Unsolicited Product Recommendation

I realized that I forgot to gush about the Readimasks fully in the last General post. They are a little expensive. HOWEVER, they gave a great seal (though see below) and were EXTREMELY comfortable.

I do not have dangerously sensitive skin — I don’t go into anaphylactic shock when I touch latex — but it is sensitive enough that I don’t like a lot of the masks. The 3M Aura, for example, doesn’t quite get to the level of “itch”, but I also don’t like having it on my face. Conversely, I could wear the Readimask for hours and hours and hours and absolutely did not mind having it on my face. I also greatly appreciated not having straps. (Headband straps hurt my head after a while; earloops are a pain to deal with when putting on or taking off because they try to use the same space as my hearing aids.) The glue also, as advertised, did not irritate my skin at all.

Because they are stick-on, so re-using them is harder than re-using a banded mask. However, their web site claims that they can be re-used three to five times, and say that you can put it on parchment paper and then peel it off again later. (Their tech support person says that they like to put it on plastic from a ziploc freezer bag.) I have not exactly tried rewearing a mask, but as I mentioned in the previous General post, I had to take off my Readimask before getting on a plane, and so restuck the bottom part of the mask. It felt like it made a good seal when I restuck it, but I haven’t tried doing a fit test with a restuck mask.

I have to admit, twice, I did feel a bit of leakage right under the chin. The instructions say to open your mouth slightly when applying, which I had a tendency to forget to do. (I don’t know if I forgot those two times.) I found that if I taped the bottom excess mask fabric to the side after sealing the mask at the bottom, there wasn’t a tendency to pull open. The trick was finding tape which would stick to the mask. The mask comes with a strip of tape at the bottom (not sure why), and I found I could use that. (It’s also possible that I didn’t get it sealed perfectly well at the bottom when I applied it. More research is needed.)

The Readimasks cost USD$40 for 10, plus shipping from the US. If I never reuse them, then that’s a little more expensive than 3M Auras (which are easier to re-use). If you get a subscription of 10 per month, the price is 50% off; if you can in fact re-use them, then they become competitive on price with other N95-class masks.

Finally, they have ones (for USD$6 plus shipping from the US) which have built-in eyeshields which they claim protects against all kinds of nasties — even pepper spray! So if you think there’s a chance you might get exposed to nasty chemicals, it might be useful to have some of these on hand.

Bottom line: you might not want these as your “everyday” mask, but if you absolutely have to do something dangerous — if you need to spend a day in the hospital or if your life just would not be complete without going to that Flaming Icebergs rock concert, I recommend that you try these.

Long COVID

This Data Brief from USA (2024-06-11) found that about 7% of US adults had ever had Long COVID.

This preprint from USA (2024-06-19) also found that if you took IgG from Long COVID patients and injected it into mice, then the mice started acting in ways which look sort of like Long COVID — just like this preprint from the Netherlands (2024-05-31) found (as I reported in the last General post). Yay for reproducibility!

This paper from Germany (2024-06-18) found that a COVID-19 infection is somewhat preventative against Long COVID. People who didn’t get Long COVID after their first infection were 50% less likely to get it after their second infection.

This paper from USA (2024-06-17) looked at Long COVID recovery among people who self-reported that they ever had COVID-19:

The median time to recovery was 20 days;
- Median time to recovery was 57.6 days for hospitalized participants;
- Median time to recovery was 32.9 days for “outpatient” participants (which I think means they were seen at a clinic and then went home, versus being hospitalized or not seeking treatment).
22.5% had not fully recovered by 90 days post-infection;
People who had been vaccinated were 30% more likely to recover by the 90-day mark (in part because they had milder cases);
People who had Omicron were 25% more likely to recover by the 90-day mark than those who had an earlier strain (in part because they had milder cases);
Men were 15% more likely to recover by 90 days than woman;
People who had cardiovascular issues prior to the pandemic were 16% less likely to recover by 90 days.

Alas, this (small) study in the USA (2024-06-07) did not find that Paxlovid made any difference to Long COVID patients.

COVID-Related Excess Deaths and Sickness

This preprint from USA and UK (2024-04-05) found that COVID-19 increases risks in cancer survivors. Among people who had a cancer diagnosis before the pandemic and did not die directly from from COVID-19, people who tested positive for COVID-19 were 138% more likely to die than those who were negative; they were 79% more likely to die of cancer than people who tested negative.

This paper from USA (2024-05-28) found that COVID-19 infections increase mental health issues in children and adolescents. Children were 6.0 times as likely to get a mental health diagnosis after a COVID-19 infection as the uninfected; adolescents with COVID-19 were 4.2 times as likely as the uninfected. Apparently, other respiratory diseases can also increase the risk of mental health issues in adolescents, but the risk was 57% higher with COVID-19 than with other respiratory illnesses.

This paper from USA (2024-06-10) found that kids who were hospitalized with acute COVID-19 or MIS-C were likely to develop neurological conditions. 18% of kids hospitalized with COVID-19 had a neurological manifestation (like encephalopathy, seizures, delirium, or autonomic nervous system problems) during hospitalization, and 24.8% of the MIS-C kids did.

Mitigation Measures

This paper from USA (2024-06-11) found that masks work. They captured the exhaled breath from volunteers who were infected with COVID-19 and analyzed the samples for COVID-19 RNA.

