CORONAVIRUS INFO PROVIDED BY DR. JIM HARRIS – 6/24/2022

HELLO,

YOU CAN HAVE A GOOD TIME WHILE BEING VERY CAREFUL AND WEARING YOUR MASK.

FROM THE NYT today:

(J. Harris: Notice the recent Covid counts in East Texas are markedly elevated. Fortunately, most of these folks do not require hospitilization — which means most likly that we now have the Omicron subvariants BA .4-.5 making a visit. I personally know several local and Texas people who have become ill this week.)

FROM THE NEJM:

Neutralization Escape by SARS-CoV-2 Omicron Subvariants BA.2.12.1, BA.4, and BA.5

”…These data show that the BA.2.12.1, BA.4, and BA.5 subvariants substantially escape neutralizing antibodies induced by both vaccination and infection. Moreover, neutralizing antibody titers against the BA.4 or BA.5 subvariant and (to a lesser extent) against the BA.2.12.1 subvariant were lower than titers against the BA.1 and BA.2 subvariants, which suggests that the SARS-CoV-2 omicron variant has continued to evolve with increasing neutralization escape. These findings provide immunologic context for the current surges caused by the BA.2.12.1, BA.4, and BA.5 subvariants in populations with high frequencies of vaccination and BA.1 or BA.2 infection…”

FROM HOPKINS SELECTIONS”

1. Hospitalized Patients with Severe COVID-19 During the Omicron Wave in Israel – Benefits of a Fourth Vaccine Dose (Clinical Infectious Diseases) Among hospitalized patients with severe/critical breakthrough COVID-19, a recent fourth dose was associated with significant protection against mechanical ventilation or death, compared to three doses.

2. SARS-COV-2 REINFECTION The newest Omicron subvariants of BA.4 and BA.5 are driving increases in new SARS-CoV-2 infections in several regions, with many people experiencing reinfections despite immunity from prior infection or vaccination (1+ shots). These subvariants appear to be able to evade antibodies more easily than their predecessors, possibly due to new and different spike proteins. Though global COVID-19-associated mortality appears to be decreasing, a new preprint study posted on Research Square cautions that reinfections pose an increased risk of hospitalization (HR 2.98), all-cause mortality (HR 2.14), and sequelae in pulmonary and other organ systems. The risk of these adverse outcomes—including those impacting the heart, blood, kidneys, lungs, and brain—were most pronounced in the acute phase of infection but persisted throughout the 6-month follow up. Additionally, for every reinfection (1, 2, 3+) there was a stepwise increase in risk for all sequelae evaluated, including hospitalization. Although not yet peer-reviewed, the study serves as a signal that the COVID-19 pandemic remains a threat to the health of the world’s population, and individuals must continue to take precautions to prevent infection.

FROM BECKERS:

1. Pending approval, Moderna aims to deploy subvariant vaccine in August

Moderna expects to distribute its bivalent booster vaccine candidate by August and has already produced the doses as it awaits approval.

“We’ve been producing millions of doses over the last couple of months,” Moderna’s president, Stephen Hoge, MD, told the Financial Times. “We would hope to have tens of millions to hundreds of millions of doses available in August, September and October to support boosting prior to the fall respiratory virus season.”

The candidate boosted antibodies “5.4-fold above baseline” against omicron subvariants BA.4 and BA.5 among the phase 2/3 trial’s 800 participants, according to a June 22 press release. Moderna said it has “already shared these data” with regulators and, if authorized by the CDC and FDA, expects rollout to be this fall.

The subvariants accounted for almost 35 percent of COVID-19 cases as of June 18, according to CDC data. The week earlier, they caused 21.6 percent of cases.

FROM JAMA

Experimental Open-source Low-cost Ventilator Could Meet Critical Need

FROM SCIENCE:

What causes Long Covid? Here are the three leading theories

(J. Harris: This is a very readable article of importance.)

FROM REUTERS:

Mexico records most daily COVID-19 cases since February, signaling 5th wave

Mexico reported 16,133 new COVID-19 cases in the country on Thursday, the highest daily number reported since late February, according to data released by the Health Ministry.

FROM THE LANCET:

1. How to interpret the total number of SARS-CoV-2 infections

”…since the beginning, it has been clear that reported cases represent only a fraction of all SARS-CoV-2 infections….According to COVID-19 Cumulative Infection Collaborators findings, a staggering number of people, 3·39 billion (95% uncertainty interval 3·08–3·63) or 43·9% (39·9–46·9) of the global population, are estimated to have been infected one or more times between March, 2020, and November, 2021. Remarkably, this was before the highly transmissible omicron (B.1.1.529) variant swept the globe. These estimates of total infections are wildly different from the number of reported cases, which stood at 254 million as of Nov 14, 2021.3..COVID-19 Cumulative Infection Collaborators study also highlights vast regional discrepancies, painting a very different picture from that provided by reported cases. From case reports, one would conclude that the highest cumulative incidence was observed in Europe and North America and the lowest in Africa. However, this study estimated that 70·5% (61·6–75·9) of the population in sub-Saharan Africa has been infected with SARS-CoV-2, compared with 30·9% (28·8–32·8) of the population in high-income North America. Underlying this apparent reversal of patterns are stark differences in case detection; fewer than 1% of infections were reported as cases in sub-Saharan Africa whereas nearly half were reported in high-income North America. It is crucial that this underreporting is considered when we compare the impact of the pandemic and the effectiveness of responses among nations…..one could argue that the proportion of the population ever infected is no longer a meaningful metric of population immunity… how do layers of vaccine-induced and virus-induced immunity combine to confer protection to the population? Perhaps most importantly at this moment in the pandemic, we need to identify the sub-populations that remain susceptible to severe disease and death. Serosurveys combined with morbidity and mortality surveillance and detailed monitoring of vaccine coverage are essential to identify the groups lacking immunity from vaccination or previous infection.5, 6, 7 Integrating data enables the kinds of insights offered by COVID-19 Cumulative Infection Collaborators to inform the next phase of the pandemic response, and we should sustain this effort…”

(J. Harris: This Comment in Lancet is very readable and very sobering. It seem “the fat lady” hasn’t sung yet — if fact, she doesn’t even have the musical score yet. Hell.)

2. COVID-19 in North Korea

AND LASTLY:

1. MILTON TOMATO wishes to announce that yesterday he used his personal influence and got 0.2 inches of rain!

2. Tom Allin sends out good jokes as he travels the world: