2024-03-15 General – Pandemic in British Columbia

Long COVID

Today is International Long COVID Awareness Day. Yeah, I wouldn’t have known either if I didn’t actively seek out COVID-19 information.

It got almost no media coverage.

Ironically, the thing that did get media coverage today was a presentation which found that Long COVID wasn’t all that different from what people got after an influenza infection or much more frequently found per flu case. One of the researchers said that we shouldn’t call those post-COVID long illnesses “Long COVID” because it isn’t unique/exceptional – and so of course all the headlines said, “RESEARCHERS SAY LONG COVID DOESN’T EXIST!”

I think the polarity of what the researcher said was backwards: we shouldn’t pay less attention to Long COVID, we should pay more attention to Long Flu!

Even if Long Flu happens as frequently after a flu infection as Long COVID after a COVID-19 infection, Long COVID is still numerically worse. People catch the flu, on average, around once per decade. People are catching COVID-19 multiple times per year. (And yes, your chance of getting Long COVID goes up with every new infection.)

This paper from Germany (2024-03-01) found that people with Long COVID had significant sleep disruptions — including more sleep apnea — than controls.

Pathology

This paper from Ireland (2024-02-29) found that babies born early in the pandemic had significantly lower allergies than previous cohorts, and significantly more of the “good” gut bacteria. One possibility for that might be that, because of various mitigation measures, they didn’t get sick as often and thus didn’t get as many antibiotics. (Antibiotics kill the “good” bacteria as well as the “bad” bacteria.)

I keep seeing papers like this one from China (2024-03-09) which breathlessly announce that SARS-CoV-2 has been found in tissues far from the respiratory system. (This paper found SARS-CoV-2 in cerebral spinal fluid.) Isn’t this common knowledge now, if not among the lay public, but at least among COVID-19 scientists?!?!? Seriously, I can’t think of an area in the body where I have not seen a paper saying, “found SARS-CoV-2 here!” Maybe ovaries, I won’t swear that I’ve seen a paper that found SARS-CoV-2 in ovaries (but I definitely have seen a paper which found SARS-CoV-2 in male ovaries i.e. testicles).

This paper (2024-03-11) found that the global life expectancy dropped by 1.6 years in 2020/2021, while it had been increasing before the pandemic. Child mortality, however, continued to decrease.

This report from USA (2024-03-14) found that MISC cases per capita declined by 80% in 2023 over the last three quarters of 2022. They also found that more than 80% of the kids with MISC were unvaccinated, and 60% of the vaccinated kids with MISC were not up to date with their vaccines.

This paper from USA (2024-03-13) found that men with a severe case of COVID-19 and specific mutation in an interferon had an 80% lower risk of dying than the men with a severe case of COVID-19 without that mutation. Men under 78 with the mutation had an 80% lower risk of death than controls.

Transmission

This preprint from US (2024-02-15) found that 16% of a small sample of housecats between mid-2020 and mid-2021 had COVID-19 antibodies in their blood. 44% of cats sampled in the fall of 2020 were seropositive, however.

This paper from Germany (2024-03-08) is mostly about comparing genomic sequencing to traditional interview-based contact tracing (and surprise, surprise, genomic sequencing is much better than interview-based), but also noted that 19.2% of patients in hospital who had COVID-19 caught COVID-19 in the hospital.

This paper from Canada (2023-02-21) found that 20% of Ontario doctors had gotten COVID-19 by the end of 2022. They also looked at the risk based on demographics and timing:

22% per decade less likely for older doctors;
30% less likely for rural doctors;
26% less likely if they lived in more marginalized neighbourhoods;
14% more likely if they were female;
16% more likely if they worked in care homes
Twice as likely if they had a high patient load than a low patient load;
25% more likely if they were pediatricians;
46% less likely if they were opthalmologists;
38% higher risk of infection during the first two waves compared to matched controls in their community;
7% lower risk of infection during and after the third wave compared to matched controls in their community.

Treatments

This Government of BC web page says that “the federal supply of Paxlovid is ending”, and all of the federal supply has expiry dates before March 31, 2024. I am not sure what that means, but I think it means that the feds aren’t going to pay for it any more. (The page does say that Paxlovid is a Full Payment drug, i.e. patients don’t have to pay anything for it.)

It was just brought to my attention that the US FDA authorization for Paxlovid has a warning that Paxlovid might interfere with hormonal birth control. Now, I think this is unlikely to be an issue in BC, since BC says that you have to be over 70. 🙁 If you live in Manitoba or somewhere where the age limit is way lower, it might be an issue.

Vaccines

There are some slight risks of cardiovascular events from getting a COVID-19 vaccination. But there are also risks from getting a COVID-19 infection. What’s the balance? Well, this study using data from Spain/UK/Estonia found that the risks of serious CV issues were lower for vaccinated people who got infected than for the unvaccinated, by A LOT:

CV Event	Time post infection	Reduced Risk
Heart Failure	0-30 days	39%
Venous clot	0-30 days	47%
Arterial clot	0-30 days	28%
Heart Failure	6-12 months	48%
Venous clot	6-12 months	50%
Arterial clot	6-12 months	38%

Reduced risk for vaccinated people compared to unvaccinated

Note that this doesn’t even take into account that vaccinated people are less likely to catch COVID-19 than unvaccinated people.

This review article (2024-03-11) found that pneumococcal conjugate vaccines (PCVs) provided about 32-35% protection against COVID-19 lower respiratory tract infections compared to controls.

Variants

This article (2024-03-13) reports that the World Health Organization has reclassified SARS-CoV-2 from biosafety level 3 (BSL-3) to BSL-2 most of the time. For handling high concentrations of live variants of concern, they recommend staying at BSL-3.

Money

This paper calculated, based on a USD$530 price for Paxlovid and a value of USD$100,000 for each year of life lost, that giving Paxlovid to 20% of symptomatic patients would save USD$56.95 billion to US $170.17 billion (billion with a B!). Now, the price of Paxlovid has since gone up to USD$1,400, and I don’t see any evidence that they looked at the different effectiveness of Paxlovid by age coupled with the different rates of spread by different ages, BUT those are still extremely large numbers.