COVID Here comes COVID-19 version BA.2, BA.4, BA.5,...

[Astronuc]

Move over BA.5, here comes BQ.1.1!

Could omicron subvariant BQ.1.1 render COVID drugs useless?​

https://www.msn.com/en-us/health/me...bq-1-1-render-covid-drugs-useless/ar-AA12JLtT

The omicron variant of COVID-19 is still evolving, and new omicron subvariants have a better ability to evade Coronavirus drugs or immunity acquired through past infection or vaccination.

The list of variants that may be a cause for concern is only growing. Subvariant BQ.1.1, an offspring of the BA.5, may be able to evade all defense tools we have against COVID-19, leading to more hospitalizations and more cases of long COVID and death.

From BQ.1.1 to XBB and beyond: How the splintering of Omicron variants could shape Covid’s next phase​

https://www.statnews.com/2022/10/06/bq11-omicron-variants-splintering-covid-next-phase/

The strains virologists are tracking — from BA.2.75.2 to BQ.1.1 to XBB and beyond (“The names are getting ridiculous,” Peacock said) — are themselves descendants of earlier forms of Omicron, such as BA.2 and BA.5. It’s an example of how, since Omicron emerged nearly a year ago, the coronavirus’s evolution has been more akin to the “drift” seen with influenza, rather than the earlier succession of very different variants, from Alpha to Delta to the original Omicron.

 

[Laroxe]

I'm not qualified to dispute this claim, but I would like to point out that in the USA, Covid is currently killing 3 times as many people as the flu, statistically speaking:

Per the CDC, 300,000 people died of the flu for the years 2010 thru 2017, yielding a death rate of 100 people per day. Current CDC Covid claims are about 300 deaths per day.

Again, I'm not disputing your claim. I'm just reminding people that this is still a complicated and dynamic situation.

Well yes, dynamic is a good word to describe it and don't worry about disputing my claims, I'll try not to get upset. :)

There is no doubt that Covid 19 has had a significantly higher case mortality rate than flu and this will still be true if we used the cumulative case fatality rate, but remember how estimates have progressively changed over the length of the pandemic. At the start of the pandemic in some areas the case fatality rate was reported as high as 15% but as our understanding of the disease increased the reported rate dropped very quickly, we then had the introduction of vaccine's, antibody treatments,
anti-viral's and better care protocols alongside increasing numbers of deaths in the high risk populations and more recovered individuals. The latest variable was the spread of the Omicron variants, which appear to be much more transmissible but less virulent, causing a milder disease. So, as you say this is a dynamic response to the situation and the metrics change.

Forgive me if I us the numbers from the UK's office of statistics, I'm in the UK but I expect there will not be huge differences. So, in the UK, at the end of December 2021, the rolling seven-day Case Fatality Rate (CFR) for Coronavirus was about 0.3 per cent or one death in 333 cases. As a comparison the commonly used estimate of the death rate for flu sits somewhere between 0.1 and 0.2 per cent - or between one death in 1,000 and one death in 500. So Covid 19 was still killing more people, however since then the numbers have continued to change, in England, the case fatality rate, in the seven days up to January 26 was then just 0.14 per cent - one death in 714 positive cases. The large change seen in such a short period was at least partly due to the correction of a distortion, when hundreds of thousands of reinfections were added to the case data.

The infection fatality rate, a different metric that looks at all cases not just the confirmed cases offers a similar picture. The Covid symptom tracker app, suggested an estimated 9.2 million Covid infections since the start of December in the UK, and 10,670 reported deaths, an IFR of 0.11 per cent over that data collection period.
Getting a reasonably representative estimate of deaths from flu is equally problematic and we really need to go back to the years pre Covid 19. Again as an example, the figures from the US Centers of Disease Control from 2017 to 2018 estimate the IFR of flu to be around 0.12 per cent and the case fatality rate to be 0.27 per cent. The main issue is in avoiding Covid 19 estimates using cumulative deaths, there has never been a single representative fatality rate for either Covid 19 or Flu, we need to use the current figures for Covid with more accepted estimates for flu, because the current figures are not representative.

Sorry this is so long.!

 

[Astronuc]

BA.5 waning, BF.7 and BQ.1 variants gaining
https://www.cnbc.com/2022/10/14/omi...ging-variants-gain-ground-cdc-data-shows.html

Although the omicron BA.5 variant remains dominant in the U.S., it is starting to lose some ground to other versions of the virus, according to CDC data. The omicron subvariants BQ.1, BQ.1.1 and BF.7 have gained ground and are causing about 17% of new infections, according to the data. Scientists and health officials are closely monitoring these emerging variants because they appear to have a growth advantage over BA.5.

Omicron BA.5 has splintered into several new but related variants that include BQ.1, BQ.1.1 and BF.7. The U.K. Health Security Agency, in a report earlier this month</a>, said these three variants are demonstrating a growth advantage over BA.5, which was the most contagious version to date.

In the U.S., omicron BA.5 makes up about 68% of all new infections, down from about 80% at the beginning of October. BQ.1, BQ.1.1 and BF.7 are now causing about 17% of new infections combined, according to the CDC data. About 3% of new infections are attributable to BA.2.75. and BA.2.75.2, which are related to the omicron BA.2 variant that caused a bump in cases during the spring but was pushed out. Scientists at Peking University in China found that omicron BA.2.75.2 and BQ.1.1 were the most adept at evading immunity from prior BA.5 infection and several antibody drugs. The study, published earlier in October, has not been peer reviewed.

https://www.usnews.com/news/health-news/articles/2022-10-14/new-omicron-subvariants-bq-1-bq-1-1-spread-amid-concerns-of-next-coronavirus-wave

 

[Astronuc]

Subvariant XBB?!
https://news.yahoo.com/nightmare-covid-variant-beats-immunity-025733218.html

A new subvariant of the novel-coronavirus called XBB dramatically announced itself earlier this week, in Singapore. New COVID-19 cases more than doubled in a day, from 4,700 on Monday to 11,700 on Tuesday—and XBB is almost certainly why. The same subvariant just appeared in Hong Kong, too.

