Everyone else has already jumped in with most of what I would have said.
The other point I would add is that we don’t even know what variant(s) will be predominant when the next gen boosters come out. I would also lean towards responding to the immediate situation risk since we really don’t know what the situation will be in the Oct-Nov-Dec timeframe.
I was actually just coming in to post this article, with a couple very relevant comments. It’s an interview with Peter Hotez, who is one of the developers of the Covid Corbevax vaccine that is being used in India.
The “So, what’s the point?” question disturbs me. I can easily answer that question. The fact that someone who is supposedly an expert can’t gives me a lack of trust in their words!!!
I’ve been meaning to post an update on Long Covid for awhile. Unfortunately, it feels like there are still more questions than answers, but I think more voices are starting to at least get on the same page with what the questions even are.
This was just updated by the CDC this week and it gives a good very general overview. Here’s their current high level stats:
So in everything I’ve been skimming lately about Long Covid, there is some good news and some not-so-good news.
First, two pieces of good news.
Good News #1 Vaccination helps reduce the risk of Long Covid. How much is still unclear (study results vary, and are usually at least a variant or two behind), but given that any vaccination comes with a very small risk, it’s good to know that very small risk is very much outweighed by the benefits, both from reducing the possibility of severe acute disease and Long Covid. This at least makes the risk math around getting vaccinated/boosted fairly clear.
Good News #2. At least for the original Omicron variant, Long Covid is less likely from Omicron than Delta. (Note: At a population level, this is offset by the abundance of Omicron, so this is just at the individual risk level.)
And if doing napkin-type math, that makes a lot of sense to me. It is very likely that Long Covid doesn’t have just one underlying mechanism. Some of the underlying mechanisms likely are related to the severity of the original acute infection (example: PICS=post-intensive care syndrome). Some of the underlying mechanisms appear unrelated to the severity of the original acute infection, occurring even in some asymptomatic cases. If vaccinations reduce disease severity, and if Omicron is less severe than Delta, it would make sense that the mechanisms related to acute disease severity would occur less often. What’s less clear is whether mechanisms unrelated to disease severity are diminished.
Now, the Not-So-Good News. Now that reinfections are becoming more common, we have data on results of reinfections. The hope that subsequent re-infections would be highly unlikely to result in Long Covid isn’t panning out. (“I didn’t get it the last time, so I won’t get it the next time” isn’t a given.)
Here is Eric Topol’s interpretation of the recent study that excerpt is from. Some people are disagreeing with his interpretation, but Dr. Osterholm basically said the same things about it as Topol did, so it’s likely not completely off target.
Full study:
I know it seems to be harder and harder to avoid infection. But I’ll paraphrase what one person said on #MedTwitter.
The best long term health strategy is to have zero Covid infections. The second best strategy is to only have one infection. The third best strategy is to only have two infections. Etc.
So it’s not “well, I’ve already been infected once and gotten it over with, so how many more times I get infected doesn’t matter.” It’s not a binary thing.
There’s a balance to strike between meaningful risks and not-so-meaningful risks. It’s not all-or-nothing.
I think what he’s saying is that we are chasing rainbows. The pot of gold will be somewhere else by the time we get there. The FDA is gambling that the predominant variant(s) in November/December will be similar enough to BA.5 to make the reformulation worth it. The rapid shift from Delta to Omicron, and then the shift from BA.1 to BA.5 shows it’s a total toss up whether that is a valid assumption. We’re trying to get out ahead of something we have no real idea where it’s going.
If we truly want to get out ahead of this thing, we need to be pursuing multiple vaccine approaches, I think. Mixing platforms to see if that helps durability, for instance. At least it sounds like the mRNA manufacturers are running some trials on bivalents with BA.1 and some with BA.5. Putting all our eggs in the BA.5 basket could be a gamble we should be hedging.
Because the kid’s mom - my niece - is a bubble child (said affectionately but golly, if it’s out there, she reacts to it) and we have a woodstove in the living room, we’ve had air cleaners in the living room, dining room and kichen. We do not have central air or heat.
