Coronavirus COVID-19 - Global Health Pandemic #110

[weepingangel]

Holyoke Soldiers’ Home outbreak was ‘worst’ moment of COVID pandemic for Charlie Baker​

Charlie Baker reveals his worst moment of the COVID-19 pandemic

Gov. Charlie Baker, in an interview this week, reflected on his administration's handling of the COVID-19 pandemic.

www.masslive.com

 

[otto]

I'm hoping someone can help me understand what I'm reading about the XBB variant. One study says that the bivalent vaccine provides better protection against XBB. The other study says that people who have had the bivalent vaccine might have higher risk of vaccine breakthrough from XBB.

Does this mean that the bivalent vaccine provides protection against XBB, or does this mean that the bivalent vaccine increases risk of breakthrough infection? Both? Thoughts? Am I missing something obvious?


"The study didn’t look specifically at antibody activity against the XBB.1.5 but these results did suggest that the bivalent will give you better protection against the XBB.1.5 than the original versions of the vaccines."
Forbes

"The results of the current study demonstrate that both XBB strains can evade protective immune antibodies much more efficiently than the ancestral or BA.5.2 strains, irrespective of whether the antibodies were elicited by prior infection or vaccination with either the Pfizer or CoronaVac vaccines.

The BA.5.2 lineage does not appear to induce neutralizing antibodies against XBB subvariants. Thus, the risk of reinfection or breakthrough infection is much higher in patients with a history of infection with BA.5.2 or who have received a bivalent vaccine that consists of both the ancestral and Omicron early spike proteins as compared with those infected with the ancestral variant."
News-Medical

"Since patients infected with BA.5.2 might not elicit neutralising antibody against XBB sublineage, patients who have been infected with BA.5 or those with bivalent vaccine might have a higher risk of reinfection or vaccine breakthrough infection from XBB sublineage than previous sublineages."
Lancet

 

[Kingsley]

I'm hoping someone can help me understand what I'm reading about the XBB variant. One study says that the bivalent vaccine provides better protection against XBB. The other study says that people who have had the bivalent vaccine might have higher risk of vaccine breakthrough from XBB.

Does this mean that the bivalent vaccine provides protection against XBB, or does this mean that the bivalent vaccine increases risk of breakthrough infection? Both? Thoughts? Am I missing something obvious?


"The study didn’t look specifically at antibody activity against the XBB.1.5 but these results did suggest that the bivalent will give you better protection against the XBB.1.5 than the original versions of the vaccines."
Forbes

"The results of the current study demonstrate that both XBB strains can evade protective immune antibodies much more efficiently than the ancestral or BA.5.2 strains, irrespective of whether the antibodies were elicited by prior infection or vaccination with either the Pfizer or CoronaVac vaccines.

The BA.5.2 lineage does not appear to induce neutralizing antibodies against XBB subvariants. Thus, the risk of reinfection or breakthrough infection is much higher in patients with a history of infection with BA.5.2 or who have received a bivalent vaccine that consists of both the ancestral and Omicron early spike proteins as compared with those infected with the ancestral variant."
News-Medical

"Since patients infected with BA.5.2 might not elicit neutralising antibody against XBB sublineage, patients who have been infected with BA.5 or those with bivalent vaccine might have a higher risk of reinfection or vaccine breakthrough infection from XBB sublineage than previous sublineages."
Lancet

My interpretation of the above is that if you are boosted or have had COVID that you have a higher chance of getting XBB than getting any of the other variants. Getting boosted makes you a bit less likely to get XBB than if you are not boosted. So both statements are correct. JMO - interpretation of ambiguous words.

 

[otto]

My interpretation of the above is that if you are boosted or have had COVID that you have a higher chance of getting XBB than getting any of the other variants. Getting boosted makes you a bit less likely to get XBB than if you are not boosted. So both statements are correct. JMO - interpretation of ambiguous words.

