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

[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.