COVID19 - How it's affecting you

Needless to say, I did not take mine off when the receptionist in my full GP practice said she couldn't hear me through my mask and asked me to. My husband has been with me wearing a mask for ~10 years when we are out, he never struggles to hear me. I wish people would stop treating masks as the barrier and ask for alternative communication if they need it. Now I know for the next time if it's that secretary to type the question on my phone and hold it up.

I hope you reported her to the Practice Manager. She has no right to ask/tell somebody to take off a mask. She should get her hearing checked.

It's well known that in the UK, that the vets have the nice recepionists and the GPs have the horrible ones.

It's well known that in the UK, that the vets have the nice recepionists and the GPs have the horrible ones.

I have to say, we're very lucky at our practice, the receptionists are exceptionally good.

I have to say, we're very lucky at our practice, the receptionists are exceptionally good.

Same here, no complaints.

I have to say, we're very lucky at our practice, the receptionists are exceptionally good.

I don't have health problems and therefore can't report what my present  GP's receptionists are like, but GP receptionists v Vet receptionist is well discussed on social media.

I did have a few instances when our children were little and therefore I saw them: including one who convinced a new GP what to prescribe for one of my teenagers (who was there on their own) without checking the notes to see if he was allergic to that medicine. The receptionist was very unhappy when I returned the medicine and she was told off by one of the senior GPs.

A few of the vet's receptionists (and one of the vets) became friends and years later we still go out together. I've been to the vets a few times over the years and have never seen a nasty receptionist

Agreed on Vet reception vs GP reception!

But aside from that, this is probably not too much help to anyone in the UK, but if you are trying to track what's going on over on this side of the puddle as far as Covid, a reputable source - you can track by state or individual county. It's kinda the best I've found, so far, given there is so little publically-available info.

https://public.tableau.com/app/profile/benjamin.renton/viz/InsideMedicineCOVID-19MetricsDashboard/Dashboard1?publish=yes&utm_source=substack&utm_medium=email


And this little tidbit from Twitter:

"Jim Rosenthal @JimRosenthal4 - I just received word that one of my major suppliers is not able to fulfill orders on time because one third of their employees are out with Covid.  Good reminder: We might be done with Covid, but Covid is not done with us."

Jim is an air filtration expert in Texas, and half of the Corsi-Rosenthal team that made plans for inexpensive air filters that would greatly reduce the amount of airborne Covid 19 virus in a venue available to the public at no charge.

To quote one of the Covid research wonks:

"BA.2.86 has the P681R mutation. This, alone, is bad news. In Delta, the R in pos 681 created an almost fully optimized FCS (RRRXR/S instead of RRXRR/S). This enhances furin cleavage. This makes you sicker.

Carry on with the "there is no evidence that this variant is more severe" garbage. Until you can't.

And then there's the other 29 spike mutations. I mean, come on. If this takes off we're in trouble. And when I say 'we', what I really mean is "those of you who refuse to wear masks or stay out of Weatherspoons for more than 10 hours in a row" are in trouble."
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Oh. Joy. 

So, the problematic variant has popped up in four (five?) states here now in the US and is in the wastewater of another, and has been found in the UK.

Hopefully....      Well, anyway, here is a link to a report on the long-term effects of past Covid infections, for those who might be interested.  bit.ly/3qCJoF4  (Not sure that will work as a link here). It's to Eric Topol's "Ground Truths" recap. I found the graphic to be particularly helpful.

This might also be good reading for those who still say "oh, it was just like having a cold, no big deal". https://www.bostonglobe.com/2023/05/26/opinion/long-covid-turns-three-americans-play-disability-roulette/

So it's up to 24 known cases worldwide - with several in Denmark, where they are at least monitoring it properly. Looks like the weekly growth numbers in Denmark are 60% increase per week.  Given that (as I understand it) in the USA we're only doing about 1% of the sample testing we did at the height of the Omicron wave, there's no telling what the levels actually are here. Probably not huge, but schools are already being shut down because so many of the children are ill with Covid. Without further testing. And the fact that the mutation has shown up in the upper midwest in people who have not traveled.... well, it had to come from somewhere, didn't it? Like maybe someone else who had/has it? Or maybe the deer.  (Apparently quite a lot of the native deer here have Covid?) [insert snarky tone here]

A very interesting article here on the new variant that has the science wonks up late at night:  https://12ft.io/proxy?q=https%3A%2F%2Fwww.theatlantic.com%2Fhealth%2Farchive%2F2023%2F08%2Fcovid-variant-ba-286-transmission-mutations-omicron%2F675166%2F

