week ending 2022-12-08 General – Pandemics in British Columbia

Treatments

This paper from the UK reports promising results of a cheap liver drug against COVID-19 (at least, in human organs outside humans). This drug does so by reducing the number of ACE2 receptors. (This seems odd to me — I thought I kind of needed my ACE2 receptors!)

This paper from Hong Kong found that rebound rates were really low: 0.6% for people who didn’t take Paxlovid or molnupiravir; 1% for people who took Paxlovid, and 0.8% for people who took molnupiravir.

Long COVID

This paper from the USA found that they could spot Long COVID signatures in blood even during the acute phase of illness. Signatures plural: there were two different clusters that they could tell apart.

This preprint from the USA repeats what other papers have been saying: your risk of diabetes goes up in the 30 days post-COVID. This article about the paper (okay, I didn’t read this paper itself, sue me) reports that they also found that the likelihood of a diabetes diagnosis goes down after the 30 days.

The study authors think that maybe diabetes is up in general because the pandemic led to less exercise, weight gain, and stress. They think maybe people are just more likely to find out about it because of more doctor visits as a result of the COVID-19. (Really? I don’t see doctors more in the 30 days after I recover from something.)

This paper from the UK found that kids 11-17 who had Long COVID did improve over time. The paper also mentioned that some symptoms started months after infection.

This paper from Spain found that women with Long COVID has measurably worse respiratory function than controls.

Oxygen consumption by women with Long COVID (top, yellow) and controls (bottom, blue)

This paper from Sweden said that Long COVID diagnoses were given for 1% of non-hospitalized people, 6% for hospitalized people, and 32% for those who had been in the ICU. Note that this was done with electronic records search and did not include people with “blurred vision, cognitive dysfunction, memory issues, menstrual problems, allergies, and postexertional malaise […] due to a lack of specific information in the data sources used.” They did not have a control group for reference.

Transmission

This study from the US said that in a large sample, 41.6% of the people had markers in their blood which showed they had been infected by COVID-19. Of those people, 43.7% (including 57.1% of non-Hispanic Black people!) said that they had never had COVID-19. Either they were asymptomatic, lying to the survey-taker, or lying to themselves. (Note also that 42% of Americans admitted to lying about COVID-19 somehow.)

Variants

BQ.1.1 is worse than we thought. I had been watching Eric Topol, who was saying something along the lines of, “France has a lot of BQ.1.1 and they aren’t seeing a spike, so maybe it’s okay.” Well, in his blog, he now says that it didn’t look so bad because of a testing lab strike. It actually is bad.

Some good news: this preprint from Japan says that BQ.1.1 isn’t any more deadly than BA.5, at least in hamsters.

Vaccines

This article says that Canada bought 169M doses between the start of the pandemic and May 2022; 84M got used, 15.3M got donated, and 13.6M expired. Of the 32.5M left, it says that the majority of these shots may have already or are set to expire by the end of the year. At ~$30/per pop, that means ~$5B for those 169M doses at the end of May.

I uh completely missed that Health Canada approved a Moderna BA.5 bivalent booster way back on 3 Nov 2022. My bad. So now there is a Moderna BA.5 and a Pfizer BA.5. Which is better? Moderna has 50 mg of mRNA vs. 30 mg in the Pfizer. Generally Moderna has had slightly higher effectiveness, but also slightly higher risk of side effects. If you are a young man, and hence more likely to get myocarditis, I would choose Pfizer over Moderna.

Novavax is still a very good choice. The BA.5 vax is going to be better against BA.5, but Novavax appears to give broader protection, i.e. better for what comes next. We might be at the point soon where “what comes next” is circulating more than BA.5. BQ.1 and its daughter BQ.1.1 are in the majority in the US now.

This paper from the USA says that the bivalent mRNA BA.4/5 vaccines are good against BA.4/5, but shit against BA.2.75.2, BQ.1.1, or XBB.1.

This paper from Germany says that three doses of monovalent mRNA is crap against BA.2.75.2 and BQ.1.1. Four doses of monovalent seems to work pretty well, however.

This paper from the USA looked at influenza A and not COVID-19, but found that two intramuscular mRNA vax doses plus one nasal vax dose achieved high levels of both blood and respiratory tract T-cells.

Something I was not expecting: giving the two intramuscular doses on the same side of the body elicited slightly higher levels of antibodies than doing it on different sides of the body. (!)

Mitigation Measures

This article says that of the $211B in emergency COVID-19 benefits, $32B (or 15%) went to ineligible people. A report says that’s mostly because they deliberately did checks after the money went out instead of before, so they could get the money out faster. $3.6B went to overpayments of various sorts (like double-payments to employment insurance). $15.5B went out to the wage subsidy program and looks iffy.

This article says that permanent immigration admissions from China are way up (15% over 2019), probably because of China’s strict Zero-COVID mitigation measures.

Pathology

This article, reporting on this paper, says that cold temperatures — even a drop of five degrees C — decreases your nasal immunity significantly. I guess there was some truth to “get inside before you catch cold”!

This review article from the USA says that from looking at multiple studies, it looks like the risk of getting diabetes goes up by 66% after a COVID-19 infection.

This article (referencing this paper from the USA) says that COVID-19 causes changes in the brain which are similar to changes seen from aging.