They found that a duckbill N95 mask (specifically, the ACI N95) reduced the viral load by 98% compared to unmasked, significantly outperforming a (Powecom brand) KN95, cloth masks, and surgical masks. Interestingly, the cloth masks and surgical masks were comparable to the KN95s, with the cloth mask being slightly better!

One thing that someone external said in this article about the paper was that the breath collection apparatus might not do a good job of collecting particles sent out the sides of masks (like you get with surgical masks).

Vaccines

This paper from USA (2024-06-12) found that people who had COVID-19 infections (but not people who had COVID-19 vaccinations!) got fewer coronavirus common colds. (Yes, they checked that both groups got the same amount of non-coronavirus illnesses.) They also found that people who got COVID-19 infections had antibodies to two nonstructural helicase proteins NSP12 and NSP13.

I found this old paper (2021-11-01) which says that NSP13 is among the most unchanging sites in coronaviruses. This means that if they can figure out a drug which targets NSP13, that might give treatments for all coronaviruses. From sniffing around the web looking for NSP13, it looks to me like finding a drug to take out NSP13 is a very active research area. (This should maybe go in Treatments, but it made more sense to group it with the other discussion of NSP13.)

This press release from the US FDA (2024-06-13) announces that they changed their mind: they want vax makers to use KP.2 as the base of the fall booster, not JN.1. (This matters to us because Canada usually gets whatever the US wants, due to their bigger market share.) Changing the variant to base the vaccine on is probably the right thing to do, but I worry that this is going to sound the death knell for Novavax. They have been on shaky financial ground, it takes them longer to switch strains than it takes the mRNA players, and they had already started manufacturing JN.1.

In fact, this press release from Novavax says that intend to be shipping their JN.1 vax in July. They also say that their JN.1 vax works against all the FLiRT variants (including KP.2 and KP.3), but I have not seen the data.

However, it might actually make sense to base it off of a parent of what is circulating instead of what is currently circulating. I had not realized it, but JN.1 is not a child of an XBB! XBB, BA.5, and BA.2.86 are all children of XB.2, and JN.1 is a child of BA.2.86.

I just went through the transcript and some of the video of the US FDA 185th Meeting of Vaccines and Related Biological Products Advisory Committee (VRBPAC) (2024-06-05), and the differences between XBB.1.5 and JN.1 (about forty genes different) are much greater than the differences between JN.1 and KP.2 (four genes different) and KP.3 (three genes different). You can see from the antibody neutralization differences graph that JN.1 and the KPs are very similar:

Regardless, I worry that this might be bad for Novavax: if you are a decision-maker, are you going to go for a vax tailored for what is circulating right now from the big players, or a vax tailored for what used to be circulating from an also-ran?

Also from VRBPAC: I was surprised at how fast vaccines’ effectiveness against emergency department treatment or hospitalization waned compared to effectiveness against symptomatic infection. I had had the impression that vaccines stayed effective against hospitalization longer than against symptomatic infection, but that’s not what this data shows.

VE against symptomatic infection is no lower than 30% (in people over 50 after at least four months):

But against emergency department or urgent care encounters, VE for even young adults drops to TWO PERCENT after four months compared to people who did not get a booster.

Hospitalization VE is not much better, dropping to 4% after four months for adults under 65.

VE does stay relatively high against ICU admission. That’s good.

These slides compare people who got an XBB 1.5 booster against those who did not, and in the VRBPAC video they are at about 1h14m to 1h19m, if you want to look at the slides yourself.

This paper from USA (2024-04-17) found that mRNA vaccinated mothers were 11% less likely to have a pre-term birth than unvaccinated mothers. The study found no affect of mRNA vaccination status on babies being small or of mothers getting gestational diabetes, gestational hypertension, or preeclampsia. This paper from USA (2024-06-06) found no affect of vaccination (from any brand) on stillbirth rates.

Transmission

This preprint from USA (2024-04-24) found that people are giving COVID-19 to wildlife. They found COVID-19 in six of the 23 species where they looked for it: deer mouse, Virginia opossum, raccoon, groundhog, Eastern cottontail, and Eastern red bat. Nine individuals in six species had close genomic matches to Omicron, coming from seven separate species jumps. They also found COVID-19 was three times as common in geographic areas where human presence was high.

Pathology

This paper from China (2024-06-04) reports finding SARS-CoV-2 in sperm cells.

Treatments

This paper from Hong Kong (2024-06-08) found that giving Paxlovid to adolescents reduced their risk of hospitalization by 34%.

Highly Pathogenic Avian Flu

(I decided to stop calling it “H5N1” after the person in Mexico died from H5N2.)

Transmission

This Correspondence from USA (2024-06-13) did experiments mocking up H5N1 in milk and found that in their lab, using times and temperatures used in pasturization, got rid of almost all H5N1 but there were still detectable levels in some samples. HOWEVER, this was designed to be a preliminary study, as it different from reality in some very important ways. They did not get milk from H5N1 infected cows: they took virus that had been cultured from a mountain lion (!), mixed it into raw cow milk, and heated it up in lab equipment (not an industrial pasteurization machine). This was NOT reflective of reality

According to this article (2024-06-18), the number of infected dairy herds has risen to 102.

Unsolicited Product Recommendation

Long COVID

COVID-Related Excess Deaths and Sickness

Mitigation Measures

Vaccines

Transmission

Pathology

Treatments

Recommended Reading

Highly Pathogenic Avian Flu

Transmission

Recommended Reading