And, on a more philosophical tangent, a nice article in the NY Times about how the epidemic played out in the USA in the non-science arena.   https://www.nytimes.com/2023/08/29/opinion/ezra-klein-podcast-katelyn-jetelina.html

And then there is this depressing bit of reality - https://www.forbes.com/sites/judystone/2023/08/25/public-pushes-back-on-cdcs-plan-to-weaken-infection-control/?sh=813c38a7179c

And this.  As before, we're on our own. - https://abcnews.go.com/US/trumps-former-health-adviser-believes-current-covid-response/story?id=102646852

So. A bit of news from monitoring the research chatter:   

The wonks are saying that the new variant is, basically, as different from Omicron as Delta was from the original version. (You remember Delta, right?)  As such, they are saying that the new variant most likely will punch through the current (and proposed for this fall) vaccines, due to the number of mutations. So while getting the vaccines currently under development or available will protect you from some strains (which is good - they are still around),  it will not offer much help for this one  (BA.2.86).

They are saying BA.2.86 has been around for a while, as there are already offspring variants with different mutations developing in different parts of the world. So it's been flying under the radar. They have now identified 29 samples - in Denmark, UK (2 in England, 2 in Scotland), US, Israel, Japan, South Africa, Portugal, Sweden, Canada, and France plus in waste-water from Spain, NYC and Switzerland.

The US is doing almost no monitoring. The UK ramping up Covid monitoring is the sanest thing they've done in years.

Telling people the existing vaccine will be effective against BA.2.86, not so much.

On the good side, the wonks are also saying that it (BA.2.86) doesn't appear to be as highly contagious as the current XBB strain at present.  (Not that it's not contagious, just not as wildly contagious.)

However, because I just have to leave things on a dismal outlook:  They are much more concerned with what the potential offspring of this virus could mutate into.  Apparently the first strains of the XBB series were nasty, but not so highly-contagious until it mutated.  So they are worried that the BA.2.86 could do the same - and there is no vaccine for it yet.

And, of course, the more times you get any variety of Covid, the more damage you are doing to your immune system and, potentially, inner-workings. Even if it's "just like a mild cold". Or you don't realize you're infected. Nice. 

So do take precautions?  Filter your in-building air with at least a hepa/MERV13 filter, or even opening the windows, wear an N-95 or better in places with poor airflow, and avoid crowds.

Good luck.

They say it's starting to mutate (sample from Colorado, I think, is changed), and they are watching it (and several others) with laser-beam focus.

They also say that the bird flu has mutated, in a bad way. H3N8. “Importantly, we discovered that the virus had acquired human receptor binding preference and amino acid substitution PB2-E627K, which are necessary for airborne transmission. Human populations, even when vaccinated against human H3N2 virus, appear immunologically naïve to emerging mammalian-adapted H3N8 AIVs and could be vulnerable to infection at epidemic or pandemic proportion."
https://www.nottingham.ac.uk/news/bird-flu-human-transmission


I can't wait until whatever is still alive in the permafrost defrosts and joins in all this fun.     

Edit Sept 6:  Moderna is saying their "updated vaccines (which target XBB.1.5 "Kraken") work against BA.2.86 ("Pirola") as well as against EG.5* ("Eris")", so that's good. If it'll still work if any of them mutate significantly, who knows? But for now, that's good.

No, I have nothing better to do, thank you. 

This morning:  The Sato Lab (Japan) reports:  "All vaccine sera tested (monox3, monox4, BA.1 bivalent, and BA.5 bivalent) showed NO neutralizing activity against BA.2.86"  and "Altogether, it is suggested that BA.2.86 is one of the most highly immune evasive variants ever and should have the potential to be considered as a variant of interest."

And then there's the press releases from Big Pharm:

Sept 6 (Reuters) - Moderna (MRNA.O) and rival Pfizer (PFE.N) on Wednesday said their updated COVID-19 vaccines generated strong responses in testing against the highly mutated BA.2.86 subvariant of the coronavirus that has raised fears of a resurgence of infections. Moderna said its shot generated an 8.7-fold increase in neutralizing antibodies against BA.2.86 compared with an untreated natural antibody response in clinical trials in humans. The variant is currently being tracked by the World Health Organization (WHO) and the U.S. Centers for Disease Control and Prevention (CDC).

“We think this is news people will want to hear as they prepare to go out and get their fall boosters,” Moderna head of infectious diseases Jacqueline Miller said in an interview, adding that the data should also help reassure regulators. Pfizer said its updated vaccine with partner BioNTech (22UAy.DE) elicited a strong antibody response against BA.2.86 in a preclinical study in mice. Moderna, Pfizer/BioNTech and relative newcomer to the COVID vaccine market Novavax (NVAX.O) have created versions of their shots aimed at the XBB.1.5 subvariant, the dominant variant through most of 2023. Those are expected to be rolled out this autumn.

