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

I believe all the majors now run their HVAC on full while parked. (Although the boarding process is probably still a big risk as everyone packs in the aisle, no separation, and breathing right on top of those who may have already been seated.)

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I commented on the hepatitis on another thread. The etiology is not clear. Adenovirus is postulated. Before Covid, adenovirus existed but didnā€™t cause liver disease like this, unless itā€™s a new variant. What is different is the presence of circulating SARS2 in the community. All the cases in Israel were infected with SARS2 except 1, and verbally but not publicly confirmed the last one was positive as well.
So, again, no one knows for sure, but

  1. could be SARS2, lots of articles published how it causes severe hepatitis, hereā€™s only one:
    Severe Hepatitis in Pediatric Coronavirus Disease 2019 - PubMed
  2. adenovirus/SARS co-infection wreaking havoc on the liver (adenovirus alone, okay; SARS2 alone, okay; both combined - too much)
  3. SARS-weakened immune system, letting adenovirus in to produce severe hepatitis (SARS causes lymphopenia)
  4. something else
    But not related to the vaccine.
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Study about factors correlating to risk of needing ventilation or dying for COVID-19 patients:

https://www.nature.com/articles/s41598-022-10344-3

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Study checks neutralization capabilities of antibodies from:

  • 24 people infected with BA.1 but not vaccinated.
  • 15 people infected with BA.1 after vaccination with Pfizer or J&J vaccine.

against BA.4 and BA.5. Results:

  • Not vaccinated: 7.6-fold drop against BA.4, 7.5-fold drop against BA.5.
  • Vaccinated: 3.2-fold drop against BA.4, 2.6-fold drop against BA.5.
  • Vaccinated people had BA.4 and BA.5 neutralization levels 5-fold higher than unvaccinated people.
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I am in a Johns Hopkins study for immunocompromised/chronic illness. Six months after my second shot and just before my first booster on 11/6, my semi-quantitative antibody test was 1078U/ml.

I have been tested pre-booster, at two weeks after booster, 4 weeks, 3 months and 6 months. Results were all >2500.

They are now reporting up to >25,000. My test at 6 months after my first booster, on 5/3, was 6074 U/mL.

There is a note at the bottom that values greater than or equal to 0.80 U/mL are considered positive.

Noone really knows what these test results mean. It is interesting that the first booster clearly ā€œboostedā€ my antibodies because 6074 is much higher than 1078. But does this mean I should wait for my second booster?

I will continue to post my results here as I continue with tests before second booster and then at the same intervals as before. I have read that antibodies can go as high s 25,000 in the short term, after a vaccine. Mine was Pfizer so far.

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Hereā€™s a link to an update my medical boy received today:

Cases appear to be increasing, though hospitalization and death are not increasing as much:

On the long COVID (or perhaps medium-term COVID) front, a UK study mentions 8-9% of vaccinated people self reporting symptoms four to eight weeks after infection with Omicron, with similar rates for two or three doses of vaccine. However, for Delta infections, about 16% with two doses reported symptoms four to eight weeks after infection, compared to 8% with three doses.

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Page describes how vaccine companies and regulators are trying to chase variants:

Recent data in California indicates that boosted people now have a higher rate of cases and hospitalizations than vaccinated but not boosted people (but both much lower than unvaccinated people).

Per 100,000:

Type Unvaccinated Vaccinated, not Boosted Boosted
Cases as of May 1 66.6 6.5 13.6
Hospitalizations as of May 1 11.4 1.1 1.5
Deaths as of April 23 1.3 0.1 0.1

While apparently strange, it is likely that it has to do with older people (and probably other people more vulnerable to COVID-19) being significantly more likely to get boosted, versus getting vaccinated but not boosted.

As of May 20, 2022:

Age % Unvaccinated % Vaccinated, not Boosted % Boosted
5-11 65.0% 35.0% 0.0%
12-17 33.3% 32.4% 35.3%
18-49 22.2% 25.7% 52.1%
50-65 16.2% 18.4% 65.4%
65+ 15.7% 9.5% 74.8%
All 24.8% 16.6% 58.6%
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Why would they be ā€œmore vulnerableā€? Older people are more likely to be cautious and less likely to be exposed. Another possible explanation is that many people who decided not to get boosted were those who caught Covid in the fall or New Year and concluded that a booster was therefore unnecessary. If theyā€™ve already had Delta or especially Omicron in combination with the vaccine that is probably producing more immunity than the booster. Certainly most people we know with Covid at the moment have not had it before.

