COVID-19 treatment and vaccine update thread

[Smoove_B]

Oct 11th update:

This is now a significant fall lull relative to prior years. Transmission has decreased substantially since early September. Estimates:

310,000 new infections/day
1 in every 108 people currently infected
Numbers at half the 12-month average

[Kraken]

Hooray! We've finally conquered Covid. That line isn't going to go back up.

[LordMortis]

Is that J Weiland from the GoGos? Maybe this will be catalyst to get me out of the house and around people? Though 108 still seems crazy high to me and that is way lower than normal lows. Crazy. Past years suggest this the end of valley, right? Right before Halloween parties and then packing in warm closed spaces for the holidays. Let's hope the peak is a ways off and also statistically much lower.

[Max Peck]

We now have a timeline for the fall COVID vaccination program here in Ontario. Designated at-risk demographics are eligible now, and the general population will be eligible as of 28 October.

[Smoove_B]

Is that J Weiland from the GoGos?

Are you talking about the actress from Bill and Ted's Excellent Adventure?

Maybe this will be catalyst to get me out of the house and around people? Though 108 still seems crazy high to me and that is way lower than normal lows. Crazy. Past years suggest this the end of valley, right? Right before Halloween parties and then packing in warm closed spaces for the holidays. Let's hope the peak is a ways off and also statistically much lower.

Everyone is still reading the tea leaves. It could be that we've been soaking in COVID-19 for so long now that the disease dynamics/spread has changed. Maybe we really are going to Great Barrington Declaration our way out of this on the backs of sick, disabled and dead folks. I really don't know anymore but I'm also 100% confident this is now the world we live in and people should just get comfortable with being sick multiple times a year and possibly to the point where it affects your long term health.

But yes, seeing what happens post Halloween and Thanksgiving will certainly be something to watch.

[Smoove_B]

I'm sure the auto insurance industry will respond accordingly:

Findings indicate an association between acute COVID-19 rates and increased car crashes with an OR of 1.5 (1.23-1.26 95%CI). The analysis did not find a protective effect of vaccination against increased crash risks, contrary to previous assumptions. The OR of car crashes associated with COVID-19 was comparable to driving under the influence of alcohol at legal limits or driving with a seizure disorder.

...

The study suggests that acute COVID-19, regardless of Long COVID status, is linked to an increased risk of car crashes presumably due to neurologic changes caused by SARS-CoV-2. These findings underscore the need for further research into the neuropsychological impacts of COVID-19. Further studies are recommended to explore the causality and mechanisms behind these findings and to evaluate the implications for public safety in other critical operational tasks. Finally, neurologists dealing with post-COVID patients, should remember that they may have an obligation to report medically impaired drivers.

This fits with my anecdotal experience on local roads and highways that people seem to really have lost the ability to drive over the last ~5 years.

[FishPants]

Got my Moderna 2024 edition and flu shot on Saturday with my wife, while the pharmacist seemed to use his needle like a dart (even with a 1..2...3 STICK! approach as he psyched himself up for it) it wasn't all that bad. Got it at 10am, and by 9pm I couldn't stay awake for anything - otherwise no other affects. I wasn't too concerned about it until an acquaintance (sort of) 52 year old guy, athletic and fairly clean living ended up in ICU (and continues to be) due to random blood clots that have caused all kinds of shit to his organs while he's been in a coma for 3 weeks. They figure probably covid related but can't tell for sure, but not a lot of other reasons for blood to start clotting out of nowhere.

[Smoove_B]

Nasal vaccines are coming:

Vaccines delivered through the nose are now being tested for several diseases. In the U.S., early clinical trials are showing success. Two of these vaccines have generated multiple immune system responses against the COVID-causing virus in people who received them through a puff up the nose; earlier this year their makers received nearly $20 million from Project NextGen, the Biden-Harris administration’s COVID medical initiative. Researchers are optimistic that a nasal spray delivering a COVID vaccine could be ready for the U.S. as soon as 2027. Although recent efforts have focused on inoculations against SARS-CoV-2, nasal vaccines could also protect us against the flu, respiratory syncytial virus (RSV), and more.