Ambiguous indeed! That's how I understand it as well, that the bivalent vaccine increases the likelihood of XBB vaccine breakthrough. Breaking that down, people who have not had the bivalent vaccine have a decreased likelihood of vaccine breakthrough. That would suggest that XBB infection is facilitated or made easier by the bivalent vaccine. That makes sense, to some degree, but it also means that the vaccines have provided a pathway for covid variants. That is not something that governments want people to know, so I'm wondering whether my reasoning is 2+2=17.

 

[Niner]

Ambiguous indeed! That's how I understand it as well, that the bivalent vaccine increases the likelihood of XBB vaccine breakthrough. Breaking that down, people who have not had the bivalent vaccine have a decreased likelihood of vaccine breakthrough. That would suggest that XBB infection is facilitated or made easier by the bivalent vaccine. That makes sense, to some degree, but it also means that the vaccines have provided a pathway for covid variants. That is not something that governments want people to know, so I'm wondering whether my reasoning is 2+2=17.

Now I am supposed to get my 5th shot next week for the bivalent vaccine - should I get this - OR not?? I am still confused on what was just posted on this... TIA!

 

[HongKongPhooey]

Now I am supposed to get my 5th shot next week for the bivalent vaccine - should I get this - OR not?? I am still confused on what was just posted on this... TIA!

I would follow the advice of your doctor Niner. I think it’s the best thing we can do personally.

 

[BetteDavisEyes]

Ambiguous indeed! That's how I understand it as well, that the bivalent vaccine increases the likelihood of XBB vaccine breakthrough. Breaking that down, people who have not had the bivalent vaccine have a decreased likelihood of vaccine breakthrough. That would suggest that XBB infection is facilitated or made easier by the bivalent vaccine. That makes sense, to some degree, but it also means that the vaccines have provided a pathway for covid variants. That is not something that governments want people to know, so I'm wondering whether my reasoning is 2+2=17.

This must have been what my brother had read and told us about it on New Year's when he came to watch the Lions' game. He hasn't gotten the bivalent booster yet and is hesitant to get it now after learning about the possibility of reinfection. DH and I got the bivalent booster in mid-November and have decided that we are not going to get any more vaccines until their efficacy and reliability is determined. JMO

 

[anneg]

@otto -- I don't think it's correct to say the following:

that the bivalent vaccine increases the likelihood of XBB vaccine breakthrough. Breaking that down, people who have not had the bivalent vaccine have a decreased likelihood of vaccine breakthrough. That would suggest that XBB infection is facilitated or made easier by the bivalent vaccine. That makes sense, to some degree, but it also means that the vaccines have provided a pathway for covid variants.

In fact, this sounds to me like anti-vaccine talking points. MOO of course.

Maybe this article by Eric Topol would be helpful in answering your questions.

A new variant alert

The XBB.1.5 variant is on a growth spurt in the United States

erictopol.substack.com

Excerpt (BBM):
This week in NEJM, the Emory group published the data on the bivalent BA.5 booster and how it helped against XBB: "Persons who received the BA.5-containing bivalent booster had better neutralizing activity against all Omicron subvariants (especially against BA.2.75.2, BQ.1.1 and XBB) than those who received 1 or 2 monovalent [original] boosters." This finding of some cross-immunity protection has been backed up by live virus lab studies by 3 other groups.

Although we don’t know precisely how well the bivalent booster does against XBB.1.5 yet, the new lab data, showing lack of added immune evasiveness, supports there would be cross-immunity protection (just as seen with XBB). So if you haven’t had a booster in the past 4+ months, this would be well advised. Other than the bivalent booster, it’s the usual stuff of high quality masks, ventilation, air filtration, testing, etc. My podcast this week with Professor Linsey Marr, my go-to expert on air—virus transmission and a great explainer is well worth a listen (transcript coming soon) for the value of masks and how to reduce spread.

 

[otto]

@otto -- I don't think it's correct to say the following:

In fact, this sounds to me like anti-vaccine talking points. MOO of course.

Maybe this article by Eric Topol would be helpful in answering your questions.

