week ending 2022-11-17 General – Pandemic in British Columbia

Note: This week’s post will probably be a little briefer than normal because Life is happening to me. (Everything’s fine, just busy.)

Vaccines

This article reports that Canada has authorized using Novavax as a booster dose. From a practical standpoint, I think what that means is that the pharmacist doesn’t need to give you a speech about how you’re doing this “off-label” and are you suuuure you want a Novavax booster?

This Moderna press release says that their BA.5 bivalent vaccine gave 5 times higher antibody levels against BA.4/5 than the Moderna Classic monovalent gave. That’s solid. It’s not fantastic — the scientists look for a 10x improvement — but it’s quite good.

Pfizer announced that it’s starting Phase 1 trials of a new COVID-19 vax, one that has proteins from the spike and non-spike parts of the virus, including parts which don’t mutate as fast. The hope is that it will give broader, more durable immunity.

One side effect of using more proteins is that it might make it impossible to tell if someone’s had a COVID-19 infection. If it gives broader and more durable coverage, that’s a tradeoff I’m willing to make.

This paper from Canada says that you are almost three times as likely to get myocarditis or pericarditis from a Moderna vax than from a Pfizer vax. The risk goes slightly over 3x for men over 40 (who have a lower absolute risk than younger men). (Note: you are much MUCH more likely to get myocarditis or pericarditis from a COVID-19 infection than from the vaccination.)

This preprint from Pfizer showed that the bivalent BA.4/5 elicited many more antibodies against new variants than Pfizer Classic monovalent after three doses of Pfizer Classic in people over 55:

Variant	GMFR from Classic	GMFR from bivalent	GMFR from Classic for uninfected	GMFR from bivalent for uninfected
Classic (WA1-2020)	3.0	5.8	4.4	9.9
BA.4/5	2.9	13.0	3.0	26.4
BA.4.6	2.3	11.1	2.5	22.2
BA.2.75.2	2.1	6.7	2.0	8.4
BQ.1.1	1.8	8.7	1.5	12.6
XBB.1	1.5	4.8	1.3	4.7

GMFR = geometric mean neutralizing titer fold rise

Mitigation Measures

This paper from Germany found that instituting a night curfew (on top of other mitigation measures) didn’t do squat for the COVID-19 infection rate.

Long COVID

This paper from Spain says that 59.7% of hospitalized patients and 67.5% non-hospitalized patients had at least one Long COVID symptom after two years. HOWEVER, this study was done with a phone survey and does not have a control arm. I can imagine that they asked, “do you have days where you feel tired?”, and c’mon, everybody has days when they feel tired.

More interesting to me were some specific, unusual symptoms:

21% of non-hospitalized patients lost their smell early in their recovery, while only 10% of hospitalized patients did;
20% of hospitalized patients had some memory loss, while 15.9% of non-hospitalized patients did.

Co-morbidities correlated with shortness of breath and fatigue.

Pathology

This paper from the UK pulled two matched cohorts of patients: one cohort had had influenza infections and one had had COVID-19 infections. They found that the people who had had COVID-19 infections were 87% more likely to develop epilepsy.

Treatments

This preprint from the USA found that 14.2% of people who got Paxlovid and 9.3% of people who did not (a difference of ~5%) tested positive for COVID-19 afterwards (“viral rebound”). 18.9% of people who got Paxlovid has symptom rebound, compared to 7.0% in the control group (a difference of ~12%). So yes, Paxlovid rebound happens, but it’s not nearly the majority of cases. (It is absolutely not a valid reason to not take Paxlovid.)

Transmission

I had seen papers before which said that air humidity matters for COVID-19: too dry or too wet is bad. This paper from the USA looked specifically at indoor air humidity, and found the same thing: you want a Goldilocks humidity of between 40 and 60%.

This article says that there are 31 different animal species which have been observed to catch SARS-COV-2 including mink, deer, dogs, cats, ferrets, lots of large felines, cows, fox, otters, hyenas, hippos, manatees, hamsters, beavers, anteaters, coati, binturongs, marmosets, various primates, and — my favourite — the large hairy armadillo.