The Road goes ever on and on ... Day 289 (789)

I had several sets of notes taken for today's blog and then sat down and followed a tweet from Eric Topol that sucked me down a rabbit hole of sorts. The original reference requires no technical background to understand, but if you don't want to check for yourself, here are a few key points:

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"The Delta variant that caused devastating surges around the world in 2021 had mutations in L452 as well, so many scientists have been watching this hot spot carefully, including Yunlong Richard Cao of Peking University. On 11 April, Cao says, he and his colleagues noticed a pattern: New Omicron sublineages from New York, Belgium, France, and South Africa all had changes in L452. 'The independent appearance of four different mutations at the same site? That's not normal,' Cao says.

"...the new variations apparently helped the Omicron subvariants evade those previously powerful antibodies."

"Based on its immunological profile, it 'should be called SARS-3,' he says--an entirely distinct virus. ['He' is Linfa Wang, a bat coronavirus researcher.] "The limited protection that BA.1 provided against the new subvariants in lab studies has already raised questions about how useful the new Omicron-specific vaccines might be. Wang says the virus is evolving too quickly for strain-specific vaccines to keep up. Instead, a broad cocktail of monoclonal antibodies targeting different strains might be the best way forward, he says."

"Kristian Andersen, who studies viral evolution at Scripps Research, draws a sobering lesson from the newest Omicron variants. Although we don't know what future variants will look like, he says, 'we can be certain that they'll continue to be more and more capable of immune escape,' possibly leading to lower protection against nor just infection, but also against severe disease. 'We need to focus on broadening out immunity,' he says.

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Son #1 says this is all hype despite its having been published in Science, a quite reputable journal. He reads it as the variants not being an "entirely distinct" virus, but just a mutated, milder form. In my Twilight Zone, dystopian mind, I find it well worth concrete investigation. Maybe covid-19 should be covid-21 since Omicron emerged in late 2021. In terms of immunity, I've read that people with antibodies to the older, "original" version of SARS have some immunity to the novel version of SARS. In that case, having had SARS-2 should give some immunity to SARS-3. Stay tuned. News at 11:00?

As for the other notes I made, the state media in North Korea is now saying "covid" instead of "fever." Six deaths have been reported in the 350,000 cases. It seems that while the entire country is essentially locked down, 187,800 people are in formal quarantine. Kim Jon-Un has been seen wearing a mask. He criticized health officials saying that the outbreak "shows that there is a vulnerable point in the epidemic prevention system." (If I were one of those health officials, I'd be worrying about how to get my ass and those of my family out of the country without delay.) Analysts are warning of a major humanitarian crisis. One says, "We are in the early stage of the spread of vast human misery. The nature and scale of the illnesses, deaths, hunger, and starvation can only be established much later." Some people are wondering whether the new publicity is really a request for help. China has formally offered help. South Korea and the US have made it known that they are open to dialogue. 

After the director of WHO called China's zero-covid policy "unsustainable," all photos and references to him have been removed from the Chinese internet. The government has called the WHO director's remark "irresponsible" adding that WHO did not have a "proper understanding of the facts." As Dragnet's Sgt. Friday used to say, "The facts, ma'm. Nothing but the facts."

The Road goes ever on and on ... Day 145 (645)

As European countries put new restrictions in place or tighten the ones already in effect, we in the US are doing very little in terms of trying to slow the pace of Omicron. New York City will announce this week whether they will hold or cancel next week's New Year's Eve celebration in Times Square. The fact that they have noted that it will be outside and allow entry only to vaccinated people leads me to believe it will still be held. Some local governments and private institutions have been putting in place pandemic measures that feel like last year, but it may well be too little even if it's at the right time. Several governors, including one currently testing positive for covid, have said they have no intention of putting restrictions in place again. 

So just how bad are things here? Last week saw a 17 percent increase in covid cases and a nine percent increase in deaths. Descriptors bandied about include "viral blizzard," "winter of severe illness and death," and "extraordinary." Fifty million Americans remain unvaccinated, and it's not at all clear if many or most of those ever will get vaccinated. New cases in New York City are up 60 percent over two weeks. Washington, DC is seeing three times as many new cases daily as at the start of December. POTUS will address the nation tomorrow night. According to his press secretary, he "will announce new steps the Administration is taking to help communities in need of assistance, while also issuing a stark warning of what the winter will look like for Americans that choose to remain unvaccinated."