Thankfully we won't have to worry about COVID-19 in 2027 so taking as much time as possible makes sense.

[Lassr]

Got my Covid booster Friday. My arm hurt for 2 days and that was it. I'm now fully vaccinated for the winter as I got my Flu shot the week before.

[Smoove_B]

Not even news anymore, but ACIP met today:

CDC now recommending 6-month vaccine cadence for:

•everyone 65 years and older.

•moderately to severely immunocompromised of any age (who can also get more doses in consultation with their clinicians).

Policy is for 2024-2025 only.

[LordMortis]

I will be seeking six month boosters if they are covered then. Putting it in my calendar.

[Unagi]

I wasn't too concerned about it until an acquaintance (sort of) 52 year old guy, athletic and fairly clean living ended up in ICU (and continues to be) due to random blood clots that have caused all kinds of shit to his organs while he's been in a coma for 3 weeks. They figure probably covid related but can't tell for sure, but not a lot of other reasons for blood to start clotting out of nowhere.

I'm sorry, but - what ?

[Max Peck]

I wasn't too concerned about it until an acquaintance (sort of) 52 year old guy, athletic and fairly clean living ended up in ICU (and continues to be) due to random blood clots that have caused all kinds of shit to his organs while he's been in a coma for 3 weeks. They figure probably covid related but can't tell for sure, but not a lot of other reasons for blood to start clotting out of nowhere.

I'm sorry, but - what ?

Is this the first you've heard about COVID-19 causing blood clots? It's been a known issue since fairly early on in the pandemic.

[Smoove_B]

A study that was just published on long-term effects of COVID-19 infection:

We used a cohort of US Marines from a previous longitudinal, prospective observational study of acute SARS-CoV-2, most of whom were enrolled prior to infection. A panel study was established to assess for post-acute sequelae of COVID-19 (PASC), defined as symptoms at least 4 weeks after symptom onset or diagnosis. Symptoms were assessed through questionnaires and validated quality of health metrics. Periodic US Marine Corps fitness testing metrics provided an additional standardized functional assessment and were compared to a pre-pandemic cohort.

...

Globally dispersed Marine participants (n = 899) seen an average of 330 days following initial enrollment were predominately male (n = 825, 91.7%), White (n = 613, 71.6%) or Black (n = 149, 17.4%) with a median age of 18 years (interquartile range: 18–19). Among 798 SARS-CoV-2 infected participants, 197 (24.7%) developed PASC. The most prevalent symptoms were loss of taste and/or smell (n = 82; 41.6%), shortness of breath (n = 74; 37.6%), and cough (n = 45; 22.8%). Those with PASC had higher rates and severity of somatic (p < 0.0001), general depressive (p < 0.0001), and anxiety (p = 0.005) symptoms. Compared to a historic cohort of Marines, participants with PASC scored worse on their physical fitness assessments due to slower run times (p = 0.002). Those with PASC continued to have decreased physical performance one year after completing initial training.

Explain:

In this population of healthy young adult US Marines with mostly either asymptomatic or mild acute COVID-19, one fourth reported physical, cognitive, or psychiatric long-term sequelae of infection. The Marines affected with PASC showed evidence of long-term decrease in functional performance suggesting that SARS-CoV-2 infection may negatively affect health for a significant proportion of young adults.

No really, I don't understand. What does it mean?

Compared to historic data for U.S. Marines, about 25% of those infected in this group (N=798) reported or were evaluated to have chronic physical and mental health issues after experiencing mild or asymptomatic infections of COVID-19.

Maybe it will take the military documenting how COVID-19 is impacting the health of potential soldiers for us to do something. Hell, that's what changed after WW1 here in America - when the military documented just how hard it was to bring soldiers up to a "combat ready" standard based on horrific baseline health status in America at the time.

[Unagi]

I wasn't too concerned about it until an acquaintance (sort of) 52 year old guy, athletic and fairly clean living ended up in ICU (and continues to be) due to random blood clots that have caused all kinds of shit to his organs while he's been in a coma for 3 weeks. They figure probably covid related but can't tell for sure, but not a lot of other reasons for blood to start clotting out of nowhere.

