Vaccines
It’s here! This preprint from India has the first data for nasal vaccines in humans that we’ve seen. It compares of the same inactivated adenovirus delivered nasally (BBV154) and intramuscularly (Covaxin), both from Bharat Biotech:
Levels of antibodies and good things range from about 1.5x to almost 2x higher when delivered nasally. There were also four times as many side effects in the intramuscular version than the nasal version.
Two weeks ago, I reported that the US CDC thought there might be a slightly elevated risk of stroke after a Pfizer vax. Multiple organizations have looked into their data, and do not see a link. For example, here’s an article on what PHAC didn’t find. This article mentions in passing that in the CDC study, it looked like there were more strokes because the control group had an unusually low number of strokes, not because the vax group had an unusually high number.
Transmission
This paper from the USA says that they found Alpha, Delta, and Gamma circulating endemically in white-tailed deer, long after those have basically gone extinct in humans. There’s also been a lot of divergence in those strains, showing that the virus has stuck around in deer long enough for it to mutate quite a bit.
This paper from the USA found that an elderly (vaccinated) lion at a zoo caught COVID-19 (presumably from humans) in December 2021 and then passed it back to three of its (vaccinated, mask-wearing) handlers. (The article mentions that the lion was disabled enough that it had to hand-fed, which freaks me out a bit.) Presumably, the lion was unmasked.
Mitigation Measures
This press release says that the World Health Organization determined that we are still in a pandemic. I have the sense that it was close, and I bet in three months, they will lift the “we are in a pandemic” resolution.
Why does this matter? Mostly because it will make it harder for governments to continue with their pandemic resolutions.
Testing
This article says that Roche is developing a better PCR test for XBB.1.5.
Long COVID
This paper from USA looked at people who had gotten a COVID-19 test. Of the people who were positive, about half had symptoms after three months. However, about a quarter of the people who were negative (who presumably had some other upper respiratory infection) still had symptoms after three months!
There were slight differences in which symptoms were most common at three months. Loss of smell or taste were in the top five symptoms COVID-positive participants but not in the top five for COVID-negative patients. (COVID-negative participants had runny nose and joint pain in their #4 and #5 positions.)
The message I take from that is that other viral infections are not as benign as I thought!
Treatments
This press release reports that the US today withdrew authorization for Evusheld — a monoclonal antibody which was used sort of like a vaccine — because it’s not effective against the current strains. 🙁
This article from the USA (reporting on this survey) says that Paxlovid is way under-prescribed, in part because doctors were hesitant to prescribe it. Many doctors were concerned about drug interactions (even though there’s only two drugs that patients can’t safely just stop taking for a week to go on Paxlovid) or about Paxlovid rebound (even though rebound happens without Paxlovid too). Some doctors feel that patients “aren’t sick enough”, even though you have to prescribe Paxlovid before symptoms have a chance to get bad!
I don’t know how underprescribed Paxlovid is in Canada, but we have the additional problem here of a lot of people not having family doctors. This article says that the number of Paxlovid prescriptions in Ontario doubled when pharmacists were given authority to prescribe it.
This paper from the UK found that while treatment with molnupiravir did reduce severity and reduce recovery time, it didn’t decrease hospitalizations or deaths.
It’s worse than that, however. This preprint from Australia says that in immunocompromised people, molnupiravir caused mutations which not only persisted but also spread. This article talks about how molnupiravir is just not worth the risks.
This paper says that with VV116, a Chinese antiviral, people recovered 17% faster than with Paxlovid, and with about 13% fewer side effects. None of the VV116 patients or Paxlovid patients died or had severe COVID. I do not know how VV116 interacts with other drugs (which is one of the big problems hindering Paxlovid; while Paxolovid’s drug interactions can mostly be managed, there are two drugs which can’t be stopped, and it’s better to not have to stop them).
Recommended Reading
This blog post gives a detailed look at Sweden’s excess mortality rates. Spoiler: it turns out that minor procedural changes can make a big difference in numbers. The post’s “cumulative deaths” chart is not monotonically increasing (people came back to life???), so it’s hard for me to endorse the conclusions. However, the discussion is very interesting.
This article talks about bivalent boosters and who should get them. Spoiler: it draws the conclusion that you should absolutely get a booster if you are over 50 and maybe you don’t need bother if you are under 50. HOWEVER, the article does not consider Long COVID at all.
This article discusses the future of vaccines, going through all the different types which are in the pipeline.
This article gives a detailed status update on where we are with variants. If you read this blog regularly, there probably won’t be much that surprises you.
This article talks about wastewater surveillance in airplanes, including explaining why it’s a harder problem than measuring levels in sewer wastewater.