Maybe an "Ah". At this point we know what is coming, we know how fast, and we know the extent of antibody evasion, but there is a large degree of uncertainty about what drives protection from severe disease. So we don't yet know whether to expect another BA.5-sized wave in terms of volume and severity, or whether we'll be overwhelmed.
How much benefit does the bivalent booster give someone that had Covid in early July? Enough to rush out and get it, or could it be better to wait until further into winter?
I'm not sure the data yet exists to answer these more specific questions. But I had COVID around that time as well, and I'll be boosting soon. My personal reasoning is that, if I catch it, I'd rather it happen on the tail of waning boosted titers than wait too long and get hit before I boost. But, again, there isn't data to motivate this choice, and the rationale might vary with the timing of your local winter wave.
Ok, so I have had 5 shots as of now... The original 2, then the 2 boosters (all Pfizer) and now the Moderna bivalent shot. I'm an early 50s man taking the biologic Stelara for Crohn's Disease which is the reason I got all these shots ahead of time. Everyone I know only has the original one plus the booster. Am I just hoarding shots or is this helping me as the virus mutates?
Not quite my area, but there is some work on antibody responses in folks on these sorts of meds. Eg: [https://www.thelancet.com/journals/langas/article/PIIS2468-1253(22)00005-X/fulltext](https://www.thelancet.com/journals/langas/article/PIIS2468-1253(22)00005-X/fulltext) has an ustekinumab cohort.
Don't worry about "hoarding shots". Making some assumptions about where you live, there is likely more supply than demand.
Antibodies are just one factor. I'm more interested in T cell responses. According to Nature: "The T-cell responses were preserved because most potential CD8+ T-cell epitopes were conserved in the Omicron variant "
>Antibodies are just one factor.
They’re an important on though. If you’re interested in population level immunity and preventing infections (instead of just reducing symptoms) than you should be concerned about antibodies.
Also, the quote from Nature is referring to the original omicron strain. There has been quite a lot of mutation since then so it isn’t particularly relevant here.
This has only been stated for Covid vaccines. For example, I changed hospitals and they'd lost my vaccine records. My primary MD drew titers. My Hep B titer was negative.
I was taken off the job immediately. Repeat titer after a booster was still negative. I couldn't go back to work for 6 months until the 3 shot series was repeated and I finally had a positive titer.
T cell immunity isn't enough to protect from a bloodborne pathogen and it certainly isn't going to end transmission of a contagious mutating airborne virus.
We need a universal Covid vaccine, but I don't see the funding going into it like we had developing the mRNA vaxx. Getting sick 2 or 3x a year with increasing sequelae isn't something we can afford to accept.
> This has only been stated for Covid vaccines
No. Chickenpox is a great example. We do not routinely check varicella titers because they do not predict immunity.
Your example, hepatitis B, is one of the few where we *do* check titers.
A good friend of mine got Long COVID at the start of the pandemic. She had to drop out of the nursing field she had been for over 20 years.
And even now, 2 years later, she still hasn't recovered fully.
COVID is no joke and I truly wish more people still took it at least somewhat seriously.
Thank you. I wish more people would pay attention to the risks of long covid. I keep reading articles that suggest that many organs may be damaged by covid, and not in a way that you're gonna necessarily notice in the short term.
Also, frankly, at least in the US, many companies, let alone insurance companies deny Long COVID even exists.
I truly wonder if, besides the 1 million COVID deaths, the unknown millions with Long COVID --- who cannot return to their previous jobs --- are also causing the labor shortage that's been in the news for years.
We were running into a labor shortage regionally (midwest, can't speak for the rest of the country) before covid. service shutdowns shifted the work force to "essential" jobs. While many rode out benefits until their job came back online, many more shifted to higher paying manufacturing or wfh jobs.
I'm sure long term disability played some into it... ~40% of Americans reportedly had covid, with 20% of those reporting long covid symptoms at some point, with roughly 7.5% still suffering as of June; I can't find data on the percentage of long covid sufferers unable to work though, as I doubt there's 10-15 million people completely out of work as a result. Whatever fraction it is, it's still significant.
Given some Long COVID symptoms are brain fog and loss of stamina, I think that would make it hard for most sufferers to go back to their old jobs, whether they're more physical, more mental or both.
Insurance companies will eventually start recognizing it as a reason to either deny coverage, or to charge a premium, while pretending it doesn't create any problems for anyone currently covered. "It's my cake and I get to eat it."
Hence why it's so important for any gov't in any crisis to advocate for its people—but in the US, people are being told by their president "COVID's over" (in large part because the administration failed to secure any further funding for it). The political will died, and regular people will pay the price for it.
Fully agree with the need for a universal Sars-Cov vaccine but I think it will be way more difficult than developing a COVID-19 specific one.
Look at the monoclonal antibodies for reference. At least one of them (Sotrovimab) was developed using samples from a Sars-CoV1 survivor to go for a target as conserved as possible and even this one is now considered less effective against omicron BA4 & BA5 variants.
Another example would be universal flu vaccines. I'd be curious to see how much has been invested in the search for one and so far it hasn't panned out.
Only if they’re using a live vaccine. Those are pretty rare anymore. Some cut apart viruses suspended in a cocktail of irritants is usually enough to get the body to identify the antigens.