A highly mutated descendant of the Omicron variant of the SARS-CoV-2 virus that drove a record wave of infections starting around a year ago, XBB is in many ways the worst form of the virus so far. It’s more contagious than any previous variant or subvariant. It also evades the antibodies from monoclonal therapies, potentially rendering a whole category of drugs ineffective as COVID treatments.

“It is likely the most immune-evasive and poses problems for current monoclonal antibody-based treatments and prevention strategy,” Amesh Adalja, a public-health expert at the Johns Hopkins Center for Health Security, told The Daily Beast.

Meanwhile,

In the United Kingdom, infections from a highly mutated subvariant called BQ.1.1 are doubling every week—a rate of growth that far exceeds other leading subvariants. In the U.S., BQ.1.1 is spreading twice as fast as its cousin subvariant BA.2.75.2.

That means BQ.1.1 is very contagious. But that’s not the subvariant’s most alarming quality. What’s most worrying is that it also evades certain antibodies. In fact, BQ.1.1 seems to be the first form of COVID against which antibody therapies—evusheld and bebtelovimab, for instance—don’t work at all.

https://www.thedailybeast.com/deadly-twist-in-covid-variant-takes-the-world-by-surprise

BQ.1.1 wasn’t the inevitable winner of the viral competition that raged, mostly unseen, in the months following the peak of the BA.5 wave. There were other highly contagious and somewhat evasive subvariants, including BA.2.75.2 and BA.4.6.1.

But BQ.1.1 had an advantage, thanks in part to an eyebrow-raising three major mutations on its spike protein, the part of the SARS-CoV-2 virus that helps it grab onto and infect our cells. These mutations—N460K, K444T, and R346T—make BQ.1.1 more contagious than its cousins.

 

[Astronuc]

In New York - October 17, 2022

For samples of SARS-CoV-2 collected between September 25 -- October 8, 2022 from New York that are sequenced and uploaded into GISAID, 99.0% were the Omicron variant. During this time period 3.0% of sequences were lineage BA.2, 0.9% were BA.4, 15.6% were BA.4.6, 67.0% were BA.5, 4.7% were BF.7, 5.0% were BQ.1, and 2.8% were BQ.1.1 .

Between October 9 and October 15, 2022 CDC’s program for HHS Region 2 (New York, New Jersey, Virgin Islands, Puerto Rico) estimated 100% of samples were the Omicron variant. During this time period 1.9% of sequences were BA.2.75, 2.3% were BA.2.75.2, 0.4% were BA.4, 12.5% were BA.4.6, 57.4% were BA.5, 5.9% were BF.7, 11.6% were BQ.1, and 8.0% were BQ.1.1.

Omicron subvariants dominate in NY and CDC Region 2.

BA.4 reached a peak of 16% of sequenced variants last couple of weeks in June before decreasing. BA4.6 showed up, and is now about 15.6% of SARS-Cov-2 infections. On the other hand, BA.5 was about 5% of sequenced variants the two weeks ending 4 June, but in the two weeks ending Aug 27, it accounted for 84% of SARS-Cov-2 sequenced variants, and now represents about 67% of sequenced variants. Now BF.7, BQ.1, BQ1.1 and something considered 'other' are being sequenced.

 

[Laroxe]

I think when we consider the evolving pandemic, its useful to consider how evolution actually works. We know there are a huge number of variants out there and some of these variants are able to evade some of the effects of the antibodies we produce following vaccination or natural infection. The emphasis here is on the word "some", we produce a wide range of antibodies to all parts of the virus and these antibodies vary in their effects on the virus. Its clear that some variants that have changed the structure of the spike protein may be able to reduce the effects of some of the antibodies. However none of the variants have so far shown the ability to escape all of the antibodies, they can avoid some, but not all.
We now know that most of the variants seen have actually been around since the very early days of the pandemic and generally natural selection occurs when a particular variant gains a selective advantage over the others because of the way it interacts with its environment. Remember that since the pandemic got started, we have been taking actions that can significantly effect the way the virus spreads, while at the same time, the vaccination campaigns have rapidly changed the population level immunity. In fact with each of the vaccines there are some differences in the antibodies produced. We need to stop thinking that the emergence of new variants occurs because of recent mutations, the fact is we have introduced huge changes in the environment and so the selective pressures on the virus change.
While we tend to focus on issues like transmissibility and disease severity, its often the case that the changes we see, occur because of, other, often minor changes. A virus capable of faster reproduction, even quite small changes can shorten the incubation period and if virus reproduction precedes the onset of symptoms the onset of symptoms so much the better. A virus that rapidly leads to symptomatic disease is likely to avoid the rapid rise in antibody levels because of the short period of time, so we would see increased rates of reinfections and perhaps more sever disease. It can in-fact be very difficult to make sense of all the changes that might exert a selective pressure, we don't even know what we should be looking at until a new variant starts to take over.
All of these issues mean that the studies on serum antibodies can be misleading, we know they have a very limited role in preventing infections and their effectiveness varies. Its now considered the the role of various T cells, particularly those in local tissues my be far more important in slowing the progression of disease and preventing death. It also appears to be the case that the various T cells and other memory cells are activated by highly conserved parts of the virus so there can be little resistance developed.

 

[kyphysics]

I have a love-hate relationship with Eric Feigl Ding's tweets. He's obviously uber qualified (Harvard Professor of Epidemiology), but I honestly feel he can be "overly dramatic" with his "tone." Some have called him sensationalist. I don't think he is in intent, but his "interpretation" of data and what it means is sometimes "worse" than how I perceive things.

Anyhow, this is an interesting thread on latest variants and what they could mean for the winter.


Part way down the thread, he posts this, which I agree is the million dollar question. It's still worth tracking to see if this holds in new data.

I got my bivalent booster a few weeks ago, thankfully.

^^^Long thread, but worth checking out his opinion on timing of winter surge, etc.

 

[Laroxe]

Throughout much of history, claiming to be able to predict the future, particularly a future filled with death and disaster has been an effective way of becoming well known. Its perhaps worth considering some of the issues around Covid 19 to give this claim some context.

