Inside Medicine. What Are You Seeing? [COVID-19 medical news]

Virus unpredictability coupled with our complacency is a bad combo

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I think itā€™s difficult to predict because the UK and Israel, for example, are in a different Vaccine cycles than the US. Israel started/vaccinated a huge portion of their older population back in Jan/Feb whereas the UK gave everyone a first shot then made them wait 12 weeks for the second. In both countries the younger cohorts were vaccinated last. The UK only recently (July 19 for England) lifted restrictions and Scotland has never lifted masking requirements. Israel lifted masking in May I believe and recently reinstated masking. So many variables. Iā€™d also be interested to hear opinions as to why the experts are making their respective predictions.

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Some of us did get vaxed in Feb & earlier and are 60+. The healthcare providers and many elders in US were vaccinated Nov-Feb, so if itā€™s time for a booster in Israel, itā€™s time for one in US for similarly situated folks.

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Was this posted? Thread moves so fast!

https://www.cnn.com/2021/08/05/middleeast/israel-boosters-restrictions-covid-spike-intl/index.html

Israel seems rather desperate to get their 60+ boostered.

good article on the PTown outbreak - How A Citizen Scientist Helped CDC Spot The Provincetown COVID-19 Outbreak : Shots - Health News : NPR

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Very interesting articleā€”thanks for posting.

On the point below, I feel like a broken record, but PCR does not test for ā€œthe amount of virus.ā€ It detects viral RNA, which could be fragments of neutralized virus, not whole, active, infectious virions.

And ā€” most surprisingly ā€” the amount of virus measured in a subset of people who tested positive was nearly identical among vaccinated and unvaccinated people.

Due to that idea, Iā€™ve heard quite a few people saying that vaccinated people are just as likely to spread the virus as unvaccinated. That is not supported by any evidence. First, in Provincetown, they only got these readings in a subset of the group of vaccinated people who tested positive. Some who tested positive had very little viral RNA. Secondly, you have to think about the real denominator which was the 110,000+ people who crowded into tiny Provincetown in waves over the two weeks of the outbreak. Out of over 110,000, only 469 tested positive.

Hereā€™s a excerpt from an article about misinterpretations of the Provincetown report:

Some experts think the CDC is over-interpreting the MMWR reportā€™s results, although they say the agency is still right to recommend masks in addition to vaccines. Thatā€™s because the diagnostic test data in the report are unlikely to fully reflect how infectious someone is, particularly in vaccinated people.

For one, these sorts of PCR tests are good at identifying viral RNA, but they canā€™t tell whether that genetic material is in an intact, infectious virus particle or not. That becomes especially relevant for vaccinated people, Deepta Bhattacharya, an immunologist at the University of Arizona College of Medicine, said.

ā€œAntibodies from a vaccinated person can coat the released virus and keep it from infecting other cells,ā€ he told us. ā€œAnd T cells can kill infected cells, releasing viral genetic material but not infectious particles.ā€

Second, the tests are only looking for RNA present in the nose and throat, not the lungs ā€” even though vaccines are likely to have more of an impact there, according to previous research.

ā€œThough it isnā€™t entirely clear how much of transmission comes from the lungs vs. the nose and throat,ā€ Bhattacharya said in an email, ā€œit is almost certainly some.ā€ That would also suggest a vaccinated person with a similar cycle threshold as an unvaccinated person would be less infectious.

Vaccinated people also likely arenā€™t infected as long, since their immune systems are quicker to respond to the virus, which would also make them less likely to infect as many people as an unimmunized person.

Bhattacharya pointed to an unpublished study from Singapore, posted to the preprint server medRxiv on July 31, that found viral loads were similar in vaccinated and unvaccinated people to start, but decreased more quickly in vaccinated people.

From: CDC report on Provincetown COVID outbreak misinterpreted on social media

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I just read this article for the NYT and now Iā€™m wondering how schools will respond. Iā€™m not going back full time this fall, so I suppose I wonā€™t need to worry about it (and might totally retire anyway with the resurgence), but my mind is pondering how Iā€™d handle it anyway. One has to move on with material, but when you have students you know ā€œcan do itā€ it would be a tough call giving them bad grades knowing how it will affect their self-esteem and future.

This is so scary, I feel like we are sending a whole generation of children overboard. Who knows what the lifelong implications will be? :frowning:

Iā€™ve posted here before that my D24 has a long-covid symptom (parosmia). I am happy to report that it is slowly improving. Well, it is changing, anyway, into a form that is less intolerable. Most things still donā€™t taste as she expects them to, but only a few things are still completely intolerable (taste like moldy garbage). As distressing as it has been, Iā€™m thankful she doesnā€™t seem to have developed any of the other, truly scary symptoms so many people seem to be plagued with.

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Someone made a risk estimator for getting COVID-19. It estimates risk in ā€œmicroCOVIDsā€, defined as:

The custom scenario includes selections for your vaccine, how many nearby people, distance from them, duration of presence, outdoor/indoor, mask type, talking, and characteristics or other people.

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Heard today from a nurse (so I believe it) that a women had as a COVID vaccine side effect very noticeable hair loss.

Hair ā€œlossā€ is a known side effect of fever, including that caused by Covid. Stress, too can cause this.

So if someone comes down with a fever after vaccination, hair shedding can happen (this is not hair loss though).

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I had a gi illness several years ago that lasted awhile and I lost clumps of hair. It was scary. So Iā€™m sure it could happen with covid. But I also know people that lost hair due to autoimmunity and not as a symptom of another autoimmune disease. It was just the hair. Occasionally, weird immune things happen after vaccination so hair loss could happen but I would expect it to be short-lived if itā€™s really from just from the vaccine. I know someone who had pericarditis from the vaccine and know of another person who had a skin problem. Both resolved in a short time, though.

As a nurse, I regretfully say that just because you heard it from a nurse doesnā€™t mean a whole lot.

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Thanks for this. Shared with my kids :slight_smile:

Yes, thatā€™s a handy, interesting app. It convinced my niece not to get her hair cut.

Just sayingā€¦ Apps like this can create an unnecessary anxiety in people who are already on the brink of a breakdown.

OK, I am fully vaccinated and I flew on an airplane last weekend. The app says I am at an extreme risk of developing Covid. Seriously? If I tweak just one parameter, just a tiny bit by selecting the next thing from the dropdown menu, my risk drops to average. Seriously?

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Some parameters do make a big difference (indoor vs. outdoor, vaccination) in COVID-19 risk.

Note that I said ā€œfully vaccinatedā€ and ā€œairplaneā€ - canā€™t change those to non-vaccinated or outdoors. :wink:

Or they can calm people down by showing them that some common situations or encounters* are lower risk than they assumed.

*For example, a walk outdoors in an uncrowded park where someone briefly passed by within 6 feet.

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Try plugging that inā€¦ :wink: