Monday, June 27, 2022

The Road goes ever on and on ... Day 333 (833)

On the monkeypox front, WHO has decided that monkeypox is not a "public health emergency of international concern," but merely an "evolving health threat." Good to know.

The FDA's independent advisory panel has been asked to make a recommendation on whether to update existing covid vaccines to target a new version of the virus before fall boosters. One issue is that there is not time for lengthy human trials. Should the vaccine target Omicron or BA.4 and BA.5? What if a new mutation surfaces before fall? Pfizer has said that it might be able to have a targeted vaccine ready by October, while Moderna says it could not be ready until the end of 2022 or early in 2023. One option is sticking with the existing vaccines. They provide little protection against infection but do protect well against severe disease. Either way, there may not be enough vaccine available to offer everyone a booster. Boosters may have to be limited to people over the age of 70 or people over the age of 50 who have serious underlying conditions. This is very much a developing story.

A study published in the British Medical Journal reported that 32 percent of older adults in the US who survived covid infections had symptoms of long covid up to four months later, over double the rate found in an earlier study of adults between the ages of 18 and 64. There are other studies showing symptoms lasting a year or more. I will admit that the possibility (probability?) of long covid figures in my consideration of whether a specific action is worth the risk of doing. There are some sources who say we should stay masked in indoor public settings for an indeterminate amount of time. One said that she expected to stay masked in such settings for the rest of her life. I'm not sure I'd go that far, but it may merit some thought.

A study in the Canadian Medical Association Journal says that Canada handled the first two years of the pandemic better than several other countries with similar infrastructure and health care. Results covered the period from February 2020 to February 2022 for the countries of Belgium, Canada, France, Germany, Italy, Japan, the Netherlands, Sweden, Switzerland, the UK, and the US. Compared to the other countries of the G10, Canada had the highest vaccination rate, the lowest number of covid cases, and the lowest number of deaths related to covid. The Canadian per capita case rate was 82,700 per million people. All the others except for Japan were over 100,000 per million. The per capita death rate was 919 per million people, the second lowest after Japan. All the other countries had death rates over 1,000 per million. Over 80 percent of eligible Canadians had gotten two doses of vaccine as of June; the other G10 countries fell between 64 and 70 percent. The authors cited Canada's implementation of strict and persistent public health measures kept in place for almost all of the two-year period. They acknowledge that there was a significant economic impact. In response to the question of whether it was worth it, a co-author of the study remarked, "Was it worth it? That's not a scientific question. That's a values and morals and policies question."

And doesn't that sort of sum up much of the pandemic? The interplay of the science with the values and morals and policies. I'm not sure we'll ever sort out exactly what was right when, where, and for whom.

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