Among the 5 main variants there are a large number of sub variants and currently in the currently dominant Omicrom variant, more than 300 subvariants have been identified. Many of these have genetic changes that could alter the criteria that label them as “of concern”. The majority of these changes lead to alterations in the spike protein of the virus, particularly in the receptor binding domain. It seems that the number of changes in the spike protein correlates with the degree of antibody evasion seen in the virus. However, vaccination and prior infections do mean that all of the variants have to overcome the same antibody defences, this has lead to convergent evolution in which different strains share similar mutations in order to overcome these defences. It has been suggested that the greater the number of these changes, the faster the virus seems to take over from the previous dominant strains.

Really, predicting how the virus and the disease it causes will evolve, is really a triumph of hope over experience, we simply have to little information about the selective forces at work and what evidence we do have is inconsistent and confusing.
The initial indicators were that cases involving the variants BQ1 and BQ11 were increasingly being identified and they appeared to be set to become the dominant strains, however, the rates of these increases was highly variable depending on where the sampling was carried out. In some areas in which a rapid rise was detected, it suddenly seemed to stop, in the UK for example which appeared to be heading rapidly into a new wave of infections, the rate of increase has stalled with some suggestion that the numbers are actually dropping again. There are also, several other variants that appear to have greater immune evasion abilities and that have cause rapid increases then simply fizzled out. It is thought that the most immune evasive variant is in fact BA4.6, currently the second-most-prevalent strain in the U.S. And for many of the previous weeks, while its share of cases has increased over that time, (@ 11%), its growth nationally has been rather slow. Another new variant BF7 is also circulating in the US and is increasing, currently causing around 7% of cases. Its interesting that despite the evidence of antibody resistance, none of these variants stand out as particularly more dangerous, which is rather curious. So despite calls to increase surveillance, the reduced risks, seems to have reduced its importance, and the level of surveillance has actually fallen as concern shifts to other respiratory diseases and new information about older diseases. This means the data we have has become increasingly less reliable. We also need to consider that most of the variants identified for increased surveillance in the past and found in significant numbers of people, have simply disappeared from sight.Of course if a variant can resist the effects of circulating antibodies its hardly surprising that humoral antibodies will become increasingly less less effective in preventing initial infection and symptomatic disease. This will depend on the number of antibodies that are effected and their relative importance in resistance. Unfortunately most of the information we have only looks at overall antibody levels and we simply don't know the levels of antibodies needed to have a significant effect. Its certainly true that there are a significant number of cases arising in the vaccinated population and even in people during the periods they should have the highest levels. Measures of antibodies without some baseline level of known effectiveness really tells us nothing, a vaccine might be very good at creating an antibody response but that doesn't really tell us it effects on infection.Many virologists have suggested we should not consider a vaccine as offering significant protection from symptomatic infection, its function is in protecting people from serious disease and death, something which it appears to do quite well.Unfortunately for most viral diseases antibody levels provided a reliable measure of resistance, this actually meant that other parts of the immune system attracted far less attention and have been relatively poorly understood. Covid appears to have changed that, it seems that cell based immunity and tissue resident T cells play a very significant role in immunity and have their own persistent memory systems. Luckily all of the vaccines also stimulate significant T cell and tissue immunity, even though that was never really considered in their design. Currently there is no evidence that the effects of these systems can be effectively avoided by any of the variants

As most of these variants reduce the effectiveness of particular antibodies, it isn't surprising that they can impact on the effectiveness of antibody treatments used in prophylaxis for vulnerable people. This has caused significant concern.

 

[Sagittarius A-Star]

Spread of the SARS-CoV-2 Omicron variant sub-lineage BQ.1 in the EU/EEA​

...
European Union/European Economic Area (EU/EEA) countries have detected the circulation of SARS-CoV-2 variant sub-lineages BQ.1 in levels ranging from 0−19% during week 40. This variant originates from the BA.5 Omicron Variant of Concern (VOC).
...

• BQ.1, including its sub-lineages, has been designated as Variant of Interest (VOI) by ECDC as of 20 October 2022. Based on modelling estimates, it is expected that by mid-November to beginning of December 2022, more than 50% of SARS-CoV-2 infections will be due to BQ.1/BQ.1.1. By the beginning of 2023, more than 80% of SARS-CoV-2 cases are expected to be due to BQ.1/BQ.1.1.
• The observed increase in the growth rate of BQ.1 is probably driven mainly by immune escape. This variant and its sub-lineages will probably contribute to a further increase in cases of COVID-19 in the EU/EEA in the coming weeks and months. The extent of the increase in COVID-19 cases will depend on various factors, including immune protection against infection influenced by the timing and coverage of COVID-19 vaccination regimes, and the extent, timing and variant landscape of previous SARS-CoV-2 pandemic waves. Based on limited available data, there is no evidence of BQ.1 being associated with a greater infection severity than the circulating variants BA.4/BA.5.

Source:
https://www.ecdc.europa.eu/en/publi...s-cov-2-omicron-variant-sub-lineage-bq1-eueea

 

[Astronuc]

Locally, we've had 8 deaths due to Covid-19 during the month of October, which is about the same for September, and down slightly from 12 in August, 13 in July. During last summer, we dropped below 100 active cases per day, but then increased after July 4 holiday. With each holiday, we seem to see a slight increase in positive cases and hospitalizations. I believe most, if not all, hospitalizations and fatalities involve unvaccinated people, and most are elderly, 60+. I suspect by next weekend, 5 days after Halloween, we will see an increase in positive cases.

Looking at NY State, which I have been following since March 2020, as of October 28, the state has performed 121,492,632 tests (~6x entire state population) for SARS-Cov-2 and reported 6,157,918 cumulative positive results, including reinfections. The positive cases could be under-reported by a factor of 2. I've heard estimates of something like 75 to 80% of children have contracted the virus, but I can't remember if that is NY state, or nationwide, or perhaps both.