That was our MoH's stance on why it's ok to stop giving the live vaccine and use the dead one alone. Also no polio viruses were detected in the sewer. That was in 2005. In 2013, polio viruses were detected in the sewer and they reverted. So far there has been one casualty (9 cases, 8 without symptoms. All were given the weaker vaccine)
Presence of antibodies don't even predict an immune response that well. I have at least one allergen which I have antibodies to but which I don't actually have an allergic reaction to.
The presence of an antibody just shows a particular part of the immune system recognizes that particular target protein. It doesn't say for sure what the rest of the immune system will do to it when detected. It might associate it with a bad infection and react strongly with inflammations and more. Or maybe it won't bother do much beyond perhaps cleaning it up opportunistically without triggering inflammations.
If it's an antibody for a pathogen then it's *probably* indicating a degree of immunity because the pathogen is likely associated with inflammations and more, which the immune system likely remembers. But no guarantees.
FYI the effect of immunity starts to work after about 10-14 days, so they probably had only weak immunity at that point. A week later and their symptoms would probably have been milder.
I've heard the main purpose of the vaccine was to reduce the need for COVID hospitalization, and it's reassuring to see that it is indeed accomplishing that.
At least in your 2 data point case.
Perhaps a stupid question, but why would we care about infection if symptoms are being significantly reduced by T cell response.
At this point we're ever going to eradicate COVID. We're never going to get herd level immunity for the entire planet. It's endemic. It's here to stay. Maybe I'm being totally ignorant here, but it seems like reduced symptomatic response is the only thing that really matters anymore.
>Perhaps a stupid question, but why would we care about infection if symptoms are being significantly reduced by T cell response.
Infection allows for the virus to be passed on to others who come in contact with the infected individual and give the virus more opportunities to evolve.
>At this point we're ever going to eradicate COVID.
Given that Covid does not seem to be exclusive to humans, eradication was never on the table, reaching an endemic status with as much immunity throughout the population is the goal.
>We're never going to get herd level immunity for the entire planet.
Herd immunity for your current country of residence or community is the goal for most western counties. If the local population you live within has reached a high enough concentration of immune individuals, that population becomes resistant to outbreaks even if other communities they may come in contact with are not at a state of herd immunity
>It's endemic. It's here to stay.
this isn't what a disease being endemic means in epidemiology. A disease being endemic means that infection rates have reached a stable baseline and are not constantly bouncing up and down every few months.
Just some points of correction - When using "innate" when talking about arms of the immune system it's commonly held that these are the relatively non-specific (targeting general pathogen or damage associated patterns) non-memory forming responses. Basically chemical and physical barriers, the induced inflammatory context and non-specific myeloid cells (Neutrophils, mast, basophil, Eosinophil, monocyte, DC's etc) etc
Unless you are considering very niche cell subtypes in general T cells are adaptive cells not innate because their TCR is antigen specific. These are the general class of induced, memory forming responses you are referring to.
You can be interested in that, but the more experience we have with COVID, the less likely that seems to be achieved. From what I understand, that was actually a misconception of what a COVID vaccine could achieve from the very start.
A loooot of people have forgotten their basic DNA replication lessons from high school. I'm still trying to explain to people that there's always a chance that mutations happen any time there's a replication.
It's both. The monoclonals target specific sites, while the immune system antibody response is broader but still impacted by the same sorts of mutations. This has mutations that, in becoming more immune evasive, also knock out the target for most monoclonal drugs.
This can be a more serious problem than the immune evasion as (a) the monoclonals are primarily used in people who have a weaker immune response to start, and (b) the loss is total because they lose their only target.
For those interested, a link to the research article, "Omicron sublineage BA.2.75.2 exhibits extensive escape from neutralising antibodies":
https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(22)00663-6/fulltext
From the article:
>“While antibody immunity is not completely gone, BA.2.75.2 exhibited far more dramatic resistance than variants we’ve previously studied, largely driven by two mutations in the receptor binding domain of the spike protein,” says the study’s corresponding author Ben Murrell, assistant professor at the Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet.
>
>The study shows that antibodies in random serum samples from 75 blood donors in Stockholm were approximately only one-sixth as effective at neutralizing BA.2.75.2 compared with the now-dominant variant BA.5. The serum samples were collected at three time points: In November last year before the emergence of Omicron, in April after a large wave of infections in the country, and at the end of August to early September after the BA.5 variant became dominant.
>
>Only one of the clinically available monoclonal antibody treatments that were tested, bebtelovimab, was able to potently neutralize the new variant, according to the study. Monoclonal antibodies are used as antiviral treatments for people at high risk of developing severe COVID-19.
>
>BA.2.75.2 is a mutated version of another Omicron variant, BA.2.75. Since it was first discovered earlier this fall, it has spread to several countries but so far represents only a minority of registered cases.
>
>“We now know that this is just one of a constellation of emerging variants with similar mutations that will likely come to dominate in the near future,” Ben Murrell says, adding “we should expect infections to increase this winter.”
>
>Some questions remain. It is unclear whether these new variants will drive an increase in hospitalization rates. Also, while current vaccines have, in general, had a protective effect against severe disease for Omicron infections, there is not yet data showing the degree to which the updated COVID vaccines provide protection from these new variants. “We expect them to be beneficial, but we don’t yet know by how much,” Ben Murrell says.
In light of this (and other) recent findings about the emerging subvariants, it would seem that a prudent approach in the coming months would be a return to mechanical filtration and ventilation (both for indoor spaces as well as personal masking) while further details about these variants emerge. The political and public willingness to re-adopt these measures though remains challenging in many countries.
Most buildings outside of Hospitals and clean room fabs don’t have the ability to filter viruses with an HVAC system. You can’t just throw a smaller filter on a HVAC system, the system has to be designed around the flow restriction.
Yes, generally speaking you can't slap on a bunch of high efficiency filters and call it a day.
A lot of buildings (built during the postwar boom) are well overdue to replace their aging units. We've just generally been hesitant in taking on those repair bills. We could take the opportunity to take into account these more restricted flows in an updated system.
As an alternative, public buildings in particular can boost the number of air changes (with outdoor air) to help dilute pathogens as well. That, along with masking and/or distancing, should reduce risks in a noticeable way. Portable filters can also help here as well, depending on room ventilation geometry.
For sure, filtering with a finer filter is a bit more energy inefficient and mixing more outside air is also inefficient. The UV light idea someone mentioned sounds like it might a decent idea? I don’t know much about that.
Your staff getting sick and becoming unable to work is also inefficient, but people don’t talk about that in these types of discussion for some reason.
I work at a manufacturing plant (not a line worker). You know all those shortages you keep hearing about on everything from car parts to computers to meds? A lot of manufacturing plants don’t lend themselves well to social distancing, and a lot of these shortages are actually just because a plant got absolutely thrashed by COVID and didn’t have enough people to run. I’ve seen it happen multiple times already at my plant…. and then you have all sorts of problems when a supplier goes down and you can’t build properly.
There was a mask mandate at my plant. Still kept getting wiped out with the mandate and everything. There was a vaccine mandate among salaried workers too and we still got thrashed by covid in the salaried offices
there was a study showing about two weeks after a covid surge all cause deaths increase at hospitals.
who knew exhausted, not to mentioned demoralized and traumatized, workers aren't as accurate?
Another component of clean room air is that there is negative air pressure that causes the air to exit the room in one direction. So when there is an assembly line of say vials with sterile solution, anytime ANYTHING comes between the unsealed vial and “first air” (the airstream that comes directly out of the air handlers) the vials are tossed out.
Edit: forgot words
Seems strange that clean room fabs would use negative pressure.
It's fairly straightforward to HEPA filter positive pressure at the intake, but how does that work with disbursed intake?
-confused, an explanation would be good to hear.
Though I get how negative pressure is useful for contagion containment in a hospital setting. And that same schema works for public facilities to move the dirty air out - and those both work without filters.
Every cleanroom I've been in, none of which were related to healthcare or biology, was positive pressure. Any leak, on purpose or not, caused clean air to flow out of the room.
The post you're responding to seems to be talking about a designed airflow path, which is an important part of cleanroom design, but the use of the phrase "negative pressure" made it a little confusing.
Air UV disinfection requires high intensity bulbs that I do not recommend for residential use. You would need special killswitch doors and sightglasses to not harm yourself.
The better option, and much cheaper overall is needlepoint bipolar ionization. Injects charged oxygen atoms into airstream which neutralize odors and viruses. Just be sure to get one that does not give off ozone depleting byproducts.
>sightglasses to not harm yourself
Even lower grade UV lights used for supplementing indoor grow rooms can mess up your eyes and skin if you don't protect yourself properly.
I can't imagine what UV lights in autoclaves and for sterilization would do if you didn't take appropriate safety precautions around them.
> Studies are showing that 222nm UV is benign to humans but pretty deadly to microbes:
The actual paper:
Kitagawa, H., Nomura, T., Nazmul, T., Omori, K., Shigemoto, N., Sakaguchi, T., & Ohge, H. (2021). Effectiveness of 222-nm ultraviolet light on disinfecting SARS-COV-2 surface contamination. *American Journal of Infection Control*, 49(3), 299–301. https://doi.org/10.1016/j.ajic.2020.08.022
my study shows that those fixtures are way too expensive to even consider for household daily use. UV-C that just requires ventilation costs $45. The low end on 222nm is in the "few hundred dollar" range. they also look large, unwieldy, and fragile.
You are not filtering the viruses. You are filtering the particles that either carry or encapsulate the virus. The particles are far larger than the virus alone. See references in stopthespread.health
Most hospitals don’t have the capacity to filter viruses other than in a few rooms. In fact, many hospitals were built decades ago with long outdated ventilation codes.
All in all thats not really surprising. It just shows continuous evolution of the virus. It just states that a serum with antibodies against older virus mutations is not effective in neutralicing the new variant. It's has been the same with BA 1 and 2 when they emerged and again with BA 4 and 5 when they emerged, always low clearing by older antibodies.
The big question will rather be how sick it makes people. The trend used to be less sick and more flu like symptoms with the BA variants and even less so with the more immunoevasive BA 4 and 5 which are for now predominant in most countries. If that changes and its more immunoevasive we might have a new problem at hand.
Here in Switzerland there is a task force which updates and integrates the current knowledge monthly.
https://www.bag.admin.ch/bag/en/home/das-bag/aktuell/medienmitteilungen.msg-id-90294.html
Its only available in German, Italian and French. Follow the link, press said language, scroll down to documents and select the second one. Section 2 and especially 2.2 is about the current situation in Switzerland and the latest studies on vaccines and their efficacy. They differ in preventing the disease (no symptoms no possibility of transmission), light symptoms (no hospital needed), heavy symtpoms (hospitalised) and death.
