2026-02-20 General

Multiple Pathogens

This report from Spain (2026-02-19) says that 8.8% of hospitalized patients got a hospital-acquired infection (HAI) and they were about twice as likely to die as patients who did not get an HAI. The authors think at least half of those are preventable.

The authors note that there are three times as many deaths from HAIs as from car accidents in Spain.

NB: only 26% of HAIs were respiratory: surgical site infections (22%) and urinary tract infections (18%) followed.

Also please note farther down under COVID-19/Transmission, hospitals are nasty germy places.

🛌 This paper from Israel (2026-02-11) reports that kids with sleep apnea are way more likely to have trouble with respiratory diseases, including COVID-19, than kids without apnea. Kids with sleep apnea have:

  • a 99% higher risk of getting COVID-19 over five years;
  • a 45% higher risk of getting influenza over five years;
  • a 169% higher risk of getting pneumonia from influenza;
  • a 2596% higher risk of getting pneumonia from COVID.

COVID-19

Long COVID

This paper from USA (2026-02-19) reports that people with Long COVID had higher risks of developing mental illness symptoms compared to people without Long COVID:

  • +86% higher risk of depressive symptoms;
  • +60% higher risk of anxiety symptoms.

This higher risk persisted for at least three years.

COVID-Related Excess Death and Sickness

This paper from BC (2026-02-14) reports that the risk of type 2 diabetes is 28% higher in unvaccinated people who have had a COVID-19 infection than those who did not have COVID-19 infections. (People who were vaccinated and had a COVID-19 infection had no higher risk than people who had no infection.) The risk was higher the worse the COVID-19 infection was:

  • +15% higher risk for ambulatory care patients;
  • +98% higher risk for hospitalized patients;
  • +210% higher risk for people who went to ICU:

The higher risk persisted for three years.

From this preprint from USA (2026-02-15) reported that people hospitalized for COVID-19 had a 41% higher risk of developing sleep apnea than COVID-negative controls. People who had COVID-19 but were not hospitalized had a 33% higher risk of new-onset sleep apnea than controls. Being vaccinated didn’t change the odds.

Transmission

💨 This paper from Australia (2026-02-13) reports that hospitals are really germy places. In one hospital, they did PCR tests for COVID-19 in air samples, and found COVID-19 kind of everywhere: in a negative-pressure patient room, just outside the negative-pressure patient room, in the ICU, in the ED, in the waiting rooms, in a staff breakroom, and in a walkway. They found COVID-19 on surfaces, but it was not common — they found it in only 7% of their surface samples compared to 39% of their air samples.

They also saw a spike in the amount of COVID-19 in the air samples a week before they had a multi-ward outbreak.

Note: The article did not characterize the hospital’s HVAC system at all: What was the air change rate in different places? Were there HEPA filters on the air? How much air was recirculated? Were there portable air purifiers anywhere?

Vaccines

💉 I discovered today that Canada approved Moderna’s mNexspike COVID-19 vaccine on 2025-09-29. It’s really strange, though — that information is buried. I found the Summary Basis of Decision (issued 2025-12-12, posted 2026-01-21) and the product monograph (PDF, 2025-09-29), but I can’t find any press releases from Moderna, no announcements from PHAC, no news articles, and mNexSpike is not listed on the List of authorized vaccines and treatments for COVID-19 page. When I got a COVID-19 shot about a month ago, the pharmacist had never heard of mNexSpike. This silence is just weird.

Reminder: mNexSpike is a new vaccine from Moderna which has only little pieces of the spike protein, instead of the full spike protein. It also has only 1/5th of the amount of active ingredient as Moderna’s original Spikevax, and comes in a pre-filled syringe (which means that they don’t have to worry nearly as much about wasting doses). Best of all it’s slightly better than Spikevax — with about 13% higher relative vaccine effectiveness than Spikevax.