 

[Sagittarius A-Star]

Clinical severity of, and effectiveness of mRNA vaccines against, Covid-19 from omicron, delta, and alpha SARS-CoV-2 variants in the United States: prospective observational study
...
Results: Effectiveness of the mRNA vaccines to prevent Covid-19 associated hospital admissions was 85% (95% confidence interval 82% to 88%) for two vaccine doses against the alpha variant, 85% (83% to 87%) for two doses against the delta variant, 94% (92% to 95%) for three doses against the delta variant, 65% (51% to 75%) for two doses against the omicron variant; and 86% (77% to 91%) for three doses against the omicron variant. In-hospital mortality was 7.6% (81/1060) for alpha, 12.2% (461/3788) for delta, and 7.1% (40/565) for omicron. Among unvaccinated patients with Covid-19 admitted to hospital, severity on the WHO clinical progression scale was higher for the delta versus alpha variant (adjusted proportional odds ratio 1.28, 95% confidence interval 1.11 to 1.46), and lower for the omicron versus delta variant (0.61, 0.49 to 0.77). Compared with unvaccinated patients, severity was lower for vaccinated patients for each variant, including alpha (adjusted proportional odds ratio 0.33, 0.23 to 0.49), delta (0.44, 0.37 to 0.51), and omicron (0.61, 0.44 to 0.85).

Conclusions: mRNA vaccines were found to be highly effective in preventing Covid-19 associated hospital admissions related to the alpha, delta, and omicron variants, but three vaccine doses were required to achieve protection against omicron similar to the protection that two doses provided against the delta and alpha variants. Among adults admitted to hospital with covid-19, the omicron variant was associated with less severe disease than the delta variant but still resulted in substantial morbidity and mortality. Vaccinated patients admitted to hospital with Covid-19 had significantly lower disease severity than unvaccinated patients for all the variants.

Source:
https://pubmed.ncbi.nlm.nih.gov/35264324/

 

[kyphysics]

With each holiday, we seem to see a slight increase in positive cases and hospitalizations.

I remember reading this pattern in the news in 2021 (national cases that is). It makes sense, as people often get together in tighter spaces for longer periods of time during holidays.

Although, is Halloween considered as "dangerous," given it happens mostly outside (kids trick or treating)? I'm more worried about Thanksgiving and Christmas. Although, I wouldn't be surprised to see a significant pop up in cases post-Oct 31st.

 

[Astronuc]

Although, is Halloween considered as "dangerous," given it happens mostly outside (kids trick or treating)?

Apparently people congregate at parties. It is the congregation indoors where someone is infected and contagious that the virus is transmitted to others. Locally, in 2020 and 2021, the county where I live experienced a rise in infections within 10 days of Halloween, then the trend of new cases slowed, then picked up after Thanksgiving holiday, then slowed, then picked up with Christmas and New Year's Day, with a peak of positive cases in January the following year, 2021 and 2022, respectively. Let's see if the pattern repeats this year into next.

 

[kyphysics]

COVID booster may lower protection against omicron reinfection, study finds. Here’s why​

Julia Marnin
Thu, November 3, 2022 at 12:18 PM·4 min read

A COVID-19 booster, specifically a third vaccine dose, may lower protection against getting infected with the omicron variant again for some people — and there’s a reason why, new findings suggest.

In contrast, two vaccine doses, followed by an initial omicron infection, may protect more against a second omicron infection than an extra jab, according to a preprint study published Nov. 1 to medRxiv, a server run by Yale, BMJ and Cold Spring Harbor Laboratory. This is due to a specific reaction within the immune system, researchers concluded.

Here’s what the findings mean. . . [see full article]

Kind of a whacky finding.

 

[Astronuc]

While the situation is certainly different from last winter when Omicron dominated all other variants, a new “variant soup” of Omicron sublineages like XBB, BQ.1, and BQ.1.1 are gaining ground across the country, wiping out key tools used to protect immune-compromised people.

https://fortune.com/2022/11/04/fauc...ew-omicron-variants-bloom-winter-coming-soon/

COVID booster may lower protection against omicron reinfection, study finds. Here’s why

Pfizer/BioNTech say updated Covid-19 booster generates ‘substantially higher’ protection against Omicron subvariants than original vaccine
https://www.cnn.com/2022/11/04/health/pfizer-covid-bivalent-booster-omicron-data/index.html

NBC and ABC are broadcasting much the same story.

 

[Laroxe]

https://fortune.com/2022/11/04/fauc...ew-omicron-variants-bloom-winter-coming-soon/Pfizer/BioNTech say updated Covid-19 booster generates ‘substantially higher’ protection against Omicron subvariants than original vaccine
https://www.cnn.com/2022/11/04/health/pfizer-covid-bivalent-booster-omicron-data/index.html

NBC and ABC are broadcasting much the same story.

I remember them talking about this on TWiV and they were a bit less impressed. While it true that the bivalent vaccines do generate greater antibody responses, no one is quite sure what the antibody levels would need to be to offer any sort of protection The new variants clearly evade at least some of the antibody defences, so while there are claims of a four fold increase in the antibody levels, that really doesn't mean that it offers greater protection. We simply don't know the levels that might be needed, and the higher levels are likely to fall quickly. Some earlier studies have suggested that in terms of disease outcomes there is no difference, the vaccines are already very effective, and at that level, it will be hard to show much of a difference.

 

[Astronuc]

Some earlier studies have suggested that in terms of disease outcomes there is no difference, the vaccines are already very effective, and at that level, it will be hard to show much of a difference.

Yes, I heard the same this afternoon. While cases of BQ.1 and BQ.1.1 seem to be on the rise, the severity of illness does not appear to be greater, although I don't know if that applies to unvaccinated or immunocompromised. I do know of friends and family who contracted the virus, in the past month or two, and they all indicated it was the worst they've felt in a long time. For some, they slept a lot, and didn't eat much. Sounds like a response to the flu. Hospitalization was not required.

Locally hospitalizations have subsided, but there is a persistent low level, and in the past week, we seem to be on an upward trend. We did see a slight rise in fatalities, but that too seems to have subsided for now.

On the other hand, we are seeing an increase in influenza and RSV cases, in addition to COVID. I don't know if there are data form combined infections.

 

[Sagittarius A-Star]

mRNA bivalent booster enhances neutralization against BA.2.75.2 and BQ.1.1
...
In the one monovalent booster cohort, relative to WA1/2020, we observed a reduction in neutralization titers of 9-15-fold against BA.1 and BA.5 and 28-39-fold against BA.2.75.2 and BQ.1.1. In the BA.5-containing bivalent booster cohort, the neutralizing activity improved against all the Omicron subvariants. Relative to WA1/2020, we observed a reduction in neutralization titers of 3.7- and 4-fold against BA.1 and BA.5, respectively, and 11.5- and 21-fold against BA.2.75.2 and BQ.1.1, respectively.

