2021-12-17 General

I remember thinking it was really strange that more people died in the second year of the Spanish Flu pandemic than the first. I’m not surprised any more.

Vaccines

Someone asked me today, “would Omicron still have arisen if we’d had equitable and effective vaccine distribution globally? At first I hedged, and said we couldn’t know: maybe vaccines would have prevented some immunocompromised person from catching COVID-19 and nurturing it in their body for long enough for it to mutate. But maybe it went from human to animal and back to human, we don’t know.

But then I realized the answer is an unequivocal “no”. For starters, if Omicron gestated in an immunocompromised person, well, immunocompromised people don’t usually respond well to vaccines.

More importantly, Omicron is a mutation of a mid-2020 strain — from before vaccines were approved. If it is (as is likely) that Omicron is a human-incubated strain, then that human caught it before they could have gotten a vaccine.

The question we really need to ask is, “will vaccine equity prevent the next Omicron”, and there the answer is, “it would reduce the chance of another nasty mutant showing up”.


This article reports that Pfizer’s vaccine for very young children (ages 2-5) did not provide protection, probably because the dose was so low. They are going to see what a third dose does. I am guessing that they are looking at a third shot instead of increasing the dosage because of concerns about myocarditis.


This World Health Organizations says it has approved Covavax, which is the Serum Institute of India’s licensed version of Novavax. This is fantastic news: it means that COVAX can start distributing Novavax, which was measured to have an 89% effectiveness against infection. (Note: that 89% rating came after Alpha but before Delta and Omicron.)


This study found that the rate of myocarditis in vaccinated people under 40 was 1.4 per 100K for Pfizer and 4.2 per 100K for Moderna. Interestingly, while men had more cases, their relative risk after vaccination compared to the base rate in the population was lower than for women, I guess because women have such low rates in the general population.

Variants

I have seen several real-world-data crunchings which say that Omicron cases are doubling in less than two days. For example, 1.4 days in San Diego from this tweet:

My crunching of the (admittedly not great) BC data says that the doubling rate here is 1.3 days. THAT IS FAST. STAY HOME, EVERYBODY!


This preprint from a few days ago said that Evusheld, AstraZeneca Corp’s monoclonal-antibody-that-acts-like-a-vaccine, did not work against Omicron. This press release from AstraZeneca says that Evusheld actually does work against Omicron. (The work was done by the US’ National Institute of Health, it’s not just AstraZeneca saying “DOES TOO!”)


This tweet (coupled with the thread it points to) says “Covid spreads inside the lungs by fusing infected cells, evading antibodies. Looks like omicron can’t do this”. This could be a mechanism for Omicron being milder!

By the way, there is still not convincing evidence for COVID being milder. It looks like it’s highly unlikely to be more virulent, and there is more and more weak evidence that it’s less virulent, but there’s not strong evidence yet that it is less virulent. I’ll keep you posted.

Mitigation Measures

This article reports that everyone will need a PCR test to re-enter Canada, even fully-vaxxed people who have been gone for less than 72 hours. Bellingham, your Costco is safe from marauding Canadian shoppers once again.

Recommended Reading

This article summarizes what we know about the “Is Omicron more mild?” debate.


This article summarizes a debate I didn’t even know was happening: should the definition of “fully vaccinated” be changed to mean “three doses (two for J&J)”?

This article does a nice job explaining what the pieces of the spike are. Wonder, for example, what the furin cleavage site is? It explains.

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