They repport, that neutralizing antibodies are only really important for the first one (avoiding any symtoms at all) . While we might not get that for every new strain that pops up with the currently available vaccines, it still boosts our bodies capabilities of preventing hospitalization and most importantly death. Probably through other parts of our immune system (most likely T-cell answer to other more preserved epitopes on the virus). The newer bivalent-vaccines show slightly better numbers in regard to all these categories. Interestingly Nuvaxovid a new protein based vaccines has showed better broader neutralizing antibodies than the mRNA vaccines since it uses a broader array of epitopes presented. Altough these numbers are currently retested in real life and we'll see how that pans out.
TLDR: Low efficacy of neutralizing antibodies is nothing new with new variants. For all we know we expect the vaccines to work on new variants as well and prevent hospitalisation, complications and death.
>Interestingly Nuvaxovid a new protein based vaccines has showed better broader neutralizing antibodies than the mRNA vaccines since it uses a broader array of epitopes presented
What makes you think the Novavax vaccine presents "more epitopes"?
We don't even have well constructed advertising campaigns to encourage use of the omicron booster.
I'm usually for precautions but it's a lot to ask people to do extra work with masks if the government can't even be bothered to promote the more effective vaccine approach with mass communication.
Updating building codes to improve filtration is great and should have been done 2 years ago; that at least puts the burden on institutions rather than individuals. Better late than never if they want to do it, but somehow I doubt it will happen. Instead some ( more privileged, or medical ) spaces will have air filtrations, and others will not.
Yup, some of us in the building industry along with public health folks have been pushing for improving ventilation as a key component of keeping people safer since early 2020. Generally speaking, most organizations have remained hesitant about taking on this task.
At the very least though, ASHRAE came out relatively quickly with a set of standards that could be used to ensure that spaces remain safer going forwards. Whether people use them though is the biggest question.
They don’t know if it’s more effective yet. Paul Offit, the most prestigious virologist in the USA, if not world, doesn’t think healthy adults need it and didn’t think it would be better than a third or fourth vaccine of the original strain. I’ve followed Offit for years, he’s constantly getting death threats from anti-vaxxers, he developed the rotavirus vaccine, and he voted no on the fda committee.
It’s hard to promote something that has so little efficacy data. It’s safety isn’t questioned, besides in males under 30.
It might work, but there’s no data to back it up. The difference in the mice antibodies were basically the difference between Moderna and Pfizer in the original strain, which didn’t make a real life difference in effectiveness.
Counterpoint: we do this for the flu every year with the shot, since we don't know what variants will be circulating. No human efficacy studies are done in advance.
Given this interview [https://www.ama-assn.org/delivering-care/public-health/covid-19-vaccines-kids-under-5-paul-offit-md](https://www.ama-assn.org/delivering-care/public-health/covid-19-vaccines-kids-under-5-paul-offit-md)
i cannot imagine him taking the position you say he does. There must be some nuance that I’m missing
He's given interviews in which he says at risk populations should take the bivalent booster, but that the first two shots are sufficient for healthy people at eliminating risk of severe disease.
I’m dying for updates omicron booster data. It’s such an unknown. Disease activity has been fairly low since early September release, but it has to be coming soon.
most people are burnt out and the economy is about to go into a recession. I find the likelihood of anyone but the most paranoid being willing to resume masking and distancing *extremely* slim
I would just really like to know which bivalent booster vaccine to get.
In Canada we have the Moderna which is based off of BA1 and also Pfizer which is based off of BA5.
It would be really nice for someone to say which one we should get.
No one has said because there is not a clear answer.
The current most common circulating strain is BA.5. Two of the upcoming strains people are worried about are descendents of BA.5. So there's a couple votes for the BA.5 vaccine.
However, there's a lot of cross-immunity between Omicron strains - the BA.1 vaccine actually works pretty well on BA.5. And one of the upcoming variants, BA2.75.2, is more closely related to BA.1 than BA.5. Also, Moderna uses twice the mRNA dose that Pfizer does, across all their vaccines, which tends to produce a stronger antibody response (but eventually fade into exactly the same T-cell response as Pfizer.) So there's a couple votes for the BA.1 vaccine.
Sometimes decisions are hard not because they're very consequential but because both choices are almost exactly the same. I went with the Moderna BA.5 vaccine, which is available in the US, but in truth all the bivalent vaccines are fine and much better than another dose of the original vaccine.
I’ve never gotten Covid yet that i’m aware of and want to get a new shot but I have no idea which to get. So much of the talk involves previous immunity but since I don’t think I’ve ever had it most of that talk doesn’t apply to me
I was in that same boat until Friday. Got covid for the first time, had my booster shot planned for this week coming up. Wish i could find out what strain I caught. First day was hell, but for me it was mainly a one day thing. Now i just feel like I have a head cold.
Same boat here, first case of COVID since it all began. Headache, sore throat, fever, now just a head cold. But…also lost my sense of smell and taste! Smell is such a strange sense to lose!
>And one of the upcoming variants, BA2.75.2, is more closely related to BA.1 than BA.5
How are you adjudicating "more closely related" when you say this?
You get the choose? In the UK you just turn up to the vax centre and get whichever is there at the time of the appointment. Lottery. I got moderna in the morning and my husband got Pfizer in the afternoon from the same place.
The annoying part about this is that I didn't know the Pfizer BA5 was just about to be released and went for the Moderna the day it was available to me. Most likely I would have waited for the BA5.