I'm sorry, but - what ?

Is this the first you've heard about COVID-19 causing blood clots? It's been a known issue since fairly early on in the pandemic.

Guess I wasn't (at the time) sure what was and what wasn't over-hyped. And then in this case, I wasn't sure if there would or wouldn't be any other reasons for blood clots to show up - as I can't imagine this is the first time in medical history where something may cause them ?

[Smoove_B]

Guess I wasn't (at the time) sure what was and what wasn't over-hyped. And then in this case, I wasn't sure if there would or wouldn't be any other reasons for blood clots to show up - as I can't imagine this is the first time in medical history where something may cause them ?

Yeah, I can appreciate that. Similar to how they recently confirmed a link between blood type and COVID-19 risks (similar to the same risks for heart disease), there seems to be a connection with clotting and COVID-19 for some people that we still don't quite understand - thought it's likely an unidentified genetic risk factor.

It's weird because people still seem to think of it like a respiratory disease ("It's like the flu...") but overwhelmingly the evidence seems to be that it's a cardiovascular disease that is spread through the respiratory route.

[Unagi]

Thanks (yet again) for the information.

[FishPants]

I wasn't too concerned about it until an acquaintance (sort of) 52 year old guy, athletic and fairly clean living ended up in ICU (and continues to be) due to random blood clots that have caused all kinds of shit to his organs while he's been in a coma for 3 weeks. They figure probably covid related but can't tell for sure, but not a lot of other reasons for blood to start clotting out of nowhere.

I'm sorry, but - what ?

Is this the first you've heard about COVID-19 causing blood clots? It's been a known issue since fairly early on in the pandemic.

Guess I wasn't (at the time) sure what was and what wasn't over-hyped. And then in this case, I wasn't sure if there would or wouldn't be any other reasons for blood clots to show up - as I can't imagine this is the first time in medical history where something may cause them ?

Yeah I guess this guy never gets sick either, for the first time in his entire marriage his wife said he had a cold - and then went into the ER as he was having a hard time breathing (he was vaccinated during the pandemic early years, but hadn't kept up with it after that). It's a sad situation, his organs gradually failed and he died without ever waking up and being able to say goodbye to his kids (who are rightfully so gutted and destroyed). Just weeks previously he was fully healthy, completed a bike race/triathlon a month previous, and now he is gone. The amount of surgeries and specialists working on him was off the charts (They weren't placating the family when they said he was the sickest person in Canada, and had specialists across North America involved in trying to figure out what the actual fuck - he was having clots while also experiencing random bleeds in his somtach, intestines and lungs).

Nobody quite sure what the hell just happened, but they did indicate it was aligned with the the peak of covid this season. Glad I got the jab again, although I think I may be one of the only people in my social and work circles that still does - most seem apathetic at best, or "it was a scam" camp now.

[LordMortis]

Rough. That sounds a lot like my cousin, though I don't know that he had complications from blood clots. Just that he went in to a coma, came out of it, and they induced him back in to one because he was so bad off and then he died. Caught it at super spreader event fairly early in the pandemic. His wedding.

[Max Peck]

I got my COVID and flu shots this morning. I've been assigned to Team Pfizer this year, for the first time since 2021.

[Max Peck]

My immune system reaction to this year's vaccine was the mildest to date. My arm was slightly sore for a day or so, but I had no fever at all (for the first time ever) and no other side effects. GG Pfizer.

In other news, there is nothing that bureaucrats hate more than people who think outside the box to solve problems and get the job done. Unless they have some evidence that she pocketed the money and profited inappropriately, they can FRO as far as I'm concerned.

She helped thousands get COVID-19 shots. Now she's on the hook for $600K

A Kingston, Ont., doctor celebrated for organizing drive-thru vaccination clinics that helped thousands get shots at the height of the COVID-19 pandemic is now being ordered to pay back more than $600,000 in fees for those same services.

Dr. Elaine Ma said she organized 45 mass vaccination clinics that administered roughly 35,000 doses between April 2021 and the following February.

