Cont: The One Covid-19 Science and Medicine Thread Part 3

[Puppycow]

For the time being, Japan seems to be headed in the right direction. Cases are down.

https://toyokeizai.net/sp/visual/tko/covid19/en.html

Of course, Japan was a latecomer to getting its population vaccinated (I'm still less than a month out from getting my second dose) so there has been less time for the immunity to wane.

 

[Puppycow]

Mu over 7 times more resistant to antibodies than first virus strain

The new Mu variant of the novel coronavirus is more than seven times more resistant to antibodies created by vaccinations than the original strain of the virus, a study by a Japanese research team has found.

Despite the increased resistance, “the Mu variant does not make vaccines ineffective, nor does it require new anti-virus measures at the individual level,” said Kei Sato, an associate professor of virology at the University of Tokyo’s Institute of Medical Science (IMS) and a member of the team.

“(But) we found that the variant is the most resistant to antibodies among the previously detected strains of the virus,” he added. “It’s crucial to identify what types of variants are spreading. That will require an expansion of capacity to conduct genome analyses, which can provide detailed genetic information of the virus.”
. . .

The Mu variant was more likely to reduce the effectiveness of antibodies produced from vaccinations than other strains of the virus, the team's results showed. But some of the immunity acquired through inoculations work by different mechanisms from that of antibodies.

Hmm.

 

[crescent]

The dubious rise of ivermectin as a Covid-19 treatment, explained

This is the most comprehensive article I've yet seen regarding Ivermectin. The article doesn't present anything new but goes more in depth into how the drug became so popular as a requested treatment for covid via poorly designed or fraudulent study results (as in, it actually looks at some of the studies and the shortcomings of those studies). Also points out that it is a human-use drug with great value - just not for covid.

Partisans on the other side have made their own sloppy (if decidedly less egregious) claims in the effort to debunk the ivermectin mania, ridiculing the drug as “horse paste” when it’s actually an anti-parasitic medication for humans, taken by hundreds of millions each year. (It’s also a veterinary drug that can get rid of parasites in animals.)

One of the most prominent studies finding positive results for ivermectin was a study from Egypt with lead researcher Ahmed Elgazzar of Benha University. “It was one of the first papers that led everyone to get into the idea ivermectin worked,” researcher Eduardo López-Medina told Nature.

It found extraordinary results for ivermectin, and even though it had not undergone peer review, it was widely cited and was incorporated into various efforts to estimate ivermectin’s benefits. But it was criticized from the get-go for unclear methodology and for not publishing the underlying data the researchers used to find their conclusions (publishing such data is generally good practice to make sure other researchers can do their own vetting of a study).

Then some researchers noticed bigger problems: Most of the introduction to the paper was plagiarized, the numbers in its tables didn’t add up, and the experiment as described would have been very difficult to conduct. Soon, it was removed by the preprint platform that had hosted it. (Elgazzar maintains that his study is legitimate and says the removal occurred without his permission.)

IMHO, some of the current attempts to communicate the ineffectiveness of ivermectin imply that the medicine has no human use - but many of the pro-ivermectin people know that it does have human use and is perfectly safe when used at the right dosage. This causes credibility gap in what is an otherwise solid argument against using the stuff to treat covid. Ineffective against covid, but otherwise safe if used at the right dose. I mean, its been years, but I'm pretty sure I took the stuff when I was in the Peace Corps. I didn't die or get sick or become sterile. I didn't even have worms, they just made all of us take an anti-parasite drug when we completed service as a precaution.

At any rate, the linked article seems a nice one-stop-shopping source for all things ivermectin.

 

[marting]

The USA's FDA had an open panel discussion of the latest Pfizer mRNA booster data. Lots of good info and Q/A by the Israeli's (see the article published this week in NEJM) as well as Pfizer's data and the FDA's own research.

https://www.youtube.com/watch?v=WFph7-6t34M

My impressions from viewing about half of it:

Nice job FDA.

