SARS-CoV-2 Coronavirus (COVID-19)

Long COVID is now well recognised and case definitions have been published since last October (which includes symptoms lasting more than 12 weeks after COVID). Review articles suggest it may actually represent four different syndromes.

The prevalence currently quoted range from 10 - 45% of those admitted to hospital. In other words, a large minority.

It is one of the strongest arguments against using herd immunity as a strategy to combat the pandemic.

COVID-19 is a new disease and there are too many unknowns about it. The Professor of Virology at our Institution recently reminded us how long it took for people to realise that mumps infections resulted in male sterility - and there are still those who question the MMR vaccine!

Here is an article from the BHF charity on long COVID if anyone you know has it:

Long Covid: what are the symptoms and how long does it take to recover? | BHF

 

The current general (worldwide) advice after vaccination is to continue to follow Public Health guidance. This is not about living in fear but about reducing transmissions to protect others.

As an aside, on activities to reduce transmissions, a paper modelling airflow with various configurations of open windows in a Prius

Below is a heat map from that paper showing an infected driver and various configurations of window opening (closed windows shown as solid lines).

The best option is to have all windows open. But if not possible for any reason, having two open which are across from the driver and across from the passenger will create an airflow curtain that protects the passenger.




Original paper is here:
Airflows inside passenger cars and implications for airborne disease transmission | Science Advances

This is an easier read:
How Many Car Windows Should Be Open to Minimize COVID-19 Risk?

 

Just to be clear, here you mean herd immunity without vaccination? I would think herd immunity is almost always accomplished with concerted vaccination effort.

 

People Lie.
Numbers are the enablers.
That means we DON'T know....

Undercounts were reported in a certain NE state that fumbled the snap with hospitalizations and elder-care facilities...but I'm getting reports from inside the wire at two hospitals in two states (WI and TN) that some non-covid deaths are currently being added to the body count because of financial incentives from dot.gov.
Unfortunately....death attributions are viewed somewhat like hydroxychloroquine use.
There's no normal toned discussions, only shouts and whispers.
The Spanish flu initially (and....some sources say later on too) resulted in a lot of deaths that were erroneously diagnosed as things like "trench cough"....scarlet/yellow fever, etc. If you think that people are somewhat under-served by the medical community in the American South, turn the Way-Back(TM) machine back a hundred years.

I remember reading where exhumations were a thing for scientists studying the 1918 outbreak.
One imagines a future 100 years from now where scientists are befuddled by samplings from both kinds of non-COVID victims.

One of the books I referenced LAST January, Laura Spinney's book Pale Rider is pretty informative.
I had read it a few months earlier because I'm something of a history geek.
I've since read Berry's miss-titled book The Great Influenza. The story of the deadliest pandemic in history.
The title isn't incorrect because Barry chose not to call it the Spanish Flu, but rather because it was FAAAAAAR from the deadliest pandemic in history......but history is like....."science and data."

Fun Fact:
In the summer of 2005, President Bush read Barry's book while on vacation. He called on the federal government to prepare for future pandemics in a November 2005 speech....that was widely ignored.

Squirrel Alert:
I'm going to have to give more of John M. Barry's books a tumble before they fire up the salamanders.....and I may owe him something of an apology.
We'll see.
I'd always considered him a leftist, but I'm becoming increasingly aware that there are a few very brave classic liberals out there who have not forgotten that the way to combat hate is with MORE speech.....not less.

 

Yes I do. I was referring to the deliberate strategy, that some had, to allow the virus to freely run through the population.

I was not referring to herd immunity resulting from widespread vaccination.

You may have come across the expected consequence, should we be successful in achieving worldwide herd immunity through a combination of vaccinations and infections.
As it will be unlikely to eradicate SARS-CoV2 completely, the current speculation is that it will remain as a seasonal illness (like other coronaviruses) and become a pediatric condition (a disease of infants and children) as they will be the only ones who be naive (not previously exposed). The current vaccines are not licensed for use in children and Public Health officials may eventually decide they don’t need to be.

 

One example of herd immunity that was not mostly achieved through vaccination is chicken pox.

It is not included in routine childhood immunisation in the U.K., but given to ‘the vulnerable’.

Chickenpox vaccine overview - NHS

 

Seems to me that there might be a lesson there.....but in the meanwhile I see nothing wrong with vaccinations over a broad age-range while we wait and given an adequate supply.
I'm sorta curious about how NHS ladled out THEIR COVID vaccines.....
I've read about the "one jab" policy but I haven't seen or heard about their wasting doses because they refused to inoculate stand-by patients who fell outside of the selected group's age/occupational/socioeconomic group.

 

couldn't you say the same for the vaccines?

 

Updated guidelines, and perfect timing.

WHO Information Notice for IVD Users 2020/05

 

Thanks:

WHO requests users to follow the instructions for use (IFU) when interpreting results for specimens tested using PCR methodology. ​

Wow! RTFM (Read The Fine Manual).