A new variant alert

The XBB.1.5 variant is on a growth spurt in the United States

erictopol.substack.com

Excerpt (BBM):
This week in NEJM, the Emory group published the data on the bivalent BA.5 booster and how it helped against XBB: "Persons who received the BA.5-containing bivalent booster had better neutralizing activity against all Omicron subvariants (especially against BA.2.75.2, BQ.1.1 and XBB) than those who received 1 or 2 monovalent [original] boosters." This finding of some cross-immunity protection has been backed up by live virus lab studies by 3 other groups.

Although we don’t know precisely how well the bivalent booster does against XBB.1.5 yet, the new lab data, showing lack of added immune evasiveness, supports there would be cross-immunity protection (just as seen with XBB). So if you haven’t had a booster in the past 4+ months, this would be well advised. Other than the bivalent booster, it’s the usual stuff of high quality masks, ventilation, air filtration, testing, etc. My podcast this week with Professor Linsey Marr, my go-to expert on air—virus transmission and a great explainer is well worth a listen (transcript coming soon) for the value of masks and how to reduce spread.

Not an anti-vaxer. I'm vaccinated, and have never had covid. However, I do have vaccine fatigue. When covid started, I did not expect that I would need a booster every 6 months to fend off the ever mutating virus. It seems that as soon as the vaccine is widely available, the virus has already mutated to evade both antibodies and vaccines. The XBB variant seems to be exactly that, a variant for which there is no current vaccine that makes any difference.

Research surrounding the XBB variant seems ambiguous. On the one hand, messaging is to continue with vaccine boosters every 6 months - standard response from health officials. On the other hand, vaccine boosters are known to have limited effectiveness with this new variant, with some research suggesting that the bivalent vaccine increases risk with this variant.

https://www.publichealthontario.ca/-/media/Documents/nCoV/voc/2022/11/risk-assessment-omicron-sub-lineage-xbb-xbb1.pdf?rev=b48093a8aefb4c59b4bd5f2480873afd&sc_lang=en

 

[BetteDavisEyes]

Not an anti-vaxer. I'm vaccinated, and have never had covid. However, I do have vaccine fatigue. When covid started, I did not expect that I would need a booster every 6 months to fend off the ever mutating virus. It seems that as soon as the vaccine is widely available, the virus has already mutated to evade both antibodies and vaccines. The XBB variant seems to be exactly that, a variant for which there is no current vaccine that makes any difference.

Research surrounding the XBB variant seems ambiguous. On the one hand, messaging is to continue with vaccine boosters every 6 months - standard response from health officials. On the other hand, vaccine boosters are known to have limited effectiveness with this new variant, with some research suggesting that the bivalent vaccine increases risk with this variant.

https://www.publichealthontario.ca/-/media/Documents/nCoV/voc/2022/11/risk-assessment-omicron-sub-lineage-xbb-xbb1.pdf?rev=b48093a8aefb4c59b4bd5f2480873afd&sc_lang=en

This. Exactly. The series of "boosters" that has been required to try to stay ahead of the virus and its varied mutations is getting ridiculous! DH and I are vigilant about our health and have had both original vaccinations and the first two boosters six months apart. If we weren't going on a cruise later this month, I'm not sure that we would have gotten the bivalent booster because we are somewhat skeptical about the repeated doses of vaccine. There comes a point where we have to ask ourselves whether the repeated injections are truly safe and effective. I'm not anti-vax, but the time has come to reevaluate the rationale behind boosters every few months. JMO

 

[WichitaFalls]

Not an anti-vaxer. I'm vaccinated, and have never had covid. However, I do have vaccine fatigue. When covid started, I did not expect that I would need a booster every 6 months to fend off the ever mutating virus. It seems that as soon as the vaccine is widely available, the virus has already mutated to evade both antibodies and vaccines. The XBB variant seems to be exactly that, a variant for which there is no current vaccine that makes any difference.