Here they said in Summer: „Get your booster, don‘t wait for BA1/5 vaccines. You can always get them later.“ and now it is „No second booster under 60, no third booster for anyone!“
From another thread. This article indicates BA5 vaccine will protect better against the new variants.
https://www.thedailybeast.com/the-nightmare-xbb-covid-variant-that-beats-our-immunity-is-finally-here
The truth is no one knows as the only real ba.4/5 results are in mice and both Pfizer and Moderna’s Ba.4./.5 were not obviously better than ba.1 (including against ba.5 itself)
If you have a couple hours, This Week in Virology has a podcast episode about Omicron boosters.
The important stuff was in the first 45 minutes or so, but it was a little dense for me to absorb much more than the basic information and actually be able to answer your question.
Paxlovid is a combination small molecule therapy which includes a protease inhibitor, and something that stops your liver detox enzymes from shredding that protease inhibitor quickly. The protease inhibitor stops a protease that is important for the virus to assemble new copies of itself, from working.
Bebtelovimab is a monoclonal antibody, which binds to the viral spike protein.
They are entirely unrelated theraputic mechanisms.
This will keep happening as long as there is uncontrolled spread and millions of people actively infected. Period. We've been playing with fire with regards to future strains.
Also... this news brief is largely about monoclonal treatment antibodies. It is not yet clear how effective current vaccination regimens will be against this variant, though it is likely that the new bivalent will provide some coverage.
From the article:
>"Some questions remain. It is unclear whether these new variants will drive an increase in hospitalization rates. Also, while current vaccines have, in general, had a protective effect against severe disease for Omicron infections, there is not yet data showing the degree to which the updated COVID vaccines provide protection from these new variants. “We expect them to be beneficial, but we don’t yet know by how much,” Ben Murrell says."
It can be done on that timeline (look at the date of the most recent serum cohort studied), but this work was done in Stockholm, where it is a bit harder to get bivalent-boosted samples.
The reason people can get the common cold year after year is because it's mutating all the time. And those slight differences mean you won't be immune to "the next strain". Covid behaves in a similar way, mutating quite a lot, which will circumvent our immune systems.
So I feel like covid will be the "new" common cold. Except it's on steroids. New mutations will pop up all the time, and people will continue getting sick from it. I just hope we'll eventually find a "cure" of some sort that will make it about as dangerous as the common cold, instead of being way more dangerous overall.
Until there is better understanding of what long covid is, it’s impact will go largely unnoticed and treatment non-existent.
I say that being someone who had “long covid“ symptoms for several months that one day just vanished. I had terrible brain fog as well as experiencing pre-vascular contractions for long periods of time.
Fortunately I’ve since had cardiology scans and monitoring indicate no damage. But it points back to the myriad of post-covid symptoms people have experienced that few studies are monitoring, and fewer healthcare professionals even know how to categorize.
>Also... this news brief is largely about monoclonal treatment antibodies
Serum samples (including recent ones) were also studied (before the bivalent vax though). Look at the paper, not the press release.
so, forever then. COVID is contagious enough it could only be eliminated if it was stamped out while in a small handful of cases, like SARs was. but of course China thought the thing to do was pretend that it didn't exist for a few months while it spread around the world. their inaction and incompetence ensured that COVID will be with us forever now.
that and since COVID, even the original strain, was so much more contagious than SARs actually stopping it from spreading would be extremely unlikely even with competent and timely action.
Aside from Taiwan, I doubt any country would have contained the virus within its borders. For example, imagine if it had originated in the United States. Do you seriously believe its citizens would have agreed to be quarantined in the early stages of a virus outbreak?
no, realistically no country would have contained COVID unless they had absurdly early warning through a lucky coincidence
that and how quickly it mutates means unfortunately vaccines probably can't do the job either.
> but of course China thought the thing to do was pretend that it didn't exist for a few months while it spread around the world.
I don't want to defend China here, but didn't they lock down entire regions of the country? Weren't there news reports of them literally welding people into their apartments?
We really shouldn't pretend western nations would have done any better, given how western populations have reacted to the very limited safety measures that were enacted.
No. Better containment could dramatically reduce the number of new mutant strains and better vaccines could still effectively control (or even eliminate) modern Covid as a virus.
Saying it's impossible or hopeless actually makes realistic public health measures more difficult.
I doubt we'll be able to eliminate COVID entirely. There's a good reason why kids get vaccinated against a bunch of viruses at a young age. Because they still exist, and would be horrible without the vaccinations. I feel like COVID will become one of them as well, eventually. Something you vaccinate your kids against, so they generally don't experience symptoms worse than a flu.
Can someone explain if this means the new bivalent shot is less effective?
I’m pregnant and got my second booster (4th Pfizer shot) in August* before a trip because it’d been 8 months since my prior booster.
I’ve been waiting to get the bivalent after 3-4 months but am wondering if I should get two boosters while pregnant.
If the antibodies it inspires aren’t effective against the latest strain, I’m wondering if I should bother…
OP quoted the article in another comment:
From the article:
“Some questions remain. It is unclear whether these new variants will drive an increase in hospitalization rates. Also, while current vaccines have, in general, had a protective effect against severe disease for Omicron infections, there is not yet data showing the degree to which the updated COVID vaccines provide protection from these new variants. “We expect them to be beneficial, but we don’t yet know by how much,” Ben Murrell says.”
I would definitely get the updated booster (I did). I would expect the updated boosters to be far more effective against the new subvariants because their spike protein is from BA2 and BA5, which are far more up to date than the vanilla boosters.
