COVID UPDATE SEPT 23

The booster programme for winter illnesses is now under way in the UK. So is there anything new with COVID19? Well, the individual risk has never been lower, we have good treatments, brilliant vaccines and immunity which has been built up over three years. So while COVID19 is not much in the news it remains a public health problem with mortality about twice that of a bad flu year.

Last week there were over 2,700 admissions weekly in the UK, hinting at what might be to come this winter. Even now, 20 people daily have COVID listed as their cause of death. Long COVID also continues to be an issue, particularly for those infected in 2020, with estimates that a million people continue to struggle and perhaps always will. Hospitalisation is worth avoiding.

Latest strains

Sars-Cov-2 continues to mutate away, the latest version, BA.2.86 or “Pirola”, is described as a ‘variant under monitoring’ and has 30 genetic changes in the spike protein when compared to BA 2. This is causing concern is some quarters, but seems unlikely to be more virulent than other strains. EG5, or “Eris” is similarly being monitored in the US and is a ‘variant of interest’.

The origin of such variants is suggested, as before, to be a prolonged infection in an immunocompromised person which allows time for these genetic changes and so turbocharging viral evolution.

Boosting – who?

There is a big difference between the US, where boosters continue to be recommended for all, and the UK, most of Europe and the WHO, who suggest boosting for those over 65 or those with vulnerabilities.

I cant help but think we have got this right. Given that the vaccines are effective at keeping you out of hospital and preventing dying, it’s worth concentrating efforts on the groups most at risk of these outcomes. Advising everyone to get boosted simply gives more ammo to the significant antivaccine movement in the USA with their new “don’t comply” mantra, when the aim should be to try to repair trust in public health authorities, so badly damaged by social media and its many manipulators.

I can see the CDC’s point, vaccines are safer than infection at every age, but with the individual risk so low, it’s a hard strategy to sell, more so due to a heavily polluted internet.

Boosters – Which?

This paper looked at the effectiveness of different vaccine in Nordic nations, suggests that boosting with different vaccines from the first course offered the best protection against severe infection and death, so the message is to mix up your vaccines. This is already the case in the UK, where the primary does were mainly the AZ vaccine, then followed by the more effective mRNA vaccines.

Will I be getting a booster? At 67 it makes sense to me. This study shows no increase in risk from significant illness in the month after a fourth booster. In other words, they continue to be way safer than COVID infection.

This study shows they work: “The analysis, involving 2.5 million booster recipients aged 50 years and older, estimated a 65-70% relative reduction in risk of covid-19 associated hospital admission or death in the three months after the bivalent booster. This translated to an absolute reduction of 92-113 hospital admissions and 34-39 deaths for every 100 000 booster recipients.”

Moderna has developed a more selective vaccine which targets just two sites on the spike protein instead of the whole thing. This is now being looked at but wont be available this winter. It seems to work as well at one tenth of the dose of the current batches and offers a glimpse of whats to come.

Flu and COVID vaccination at the same time?

The  ComFluCOV study is reassuring when it comes to getting both vaccinations at once. Comparisons between those having the vaccinations at different times or the same time showed no difference in side effects, so it saves time and resources to do this is you wish.

So take your choice. I will be having mind along with the flu shot, ideally at the same time.

COVID and the brain

This study in the BMJ raises a few red flags for me. I, and many of my friends with MS are aware that infection with EBV is one of the fundamental causes of the demyelination which causes us problems, and I did worry that a novel virus like Sars-Cov-2 may also have long term effects.

Essentially, early in the pandemic there were indeed many impacts on the brain ranging from headaches and brain fog to death from stroke. COVID19 also has effects on the brain in terms of long COVID, and then the question remains regarding longer term effects, like demyelination, some types of Parkinson’s and cognitive decline. Time will tell.

COVID and the heart

This recent review looked at the long term effect of SARS-CoV2 infection on the heart and found those infected were 1.5 times more likely to have a stroke, nearly twice as likely to have a heart attack, and had between 1.6 and 2.4 times the risk of developing different types of arrhythmias. They looked at the records of 42 million infected and non infected Americans and the overall results are represented below.