Research surrounding the XBB variant seems ambiguous. On the one hand, messaging is to continue with vaccine boosters every 6 months - standard response from health officials. On the other hand, vaccine boosters are known to have limited effectiveness with this new variant, with some research suggesting that the bivalent vaccine increases risk with this variant.

https://www.publichealthontario.ca/-/media/Documents/nCoV/voc/2022/11/risk-assessment-omicron-sub-lineage-xbb-xbb1.pdf?rev=b48093a8aefb4c59b4bd5f2480873afd&sc_lang=en

I along with everyone else suffer from the fatigue of COVID/vaccines and everything surrounding it. I honestly don't know if XBB is the monster of all monsters or it isn't. My brain is tired of trying to understand opposing scientific articles and my "fear of the unknown" cup is just about empty. MOO - my thinking is . . . do every vaccine recommended (putting all my eggs in the science basket), always wearing a good mask while shopping and avoiding crowds while hoping and praying for the best for everyone.

 

[Auntie Cipation]

I think there are aspects to covid that we (humanity) either haven't seen before, or haven't seen recently enough to be in people's memory.

I think what they are learning is that currently the vaccines only provide a few months' worth of immunity, which is why the frequent boosters.

We get a flu shot every year. To me there is nothing special about the one year timeframe making that an acceptable wait time but not any shorter. I'll happily get a booster as often as advised, even if it was every month or every week.

I do think that within the next year or two we will have a booster that covers a much wider range of variants. Hopefully it will also last for a longer time. Either way, from what I am reading about the consequences of Long Covid (essentially shredding your immune system from being able to fight off essentially ANY disease), I will happily take a covid booster every week if needed, and keep wearing a mask, to avoid getting it, and absolutely to avoid getting repeat infections.

 

[dmac55]

I along with everyone else suffer from the fatigue of COVID/vaccines and everything surrounding it. I honestly don't know if XBB is the monster of all monsters or it isn't. My brain is tired of trying to understand opposing scientific articles and my "fear of the unknown" cup is just about empty. MOO - my thinking is . . . do every vaccine recommended (putting all my eggs in the science basket), always wearing a good mask while shopping and avoiding crowds while hoping and praying for the best for everyone.

I’m the same
For myself, I do everything I can today, and hope for something better tomorrow

 

[otto]

The XBB variant is getting a lot of international attention, with several countries again implementing the requirement for a negative covid test for people arriving from China. The XBB variant is already in most countries (5 cases in BC announced this morning), and the concern seems to be that it is more contagious than other variants. As usual, the biggest concern is that too many people will become sick at the same time, and overwhelm health care facilities - exactly what we've seen in China in the last week. There's nothing to suggest that the variant is more deadly.

 

[anneg]

Thread on Twitter by Dr. Peter Hotez (I think I messed up copying and pasting, sorry):

https://twitter.com/x/status/1610643909377392640

Replying to
@PeterHotez
3/2 (sorry 3 not 2) after the bivalent but mostly mild. So questions will be: boost again with bivalent in February? Would a 2nd dose of BA.5 help? Or pivot to a trivalent of mRNAs: Original China lineage + BA.5 + XBB.1.5 if companies can turn this around quickly?
https://twitter.com/PeterHotez/status/1610644651186483217/analytics
Prof Peter Hotez MD PhD

@PeterHotez
·
3h

4/2 I think VRBPAC meets soon to discuss. In meantime we’re making a bivalent recombinant protein Covid booster for global health and that seems to be going well

 

[anneg]

Thread on Twitter by Dr. Peter Hotez (I think I messed up copying and pasting, sorry):

https://twitter.com/x/status/1610643909377392640

Replying to
@PeterHotez
3/2 (sorry 3 not 2) after the bivalent but mostly mild. So questions will be: boost again with bivalent in February? Would a 2nd dose of BA.5 help? Or pivot to a trivalent of mRNAs: Original China lineage + BA.5 + XBB.1.5 if companies can turn this around quickly?

https://twitter.com/x/status/1610644651186483217

Prof Peter Hotez MD PhD
@PeterHotez
·
3h

4/2 I think VRBPAC meets soon to discuss. In meantime we’re making a bivalent recombinant protein Covid booster for global health and that seems to be going well

The CDC Data Tracker shows the 18.6% reduction of risk cited by Dr. Hotez actually refers to DEATHS, not hospitalizations.