I liked the data presentation except for some, long winded stuff where they were just scaling data in a what-if sense that should already be clear. Good questions/discussion of waning immunity relative weight of time v Delta variant differences. Still unknown but general opinion is both with it being somewhat more likely principal cause is time.

Boosters produce exceptionally strong antibody response against original and Delta. Much stronger than after the second dose.

Negative reactions/complications are low freq. and similar to second dose.

Congruent results in Israel's data which has about a 2 month lead over USA data.

 

[The Atheist]

Boosters produce exceptionally strong antibody response against original and Delta. Much stronger than after the second dose.

It should be national policy in every country with high vaccination rates to give a booster after 5-6 months. Not doing so can only lead right back to where we started - high number of deaths among the aged.

The only thing I can see holding it back is the myth that it will stop vaccines from being sent to developing countries.

 

[marting]

FDA review panel rejected 16-3 Pfizer's request for approving booster shots for 16 y/o and above but is debating approving for a subset of elderly and perhaps health care workers. Good chance that will be approved. Risk/benefit is clear in that group but not clear in young people that are at very low covid risk. Sort of really low risk but also really low benefit.

 

[Skeptic Ginger]

FDA review panel rejected 16-3 Pfizer's request for approving booster shots for 16 y/o and above but is debating approving for a subset of elderly and perhaps health care workers. Good chance that will be approved. Risk/benefit is clear in that group but not clear in young people that are at very low covid risk. Sort of really low risk but also really low benefit.

Bull **** noted.

I said this before and now see some news reports backing me up:

More kids are hospitalized with Covid, but researchers aren’t sure if they’re sicker, too

Keiser said Kali’s death was “really shocking,” but it should not have been, given that 40 percent of the county’s cases are people under 20 and the single largest demographic is children under 10. ...

“But in some ways again when you step back and you look and see how delta can spread very rapidly and kids now are one of the largest unvaccinated groups in the country, it shouldn’t be surprising to us, even though it was quite shocking.”

As of Sept. 9, nearly 5.3 million children had been diagnosed with Covid-19, representing 15.5 percent of all cases, according to the American Academy of Pediatrics. More than 243,000 cases were reported from Sept. 2 to Sept 9., the second-highest number of child cases in a week since the beginning of the pandemic, representing nearly 29 percent of the weekly reported cases, according to AAP. The highest number of cases was just one week prior, with 251,781 new cases. The AAP reported that after declining in early summer, “child cases have increased exponentially, with nearly 500,000 cases in the past 2 weeks.”...

“We can confidently state that the biggest impact of delta on children is simply greater case numbers or the much larger number of children with Covid.”

What I posted earlier was that low fatalities and hospitalizations in kids was likely due to the fact we had a relatively small sample size and when more kids start getting infected as schools reopen we are going to see the numbers of serious COVID in kids go up simply because we will be seeing a more representative sample of kids getting infected.

And that is what we have now. There is an ongoing debate about whether or not the delta variant is causing more serious disease in kids. That may be true. And the increase in children's deaths might be a combination of both reasons.

But the bottom line, it's time to stop acting like the kids are OK. They need vaccinations and masks. And the idea there is some unknown risk of kids getting the vaccines that surpasses the risk they face from COVID is not supported by the evidence.

 

[marting]

Bull **** noted.

I said this before and now see some news reports backing me up:

More kids are hospitalized with Covid, but researchers aren’t sure if they’re sicker, tooWhat I posted earlier was that low fatalities and hospitalizations in kids was likely due to the fact we had a relatively small sample size and when more kids start getting infected as schools reopen we are going to see the numbers of serious COVID in kids go up simply because we will be seeing a more representative sample of kids getting infected.

And that is what we have now. There is an ongoing debate about whether or not the delta variant is causing more serious disease in kids. That may be true. And the increase in children's deaths might be a combination of both reasons.

But the bottom line, it's time to stop acting like the kids are OK. They need vaccinations and masks. And the idea there is some unknown risk of kids getting the vaccines that surpasses the risk they face from COVID is not supported by the evidence.