Question:  Did the Sato lab have access to these new variations of the vaccine when they were doing their testing?  If not, I do hope they are provided with samples soon!   Some of the science wonks are complaining that Pfizer  has not released their actual data. Also, their studies seem to be showing that    "Three monoclonal antibodies (Bebtelovimab, Sotrovimab, Tixagevimab) that were antiviral against the parental BA.2 (see the G2P-Japan 9th paper) did NOT work against BA.2.86 AT ALL. " 

No, I have nothing better to do, thank you. 

This morning:  The Sato Lab (Japan) reports:  "All vaccine sera tested (monox3, monox4, BA.1 bivalent, and BA.5 bivalent) showed NO neutralizing activity against BA.2.86"  and "Altogether, it is suggested that BA.2.86 is one of the most highly immune evasive variants ever and should have the potential to be considered as a variant of interest."

And then there's the press releases from Big Pharm:

Sept 6 (Reuters) - Moderna (MRNA.O) and rival Pfizer (PFE.N) on Wednesday said their updated COVID-19 vaccines generated strong responses in testing against the highly mutated BA.2.86 subvariant of the coronavirus that has raised fears of a resurgence of infections. Moderna said its shot generated an 8.7-fold increase in neutralizing antibodies against BA.2.86 compared with an untreated natural antibody response in clinical trials in humans. The variant is currently being tracked by the World Health Organization (WHO) and the U.S. Centers for Disease Control and Prevention (CDC).

“We think this is news people will want to hear as they prepare to go out and get their fall boosters,” Moderna head of infectious diseases Jacqueline Miller said in an interview, adding that the data should also help reassure regulators. Pfizer said its updated vaccine with partner BioNTech (22UAy.DE) elicited a strong antibody response against BA.2.86 in a preclinical study in mice. Moderna, Pfizer/BioNTech and relative newcomer to the COVID vaccine market Novavax (NVAX.O) have created versions of their shots aimed at the XBB.1.5 subvariant, the dominant variant through most of 2023. Those are expected to be rolled out this autumn.

Question:  Did the Sato lab have access to these new variations of the vaccine when they were doing their testing?  If not, I do hope they are provided with samples soon!   Some of the science wonks are complaining that Pfizer  has not released their actual data. Also, their studies seem to be showing that    "Three monoclonal antibodies (Bebtelovimab, Sotrovimab, Tixagevimab) that were antiviral against the parental BA.2 (see the G2P-Japan 9th paper) did NOT work against BA.2.86 AT ALL. "

In the UK it's unlikely we will even have access to the new vaccines, JCVI moved up the vaccine schedule for older and vulnerable people but has said to use the old stock... They still find us expendable. (I had such a severe reaction to the first two that I don't feel safe getting another one until they understand the autoimmunity caused by the spike protein.)

I wish they would bring back masking and provide n95s/equivalent to everyone. Very tired of the isolation while also losing mobility.

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In the UK it's unlikely we will even have access to the new vaccines, JCVI moved up the vaccine schedule for older and vulnerable people but has said to use the old stock... They still find us expendable. (I had such a severe reaction to the first two that I don't feel safe getting another one until they understand the autoimmunity caused by the spike protein.)

I wish they would bring back masking and provide n95s/equivalent to everyone. Very tired of the isolation while also losing mobility.

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I can imagine. Seriously.     I maintain a low profile and am rarely in public places anymore. I am scared to death for my daughter, who has to go onto a university campus that has 45,000 students and about half that number of staff and researchers. And rides public transit to get there and back again. She's being heroically careful, but it only takes one small slip.

But that's my personal Covid nightmare, not yours. So back to jabs.

On the positive side, there are several variants running amok, and the older vaccines (although not the original one) still have some impact on some of them, so it's not a wasted jab, entirely.  Unless one has a bad reaction to it, of course.

They really should start encouraging masking pretty much everywhere, and see about proper ventilation. Apparently there's a nursing home there that has had an 87% infection rate by the BA.2.86 variant. Plus a good number of the staff as well. While nobody in that care home has died yet from it, the unseen aftereffects will undoubtedly hasten some of them to an early grave. And it was all so preventable. Sad. Especially sad how quickly people have "forgotten" the recent past.   