COVID Data Tracker

CDC’s home for COVID-19 data. Visualizations, graphs, and data in one easy-to-use website.

covid.cdc.gov

Summary

• All vaccinated groups had overall lower risk of dying from COVID-19 and testing positive for COVID-19 compared with people who were unvaccinated.
• People who were vaccinated with an updated (bivalent) booster dose had lower rates of dying from COVID-19 and slightly lower rates of testing positive for COVID-19 compared with people who were vaccinated but had not received an updated booster dose.
• Age-standardized rates of cases and deaths by vaccination status and receipt of the updated (bivalent) booster dose do not account for other factors like the higher prevalence of previous infection among the unvaccinated and un-boosted groups; waning protection related to time since vaccination; and testing practices (such as use of at-home tests), underlying conditions, and prevention behaviors which likely differ by age and vaccination status. Additionally, any data recording errors that misclassify monovalent and updated (bivalent) boosters at the time of vaccine administration would make rates between the two groups appear more similar.

 

[Arkay]

I'm a Covid virgin who has had all five shots so far. I still wear a mask anytime I'm indoors in a public place, and I would take a shot every week if necessary..

It's my opinion that not taking every shot offered is equivalent to refusing a miracle.

Imagine if during the Black Death there was such a thing as antibiotics and knowledge of germ theory, but people refused to take them.

IMO we are blessed to live now.

 

[Auntie Cipation]

Personally, as a relatively healthy person with (I believe) a hardy immune system, I am not at all worried about experiencing covid in its acute phase. I'm definitely not worried about dying from an acute covid infection.

If anything, as a person who lives alone, I think about things like spending a week feeling ill and without the energy needed to keep my house warm in the winter (wood heat), keep my pets and myself fed, etc.

And even though I'm still cautious, I've even stopped being particularly worried about unknowingly spreading it to others, as I see almost no one around me taking precautions anymore, and there comes a point where I accept that other people are responsible for their own risk for the most part.

My concern is nearly 100% about Long Covid -- what we already know and suspect about it is enough to warrant my elevated concern, and after adding in recognition that there is undoubtedly more we will learn about LC in coming years, even moreso.

 

[anneg]

Personally, as a relatively healthy person with (I believe) a hardy immune system, I am not at all worried about experiencing covid in its acute phase. I'm definitely not worried about dying from an acute covid infection.

If anything, as a person who lives alone, I think about things like spending a week feeling ill and without the energy needed to keep my house warm in the winter (wood heat), keep my pets and myself fed, etc.

And even though I'm still cautious, I've even stopped being particularly worried about unknowingly spreading it to others, as I see almost no one around me taking precautions anymore, and there comes a point where I accept that other people are responsible for their own risk for the most part.

My concern is nearly 100% about Long Covid -- what we already know and suspect about it is enough to warrant my elevated concern, and after adding in recognition that there is undoubtedly more we will learn about LC in coming years, even moreso.

Yes, Long Covid is scary, and I'm unhappy that I got Covid mainly because of the threat of Long Covid. It was a wonderful holiday season until Covid, and then my son got it, sigh. But he's fine and I'm grateful that my DH, DIL and GS didn't get it.

 

[anneg]

Personally, as a relatively healthy person with (I believe) a hardy immune system, I am not at all worried about experiencing covid in its acute phase. I'm definitely not worried about dying from an acute covid infection.

If anything, as a person who lives alone, I think about things like spending a week feeling ill and without the energy needed to keep my house warm in the winter (wood heat), keep my pets and myself fed, etc.

And even though I'm still cautious, I've even stopped being particularly worried about unknowingly spreading it to others, as I see almost no one around me taking precautions anymore, and there comes a point where I accept that other people are responsible for their own risk for the most part.

My concern is nearly 100% about Long Covid -- what we already know and suspect about it is enough to warrant my elevated concern, and after adding in recognition that there is undoubtedly more we will learn about LC in coming years, even moreso.

As a person living alone, do you have a plan for getting help if you get sick and can't keep up with things? That would be a big concern for me too if I lived alone.