Her work was recognized by the Ontario College of Family Physicians, which granted her its Award of Excellence in 2021, in part pointing to Ma's role in boosting local vaccination rates.

About a year later, the doctor said she received notice from the Ontario Health Insurance Plan (OHIP) seeking to recoup the money she had billed for the shots — approximately $600,000, plus around $35,000 in interest.

"I was shocked that OHIP chose to do this and chose to not look at the big picture here, which is, we saved lives," said Ma, adding that although only a few years have passed, people already seem to be forgetting what life was like amid the first waves of COVID-19.

It also stands in stark contrast to the praise from Ma's medical colleagues.

Dr. Dominik Nowak, president of the Ontario Medical Association, called Ma's efforts during the pandemic "heroic."

"This is an example of a doctor that should be celebrated, rather than having barriers and clawbacks and a bureaucracy that's unnecessarily rigid," he said.

Nowak described OHIP's apparent "hunt" for a reason to recover money from a physician who tried to lend a hand during the pandemic as a "breach of trust."

Dr. Piotr Oglaza, medical officer of health for Kingston, Frontenac and Lennox & Addington Public Health, said Ma's clinics had the full support of his organization. He even participated as a volunteer.

He wrote a letter to the board on her behalf urging it to consider the context in which her clinics were held, and crediting the drive-thru model with relieving pressure on the public health system by providing roughly seven per cent of all doses administered in the region.

Oglaza said neither he nor Ma were aware of the OHIP bulletin she's now accused on contravening. Had he been, he said he would have raised it with the province and has no doubt it would have been waived, given the desperate push for vaccinations at the time.

He also warned Ma's ordeal could discourage physicians from taking on the logistics and liability of a mass vaccination project the next time Ontario faces an emergency, because they risk getting caught up in technicalities from OHIP.

"I think that that will be really, truly catastrophic," said Oglaza.

[Isgrimnur]

Flu, Pfizer, and Tdap acquired.

[Smoove_B]

Interesting to see

A REALLY good sign for winter, with infections dropping again this week. 3x of 12 month avg, and 3x of early Nov avg (2020-2023). Looking less likely to reach 1M infections/day in Dec.

185,000 new infections/day
1 in every 180 people currently infected

[Max Peck]

I'm not sure that the current trend tells us much, going forward, other than being another indicator that COVID-19 isn't particularly seasonal. It doesn't even seem all that unique when I look at the historical local wastewater data.

In 2021 there was no fall wave until December. In November 2022 the levels were dropping much as they are this year, but then a new wave started in December. In 2023 the levels started climbing in mid-summer and kept going up until they peaked in January 2024. So what we're currently seeing is actually kind of normal (with 2023 being an outlier), to the extent that anything this chaotic can be said to be normal. ¯\_(ツ)_/¯

[Smoove_B]

If you were waiting for the holiday forecast, I have good news!

Holiday Season Forecast:

The wildest forecast I've ever made was for Dec 2021, predicting multiple millions of daily infections. This one is easily second place. A very muted holiday wave relative to all prior years, due to weak evolution and large summer numbers.

The one thing I'd like to take the time to point out (that I don't think he's mentioned) are the "trough" points on graph - where cases reach their lowest. On this graph the peaks are red and the troughs are a cornflower or purple.



What I want to highlight is that if you draw a line from the start (May of 2020) to the last trough (10/10/2024), you might note that it's increasing. When folks keep saying "COVID is endemic", it's that bottom line then that they're talking about. But wait, you say, isn't that line slowly increasing - it's not flat.

Yes, yes it is. And that's the point public health folks have been trying to make. "Endemic" isn't good (or bad). It just measures the background level of cases that exist as all times. What's happening (over time) is we're seeing more and more cases - the "floor" (i.e. the amount of cases we're always soaking each other in) is slowly rising.

I'm sure it'll be fine.

[Max Peck]

The reporting here, as of the week ending 9 November, shows wastewater levels as "moderate" and stable (i.e. similar to the previous week). However positivity was very high (18.3%) and stable, while hospitalizations were very high and increasing (69 for that week, out of a cumulative 365 for the year to date).