2024-09-25 General/BC

About scheduling: I seem to take longer and longer to get this done. Unless anybody says something about it, that’s not likely to change.

COVID-19

Long COVID

This paper from USA (2024-08-09) reports that 71% of pediatric Long COVID patients have problems with orthostatic intolerance, which basically means they have trouble with maintaining blood pressure to the brain when they stand up. While Long COVID is fiendishly difficult to diagnose, orthostatic intolerance is easy to diagnose. Have the patient lie down for 15 minutes, then stand up and lean against a wall for ten minutes, taking pulse rate blood pressure measurements frequently. If the heart rate stays elevated and blood pressure (as measured at the arm) stays low, that’s a problem.

In 2021 there was a COVID-19 “challenge study” in UK — a group of 36 unvaccinated young adults was deliberately inoculated with COVID-19 under very controlled conditions and studied aggressively. I felt strongly at the time that this was unethical because we already knew that COVID-19 could lead to long-term negative effects. About half of the volunteers got COVID-19 infections and half did not.

This paper (2024-09-21) found that there was in fact a harm to the volunteers. The infected participants had a statistically significant cognitive decline compared to the inoculated-but-not-infected cohort — even though the infected participants didn’t notice any difference.

Composite of tests where there is a learning component, i.e. you get better with practice.
Composite of cognitive tests that have a learning component.

The biggest difference between infected and non-infected volunteers was in tasks involving memory and executive function.

NB: I still think it is unethical to deliberately infect volunteers, but I think it is way more unethical to deliberately accept infecting the general public over and over again.

This paper from USA (2024-06-08) reports that metformin dramatically lowered the risk of Long COVID in overweight or obese people.

  • Participants who took metformin had a 41% lower risk of Long COVID than people who took a placebo.
  • Participants who took metformin within three days of a positive COVID-19 test had a 63% lower risk of getting Long COVID than those who got a placebo.
  • Ivermectin and fluvoxamine did not reduce the risk of Long COVID.

This blog post (2024-09-19) from a caretaker of a severely disabled Long COVID patient (PhysicsGirl) reports that after a stellate ganglion block, PhysicsGirl — while still profoundly disabled — had improved energy, cognition, and could tolerate more foods.

If you get Long COVID, this is a great resource from The Sick Times and Long COVID Justice of what to do next. Note that you might want to give this link to a trusted person so that they can find it. If you get Long COVID, you might not be capable enough to find it yourself.

Transmission

This article (2024-09-17) reports that about half of Americans surveyed think they are never going to get COVID-19 ever again in their lives. Meanwhile, this site estimates that there are currently about a million infections per day in the USA (or about 1 in 40 people EACH DAY), and that the average number of COVID-19 infections Americans have already had is 3.42. So yeah, if you aren’t taking mitigation measures, you will get COVID-19 again. And again. And again.

This data is about Americans, and I understand that we are not Americans. It would be nice if Canadians were smarter than Americans, but I’m not sure that we are. 🙁

This paper from USA (2024-09-13) reports that COVID-19 transmission in a psychiatric hospitals was very high. The hospital relatively quickly isolated patients who had symptoms in negative pressure rooms, but only tested incoming patients who had symptoms or were cognitively challenged enough that they could not express if they had symptoms or not. Patients were in a one- or two-bed bedroom on a “unit” which also had bathrooms and some communal areas for treatment, meals, and relaxation.

  • Almost a quarter of patients who shared a room with someone found to be COVID-19 positive caught COVID-19 themselves.
  • 9.3% of patients who were in the same unit as someone COVID-19 positive caught COVID-19 themselves.
  • Sharing a room with a COVID-19 positive patient upped their risk of catching COVID-19 by 3.14x versus not having a COVID-19 positive roommate. (Some people caught COVID-19 from visitors or health care workers, I infer, in addition from other people in the unit.)
  • The rate which patients on the geropsychiatric ward caught COVID-19 from someone in their unit was 6.38 times higher than the average ward transmission risk.

It looks like generally, there was only one COVID-19 test for people in a unit after someone in the unit was determined to be COVID-positive. I couldn’t tell if healthcare workers were ever tested. Visitors were not tested. In some but not all periods, some combination of healthcare workers, visitors, and residents masked, but almost always with surgical masks. (The healthcare workers in the isolation units did wear N95s, but nobody else.)