Not too long ago, the news was that the majority of new cases were in people who had not yet been vaccinated. Reports out of Denmark are that most of the people infected there are fully vaccinated. As for the severity of a case of Omicron, data from Imperial College London found no evidence that Omicron is less severe than Delta based on the proportion of people seeking hospital care after they have been infected. I'll be looking for more detail on that study given how important the results would be. 

Mild or severe illness aside, there are three signs of hope. First, anti-viral drugs are becoming available. These reduce the amount of virus produced in the body and lessen that chance patients will need hospital treatment. Second, cases in South Africa appear to have peaked while early signs are that deaths could be lower than in earlier waves. The caveat is that many South Africans have infection-induced immunity in addition to that induced by vaccines. Finally, Omicron appears much more efficient than Delta in reproducing in bronchial tubes in the upper respiratory tract, where it can be more easily coughed out onto other people. However, it appears far less efficient in spreading to the lungs where it poses the greatest danger to an infected person.

And on a "you have to be kidding, right?" note, this year's flu shot seems to have been poorly matched to the flu strains circulating this season. I'll have a respiratory disease, bartender; make it a double. 

It's clear that we won't be putting in place anything like the restrictions being put in place in Europe. I read that hospitals will be filled to a greater capacity than they were in the spring of 2020. Is it pandemic fatigue that makes people today not see the value in inconvenient-for-a-short-while measures most people accepted at the outset? The less people do to help slow the spread of variants such as Omicron or to help block the development of even more such variants, the longer we may very well be only wishing we could be home for Christmas.

The Road goes ever on and on ... Day 23 (523)

I'll try not to pad this post too much, but my pandemic notes are scant. I spent a good two-plus hours this morning with my oldest friend here. I used to feel funny about calling her my "oldest" friend, at least until I realized that she is the person here that I have known for the longest time and, at 86, she really is the oldest non-family person I consider a friend. I spent time this afternoon with an even-older woman who happens to be my mom. We watched golf and chatted about the state of the golf, the world, and the two flocks of Canada geese that live around her facility and who do not seem to get along at all. I got home and found The Professor getting ready to take a walk, so I went along. 

Three more senators have tested positive for covid. All were fully vaccinated, and all have minor symptoms. This brings the Congressional covid count to 11 senators and over 50 representatives. I have not seen a similar count for governors, but Virginia's governor had it as does Texas's.

Philosophical and potentially legal question: Does a primary care physician have the right to refuse to see a patient who is unvaccinated? In other words, if I were not vaccinated, could my family doc refuse to see me for my annual physical? What I read suggested that legally it might be okay, but ethically?

Baptist Health hospitals in Jacksonville, Florida currently have over 500 covid patients. This is more than twice the number they had at the peak of the July 2020 covid surge. A church in that area with 6,000 members, primarily African American, had six members die in a 10-day span. None had been vaccinated. Now, the church has medical experts available after services not to give vaccinations, but to answer questions about the vaccines. The church has also hosted two vaccination drives at which over 1,000 shots were given.

Over one million doses of vaccine were administered yesterday. This was the first time since early July that vaccinations topped one million in a single day. The overall rate of vaccinations is over 70 percent higher than one month ago. The Culver City Unified School District, a small district in Los Angeles, will require students over the age of 12 to be vaccinated. This is the first such requirement in California and possibly in the nation as a whole. Proof of vaccination is due on November 19.

The Texas Education Agency has suspended enforcement of the ban on mask mandates, and the Texas State Supreme Court said that school districts may require masks after all. Both decisions are temporary. A Florida district that does not require masks had to quarantine 440 students two days into the school year.

Finally, a few tidbits on the non-covid side. Rattlesnakes change the frequency of their rattle the closer humans get to them. The frequency changes from 40 Hertz to 60 to 100 Hertz. The higher frequency made people in a simulation study believe that the snake was closer to them than it really was. The frequency change may be a survival technique for the rattlesnake. My question is whose survival? The snake's or ours?

And in the at-least-we-don't-have-that-disease-here-too category, Ivory Coast has Ebola cases, Guinea has cases of Marburg (Marburg's first appearance in West Africa), and Uganda has polio cases. In other words, we may have it easier here than we thought.