Huh?

Nothing to do with not vaccinating kids.

The FDA's decision is to not to recommend boosters for younger people at this time based on lack of evidence that the benefit beyond the two mRNA shots exceeds the risks given that the two shots already provides strong protection. Risks of side effects including myocarditis is similar to that of the second shot but the additional immunity from the vaccine isn't clear given the small numbers of severe breakthroughs in lower ages. Also there was a significant increase in swollen lymph compared to second dose cases, one of which wasn't resolved at the time of the panel meeting.

BTW, panel unanimously approved boosters for 65 and up as well as certain others previously approved.

 

[marting]

Topol likes it and he's about as pro vaccine as you get.

A very good outcome for this FDA Advisory Committee following what data are available w/r to age, and recognizing the need for high-risk individuals, due to co-existing conditions or occupational exposures, such as the heathcare workforce, essential workers, and teachers.

https://twitter.com/EricTopol/status/1438974306579484673

 

[Skeptic Ginger]

Huh?

Nothing to do with not vaccinating kids.

The FDA's decision is to not to recommend boosters for younger people at this time based on lack of evidence that the benefit beyond the two mRNA shots exceeds the risks given that the two shots already provides strong protection. Risks of side effects including myocarditis is similar to that of the second shot but the additional immunity from the vaccine isn't clear given the small numbers of severe breakthroughs in lower ages. Also there was a significant increase in swollen lymph compared to second dose cases, one of which wasn't resolved at the time of the panel meeting.

BTW, panel unanimously approved boosters for 65 and up as well as certain others previously approved.

So by this you didn't mean kids?

Risk/benefit is clear in that group but not clear in young people that are at very low covid risk.

It certainly doesn't sound like the 30-60 yr olds.

You mentioned 16 yr olds.

If you weren't referring to kids and you were only referring to boosters then my apologies though I doubt 16 yr olds are as low risk as you imply.

Consider my post aimed at others in the thread who keep insisting kids have such low risk from COVID.

 

[marting]

If you weren't referring to kids and you were only referring to boosters then my apologies though I doubt 16 yr olds are as low risk as you imply.

Consider my post aimed at others in the thread who keep insisting kids have such low risk from COVID.

Yes, only applies to booster shots. The FDA panel looked at evidence that indicated side effects were similar except for higher lymph swelling than that after the second dose. Since vaccinated younger people are at very low risk, they decided the evidence at this point was insufficient to recommend boosters for people down to 16. As a practical matter it would take one heck of a large trial to evaluate risk/benefit of boosters for kids that are fully vaccinated. I expect as more real world evidence comes in they will allow it. Especially if the vaccine turns out to wane for serious disease in younger people. Currently, the data has huge CIs outside of older people so they are being pretty conservative.

However, this should cut the breakthrough hospitalizations/deaths which are heavily skewed towards older, vaccinated people, by 80% or more.

 

[W.D.Clinger]

With my highlighting:

FDA review panel rejected 16-3 Pfizer's request for approving booster shots for 16 y/o and above but is debating approving for a subset of elderly and perhaps health care workers. Good chance that will be approved. Risk/benefit is clear in that group but not clear in young people that are at very low covid risk. Sort of really low risk but also really low benefit.

With Skeptic Ginger's highlighting:

Bull **** noted.

...snipped irrelevancies...

But the bottom line, it's time to stop acting like the kids are OK. They need vaccinations and masks. And the idea there is some unknown risk of kids getting the vaccines that surpasses the risk they face from COVID is not supported by the evidence.

With my highlighting:

Huh?

Nothing to do with not vaccinating kids.

The FDA's decision is to not to recommend boosters for younger people at this time based on lack of evidence that the benefit beyond the two mRNA shots exceeds the risks given that the two shots already provides strong protection. Risks of side effects including myocarditis is similar to that of the second shot but the additional immunity from the vaccine isn't clear given the small numbers of severe breakthroughs in lower ages. Also there was a significant increase in swollen lymph compared to second dose cases, one of which wasn't resolved at the time of the panel meeting.