Source:
https://www.biorxiv.org/content/10.1101/2022.10.31.514636v1

 

[Laroxe]

Source:
https://www.biorxiv.org/content/10.1101/2022.10.31.514636v1

The problem with a lot of studies like this is the assumption that the increases seen in antibody levels are clinically significant. Covid 19 has proven to be confusing in this respect with the risk of infection proving to be highly variable in a population, variations in the response to vaccines and considerable variations in the nature of the antibodies generated, when they are. It's increasingly thought that while antibody levels are the standard way to assess vaccines and for many disease seem to provide a good match to effectiveness, this doesn't appear to be true of Covid 19.

We are however aware of the fact that the high antibody levels seen following any of the Covid 19 vaccines is very short lived and may only provide enhanced protection for a matter of weeks. Remember that even as these bivalent vaccines are being rolled out, in populations already highly immune, its difficult to see any obvious impact on the rates of infection, its the rates of serious disease that are better, but this is true of both types of vaccine This explains why the focus of attention in both understanding immunity and future vaccine development has shifted beyond humoral immunity.

Its also now considered that what is called "original antigenic sin" which was thought to have a role in relatively few diseases may represent a core process in immunity, one which we are still trying to understand. Its still not clear how important this is in Covid 19 but it appears that introducing a new strain of a virus to someone immune to the original strain can significantly effect the overall immunity to both strains. This has the potential to alter the antibody mix so effecting the effectiveness and a broader antibody range has the potential to increase the risk of adverse events. However, studies that attempt to identify the various antibodies and there targets are very difficult.

The huge amounts of money for Covid 19 research has certainly lead to a great deal of new information and has significantly enhanced our understanding, but as a result of some variant of "Sods Law", each new piece of understanding generates several new questions, there is still a great deal of work that needs to be done.

 

[Astronuc]

In late October, the UK Health Security Agency assigned variant designations to two new omicron “grandchildren”: BQ.1 and XBB. This means they will be monitored by health authorities, but are not at this stage regarded as variants of concern.

https://theconversation.com/xbb-and-bq-1-what-we-know-about-these-two-omicron-cousins-193591

n the UK, Europe and North America, the prevalence of BQ.1 is rising quickly. Recent data from the UK’s Office for National Statistics (ONS) estimated BQ.1 sub-lineages (including BQ.1 and the similar BQ.1.1) made up 16.7% of infections. In the US, BQ.1 and BQ.1.1 together make up around 35% of infections.

XBB seems to be more prevalent in Asia. While the ONS data suggests it makes up only 0.7% of infections in the UK, in Singapore some 58% of recently sequenced cases are XBB. But whereas sequences of XBB are increasing globally, XBB cases in Singapore now appear to be starting to fall.

https://www.cidrap.umn.edu/news-per...dvisers-weigh-omicron-xbb-and-bq1-subvariants

As of November 14, in NY State and CDC Region 2
https://coronavirus.health.ny.gov/covid-19-variant-data (updated weekly or biweekly)

For samples of SARS-CoV-2 collected between October 23 -- November 5, 2022 from New York that are sequenced and uploaded into GISAID, 94.8% were the Omicron variant. During this time period 5.0% of sequences were lineage BA.2, 0.1% were BA.2.12.1, 0.4% were BA.4, 4.5% were BA.4.6, 30.4% were BA.5, 3.7% were BF.7, 26.4% were BQ.1, and 24.2% were BQ.1.1 .Between November 6 and November 13, 2022 CDC’s program for HHS Region 2 (New York, New Jersey, Virgin Islands, Puerto Rico) estimated 100% of samples were the Omicron variant. During this time period 0.7% of sequences were BA.2, 1.3% were BA.2.75, 1.2% were BA.2.75.2, 0.1% were BA.4, 4.5% were BA.4.6, 19.5% were BA.5, 2.9% were BA.5.2.6, 5.7% were BF.7, 2.1% were BN.1, 31.4% were BQ.1, and 28.5% were BQ.1.1 .

EU side seems relatively up-to-date
https://www.ecdc.europa.eu/en/covid-19/variants-concern

https://www.cbsnews.com/news/cdc-now-tracking-bn-1-the-latest-new-covid-variant-on-the-rise/

The Centers for Disease Control and Prevention is now tracking the rise of another COVID-19 variant known as BN.1, according to figures published by the agency this month, marking the latest new Omicron descendant now spreading around the country this fall.

Some 4.3% of new COVID-19 cases nationwide are now linked to the BN.1 variant, according to "Nowcast" estimates released on Friday by the CDC.

Prevalence of the new strain is largest in the West, in the region that spans Arizona, California, Hawaii, and Nevada. 6.2% of new cases in that area, HHS Region 9, are from BN.1.

New variants just keep coming, and there appears to be some conflict in reports of new ones like BQ.1 and subvariants and XBB being able to bypass the immune system. BN.1 is a new one to me.

 

[Astronuc]

Bloomberg - Next Covid-19 Strain May be More Dangerous, Lab Study Shows​

https://www.bloomberg.com/news/arti...ng-term-infections-it-may-become-more-harmful

A South African laboratory study using Covid-19 samples from an immunosupressed individual over six months showed that the virus evolved to become more pathogenic, indicating that a new variant could cause more illness than the current predominant omicron strain.

The study, conducted by the same laboratory that was to first test the omicron strain against vaccines last year, used samples from a person infected with HIV. Over the six months the virus initially caused the same level of cell fusion and death as the omicron BA.1 strain, but as it evolved those levels rose to become similar to the first version of Covid-19 identified in Wuhan in China.

I don't know. I've heard possibly more infectious, but not necessarily more lethal, or injurious, but of course that depends on various factors.

 

[nsaspook]

https://www.medrxiv.org/content/10.1101/2022.11.19.22282525v3

Changes in population immunity against infection and severe disease from SARS-CoV-2 Omicron variants in the United States between December 2021 and November 2022​

By November 9, 2022, 94% (95% CrI, 79%-99%) of the US population were estimated to have been infected by SARS-CoV-2 at least once. Combined with vaccination, 97% (95%-99%) were estimated to have some prior immunological exposure to SARS-CoV-2. Between December 1, 2021 and November 9, 2022, protection against a new Omicron infection rose from 22% (21%-23%) to 63% (51%-75%) nationally, and protection against an Omicron infection leading to severe disease increased from 61% (59%-64%) to 89% (83%-92%).

