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High-income countries called on to share COVID-19 vaccines quickly

  New York – The former Co-Chairs of the Independent Panel on Pandemic Preparedness and Response (IPPPR), Ellen Johnson Sirleaf, former President of Liberia, and Helen Clark, former Prime Minister of New Zealand, have expressed their deep concern at the slow pace of redistribution of COVID-19 vaccines from high income to low-income countries.

“The Independent Panel report recommended that high-income countries ensure that at least one billion doses of vaccines available to them were redistributed to 92 low- and middle-income countries by 1 September, and a further one billion doses by mid-2022”, President Sirleaf and Helen Clark said. “Ensuring that all those around the world most vulnerable to the impact of the virus, including healthcare workers, older people and those with significant comorbidities, can be vaccinated quickly is a critical step towards curbing the pandemic.”

The Co-Chairs noted that, to date, 99 million dose donations have been shipped via COVAX, out of which only 89 million have been shipped to the 92 Advance Market Commitment countries – far short of the one billion doses the Independent Panel has called for. “High-income countries have ordered over twice as many doses as are needed for their populations. Now is the time to show solidarity with those who have not yet been able to vaccinate their frontline health workers and most vulnerable populations. Reaching the goal of redistributing one billion doses by 1 September would be a vital step in protecting the five billion people aged 15 and over who live in low- and middle-income countries. The 600 million doses which have already been pledged now need to be delivered with urgency”, the Co-Chairs said.

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Survey shows healthcare workers more likely to get COVID-19 at home

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Please Reevaluate the Data on Convalescent Plasma for COVID-19

Devices:

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Great study on MASKS:

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Villages where surgical masks were promoted saw 13.6% lower rates of COVID-like symptoms and illnesses when only about 30% of people were wearing masks. That’s a big deal!

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Epidemiology/Infection control:

Most Blood Donations Contain COVID-19 Antibodies

As of August 26, 2021, the UK’s Public Health England (PHE) newly reported seroprevalence data indicates approximately 97.7% of blood donors aged 17 and over have antibodies to the SARS-CoV-2 betacoronavirus from either infection or COVID-19 vaccination…

‘If a donor has had a COVID-19 vaccine, they will generate an antibody against the spike protein, but not the nucleocapsid protein, which will only occur in the event of a COVID-19 infection.’

Note: The Red Cross stopped testing for COVID-19 antibodies in the USA on June 25, 2021. As of March 2021, about 20% of blood donations from unvaccinated people had Covid-19 antibodies, according to data shared with CNN by the American Red Cross.

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The Lancet Infectious Diseases: Delta variant doubles risk of COVID-19 hospitalisation compared to alpha variant, new UK study confirms

People infected with the SARS-CoV-2 delta variant have approximately double the risk of hospitalisation compared with those infected with the alpha variant, a study of more than 40,000 cases from England between 29 March and 23 May 2021, published in The Lancet Infectious Diseases journal has confirmed.

The risk of attending hospital for emergency care or being admitted to hospital within 14 days of infection with the delta variant was also one and a half times greater compared with the alpha variant (1.45-fold increase in risk).

This new study is the first to report hospitalisation risk for the delta versus alpha variants based on cases confirmed by whole-genome sequencing, which is the most accurate way to determine the virus variant.

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Fibromyalgia: A New Feature of Long COVID?

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(New York Times)

Tips, general reading for public:

StayAtHome

Wash your hands.

Rinse and repeat.

Politics:

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Texas and guns

Texas’s brand-new permit-less carry measure has been getting all the national attention, but that’s not the only worrying new gun law in Texas as of this week. Under the so-called Second Amendment Sanctuary State Act, state agencies are now prohibited from enforcing any new federal gun restrictions. School marshals in public, private and charter schools can carry concealed weapons instead of having to store them.

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Feel good du jour:

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Comic relief:

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Perspective/Poem

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Bits of beauty:

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