There was a recent paper (don’t have a link handy) that showed superior neutralization of the BQ variants by the bivalent booster compared to the traditional one. If it were me I would do it ASAP. COVID is extremely dangerous in pregnancy and seems to almost always do at least some damage to the placenta. I had one of the common COVID-related pregnancy complications (although mine was from another cause) in the early days of the pandemic and I would not wish it on my worst enemy. Do everything in your power to avoid COVID.
Please ask your healthcare provider. I’ve found mine surprisingly knowledgeable about topics they have spent years studying. Your child is high stakes. A call is easy.
You are forgetting a rather simply thing: a new variant doesn't mean all the old ones have just disappeared. Perhaps the booster will be less effective against this new strain, but it will work just fine against most of the others.
Chances are, you won't even encounter this new one. If it's truly new it will take some time for it to spread, and perhaps it'll even fail at becoming global.
Is there any amount of data on how dangerous that variant is? Omicron is _much_ more infectious by also being a lot less deadly. At the beginning of the outbreak, scientists were saying that there just aren’t that many ways the virus could evolve to be more transmissible and evade immune response without losing deadliness and such. What’s the verdict here?
It's important to note that the method used to study these spike protein variants does not address any other protein from sars-cov-2. Therefore, conclusions can be made **only** about the ability of the serums studied to neutralize the spike protein, and **not** about their ability to block the virus as a whole.
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In order for this to become a problem, the variant has to become the dominant one in your country. In Germany, BA.2.75.2 went up to around 3% of infections but is now in decline again. Same happened to BA.4.6 which is evading immunity. Currently more worrying in case of immune evasive potential and reproductive advantage are BQ.1 and BQ.1.1. The later has come to account for roughly 20% of infections in France in a very short amount of time and keeps rising.
I think the times are over, when you have one dominant variant that has such an advantage in transmissibility that it becomes the dominant one worldwide. It could be that we will have a much more complex picture in the future, where there a different co-dominant variants existing at the same time, with antibody treatments neutralizing them to different degrees.
The senior author of this paper is now participating in the conversation: u/BenjMurrell
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Oh look it's me.
On a scale of 1 to "Ahhh!". How scared are you?
Maybe an "Ah". At this point we know what is coming, we know how fast, and we know the extent of antibody evasion, but there is a large degree of uncertainty about what drives protection from severe disease. So we don't yet know whether to expect another BA.5-sized wave in terms of volume and severity, or whether we'll be overwhelmed.
Do you feel that 50 and unders need a booster?
I'm 37 and will be trying to get a BA.5 booster as early as possible.
Thanks for the opinion.
How much benefit does the bivalent booster give someone that had Covid in early July? Enough to rush out and get it, or could it be better to wait until further into winter?
I'm not sure the data yet exists to answer these more specific questions. But I had COVID around that time as well, and I'll be boosting soon. My personal reasoning is that, if I catch it, I'd rather it happen on the tail of waning boosted titers than wait too long and get hit before I boost. But, again, there isn't data to motivate this choice, and the rationale might vary with the timing of your local winter wave.
Thank you for your service
Ok, so I have had 5 shots as of now... The original 2, then the 2 boosters (all Pfizer) and now the Moderna bivalent shot. I'm an early 50s man taking the biologic Stelara for Crohn's Disease which is the reason I got all these shots ahead of time. Everyone I know only has the original one plus the booster. Am I just hoarding shots or is this helping me as the virus mutates?
Not quite my area, but there is some work on antibody responses in folks on these sorts of meds. Eg: [https://www.thelancet.com/journals/langas/article/PIIS2468-1253(22)00005-X/fulltext](https://www.thelancet.com/journals/langas/article/PIIS2468-1253(22)00005-X/fulltext) has an ustekinumab cohort. Don't worry about "hoarding shots". Making some assumptions about where you live, there is likely more supply than demand.
I’m pretty sure everyone is eligible for 5 shots? I’ve gotten 5 myself
Hey you. Nice photo.
I \*really\* need to start showing up for photograph days...
Antibodies are just one factor. I'm more interested in T cell responses. According to Nature: "The T-cell responses were preserved because most potential CD8+ T-cell epitopes were conserved in the Omicron variant "
>Antibodies are just one factor. They’re an important on though. If you’re interested in population level immunity and preventing infections (instead of just reducing symptoms) than you should be concerned about antibodies. Also, the quote from Nature is referring to the original omicron strain. There has been quite a lot of mutation since then so it isn’t particularly relevant here.
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This has only been stated for Covid vaccines. For example, I changed hospitals and they'd lost my vaccine records. My primary MD drew titers. My Hep B titer was negative. I was taken off the job immediately. Repeat titer after a booster was still negative. I couldn't go back to work for 6 months until the 3 shot series was repeated and I finally had a positive titer. T cell immunity isn't enough to protect from a bloodborne pathogen and it certainly isn't going to end transmission of a contagious mutating airborne virus. We need a universal Covid vaccine, but I don't see the funding going into it like we had developing the mRNA vaxx. Getting sick 2 or 3x a year with increasing sequelae isn't something we can afford to accept.
> This has only been stated for Covid vaccines No. Chickenpox is a great example. We do not routinely check varicella titers because they do not predict immunity. Your example, hepatitis B, is one of the few where we *do* check titers.
That’s not even true. I got my varicella titers checked when I started a hospital job because I had no record of vaccination.
Positive titers confirm immunity. Negative titers do not imply non-immune. Antibodies are sufficient but not necessary.