💉🤰 This paper using data from eighteen countries (2026-02-18) reports that pregnant women who had COVID-19 diagnoses are more likely to get preeclampsia than pregnant women who had not:

  • +45% higher adjusted risk;
  • +78% higher adjusted risk if they were not vaccinated.

Calculating by risk vaccination status instead of by infection status:

  • vaccinated mothers had a 30% lower risk of getting preeclampsia than unvaccinated mothers (I presume in large part because they didn’t get as many COVID-19 infections);
  • for mothers with comorbidities, vaccinated mothers had a 58% lower risk of preeclampsia than unvaccinated mothers.

Preeclampsia wasn’t the only thing that was reduced by getting a vaccination. Compared to unvaccinated women, vaccinated women who got a booster dose had:

  • 32% lower risk of maternal death or illness;
  • 29% lower odds of perinatal death or illness of their baby;
  • 33% lower odds of a preterm birth.

They also think that COVID-19 vaccination reduces the risk of various adverse outcomes events even among women who did not get COVID-19 infections. I am not convinced, given that 40% of COVID-19 infections are asymptomatic: the “unvaccinated never infected” cohort might have actually had a lot of infections. (Note that if there were a lot of asymptomatic infections, then the protective benefits of vaccination listed above are even higher!)

Mitigation Measures

😢 This paper from Canada (2026-02-17) reports that hospitalizations for child abuse dropped by 31% for roughly the first three months of the pandemic. After that, the hospital admissions returned to the baseline, but ICU admissions went up 80%. They are a bit more polite about their phrasing, but I believe this says that they missed the milder cases until they progressed to more major cases.

Healthcare Systems

This article from Canada (2026-02-19) reports that we finally have a new federal chief public health officer: Dr. Joss Reimer. Remember that Dr. Theresa Tam stepped down on 2025-06-20 per this article (2025-06-04). Dr. Reimer will start her new job on 1 April.

This paper from USA (2026-10-13) reports that hospitals that had better IT capabilities and who participated in clinical trials got better faster at treating their COVID-19 patients.

NB: this might be explainable by vaccine politics:

  • hospitals with better IT capabilities and greater participation in trials are probably usually in big cities;
  • big cities tend to vote more Democratic;
  • vaccine uptake was higher among Democrats than Republicans after a few months;
  • vaccinated people don’t get as sick.

Influenza

Vaccines

💉 Well, it looks like a lot of people complained and so the FDA caved. Mostly. This press release from Moderna (2026-02-18) says that Moderna gave a counter-proposal that they submit the same application for full approval 50-64 year-olds, get accelerated approval for the over 64 year-olds, and do a post-marketing study for people over 64. (Accelerated approval in this context means that Moderna can use correlates of protection, i.e. look at levels of antibodies in the blood instead of having to wait for people to get sick.)

Poxes

Vaccines

This article (2026-02-18) reports that the Government of Canada has ordered USD$22.5 million dollars worth of the Bavarian Nordic smallpox/mpox vaccine. (That’s not enough for everybody, but remember that old people got smallpox vaccines before smallpox was eradicated. This site says that Canada gave smallpox vaccinations until 1972; it’s a safe bet that anybody over 55 got a smallpox vaccination.)

Transmission

🎉 According to the Government of Canada’s National Wastewater Monitoring of Pathogens website, there were ZERO mpox detections in the week ending 8 Feb in any of the five Canadian wastewater monitoring sites that check for mpox! That doesn’t mean there are none in the country — there could be a case in a city which doesn’t do wastewater surveillance — but it’s good news!

Measles

Transmission

According to the Government of Canada Measles and Rubella Monitoring Report (updated 2026-02-16), in the week ending 7 February 2025, the following jurisdictions had the following number of measles cases:

  • Canada: 57;
  • Manitoba: 43 (!);
  • Alberta: 11;
  • Ontario: 1;
  • Nova Scotia: 1
  • Quebec: 1.