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This data chimes with my sonā€™s CA local high school. I donā€™t have official data just the school nurseā€™s report. Vaccinated students (2x Pfizer) are the least likely to get infected. Next is vaccinated and boosted, and highest probability of all is non vaccinated. And the virus is having a field day at the high school. They stopped doing contact tracing and just send out emails saying consider your student exposed and here is the case count for today. My daughter also said that at her CA college campus there are many many more students getting Covid now (and theyā€™re all vaccinated snd boosted) that during the winter surge. I havenā€™t looked at their campus numbers yet. Curious.

ETA: Maybe as @Twoin18 mentioned there were less college students getting Omicron in winter because there were home for winter break and there were many mitigation strategies when they returned. A majority of my daughterā€™s friends are Covid positive now and in Covid ā€œprisonā€ but not really sick. Cold-like symptoms. Iā€™m just waiting for the text telling me she has itā€¦

I read an article yesterday that explained these numbers are ā€œstrangeā€ because unvaccinated folks have probably had COVID, especially Omicron, and so have some natural immunity versus vaccines that may have waned or not stimulated an adequate immune response (for some). As @Twoin18 18 also suggested.

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Another (more likley, IMO) explanation is that many of the fully vaccinated and boosted became less concerned about being infected. They became more socially active and took fewer precautions (e.g. wearing masks) when in close proximity indoors with other people.

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Yes and some of those have waning shots/boosters. My small town is back up to 90 cases and that does not include home tests of course. Previous high during a surge was 144.

I think those who are vaccinated and boosted are also the most likely to go and get PCR tested and be counted officially rather than just doing a home test (or none at all). And I wouldnā€™t count too much on natural immunity - I know a child too young to be vaccinated who was just diagnosed for the second time in two months (and yes they tested negative and were fine in between - itā€™s a new infection, they know where the child was exposed both times).

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ā€œI read an article yesterday that explained these numbers are ā€œstrangeā€ because unvaccinated folks have probably had COVID, especially Omicron, and so have some natural immunity versus vaccines that may have waned or not stimulated an adequate immune response (for some)ā€

But the numbers Ucb called strange said that the unvaccinated were much more likely to get Covid and be hospitalized than either vaccinated unboosted (least likely) and vaccinated/boosted.

Is that necessarily true? Seems that ā€œquarantine fatigueā€ affects older people as well as younger people. Older people who live with or have regular contact with younger relatives also get exposed through those relatives (e.g. grandkids bringing unwanted viral guests from school). Those living in assisted living have frequent contact with staff.

For the same vaccination (and previous infection) status and exposure, it is also likely that older people will get a more noticeable case than younger people.

Or they did not get boosted when eligible in November / December, and then got ā€œboostedā€ by the actual virus during the first Omicron wave.

Definitely agree that many people are not reporting nowadays, but is that underreporting so different between boosted and unboosted people? Maybe the boosted people are more likely to seek out additional treatment (eg Paxlovid) even if they arenā€™t particularly sick, and get counted that way?

But anecdotally Iā€™ll note that after being exposed at Dā€™s graduation earlier this month, S23 and I (whoā€™d not previously been infected) caught Covid, whereas spouse and S18 (who had both caught Delta last summer/fall) were fine. All of us were boosted (double boosted for spouse and me).

Iā€™m not sure the experience of an unvaccinated toddler is necessarily representative of the outcomes for vax+prior infection vs vax+booster, especially as unvaccinated people seem to be in the worst position with regard to new infections.

But the corollary of this explanation is that those who didnā€™t bother to get boosted likely came to the same conclusion last year and started socializing earlier. Hence they were the ones infected in the fall and winter waves.

Iā€™m not 100% certain, but there might be a difference between then and now. The effectiveness of the initial two-dose vaccination seemed to last longer than that of the booster shot, probably because of further mutation of the virus.