week ending 2022-12-15 General

I have added a page with what to do if you get COVID-19 here. (Tl;dr: stay away from your loved ones, stay entertained, irrigate your sinuses with saline, take Paxlovid if you are over 65 or clinically extremely vulnerable, make sure you have good quality air (low in particulates, warm, and between 40% and 60% relative humidity), take probiotics, and don’t push yourself.) There’s also a checklist for what to prepare before you get sick.


This paper from multiple countries says that there have probably been ~2.75 times as many COVID-19 deaths worldwide as have been reported.

This paper from the USA found that spike proteins — all by themselves, without a virus payload — caused leaks to form in epithelial and endothelial cells. They saw leakage both in test-tubes and in mice with human ACE2 receptors. (NB: Vaccinations get spike proteins into your lymph system, not into your blood system. Well, they aren’t supposed to get into your blood system.)

This paper from Turkey found COVID-19 in penis tissue a month after the patients’ acute phase ended.

If I understand this paper from Sweden correctly, they found a gene variant in the immune system which is much better at coming up with antibodies which neutralize COVID-19. In other words, who gets sick and who doesn’t is partially genetic.

This paper from the UK found that people who had COVID-19 early on had higher levels of anxiety and/or depression — from ~1.5x to ~2x, depending on the time period. However, it’s not clear which direction the causality went: they also found that people who had pre-existing mental health issues were more likely to catch COVID-19.


This article from Ontario says that unvaccinated people have a 70% higher risk of being in a serious car crash than vaccinated people. It is unlikely that vaccination prevents car crashes; it is more likely that people who decline vaccination underestimate risks in general. (I have also seen at least one paper which found that reaction speed dropped slightly but measurably in people after COVID-19 infection. Maybe that small degradation in reaction speed translates to more accidents?)

This press release from NACI says that children 5-11 can now get the Pfizer BA.4/5 bivalent booster. It also says that they can get other vaccines (like flu) at the same time as the booster. (They have not yet approved either the Moderna bivalents for kids, though.)

This article reports that Health Canada has approved Novavax as a primary series for 12-18 year-olds.

This paper from the USA found that protection was greater from intranasally administered second doses than from intramuscularly administered second doses in mice with human ACE-2 receptors using a viral vector vaccine. (Interestingly, they used an Ankara virus — the same “cowpox” virus used in smallpox vaccinations — modified to have the COVID-19 spike protein. Wouldn’t it be nice if it also gave immunity to mpox? (Not likely, though.))

This paper from the USA found that the risk of postural orthostatic tachycardia syndrome (POTS) was 33% higher in the 90 days post-vaccination than the 90 days pre-vaccination, but it was still five times lower than the risk of POTS from a COVID-19 infection.

This paper from Hong Kong found that two doses of Pfizer or CoronaVac was useless against omicron infection. (Hong Kong is interesting because it did quite a good job of Zero-COVID until omicron hit, so their control population had very few people who had been infected.) Three doses of Pfizer gave ~50% VE against symptomatic infection and ~40% VE against any infection; CoronaVac gave about 40% VE against symptomatic infection and about 30% VE against any infection. Interestingly, two shots of CoronaVac and one shot of Pfizer gave ~55% VE, so yay for mixing and matching!

This article says that even the bivalent mRNA vaccines are shit (in testtubes) against BQ.1, BQ.1.1, XBB, and XBB.1. (Recommendation: next time you get a booster, get Novavax.)

Yes, vaccines can give young men myocarditis. Yes, according to this paper, vaccinating a million young men would cause 128 myocarditis/pericarditis cases, 110 hospitalizations (and zero deaths). However, it would prevent 82K COVID infections, 4.8K hospitalizations, 1.1K ICU admissions, and 51 deaths.

This review article on sperm found that there was no affect on sperm from vaccination with either mRNA or inactivated virus vaccines.


This article says that Paxlovid reduced hospitalization by 40% and death by 70% on vaccinated people in a major hospital system (not a randomized clinical trial). (Yes, the original Paxlovid study said it reduced hospitalization by 89%, but the original Paxlovid study was on unvaccinated people, and probably fewer people who had infection-acquired immunity.)

This article from UBC (reporting on this paper) says that they found a drug which seems to be effective in test tubes against SARS-CoV-2 and all the “common cold” coronaviruses. It works by messing up the replication machinery.

This study from the US of veterans during the BA.1 wave found that Paxlovid reduced hospitalization by about a third, and death by about about 79%. Molnupovir helped, but not as much — 9% reduction in hospitalization and 49% reduction in death. There wasn’t a significant difference in long-term hospitalization/death (among the people who lived, obviously), except for slightly lower incidence of kidney issues in the Paxlovid group. Also, they did not see a benefit for people under 65.

This preprint says that apixaban — an anti-coagulant — didn’t help patients hospitalized with COVID-19. Dammit.


Frequently, if people with chronic fatigue syndrome or Long COVID try to do too much — physical or mental — they crash and burn for several days afterwards. This paper found that people who got telephone coaching to follow a structured pacing regime (i.e. slowly, carefully increasing exertion levels over a period of weeks) could do more without crashing.


This report from the UK Food Safety Agency found that on most foods and food packaging, COVID-19 inactivated in a day or less. (For apples and olives, it was one hour!) However, for cheddar cheese and ham — highly fatty food usually kept refrigerated — levels stayed high for up to a week. Note that usually in developed countries when shipping cheese and ham, usually people don’t touch the cheese directly.

Mitigation Measures

This report estimates that a six-month delay in rolling out the COVID-19 vaccinations would have cost about CA$156 billion dollars.

Unintended Consequences

This paper from the UK says that percentage of smokers declined during the pandemic, but not as much as it was declining pre-pandemic. Furthermore, it was wickedly different by age: the percentage of young adults (18 to 24 year-olds) smoking increased by 34%, while smoking decreased by 13.6% among 45-65 year-olds.


This report from the UK on the NHS investigates why, despite more money and staff, the NHS is doing worse on several measures. (Yes, yes, I know we are not the UK, but I think there are lessons there.) Things they identified included:

  • Inflation. Yeah, they got more money in absolute terms, but it’s not that much once adjusted for inflation.
  • Staff sickness. Staff lost a lot more hours to sickness than pre-pandemic. There were still more staff hours, but not as many as it looks like.
  • Staff imbalance. They added more junior and senior staff, and fewer in the middle.
  • More beds taken up by COVID-19. Pre-pandemic, they didn’t have to use any beds for COVID-19 patients. Now they do.
  • Less able to discharge. The number of people who stayed for a long time was higher. They had trouble telling how much of it was because people were sicker and how much was from not being able to discharge patients to “social care” (which seems to cover both “nursing homes” and “living in your own home but with visits from home care aides”). However, they found that the size of the adult social care workforce declined recently, suggesting that labour market shortages mean there are fewer social care beds to discharge patients to.
  • Burnout. It might be that health care workers are less inclined to do unpaid (and hence invisible) overtime than they used to be.

The big takeaway for me was that there are just plain more sick people than there were pre-COVID-19. (Imagine if breast cancer didn’t exist before 2019, and now it exists: you’d have higher demand on the system, and that demand would not go away.) Add into that the visible Long COVID cases, plus the mostly-invisible medium-term damage from COVID-19 (all-causes mortality rates double for the year after a COVID-19 infection!), and the demand on the health care system is just plain going to be higher than it was in 2019.

Recommended Reading

This article from the US talks about the challenges of interpreting wastewater COVID-19 levels.

This article from the USA (from February 2022) is IMHO overly long, but does a good job talking about how different jurisdictions can have quite different rates of listing COVID-19 on their death certificates.

This article from the USA talks about time perception during the pandemic.