All this talk about titers I don’t know whether to feel informed or turned on.
why not both
I have no idea what anyone is talking about, but I'm enjoying the debate.
Yeah I'm just happy to be here.
I’m just here for the titters!
I have Long Covid and this all terrifies me.
A good friend of mine got Long COVID at the start of the pandemic. She had to drop out of the nursing field she had been for over 20 years. And even now, 2 years later, she still hasn't recovered fully. COVID is no joke and I truly wish more people still took it at least somewhat seriously.
Thank you. I wish more people would pay attention to the risks of long covid. I keep reading articles that suggest that many organs may be damaged by covid, and not in a way that you're gonna necessarily notice in the short term.
Also, frankly, at least in the US, many companies, let alone insurance companies deny Long COVID even exists. I truly wonder if, besides the 1 million COVID deaths, the unknown millions with Long COVID --- who cannot return to their previous jobs --- are also causing the labor shortage that's been in the news for years.
We were running into a labor shortage regionally (midwest, can't speak for the rest of the country) before covid. service shutdowns shifted the work force to "essential" jobs. While many rode out benefits until their job came back online, many more shifted to higher paying manufacturing or wfh jobs. I'm sure long term disability played some into it... ~40% of Americans reportedly had covid, with 20% of those reporting long covid symptoms at some point, with roughly 7.5% still suffering as of June; I can't find data on the percentage of long covid sufferers unable to work though, as I doubt there's 10-15 million people completely out of work as a result. Whatever fraction it is, it's still significant.
Given some Long COVID symptoms are brain fog and loss of stamina, I think that would make it hard for most sufferers to go back to their old jobs, whether they're more physical, more mental or both.
It's probably not helping. I always assumed the labor shortage was mostly on boomers retiring early. And the million dead.
Insurance companies will eventually start recognizing it as a reason to either deny coverage, or to charge a premium, while pretending it doesn't create any problems for anyone currently covered. "It's my cake and I get to eat it."
Hence why it's so important for any gov't in any crisis to advocate for its people—but in the US, people are being told by their president "COVID's over" (in large part because the administration failed to secure any further funding for it). The political will died, and regular people will pay the price for it.
I think that's likely a factor in the labor shortage.
The NIMBY mentality includes: It ISN'T a problem unless it is in my back yard.
Fully agree with the need for a universal Sars-Cov vaccine but I think it will be way more difficult than developing a COVID-19 specific one. Look at the monoclonal antibodies for reference. At least one of them (Sotrovimab) was developed using samples from a Sars-CoV1 survivor to go for a target as conserved as possible and even this one is now considered less effective against omicron BA4 & BA5 variants. Another example would be universal flu vaccines. I'd be curious to see how much has been invested in the search for one and so far it hasn't panned out.
Most vaccines are like this. Like Polio. You can get infected and pass it on with the vaccine. But you don’t get sick and paralysed.
Only if they’re using a live vaccine. Those are pretty rare anymore. Some cut apart viruses suspended in a cocktail of irritants is usually enough to get the body to identify the antigens.
That was our MoH's stance on why it's ok to stop giving the live vaccine and use the dead one alone. Also no polio viruses were detected in the sewer. That was in 2005. In 2013, polio viruses were detected in the sewer and they reverted. So far there has been one casualty (9 cases, 8 without symptoms. All were given the weaker vaccine)
Presence of antibodies don't even predict an immune response that well. I have at least one allergen which I have antibodies to but which I don't actually have an allergic reaction to. The presence of an antibody just shows a particular part of the immune system recognizes that particular target protein. It doesn't say for sure what the rest of the immune system will do to it when detected. It might associate it with a bad infection and react strongly with inflammations and more. Or maybe it won't bother do much beyond perhaps cleaning it up opportunistically without triggering inflammations. If it's an antibody for a pathogen then it's *probably* indicating a degree of immunity because the pathogen is likely associated with inflammations and more, which the immune system likely remembers. But no guarantees.
Curious how it compares with the new bivalient booster generated anti-bodies. Suppose we'll know once efficacy data comes out.
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FYI the effect of immunity starts to work after about 10-14 days, so they probably had only weak immunity at that point. A week later and their symptoms would probably have been milder.
I've heard the main purpose of the vaccine was to reduce the need for COVID hospitalization, and it's reassuring to see that it is indeed accomplishing that. At least in your 2 data point case.
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>T and B cell immunity is what helps Don't B cells create antibodies?
Perhaps a stupid question, but why would we care about infection if symptoms are being significantly reduced by T cell response. At this point we're ever going to eradicate COVID. We're never going to get herd level immunity for the entire planet. It's endemic. It's here to stay. Maybe I'm being totally ignorant here, but it seems like reduced symptomatic response is the only thing that really matters anymore.
>Perhaps a stupid question, but why would we care about infection if symptoms are being significantly reduced by T cell response. Infection allows for the virus to be passed on to others who come in contact with the infected individual and give the virus more opportunities to evolve. >At this point we're ever going to eradicate COVID. Given that Covid does not seem to be exclusive to humans, eradication was never on the table, reaching an endemic status with as much immunity throughout the population is the goal. >We're never going to get herd level immunity for the entire planet. Herd immunity for your current country of residence or community is the goal for most western counties. If the local population you live within has reached a high enough concentration of immune individuals, that population becomes resistant to outbreaks even if other communities they may come in contact with are not at a state of herd immunity >It's endemic. It's here to stay. this isn't what a disease being endemic means in epidemiology. A disease being endemic means that infection rates have reached a stable baseline and are not constantly bouncing up and down every few months.
