Government
This post says there is a rumour that Dr. Teresa Tam is going to step down, with Dr. Bonnie Henry a leading contender to replace her.
This article reports that the Auditor General had some very not nice things to say about ArriveCan. She said that it cost at least CAD$59.5M to produce, wasn’t tested well, and incorrectly told 10,000 Canadians to quarantine.
This article reports that a collection of PPE manufacturers are suing the Government of Canada. They contend that the government promised that they would buy domestically-sourced PPE and then didn’t.
Long COVID
This paper from UK (2024-02-14) found that very specific proteins in the innate immune system (iC3b, TCC, Ba, and C5a if you must know) were significantly elevated in Long COVID patients. The good news is that good inhibitors of those proteins already exist, and might be good treatments for Long COVID!
This paper from USA (2024-02-10) compares hospitalized patients with and without COVID-19. They found that 31-150 days after hospitalization, adults and children who had COVID-19 had a slightly under 20% higher risk of having more than one lingering symptom than controls, and a 50% higher risk (for adults) or 40% higher risk (for children) of having shortness of breath than controls. COVID-positive adults also had a 3x chance of fatigue compared to the COVID-negative, 25% higher chance of a new diabetes diagnosis, 44% higher risk of respiratory disease, and 19% higher risk of a blood disorder.
I don’t post every paper or article that I see. Sometimes I think a study is just whack for some reason, so let me give an example. Take this study from USA (2024-02-14): its high-level takeaway was that people with Long COVID were twice as likely to have cognitive issues than people who had had COVID-19 infections but not Long COVID.
Okay, problem number one is that the data came from a web survey. That already makes me nervous, as web surveys are not guaranteed to be representative in any way, shape, or form.
The biggest issue I had was how do you determine who has Long COVID and who doesn’t? Their description was confusing: they said both self-report and “we defined post–COVID-19 condition among individuals whose survey start date was more than 2 months after the month in which they initially identified a positive COVID-19 test and who continued to report symptoms at the time of the survey”. I am not sure how to interpret that, but it sounds like they had to say they had Long COVID and they had to have had it for at least two months after they got COVID.
The biggest problem with this is that a lot of people don’t even know what Long COVID is! And me, I would have said that if they have significant cognitive issues, then kind of by definition, they have Long COVID. The high-order takeaway which I would take from this report is “Long COVID is horribly under-diagnosed.”
Like the previous paper, I have some issues with this paper from USA (2024-02-14). Using electronic records from February 2020 to February 2021, found that people with Long COVID developed ME/CFS four times as often as people without Long COVID. It used people who did not have a positive test for COVID as controls — but many many people who got COVID-19 infections were never tested! Either they didn’t have symptoms or they didn’t believe in COVID-19 or tests were not available or they just didn’t bother.
Mitigation Measures
This old paper from USA (2021-09-21) found that bog-standard visible blue light (405nm) inactivated SARS-CoV-2 and influenza, though with exponential decay. This recent paper from USA (2023-09-19) studied 405nm light with food-borne pathogens L. monocytogenes, S. Typhimurium, P. aeruginosa, S. aureus) and found that 405nm light was pretty effective against some but not all of them. (The difference probably has to do with what kind of envelope (“skin”) the pathogen has.)
The studies used stronger lights than your standard 40-watt bulb, but I believe they would be a lot wimpier than sunlight, even through clouds. So the takeaway I have is that being outdoors in the sunshine is even more COVID-safe than being outdoors in the shade (or at night).
Treatments
This paper from China (2024-02-08) found that neither Paxlovid nor azvudine (a reverse transcriptase inhibitor) showed a statistically significant survival benefit for elderly patients with COVID-19. The study might have been underpowered, but still, there wasn’t an overwhelming obvious benefit.
This paper from USA (2024-01-16) found that computer simulations say that methotrexate — a well-established drug for chemo and immunosuppression — binds really well to the SARS-CoV-2 spike protein. Apparently, people on methotrexate have some resistance to COVID-19 and they thought methotrexate inhibited virus replication, but no, it appears to be spike binding.