This paper (2024-09-16) found “a six month oscillation” between northern USA and southern USA. My interpretation of their graphs was that people in the northern USA open their windows in the summer and close them in the winter, while people in the south close their windows in the summer and open them in the winter.

Vaccines

Well, this is interesting. This article (2024-09-19) says that Health Canada approved Novavax’ JN.1 shot. HOWEVER, it looks like the feds are not going to buy any of it because the contract with Novavax says it has to be produced in Canada — something Novavax can’t deliver on. (I think that clause is there to encourage them to actually produce vax in Canada, which… this article (2024-05-24) says has hit roadblocks.) The Novavax-has-been-approved article also says that provinces are allowed to buy Novavax… but I’m betting they won’t, justifying the non-purchase by saying that the demand isn’t there.

On the other hand, someone posted on Threads that their MLA said that Novavax was coming to BC. That’s a rumour, so don’t put too much weight on it, but I want to hope.

This article (2024-09-24) reports that Health Canada has approved Pfizer’s KP.2 vaccine.

This paper from Australia (2024-09-20) did a very detailed study of vaccines between 22 February 2021 and 22 February 2023 and found that about 3 deaths per 10,000,000 vaccinations were likely to be due to vaccination. (It didn’t say, but I am guessing that all/most of those deaths were from allergic reactions.) This is a lot lower than the COVID-19 infection fatality rate in unvaccinated people (per this paper (2022-04-16), around 1 to 5 deaths per 1000 infections).

Pathology

Humans have known for several years that COVID-19 infection increases the risk of developing diabetes. This paper (2024-09-03) explains how: pancreas cells get infected, macrophages get called to the scene, they cause inflammation, and the cells commit suicide (pyroptosis, which is a recognized way to kill off infections but which obviously causes a lot of collateral damage). (NB: They saw this behaviour with coxsackievirus B4 viruses also!)

This paper using data from Portugal and Brazil (2024-09-19) found that COVID-19 led to increased senescence (aging) of CD8 and CD4 T cells, even in mild/moderate cases of COVID-19.

This paper from USA (2023-01-05) reports that SARS-CoV-2 hijacks the cilia of the nasal epithelial cells. The viruses grab on to the tips of the cilia, then get conveyor-belted down the cilia to the main (“basal”) body where they infect the cell. Once they get into the cell, they stimulate the growth of microvillia — tiny little hairs that do not beat (AFAICT), and SARS-CoV-2 uses those to get back out into the mucus, where the action of the cilia moves the mucus along.

Treatments

This paper (2024-09-11) reports on testing of multiple nasal sprays using organelles organoids (mini human organs/cells grown and kept alive in the lab) and what effects the sprays had. Note that several of the authors work for a company which, near as I can tell, wants to bring astodrimer sodium nasal spray to market. The products and the results are:

  • Astodrimer sodium nasal spray (AS-NS, which I don’t think is a commercial product yet): 96.6% reduction in viral load. At 1:10 dilution for 24hrs, ~35% reduction in cell viability. Looks good.
  • Nitric oxide (NO-NS, not available in Canada, available under brand name Enovid, VirX, or FabiSpray in other countries): 90% reduction in SARS-CoV2 viral load. At 1:10 dilution for 24hrs, ~45% reduction in cell viability. No information on effect on cilia beating frequency. Looks pretty good.
  • Iota-carrageenan (Carr-NS, available as a product from the company Betadine): Negligible reduction in SARS-CoV2 viral load. Cilia beating frequency very slightly above normal range. At 1:10 dilution for 24hrs, ~20% reduction in cell viability. Looks bad.
  • Povidone iodine (PI-NS, available as a product from the company Betadine): No data on viral load reduction. At 1:10 dilution for 24hrs, ~98% reduction in cell viability. Looks bad.
  • Low pH hydroxypropyl methylcellulose (HPMC-NS, available as Nasaleze Travel, I think): Negligible reduction in SARS-CoV2 viral load. 20% reduction in cell viability. Cilia stopped beating completely. At 1:10 dilution for 24hrs, ~100% reduction in cell viability. Trans-epithelial electrical resistance showed significant ephithelial dysfunction after 4 hrs of exposure (all the rest of the sprays maintained resistance). Some cytotoxicity. Looks bad.

