week ending 2022-06-16 General – Pandemics in British Columbia

Long COVID

This article about Long COVID in the US is interesting. It says that a lot of the indicators which you would expect to see Long COVID shift (e.g. number of disability claims, health care expenditures), have not in fact shifted. The article gives a number of possiblities:

A lot of disabled people died of COVID, so stopped applying for disability.
People with Long COVID have a hard time applying for disability, both because their impairment makes it difficult to fill out forms and also because getting a diagnosis is so hard.
Many Long COVID symptoms degrade quality of life, but not enough to prevent someone from working. For example, if all food smells and tastes really bad now, that would not prevent you from doing your job, so you wouldn’t show up in the disability statistics.

The article suggests that COVID-19 won’t be a “mass disabling event” as much as a “mass deterioration event”.

There’s more, you should read the article.

On the other hand, this article dug into various US indicators pretty hard and estimates that about 1.6M US workers have been sidelined due to Long COVID — about 15% of all unfilled US jobs.

Two things that the author points out:

You have to be unable to work for 12 months before you can apply for disability, so it’s very much a lagging indicator. Twelve months ago today was not only pre-Omicron, it was pre-Delta.
Social Security offices were closed from March 2020 through April 2022, which the Social Security Administration says led to a decline in applications. So there’s some catchup there.

This thread (from April) does a good job explaining why we aren’t seeing trials for Paxlovid against Long COVID yet. Its main points:

Paxlovid doesn’t clear SARS-CoV-2, it’s your immune system that does that; Paxlovid buys your immune system time. That means that a short duration of Paxlovid might not help something chronic.
We don’t have safety data for a longer trial of Paxlovid. It was (reasonably) well-tolerated for a short period, but we don’t know would it be for a long period. Of course, that’s why you do trials.
A trial would probably need to be huge to make sure results were statistically significant.
There’s still no definitive test to tell if someone has Long COVID or not. That means it’s hard to only get people with Long COVID in the trial that would make the #3 even worse.
We don’t actually know how common Long COVID is (because of the difficulty measuring it).
They are busy with trialling Paxlovid in some other populations (like high-risk pediatric patients).

That article was written before there were animal models; this very recent paper says that they have shown that they can see Long COVID in Syrian Golden Hamsters (which is a BFD, BTW). This ought to help a bunch of things, including figuring out if Paxlovid helps Long COVID in rodents.

Attitudes/Beliefs

This polling report has some grim numbers about how many Canadians believe what I believe to be um utter bullshit. From on a sample of 1500 people:

19% believe that the government is covering up a massive number of deaths from vaccines;
11% believe that there are chips in the vaccines;
9% believe it is or is likely that 5G towers damaged immune systems so that we were more susceptible to COVID.

This article reports that most Canadians became more trusting in their institutions and neighbours than pre-pandemic. This correlated highly with income, however: lower-income people lost trust.

This makes sense to me: higher-income people tend to be knowledge workers who can work safely from home. Lower-income people tend to be essential workers who took the brunt of the pandemic, both in job losses and in health losses.

Collateral Damage

This article reports that a survey of Asian-Canadians found that every single one of their participants had witnessed or experienced discrimination during the pandemic.

This article says that Canada is very short of blood donors. I can’t donate, so if you can, please do!

Mitigation Measures

This article reports that the Government of Canada is temporarily dropping random COVID-19 tests for fully vaccinated inbound air passengers. Unvaccinated travellers will still be tested, although testing will move offsite. (No, I don’t know what “offsite” means. Will a bus cram travellers in together and drive them ten kilometers to a testing site? I don’t know.)

This article reports that the Government of Canada is dropping the vaccination requirement for international and domestic plane and train travel. The government is also dropping vaccine mandates for federal employees and transportation workers in federally regulated segments.

This article reports that the US is dropping COVID-19 test requirements from people who arrive by air. (It was already dropped for land, and that meant people were flying to Canada or Mexico and then driving to the US.)

This report details the types of surveillance worldwide that educational software did on children doing virtual learning. (Read it, it’s scary!) Note that kids didn’t really have a choice: if they didn’t use the ed tech, they’d be marked absent.

Testing

This paper describes a fast, presumably cheap, test which looks at how well T-cells work against SARS-CoV-2. Basically, how good is your immunity to COVID-19? This could be useful for figuring out who needs boosting and who doesn’t. (I think that with tweaking, it could even tell you how good your immunity is against a specific variant.)

This article repeats, yet again, that there are a huge number of false negatives from rapid tests, and discusses why that might be.

(Folks, if you have any symptoms at all, even if your rapid test says you are negative, ACT LIKE YOU ARE POSITIVE. Especially at the beginning of an illness, the rapid antigen tests frequently can’t pick it up. (There are very few false positives at the beginning of an illness: if it says you have COVID-19, you have COVID-19.))

This Correspondence from Canada says that 11% of Canadians had gotten COVID-19 infections before Omicron, but that it jumped up to 37% after Omicron. During the Omicron wave, 40% of unvaccinated people got sick.

This paper found that rapid antigen tests (during the Omicron period) had a sensitivity of 63% and and a specificity of 99.8%. (In other words, there were almost no false positives and a lot of false negatives.) Among symptomatic patients, the RATs had a sensitivity of 77%, while among asymptomatic patients the sensitivity was 39.2%.

Variants

This paper says that Omicron infections don’t do a good job protecting against future Omicron infections. Worse, it looks like blood of people who were exposed to a pre-Omicron COVID-19 variant plus three shots didn’t have as many antibodies against Omicron as people who had had the shots but no infections. (Note: Omicron infection didn’t give all that many antibodies even to itself.)

This paper says that blood from people who had been hospitalized with Omicron infections (but not sent to the ICU) had 10.2% fewer neutralizing antibodies against BA.2.12.1 than BA.2; they had 37.8% fewer neutralizing antibodies against BA.4/BA.5 than against BA.2. In other words, that Omicron infection you got in January isn’t going to help you much against BA.4/BA.5.

Vaccines

This article reports that the Government of Canada is changing the meaning of “fully vaccinated” to mean “up to date”.

This paper from Qatar during the Omicron period investigated the protection from vaccines (Pfizer) and/or previous infections against symptomatic infection:

Two doses of vax alone was 0% effective against symptomatic infection (but the authors noted that almost everyone with two doses had their second dose more than six months previously);
Three doses of vax alone was 52.2% effective;
Two doses of vax plus a previous infection was 55.1% effective;
Three doses of vax plus a previous infection was 77.3% effective;
BA.1 and BA.2 gave similar results.

Note that vax and/or previous infection was >70% effective against severe illness.

Pathology

This tweet thread references this paper which reports that five kids in Israel with hepatitis sure seems to be because of COVID-19 and not adenovirus. This blog post refutes it.

This paper from Denmark says that the risk of MIS-C in vaccinated kids is only 11% of the risk in unvaccinated kids. It also said that the risk of MIS-C in the Omicron wave was ~13% that of the COVID Classic or Delta waves.

Transmission

This article reports on a case of cat-to-human COVID-19 transmission.

This article reports on a study which found that children with food allergies were half as likely to catch COVID. This article says that people with allergic asthma were also less likely to catch COVID-19.

Treatments

This paper out of the USA found that Paxlovid rebound was not a big problem, with only 0.8% of study participants having a rebound of symptoms, and they had “generally mild” symptoms.

This article said that a study of Paxlovid in people who did not have risk factors (including some who were vaccinated) did not have statistically significant results. Maybe it does, maybe it doesn’t — but it’s clear that it’s not a slam dunk like it is for high-risk patients.