The HR is the hazard ratio (HR of 2 represents twice the risk) and its clear that the cardiac risk post COVID is significant, particularly for myocarditis, that whipping boy of antivaccine alarmists. Anything to the right of the line shows increased risk. The next question for me is how long that risk continues, we shall have to wait and see.

mRNA vaccines and cancer

While mRNA vaccines continue to be the target of the antivaccine industry, back in the real world, their potential to treat previously untreatable or poorly treated illness is highlighted by this study of the use of mRNA vaccines to treat pancreatic cancer. This technology has huge potential to help people live longer and suffer less.

Dodgy doctors

I have been shocked by the influence of internet savvy doctors who use the internet to get away with spouting nonsense about the pandemic and much else. Everyone is entitled to an opinion, but the attach to it medical qualifications does mean there are responsibilities too. How do they get away with it?

Some action is being taken to remove the ability of misinformation mongers to claim the title of working doctor. The incredible mind-bending Sherri Tenpenny has lost her licence after doing much damage, with the notion that vaccines cause people to become magnetic being the hilarious tip of her iceberg of nonsense. It’s hard to see how her performances are not seen as a stand up comedy routine, but she really means this and more. She is entitled to her personal view, but should not be allowed to practice medicine or claim the authority of a medic.

Likewise, Drs Kory and Malin, prime Ivermectin merchants becoming rich on the backs of their patients eating pointless and ineffective treatments have been disciplined too, and not before time. The self-aggrandising Peter McCullough has also fallen from his shaky DIY pedestal to selling junk supplements online. I totally agree with more sensible commentaries that more should be done to reduce the impact of online pundits masquerading as competent medics.

Mind damaged Americans

It is clear to me that people are being duped by superficially convincing online nonsense that manipulates their prejudices and fears. This study from the KFF organisation paints a pretty grim picture of the beliefs that many Americans now hold.

A truly astonishing 34% of Americans believe that sudden death is linked to vaccination and about 20% believe that vaccination has caused more deaths than COVID itself! These ideas can be easily debunked by clear data and well conducted studies, and yet science is clearly losing the battle for too many minds.

Of course this is on the background of significant numbers of people who believe in creation rather than evolution, the holy sanctity of embryonic life at the same time claiming the right to shoot people, and who swallow a flood of vaccine lies cannot be expected to have science as the basis of their beliefs. This makes it harder for those working health professionals genuinely try to help. I’ve said it before – Misinformation is a form of mind damage.

Even HIV denialism is on the rise and a danger to public health as well as those infected who need the right information and treatment. Climate change is too being questioned even while so many of its effects are self evident, and the need for change urgent, populist politicians are seeing climate denial as a vote winner in some marginal seats.

Misinformation UK….

It matters here in the UK too – there has been a significant rise in abortions in Scotland following some on line sensationalised nonsense regarding contraception, posted by moronic “influencers” on social media, now mainly TikTok. In effect, young women are avoiding the life changing benefits of contraception for ‘natural’ and pretty useless, methods of family planning and ending up needing abortions. Harm is being done.

As the BBC reported, the 600,000 people who read that hormonal birth control can cause infertility and brain tumours without any evidence to support such nonsense and that another pundit with 300,000 followers claims “birth control is this generation’s cigarettes” and “ruins our bodies”. Jeez!

At least here they can have access to safe abortions. In the USA the hideous, misinformation driven persecution of women whose contraception fails, who are raped, or are carrying babies with lethal defects continues while neighbouring Mexico have decriminalised abortion, turning on its head the idea that legal framework in the USA is in any way superior to its neighbour.

Indeed, to end on a positive note, across Latin America, access to abortion is improving, though with some hideous exceptions, the lives of women are being improved. Below – women fighting for their rights in Brazil….

Thanks for getting this far, and good health!