One issue is that methotrexate is not exactly a benign drug. In particular, it does not play well with alcohol — it destroys the liver. A friend of mine who had very painful arthritis was on methotrexate and couldn’t keep himself from also self-medicating with alcohol. It killed him.
Testing
This paper from USA (2024-02-13) found that BinaxNow tests (which is what the “green box” rapid tests we get in BC are) give results which are just as accurate when self-administered as when healthcare workers administer them, yay. The bad news is that 5.2% of the self-administering patients who got a positive misinterpreted what the card said — thinking it said they were negative when actually it was positive. Worse, in 12% of the positive cases, both the healthcare workers and the patients thought the test was negative when it actually said positive. (I guess the line was really faint?)
This paper from Ontario (2024-02-14) describes how Ontario does quality control on its wastewater. It turns out that the accuracy of tests — which are basically PCR tests looking for nucleotide genes — are influenced by mutations. Ontario realized this early on, and tested two different nucleotide spots, and then watched out for the two diverging (which they did when Omicron hit). That let them revise the assays.
One thing that the paper mentioned is that Ontario normalizes to the pepper mild mottle virus. The pepper mild mottle virus is a virus which infects pepper plants (the bell pepper family, not the black pepper family) but not humans. It passes right through humans and ends up in the wastewater. You would think that how much pepper we eat would change over the course of the year, but apparently pepper consumption is extremely stable. (Who knew?) Thus, but normalizing to the pepper mild mottle virus, they can control for the volume of wastewater that is treated. (Some sewer systems are not completely separated from rainwater.) ANYWAY, BC does not normalize to the pepper mild mottle virus, so IMHO the BC numbers are not as reliable as the Ontario numbers.
Pathology
This paper from USA (2024-02-13) found that women who got more than 150 minutes per week of exercise had a 13% lower risk of getting COVID-19 than women who got no exercise. For men, there wasn’t a decreased risk.
This article from Saudi Arabia found that 59% of adults who had had COVID-19 infections said that they had more hair loss during or after infection. The delay between COVID-19 infection and hair loss varied, and the duration of the hair loss varied. Interestingly, twice as many women shed than men. (Or maybe women just noticed it more?) Taking anti-virals also upped the risk of hair loss. For about half of the people with hair loss, they shed for less than six months.
Transmission
This paper from Italy (2024-02-14) speculated on why kids might not get as sick as often from COVID-19 as adults. They listed these possibilities:
- the expression level of ACE2 receptor in children is lower; the binding affinity between ACE2 receptors and viral spike proteins in children was weaker;
- children have strong pre-activated innate immune response and appropriate adaptive immune response;
- children have more natural lymphocytes (white blood cells);
- children with COVID-19 can produce higher levels of IgM, IgG and interferon (pieces of the innate immune system);
- children infected with SARS-CoV-2 can produce lower levels of IL-6 and IL-10 (other pieces of the innate immune system);
- children have fewer underlying diseases and the lower risk of worsening COVID-19;
- children are usually exposed to other respiratory viruses and have an enhanced cross-reactive immunity.
This correspondence (<- a study that has not been and will never be peer reviewed) from Sweden (2024-02-07) found that 7% of healthcare workers on duty at one hospital were COVID-19 positive. Almost half of the infected were asymptomatic, the others had only mild symptoms.
Vaccination
This paper from Italy (2024-02-14) found that the risk of hospitalized patients needing O2 was 56% lower in vaccinated patients (after adjusting for age, sex, comorbidity, and how sick they were when admitted) compared to unvaccinated patients. The risk reduction was higher earlier (62% if less than 120 days since vaccination) compared to later (43% if more than 180 days since vaccination), but I was still encouraged. I have seen lots of studies which seem to say that vaccines aren’t much good farther out than 180 days, but still having around 50% effectiveness that late is good!
Unexpected Consequences
This paper from Saudi Arabia (2023-12-31) found that children became more myopic during the pandemic, which they say is probably from increased screen (especially tablet) time. NB: They did not compare the shift to how much of a shift there was in pre-pandemic years. Maybe kids just get more myopic as they get older?