(How much is that CO2 thingy?)
I have an old tiny house. Rooms are about 14 ft square. We tend to have large personal spaces.
We - me, my sister and the doctor - think the kid had covid in late February 2020. The kid was scary sick.
Nobody else in the house got it.
We all got vaccinations when we were allowed. And boosters.
Grandson had covid fall of 2021. No one else got it, tho he did mask outside his room. He was sick.
As far as I know, neither I nor DH have had covid. We’ve had bugs but not covid. My favorite was a g.i. thing that pretty much ran thru the family, one after another.
So, we can pass germs around (I’m not always great at disinfecting handles ) but we haven’t had covid - yet.
Is this due to the air cleaners?
I’m going to keep them operating, for certain. I do not expect them to keep us from getting infected somewhere. I’m only hoping they serve to keep viral loads low in the house.
I was but I don’t know if I should trust it. The solution I put drops of into the sensor was all bubbles after I stirred it and they never popped. This free test wasn’t as easy as the other ones.
Yes. I get what he’s saying. And it is shocking he is saying it.
Delta variant is gone, and the original vaccine formulations played a role in that because they targeted it well enough (although Omicron’s virulent nature helped considerably).
But since then, everything has been Omicron. All we are seeing so far are subvariants. But we continue to rely on a vaccine that was never targeting ANY form of Omicron.
Developing an Omicron variant vaccine of any type is going to likely be more effective than an alpha/Delta vaccine. The virus has changed, but we haven’t. So if by the time the omicron version comes out we have a different subvariant, we are still closer (and so likely more effective) than the original. Even if the next mutation creates a new variant altogether, it will have descended from Omicron, and so an Omicron vaccine would still likely be more effective than a delta one.
By his logic, we shouldn’t bother reformulating the flu vaccine every year.
I think pretty much everyone was positive the next variant after Delta would be descended from Delta. It is probable the predominant variant(s) next winter will be descended from one of the Omicrons, but it is by no means certain. Too much spread. Too many animal reservoirs.
And my understanding is that BA.5 is as different from BA.1 as BA.1 is different from Delta.
There is a significant element of guess work going on.
Flu is seasonal. They are generally able to formulate our northern hemisphere vaccine based on what they see in the southern hemisphere peak in the summer, then vice versa. We don’t have that kind of predictability yet.
Osterholm has understandable concerns in the lack of humility of those who claim they have outsmarted the virus. Because those people have been consistently off base so far.
Yeah, it’s all a bit muddled. I’ve sort of got a handle on variant vs subvariant after trying to understand the phylogenetic tree. It is a bit arbitrary whether these different Omicron subvariants deserve their own Greek letter names. But they are all apparently related and on the same “branch” so they might be saving the Greek letters for the next branches. They do need to come up with a naming system within Omicron if nothing else. Because otherwise the public will do it (i.e., BA.2.75 becoming “Centaurus”).
This is a good graphic and related article that takes us through BA.1 and BA.2. They are both believed to have come from a common ancestor that has yet to be located (so are “siblings”), and all the other Omicron subvariants are believed to also share that common ancestor (either directly or indirectly).
What seems to be a bit unclear is whether BA.4 and BA.5 evolved from BA.2 or if they are more siblings to BA.1 and BA.2. That’s still being discussed as far as I can tell. There might be recombination involved. Here is one write up on that.
My understanding is the BA.1 bivalent booster could be available by September, so it will be interesting to see what they do. It sounds like from this bit that they won’t wait until October for BA.5 bivalent booster to be available.
Yesterday I saw (on Twitter) both under 50 boosters and Novavax mentioned since the FDA did just issue the EUA for that new 4th vaccine. But maybe the ACIP can multi-task? On the other hand, they haven’t had the ACIP meet without the VRBPAC first since the 12-15 when VRBPAC got salty they weren’t consulted. So… :
) but we haven’t had covid - yet.
)