I stopped at that point. Did you see something else?

Bob Wilson

 

Yes, I believe that might be why some pundits are predicting that COVID-19 might eventually end up being mostly a disorder of childhood. Small outbreaks occurring here and there of mostly mild disease and the occasional ones of serious illness. Chicken pox for example is a leading cause of stroke in children. Stroke in childhood is extremely rare, but as chicken pox is so common even rare complications like this will be seen by many paediatricians sometime in their careers.

I don't think there is either (in the long run). They are just methods of putting the queues (or lines) in the 'right' order. Always a balance of science, politics and practical logistics on the ground. The example of Indonesia (where they are vaccinating the working population first) is an illustrative one.

Perhaps we would like to think that the distributions should at least not be primarily based on 'ability to pay', but as most of these early shipments have been purchased by the richer countries there is another story here....!

The word on the ground is slightly different from what gets in the press. There have been press reports of 'wastage' but from the sentiments we hear from vaccinators it must be minimal. Doses were being given out at the end of the day to prevent wastage, but without an evidence trail and no one really looking I suspect we will never know the figures.

My second shot booking was cancelled under the revised NHS guidelines to priorise population coverage with first doses. Majority buy in for this strategy was campaigned using the evidence from the regulatory bodies.

This example from the Pfizer submission to the FDA, for example, showed divergence of the vaccinated group (in blue) from the unvaccinated group (in red) starting from around 10-14 days. In this illustration, the second shots were given at around 21 days. The darker markers are those with severe illness (leading to hospitalisation). Note that there was one person in the vaccinated group who had severe illness around 50-60 days out:

 

I appreciate there might be similarities in any situation with 'unknowns'; but the vaccines were deliberately engineered to avoid harm, they were tested in the field by independent teams and the licensing was assessed by yet other independent bodies.

I guess at this time the judgement will be based on a risk assessment of the relative 'unknowns'; between getting one's immunity from infection vs getting immunity from a vaccine.

 

I'm seeing reports that some 65 year old youngsters who are not medical or first responders are getting shots. At age 71, I'm interested but not going to push aside those in medical service. But I would have no problem waiting in a queue for those who are there for any unused vaccines from a daily event.

Bob Wilson

 

For once, we're ahead of the curve in OK. We've completed our phase 1 and are heavily into phase 2. See here. The makeup of our phases are a bit different than other states. My wife gets her second shot next week and I'm signed up along with 1 million + others waiting on our group to be called.

 

You ought to see it on THIS side of the pond.....

I seem to recall that the CDC said something about that.
My own family members over 65 have by now all been jabbed - even one much beloved Aunt who is something of an anti-vaccer.

As a military retiree and something of a history geek, my thinking is that the science on vaccines (derived in the late 1700s from Variolae vaccinae -or smallpox of the cow) is fairly settled.

One of the delicious ironies about vaccines is that one of the biggest black marks that they got was in an article published (over 20 years ago?) in a journal named for a surgical instrument used for "blood letting" - but that's peer review for you.

 

My young (73) Wife is on the call if available list at two local vaccination sites. You call the site an ask to be on the queue if you can get to the site quickly at the end of their day.

JeffD

 

A new variant of SARS-CoV-2 501Y.V2 escapes neutralization by antibody making reinfection likely. It also means the variant may render the current vaccine less effective.



Here is the original not yet peer-reviewed report: SARS-CoV-2 501Y.V2 escapes neutralization by South African COVID-19 donor plasma | bioRxiv

 

Such is now rolling out very rapidly in my area. At least three of my outdoor social circle have received it this week, and numerous others have schedule slots between now and February 2. But my spouse and a couple others didn't try as quickly, and weren't given appointments yet, but told to expect an update next week. From area news reports, it seems that the on-hand supply is approximately fully scheduled, so more appointments won't be set until more supply becomes available or sufficiently assured.

Then the several under-65 'youngsters', including me, are labeled as ineligible at this time, they'll email us with updates sometime in the coming months.

 

This study says nothing about the antibodies generated by the existing vaccines. I will treat this as FUD until there are relevant studies. It is likely that we will need to take annual vaccine as we do with the Flu, but that is another discussion.

JeffD

 

AFAIK, South African SARS-CoV-2 501Y.V2, or Brazilian P.1 variant strains have not been identified in the US. Not yet anyway. The basis of the vaccine is to induce the body's immune system to make antibodies that are similar to the neutralizing antibodies produced when a person is infected by the actual virus. I don't think it is a FUD, but is a likely evolution of the viral genome. However, not enough is known how this and any other variants so far identified are going to affect the vaccination effort.

Here are more readings about the variant virus from very trustworthy scientific journals Nature and Science
Fast-spreading COVID variant can elude immune responses| Nature |
New coronavirus variants could cause more reinfections, require updated vaccines | Science | AAAS