The 100%-Covid policy seems to be working perfectly.

 

[Astronuc]

LA County is reporting a surge in cases with COVID-19.
https://www.msn.com/en-us/health/me...mask-mandates-as-covid-cases-rise/ar-AA14PQuq

As of Dec. 1, Los Angeles County is averaging 2,490 new COVID-19 infections every day, the highest number recorded since Aug. 26, according to health department data.

Ferrer said the real count is likely much higher due to several people testing positive with at-home rapid tests and not reporting the results to health officials or due to people not testing at all.

Additionally, there are currently 1,164 residents hospitalized in the county due to the virus, which is the highest number of patients seen since Aug. 11.

New York State is seeing an increase in positive cases as well.

 

[kyphysics]

Hospitalizations signal rising COVID-19 risk for US seniors​

Coronavirus-related hospital admissions are climbing again in the United States, with older adults a growing share of U.S. deaths and less than half of nursing home residents up to date on COVID-19 vaccinations.

These alarming signs portend a difficult winter for seniors, which worries 81-year-old nursing home resident Bartley O'Hara, who said he is “vaccinated up to the eyeballs” and tracks coronavirus hospital trends as they "zoom up” for older adults, but remain flat for younger folks.

“The sense of urgency is not universal," said O'Hara of Washington, D.C. But "if you're 21, you probably should worry about your granny. We’re all in this together.”

One troubling indicator for seniors: Hospitalizations for people with COVID-19 rose by more than 30% in two weeks. Much of the increase is driven by older people and those with existing health problems, said Dr. Rochelle Walensky, director of the Centers for Disease Control and Prevention. The numbers include everyone testing positive, no matter why they are admitted.

https://www.yahoo.com/news/hospitalizations-signal-rising-covid-19-145840832.html

 

[Astronuc]

Politico reports - ‘The situation in the hospitals is grim’: States face brutal virus fallout
https://www.politico.com/news/2022/12/11/hospitals-states-virus-flu-covid-00073346
Nearly 30,000 people currently in the hospital have tested positive for Covid-19, up 30 percent since Thanksgiving.

State health officials are warning people that time is running out to get vaccinated before gathering with family over the holidays as Covid-19 cases surge nationwide alongside unseasonably severe waves of flu and respiratory syncytial virus.

And while the Omicron subvariants currently circulating are less lethal than previous variants, about 426 people are dying, on average, from Covid-19 each day — a nearly 62 percent increase from last week, according to the CDC.

In Louisiana, state health officials are recommending people consider getting tested before attending holiday gatherings.

In Mississippi, the state is down to 65 ICU beds and is now transferring some patients to other states, though Tennessee and Alabama have stopped taking out-of-state transfers.

In Arizona, hospitals have asked the state for additional resources, such as pediatric cribs.

 

[Tom.G]

A neighbor ended up in the local hospital last week for a 5 day 'vacation.'
The first 2.5 to 3 days were in the Emergency Room because all the ≅ 350 beds were full.
The hospital serves a population of roughly 250,000.

 

[Laroxe]

I know I've mentioned nasal vaccines before as the best chance we have of reducing transmission and I found this nice article on medscape which addresses the issue's. There seem to be quite a lot in development.
Remember if you don't have access you can sign up for a free accounts.
https://www.medscape.com/viewarticle/983754

 

[Rive]

In Louisiana, state health officials are recommending people consider getting tested before attending holiday gatherings.

Well, it may not worth much. I can't tell for other tests but ours turned positive only a few days later than the first (very indistinctive) symptoms started.
So far the whole thing feels like a rather straightforward cold, which then worsens with some sinus pressure.
That's with four jabs and one previous infection.

With this one it's very easy to slip up

 

[Laroxe]

It now seems that multiple variants circulating at the same time is becoming the norm, one of the newer ones, the subvariant XBB seems to be increasing, this is apparently a recombination of two other Omicron variants, the first recombination seen so far. It seems to share many of the features of other omicron variants, its easily transmitted, resists many of the humoral antibodies induced by other variants but so far doesn't show increases in disease severity.
The medscape link (remember you can get a free account) covers the current situation in the USA.
https://www.medscape.com/viewarticl...lrt_pos1_ous_221229&uac=29315AJ&impID=5043039
This is the UK monitoring site which is interesting.
https://www.gov.uk/government/news/covid-19-variants-identified-in-the-uk-latest-updates
Then there is this which discusses the situation in the USA again but with a rather alarmist twist. Scroll down past the ads.
https://www.fiercehealthcare.com/providers/xbb-covid-variant-presents-unique-threat-study

 

[Astronuc]

Nearly half of the passengers on two recent flights from China to Milan tested positive for COVID-19, Italian health officials said on Wednesday.

About 38 percent of passengers on one flight into Milan’s Malpensa Airport tested positive for COVID-19, as did about 52 percent of those on a second flight, according to local officials in Italy’s Lombardy region.

https://www.yahoo.com/news/nearly-half-passengers-china-milan-190125286.html

 

[pinball1970]

No Covid test but not good, I don't have any tests left. Chest bad.

 

[Frabjous]

No Covid test but not good, I don't have any tests left. Chest bad.

Best wishes.

 

[pinball1970]

Best wishes.

Thanks, bed for me.

 

[Frabjous]

Thanks, bed for me.

Get tested tomorrow so that you can get Paxlovid which has a time window. Make sure to take a list of drugs you are currently taking.

 

[Rive]

Thanks, bed for me.

Feel better soon!
...And get a doctor...

 

[pinball1970]

Feel better soon!
...And get a doctor...

Cheers guys, lots of sleep. 36 hours of incessant coughing quite difficult. No Dr, no home visits. @Rive unfortunately.
Not so bad now.