BTW, panel unanimously approved boosters for 65 and up as well as certain others previously approved.

So by this you didn't mean kids?It certainly doesn't sound like the 30-60 yr olds.

You mentioned 16 yr olds.

marting mentioned "16 y/o and above" because that is the group for which Pfizer had requested approval for booster shots.

With my highlighting:

If you weren't referring to kids and you were only referring to boosters then my apologies though I doubt 16 yr olds are as low risk as you imply.

Yes, only applies to booster shots.

tl;dr : It was perfectly clear (to anyone who actually reads a post before responding to it) that marting's very first post in that sequence was reporting on an FDA review panel's review of a request for approval of booster shots.

 

[The Atheist]

With school having been back for over a fortnight in UK, and with full crowds at pubs and football matches, the pandemic will flare out of control, according to most analysis I've seen.

Except, here we are 20 days later, and any increase will be apparent, given the faster-moving virus.

New cases down by almost 10%.

It looks very much like the Goldilocks number of vaccinations is 70%.

 

[Myriad]

New cases are down worldwide, and in the U.S., and in most individual countries. They're down quite a bit in many of the the least vaccinated U.S. states including Florida, Louisiana, and Mississippi. (Daily death rates are now high in those states, though, from the earlier peak cases.) States where cases have only leveled off or may be still rising include some of the most vaccinated states, such as Massachusetts and Connecticut. (But also North Carolina and Texas.) However, recent death rates are much lower in the most vaccinated states, so even if it takes longer for them to reach and get over the peak of the surge, they're still better off.

It continues to appear that there is a poorly understood (or at least, poorly reported on) negative feedback that causes surges to turn around, despite the much higher inherent infectivity of the predominant delta strain, despite lack of mitigation rules or poor compliance with same, despite low or high vaccination rates, despite not reaching anywhere close to the saturation of the whole population, and despite this occurring over a wide variety of climate conditions and living conditions. Yet, whatever it is that causes the reversal of each wave never seems to prevent the next one.

I'm pretty much baffled by it at this point. It might as well be a big dial in an evil villain's lair somewhere, that the villain and James Bond take turns turning up or down, while they have a very very long slow fight scene.

 

[RecoveringYuppy]

New cases are down worldwide, and in the U.S., and in most individual countries. They're down quite a bit in many of the the least vaccinated U.S. states including Florida, Louisiana, and Mississippi.

Just a nit here: Where did you find accurate current data for Florida? They seem to reporting in a misleading way.

It continues to appear that there is a poorly understood (or at least, poorly reported on) negative feedback that causes surges to turn around, despite the much higher inherent infectivity of the predominant delta strain, despite lack of mitigation rules or poor compliance with same, despite low or high vaccination rates, despite not reaching anywhere close to the saturation of the whole population, and despite this occurring over a wide variety of climate conditions and living conditions. Yet, whatever it is that causes the reversal of each wave never seems to prevent the next one.

I'm pretty much baffled by it at this point. It might as well be a big dial in an evil villain's lair somewhere, that the villain and James Bond take turns turning up or down, while they have a very very long slow fight scene.

Isn't that just people realizing that a lot of current cases means there is a lot of potential for exposure so people become more careful? Then, eventually they become less careful again when numbers go down.

 

[marting]

New cases are down worldwide, and in the U.S., and in most individual countries. They're down quite a bit in many of the the least vaccinated U.S. states including Florida, Louisiana, and Mississippi. (Daily death rates are now high in those states, though, from the earlier peak cases.) States where cases have only leveled off or may be still rising include some of the most vaccinated states, such as Massachusetts and Connecticut. (But also North Carolina and Texas.) However, recent death rates are much lower in the most vaccinated states, so even if it takes longer for them to reach and get over the peak of the surge, they're still better off.