Edit:  For what it's worth 29 out of the 33 residents tested had received a COVID19 vaccination dose as part of the spring booster campaign roughly four months before the outbreak. Additionally, all four residents who tested negative had received the spring booster. And whatever booster they were giving may have kept all but I believe one of the residents out of the hospital. That's not nothing.

Well congrats. The Norfolk care home is the first documented case of person-to-person transmission of BA.2.86. 

The science wonks are beginning to talk as if there's something more unpleasant floating around out there, though, from a different strain (or strains).  Eric Topol writes: 

But what’s ahead is more worrisome. As I previously reviewed the FLip variants are gaining steam and will pose more immune evasiveness than current circulating variants. The double mutation in the spike (F456L and L455F) appears to be showing up in higher proportions of circulating variants, thereby exhibiting growth advantage to the current pool. Watch out for HK.3, EG.5.1.3 and XBB.1.16.6, all of which contain this FLip that are on the move in the US, and will likely be causing more trouble in the weeks ahead as one or more become dominant here. We don’t yet know how well these FLip variants will be covered by the XBB.1.5 booster but likely not as well as what we’ve seen from the first human booster data ....  and

All of this tells us the value of the XBB.1.5 booster as a wave gets going, and that it offers a solid humoral immune response. At the least, it should provide enhanced protection against severe Covid, albeit it will not provide any lasting (more than 1-2 months) of added protection vs infection. The FDA is likely to approve the booster today or early next week. The CDC advisory meeting is set for September 12th and there have been plans for rapid distribution to at least some places in the US soon to follow (perhaps by Friday, September 15th or sometime soon thereafter).

Please don’t forget about Long Covid. Reinfections do carry an increased risk for subsequently manifesting this chronic condition. Vaccines and boosters have consistently provided some level of protection (ranging from 15-40% reduction) vs Long Covid. There has been over-emphasis on the protection against severe acute Covid (hospitalizations and deaths), not enough on the chronic form, so consider the added protection of a booster for this purpose.

At the risk of stating something you may already know - From the BBC News today:    Several Covid vaccines are being used across the UK, including ones made by Pfizer-BioNTech, Moderna, and Sanofi/GSK. All of them have been updated to make sure they more closely match recent new variants of Covid.

And

People who can have a Covid booster include:

    residents in a care home for older adults
    all adults aged 65 years and over
    people aged six months to 64 years in a clinical risk group
    frontline health and social care workers
    people aged 12 to 64 who are household contacts of people with weakened immune systems
    people aged 16 to 64 who are carers, and staff working in care homes for older adults

If it were me, I'd be asking which particular "recent new variants" are covered. That's a bit vague.  If it was the only vaccine I had a chance at, I'd still take it, but I think I'd want to know what I was being vaccinated to fight, specifically.  Of course, it's entirely possible that approvals of new vaccines happens much faster in the UK than the USA. (I wouldn't be surprised at all) So they could be talking about the hot-off-the-chemical-retorts new vaccines, after all. Which would be good, if you are able to tolerate one and you can get one.

For what any of the above is worth to you. 

At the risk of stating something you may already know - From the BBC News today:    Several Covid vaccines are being used across the UK, including ones made by Pfizer-BioNTech, Moderna, and Sanofi/GSK. All of them have been updated to make sure they more closely match recent new variants of Covid.


If it were me, I'd be asking which particular "recent new variants" are covered. That's a bit vague.  If it was the only vaccine I had a chance at, I'd still take it, but I think I'd want to know what I was being vaccinated to fight, specifically.  Of course, it's entirely possible that approvals of new vaccines happens much faster in the UK than the USA. (I wouldn't be surprised at all) So they could be talking about the hot-off-the-chemical-retorts new vaccines, after all. Which would be good, if you are able to tolerate one and you can get one.

For what any of the above is worth to you. 

From the JCVI website:

3. The currently approved and available bivalent Original/Omicron BA.4-5 mRNA COVID-19 vaccines (Cominarty and Spikevax) are considered appropriate for younger age groups and other eligible groups. These vaccines and the AS03-adjuvanted monovalent beta-variant vaccine (VidPrevtyn Beta) are also suitable for use in persons 75 years old and over as an alternative to support operational flexibility in delivery, for example for domiciliary delivery in care homes.
4. Where substantial delays might be incurred in deploying the latest UK-approved COVID-19 vaccine by December, the principle of timeliness should take priority over the choice of vaccine.

None of the autumn boosters will cover the new variants.

https://www.gov.uk/government/publications/covid-19-autumn-2023-vaccination-programme-jcvi-update-7-july-2023/jcvi-statement-on-the-covid-19-vaccination-programme-for-autumn-2023-update-7-july-2023


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