 

[Astronuc]

For samples of SARS-CoV-2 collected between December 4 -- December 17, 2022 from New York that are sequenced and uploaded into GISAID, 98.6% were the Omicron variant. During this time period 6.7% of sequences were lineage BA.2, 0.7% were BA.4, 9.7% were BA.5, 19.5% were BQ.1, 26.7% were BQ.1.1, 10.8% were XBB and 24.4% were XBB.1.5 .

Between December 19 and December 25, 2022 CDC’s program for HHS Region 2 (New York, New Jersey, Virgin Islands, Puerto Rico) estimated 100% of samples were the Omicron variant. During this time period 0.1% of sequences were BA.2, 0.4% were BA.2.75, 0.1% were BA.2.75.2, 0.0% were BA.4, 0.3% were BA.4.6, 3.7% were BA.5, 0.4% were BA.5.2.6, 1.4% were BF.7, 0.2% were BF.11, 1.3% were BN.1, 19.9% were BQ.1, 22.1% were BQ.1.1, and 50.2% were XBB.

New York state reports about 30-35 deaths per day from Covid-19. All the states seem to be doing less detailed reporting, since earlier this year.

In my county, during December we had 12 deaths and a neighboring county reported 7 due to Covid. Looking at deaths from influenza and pneumonia, our county typically reports 15 to 20 deaths per 100k annually since 2007; from 1999 to 2007, the reported deaths from influenza and pneumonia decrease from a rate of 30 per 100k to about 20 per 100k, probably due to increased vaccination rates. For 2022, the county has reported 64 deaths per 100k from Covid alone, so in terms of mortality Covid is 3 to 4x deadlier than influenza and pneumonia combined.

Neither my wife or I have had a serious pulmonary/respiratory infection in the last three years, and probably five years; I had a case of influenza back in 2017, and case of 'walking pneumonia' (mycoplasma) in 2013. Except for one other person, my wife and I are the only two among our friends and family circles who have escaped Covid, so far. We are also among the few who wear N95 masks in public.

The Centers for Disease Control and Prevention said Friday it is tracking a new variant of concern dubbed XBB.1.5. According to new figures published Friday, it estimates XBB.1.5 makes up 40.5% of new infections across the country.

XBB.1.5's ascent is overtaking other Omicron variant cousins BQ.1 and BQ.1.1, which had dominated a wave of infections over the fall. Scientists believe its recent growth could be driven by key mutations on top of what was already one of the more immune evasive strains of Omicron to date.

https://www.cbsnews.com/news/covid-variant-xbb-1-5-cdc-tracking-us-cases/

 

[pinball1970]

New York state reports about 30-35 deaths per day from Covid-19. All the states seem to be doing less detailed reporting, since earlier this year.

In my county, during December we had 12 deaths and a neighboring county reported 7 due to Covid. Looking at deaths from influenza and pneumonia, our county typically reports 15 to 20 deaths per 100k annually since 2007; from 1999 to 2007, the reported deaths from influenza and pneumonia decrease from a rate of 30 per 100k to about 20 per 100k, probably due to increased vaccination rates. For 2022, the county has reported 64 deaths per 100k from Covid alone, so in terms of mortality Covid is 3 to 4x deadlier than influenza and pneumonia combined.

Neither my wife or I have had a serious pulmonary/respiratory infection in the last three years, and probably five years; I had a case of influenza back in 2017, and case of 'walking pneumonia' (mycoplasma) in 2013. Except for one other person, my wife and I are the only two among our friends and family circles who have escaped Covid, so far. We are also among the few who wear N95 masks in public.https://www.cbsnews.com/news/covid-variant-xbb-1-5-cdc-tracking-us-cases/

I checked out our stats from UK Health Security Agency as I do not know that many people close to me, who have not had some sort of respiratory infection in the last three weeks. Friends, family and work colleagues. Nothing jumped out tbh. All Covid tests negative of the ones who got tested (including me)

RSV, cases are down except over 65s.

https://www.gov.uk/government/stati...d-19-surveillance-reports-2022-to-2023-season.

 

[jimmy4554564]

Hello quick question I read this post on reddit. Is it correct to believe that the worse your symptoms from the vaccine the worse your side effects to getting covid would be without vaccinated? What if you get the vaccines should you still be worried about covid if you reacted badly to the vaccine? Or is this just relevant to heart attacks from the vaccines?

I am a little worried now not because of the vaccines but because of the covid viruses.

 

[StevieTNZ]

Cheers guys, lots of sleep. 36 hours of incessant coughing quite difficult. No Dr, no home visits. @Rive unfortunately.
Not so bad now.

When I caught Covid in March and had a persistent cough afterwards (weeks later), my GP prescribed a 5 day course of Prednisone (two 20mg tablets daily) which seemed to do the trick.

But I'm gathering in the UK, to get ahold of a GP you need to go through a national phone number.... I would have thought you had a medical centre independent of the NHS.

 

[pinball1970]

When I caught Covid in March and had a persistent cough afterwards (weeks later), my GP prescribed a 5 day course of Prednisone (two 20mg tablets daily) which seemed to do the trick.

But I'm gathering in the UK, to get ahold of a GP you need to go through a national phone number.... I would have thought you had a medical centre independent of the NHS.

Yes after a bad chest infection a few years ago salbutamol was not taking effect. Prednisone did the trick. I cannot remember if I was already on steroids at that point.
My review with the Dr was supposed to be today (NW UK) but I got call yesterday from reception saying the Dr was off Ill with a chest infection!
Nothing now till the 25th Jan.
You can ring the GP for emergency prescription but no call outs due to my location. NHS 111number is next port of call.
Our NHS is still very stretched.

 

[pinball1970]

Hello quick question I read this post on reddit. Is it correct to believe that the worse your symptoms from the vaccine the worse your side effects to getting covid would be without vaccinated? What if you get the vaccines should you still be worried about covid if you reacted badly to the vaccine? Or is this just relevant to heart attacks from the vaccines?

I am a little worried now not because of the vaccines but because of the covid viruses.

Reddit is not a valid source for a citation. Can you find the published article this is based on?