It looks to me like NO-NS is probably the best of the bunch which has been approved anywhere (but it’s not approved in Canada or US). AS-NS looks like it would be pretty good if/when it gets approved somewhere.

The others look like they kill epithelial cells but don’t actually reduce viral load (though the viral load data was missing for PI-NS). HOWEVER, I don’t know exactly how bad it really is. Maybe the amounts that they put on the epithelial cells was really high, or the time the chemicals spent on the cells was really high? BUT they still don’t seem to reduce viral load.

The wildcard is HPMC-NS, which frankly looks kind of horrible except that it’s so horrible that the cilia stop beating completely, which — see the last snippet in Pathology, above — maybe that’s a good thing? On the other hand, the paper says that HPMC is designed to be low-pH so that it irritates the nose a little, so it will produce more mucus; that extra mucus might flush the HPMC-NS out a bit.

This paper from USA (2024-09-17) is yet another which reports that taking metformin is good for COVID-19 patients. They report that, compared to diabetics taking other (non-metformin) diabetes medications, diabetics taking metformin had:

  • 21% lower risk of Long COVID in one electronic record database;
  • 13% lower risk of Long COVID or death in a different electronic record database.

This paper from Spain (2022-06-21) reports that the saliva of people who gargled with a 0.07% cetylpyridinium chloride (CPC) mouthwash showed a significant increase in proteins from the SARS-CoV-2 nucleocapsid compared to placebo. (Translation: the CPC ripped the SARS-CoV-2 to shreds, leaving lots of pieces of the interior of the SARS-CoV-2 virus in people’s saliva.)

This review paper (2024-09-11) reports that multiple papers say that Paxlovid doesn’t help low-risk people infected with relatively recent strains — on any measures.

BC Wastewater

From Jeff’s wastewater spreadsheet:

Something that Jeff noticed is that if you look at the wastewater on a longer timescale, Fraser Health wastewater (blue) has been rising slowly but consistently since April or June, depending on how you look at it.

Recommended Reading

This blog post (2024-09-21) frames avoiding COVID-19 mitigations as a disability in and of itself, and points out that lockdowns essentially made everybody disabled: restricted in where they could go and dependent upon assistive technologies (masks). Lockdowns sometimes challenged peoples’ ability to earn a living and forced people to confront their mortality. From the article: “So when you hear someone say, ‘I can’t let COVID control my life,’ understand that they mean they can’t let themselves think about becoming disabled. They can’t open the floodgates that would force them to reevaluate everything about how they conceptualize disability. They can’t conceive of doing what millions of disabled people do every day and play with the cards they’ve been dealt.” It’s a good essay, you should read it.

This article (2024-09-16) talks about denial and how governments facilitate denial by overly cautious.

This blog post (2024-08-11) does a nice job of showing why blowing off delayed-onset diseases (like, oh, say, long-term effects of COVID-19!) is a really really bad idea.

This essay by the head of the US NIH looks back at the start of the COVID-19 pandemic, and asks what went wrong.

Mpox

Vaccines

Crap. This preprint from USA (2024-09-11) found that the Jynneos mpox vaccine waned significantly over the course of a year.

The different colours correspond to different antibodies. The important thing to see is that the levels at 12 months is quite a bit lower than peak.

H5N1

Transmission

This US CDC briefing (2024-09-20) reports that two people near the Missouri H5N1 non-dairy-worker case had upper respiratory symptoms — one health care worker and one household member. Tests on those two people are not complete, but until the tests are complete, we do not know if there was human-to-human transmission. They could have both happened to have gotten COVID-19, there’s a lot of it going around.

This US CDC briefing (2024-09-20) reports that there are now 213 infected dairy herds in 14 U.S. states.

This press release from the Massachusetts Department of Agricultural Resources (2024-09-16) reports that they tested every single dairy one of the 95 dairy farms in Massachusetts and there is are zero, none, zip infected herds in Massachusetts. Go Massachusetts!

This article (2024-09-23) reports that the number of known H5N1 infected herds in California has almost doubled, to 18.