It continues to appear that there is a poorly understood (or at least, poorly reported on) negative feedback that causes surges to turn around, despite the much higher inherent infectivity of the predominant delta strain, despite lack of mitigation rules or poor compliance with same, despite low or high vaccination rates, despite not reaching anywhere close to the saturation of the whole population, and despite this occurring over a wide variety of climate conditions and living conditions. Yet, whatever it is that causes the reversal of each wave never seems to prevent the next one.

I'm pretty much baffled by it at this point. It might as well be a big dial in an evil villain's lair somewhere, that the villain and James Bond take turns turning up or down, while they have a very very long slow fight scene.

Yeah. I've been curious about much of this as well. And there's another curious thing going on. The more heavily vaccinated states like New York have a lower CFR than than the Southern states I've looked at. During Delta Florida is running about 1.5% while New York is running half of that or less. Delta cases in Fla. have been about 6% of the population. Likely a 2x undercount. So it's a significant fraction of the remaining unvaxxed and previously uninfected. Might be a social grouping phenomena. Unvaxxxed more likely to socialize with other unvaxxed and vice versa. Higher percentages of breakthrough cases should correspond to lower CFRs and that may be the case in New York where overall cases are far less than Florida. New York cases have only been about 1% of the population so they have further to go than Fla.

 

[marting]

With school having been back for over a fortnight in UK, and with full crowds at pubs and football matches, the pandemic will flare out of control, according to most analysis I've seen.

Except, here we are 20 days later, and any increase will be apparent, given the faster-moving virus.

New cases down by almost 10%.

It looks very much like the Goldilocks number of vaccinations is 70%.

Yep. Seeing signs of similar things in the USA given the UK is almost 2 months ahead of us.

I suspect Delta is wiping up the remaining vulnerable. Mostly among the unvaxxed. Combine prior infection immunity and vax and Delta is starting to run out of steam. We are at the beginning of the end unless some variant comes along that escapes immunity or has a higher R0. Not super likely IMO. Might also be a smaller peak in the winter here depending on vax waning and booster uptake in the at risk. But it will be much smaller than prior peaks.

Different story in populations that have had near zero covid. Getting people vaxxed is critical.

 

[marting]

Just a nit here: Where did you find accurate current data for Florida? They seem to reporting in a misleading way.

You can find more current data on Fla here:
https://newsnodes.com/us_state/FL

They still report the deaths but aggregate them once a week. You can see that in the link.

Data reported to the CDC, which is where Worldometer etc gets it. is now assigned actual date of death from death certs. It takes weeks, on average, for the death certificates to get logged. They used to report deaths to the CDC the same way but changed when they started aggregating deaths once a week. But they weren't aligned with the actual date of death and reported weekly, they changed how they reported to the CDC. This prior approach made it hard to read historical case/hospitalization/death charts because the death reporting was decoupled. They changed CDC reporting to the actual death date a few months ago well before the upswing. But a side effect is that when looking at deaths within recent weeks it always looks like they are rapidly decreasing. They aren't. Ignore CDC data less than 3 weeks from the current date. It's now way more accurate but only for dates 3 weeks or more before the current date. So I find it better looking at historical data and aligning it with case numbers but it also means that recent deaths numbers are worthless.

 

[RecoveringYuppy]

Thanks for that link.

YThey aren't. Ignore CDC data less than 3 weeks from the current date. It's now way more accurate but only for dates 3 weeks or more before the current date. So I find it better looking at historical data and aligning it with case numbers but it also means that recent deaths numbers are worthless.

Yeah. I've been snapshotting a few datapoints for 6 weeks now and finding that at 3 weeks the data starts to settle down but numbers from as far back as 5 weeks are still inching up.

 

[The Atheist]

I'm pretty much baffled by it at this point. It might as well be a big dial in an evil villain's lair somewhere, that the villain and James Bond take turns turning up or down, while they have a very very long slow fight scene.

I think it's simply the case that more people have had Covid than not, thereby reducing the pool of potential victims.

Likely a 2x undercount.

Delta seems to still hold that 50-80% of people have no symptoms, so in a place like Florida, where testing is patchy at best, the numbers aren't going to mean much.