 

[jimmy4554564]

Reddit is not a valid source for a citation. Can you find the published article this is based on?

https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.122.061025
Then somehow in the reddit post it jumps to severity of covid vaccine reaction = to severity of getting covid.
Or am I misreading the comments in the posts or are people just speculating in the post. Thanks

 

[pinball1970]

https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.122.061025
Then somehow in the reddit post it jumps to severity of covid vaccine reaction = to severity of getting covid.
Or am I misreading the comments in the posts or are people just speculating in the post. Thanks

The study is looking at individuals with free spike protein in the plasma and cardiac symptoms verses a control group with neither.
Both groups vaccinated.
People on here more qualified to comment but from memory the stats were something like 1/100,000 vaccine related accidents expected. Not deaths necessarily. That data is probably out of date now.
@BillTre @atyy

 

[StevieTNZ]

Our NHS is still very stretched.

Before my nurse left for Canada in May, she said the health systems around the world are all suffering. Even in NZ our health system is stretched. If things aren't done to improve it now, I dare not think what things will be like when winter arrives this year....

 

[pinball1970]

https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.122.061025
Then somehow in the reddit post it jumps to severity of covid vaccine reaction = to severity of getting covid.
Or am I misreading the comments in the posts or are people just speculating in the post. Thanks

Some more digging on this – from the UK, worth a read.

https://www.gov.uk/government/publi...ination-guidance-for-healthcare-professionals

Also this from the lancet.

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)00842-X/fulltext

Majority of cases appear to be mild (see below) and rare, approx. 1-2 per 100,000. Any follow up studies I come across I forward a link

“The clinical presentations of myocarditis after COVID-19 mRNA vaccination have been predominantly mild and few patients have required intensive treatment.9 However, one case-series, published in 2022, of adolescent patients found a persistence of radiographic abnormalities at follow-up examinations, which could be cause for concern.11 However, the patients followed up had excellent clinical outcomes, suggesting minimal chronic morbidity attributable to vaccine-associated myocarditis. Nevertheless, the continuous surveillance of this patient group for any increased frequency of heart failure, sudden death, or related cardiac comorbidities is necessary.”

 

[Laroxe]

Hello quick question I read this post on reddit. Is it correct to believe that the worse your symptoms from the vaccine the worse your side effects to getting covid would be without vaccinated? What if you get the vaccines should you still be worried about covid if you reacted badly to the vaccine? Or is this just relevant to heart attacks from the vaccines?

I am a little worried now not because of the vaccines but because of the covid viruses.

Its currently considered that the myocarditis associated with Covid vaccination reflects a particular type of immune activation that can occur following a lot of infections and vaccinations. Its a useful reminder about the state of our knowledge about our immune system prior to Covid 19 that we still don't know why Covid 19 appears so good at invoking this, but its still a rare reaction. I haven't seen any research attempting to link this specific adverse effect to the others seen after vaccination that reflect a broader inflammatory reaction. It may have been the publicity following the death of a well known athlete that brought this issue to public attention and increased surveillance as these serious outcomes are extremely rare. In all types of myocarditis physical exertion increases risk and we still don't know if the deaths are associated with previous undiagnosed pathology. In the great majority of cases this sort of myocarditis recovers quickly with rest and it is much more likely following actual infection rather than vaccination. Its interesting that this adverse event was not recognised in the UK despite the early start of the vaccination program there. They started with the astra zenica vaccine which appears far less likely to cause this problem, introduced vaccination based on age and risk, again the elderly being less at risk and then introduced a longer gap between the 1st and 2nd dose which again reduces risk
The people most at risk are the people that we would expect to have a rapid immune response, young adults, particularly males, the mRNA vaccines appear to stimulate a rapid antigenic response and this is increased if the vaccine doses are given closely together. This provides lots of info.

https://www.mdpi.com/2076-393X/9/10/1186

 

[Astronuc]

The good news is the worst appears to be over from the RSV surge that has been making life miserable for many children and their parents. RSV cases have been falling steadily since the end of November, according to the Centers for Disease Control and Prevention.

At the same time, the flu — which also came roaring back this fall after mostly disappearing for the previous two years — looks like it's finally receding in most places, according to the latest data out Friday from the CDC.

https://www.npr.org/sections/health...-covid-omicron-subvariant-spreading-fast-data

The rate at which the coronavirus is being detected in wastewater, which has become a bellwether for the pandemic, has tripled or quadrupled in many parts of the U.S. in recent weeks, Jha says. COVID-19 hospitalizations have jumped 70%, he says. And 300 to 400 people are dying every day from COVID-19 (in the US).

To make matters worse, all this is happening as yet another new, even more transmissible variant has taken over in the United States. Called XBB.1.5, this new omicron subvariant was barely on the radar in late November. But according to new estimates released Friday by the CDC, XBB.1.5 now accounts for almost a third of new infections and is the dominant variant in the Northeast.

New York state is still reporting ~30+/-5 deaths per day from SARS-Cov-2, but deaths from RSV and influenza are rare.

Health officials in Monroe County, for example, say they've confirmed two RSV deaths and 238 hospitalizations so far this year, among nearly 2,300 cases. Both deaths involve people over the age of 65, the health department said, though infants account for the most dramatic surge in RSV-linked hospitalizations, as is expected with this illness.

https://www.nbcnewyork.com/news/hea...s-new-york-death-how-long-contagious/3957573/

Older folks (65+) likely have comorbidities that make them particularly vulnerable to influenza, RSV and SARS-Cov-2 infections.

According to the CDC, each year RSV leads to about:

• 2.1 million doctor visits among kids younger than 5
• 58,000 hospitalizations among kids younger than 5
• 177,000 hospitalizations among adults aged 65 and up
• 14,000 deaths among adults aged 65 and up
• 100 to 300 deaths in children younger than 5

From November last year
https://www.npr.org/2022/11/02/1133040571/rsv-questions-answers-treatment-options
https://www.nytimes.com/2022/11/01/health/rsv-children-vaccines.html

 

[StevieTNZ]

https://www.newshub.co.nz/home/new-...ubvariant-kraken-detected-in-new-zealand.html

The Ministry of Health said on Monday the Institute of Environmental Science and Research (ESR) reported the whole genome sequencing results for two COVID-19 cases with the subvariant late last week.

 

[pinball1970]

https://www.newshub.co.nz/home/new-...ubvariant-kraken-detected-in-new-zealand.html

Flu season a bad one in the UK according to this. https://amp.theguardian.com/society...for-decade-health-secretary-steve-barclay-nhs