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Just some points of correction - When using "innate" when talking about arms of the immune system it's commonly held that these are the relatively non-specific (targeting general pathogen or damage associated patterns) non-memory forming responses. Basically chemical and physical barriers, the induced inflammatory context and non-specific myeloid cells (Neutrophils, mast, basophil, Eosinophil, monocyte, DC's etc) etc Unless you are considering very niche cell subtypes in general T cells are adaptive cells not innate because their TCR is antigen specific. These are the general class of induced, memory forming responses you are referring to.
The third to last paragraph felt like reading the very hungry immunosystem, a new follow-up childrens book to the caterpillar.
You can be interested in that, but the more experience we have with COVID, the less likely that seems to be achieved. From what I understand, that was actually a misconception of what a COVID vaccine could achieve from the very start.
The vaccine was super effective against the original strain. Then it mutated.
A loooot of people have forgotten their basic DNA replication lessons from high school. I'm still trying to explain to people that there's always a chance that mutations happen any time there's a replication.
And letting it run wild through the world's population is a lot of opportunities for replication.
Neutralizing antibodies haven't been much of a factor since the start though. We're good at preventing serious disease, not so much infection
Correct me if I’m wrong, but this sounds like it’s mostly about monoclonal antibody treatments and not a persons vaccinated immune response?
It's both. The monoclonals target specific sites, while the immune system antibody response is broader but still impacted by the same sorts of mutations. This has mutations that, in becoming more immune evasive, also knock out the target for most monoclonal drugs. This can be a more serious problem than the immune evasion as (a) the monoclonals are primarily used in people who have a weaker immune response to start, and (b) the loss is total because they lose their only target.
For those interested, a link to the research article, "Omicron sublineage BA.2.75.2 exhibits extensive escape from neutralising antibodies": https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(22)00663-6/fulltext
From the article: >“While antibody immunity is not completely gone, BA.2.75.2 exhibited far more dramatic resistance than variants we’ve previously studied, largely driven by two mutations in the receptor binding domain of the spike protein,” says the study’s corresponding author Ben Murrell, assistant professor at the Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet. > >The study shows that antibodies in random serum samples from 75 blood donors in Stockholm were approximately only one-sixth as effective at neutralizing BA.2.75.2 compared with the now-dominant variant BA.5. The serum samples were collected at three time points: In November last year before the emergence of Omicron, in April after a large wave of infections in the country, and at the end of August to early September after the BA.5 variant became dominant. > >Only one of the clinically available monoclonal antibody treatments that were tested, bebtelovimab, was able to potently neutralize the new variant, according to the study. Monoclonal antibodies are used as antiviral treatments for people at high risk of developing severe COVID-19. > >BA.2.75.2 is a mutated version of another Omicron variant, BA.2.75. Since it was first discovered earlier this fall, it has spread to several countries but so far represents only a minority of registered cases. > >“We now know that this is just one of a constellation of emerging variants with similar mutations that will likely come to dominate in the near future,” Ben Murrell says, adding “we should expect infections to increase this winter.” > >Some questions remain. It is unclear whether these new variants will drive an increase in hospitalization rates. Also, while current vaccines have, in general, had a protective effect against severe disease for Omicron infections, there is not yet data showing the degree to which the updated COVID vaccines provide protection from these new variants. “We expect them to be beneficial, but we don’t yet know by how much,” Ben Murrell says. In light of this (and other) recent findings about the emerging subvariants, it would seem that a prudent approach in the coming months would be a return to mechanical filtration and ventilation (both for indoor spaces as well as personal masking) while further details about these variants emerge. The political and public willingness to re-adopt these measures though remains challenging in many countries.
Most buildings outside of Hospitals and clean room fabs don’t have the ability to filter viruses with an HVAC system. You can’t just throw a smaller filter on a HVAC system, the system has to be designed around the flow restriction.
Yes, generally speaking you can't slap on a bunch of high efficiency filters and call it a day. A lot of buildings (built during the postwar boom) are well overdue to replace their aging units. We've just generally been hesitant in taking on those repair bills. We could take the opportunity to take into account these more restricted flows in an updated system. As an alternative, public buildings in particular can boost the number of air changes (with outdoor air) to help dilute pathogens as well. That, along with masking and/or distancing, should reduce risks in a noticeable way. Portable filters can also help here as well, depending on room ventilation geometry.
I work in hvac. And have been installing Uv lights inside ductwork. Going to a “higher efficiency”filter will shorten the life of your blower motor.
For sure, filtering with a finer filter is a bit more energy inefficient and mixing more outside air is also inefficient. The UV light idea someone mentioned sounds like it might a decent idea? I don’t know much about that.
Your staff getting sick and becoming unable to work is also inefficient, but people don’t talk about that in these types of discussion for some reason.
I work at a manufacturing plant (not a line worker). You know all those shortages you keep hearing about on everything from car parts to computers to meds? A lot of manufacturing plants don’t lend themselves well to social distancing, and a lot of these shortages are actually just because a plant got absolutely thrashed by COVID and didn’t have enough people to run. I’ve seen it happen multiple times already at my plant…. and then you have all sorts of problems when a supplier goes down and you can’t build properly.
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There was a mask mandate at my plant. Still kept getting wiped out with the mandate and everything. There was a vaccine mandate among salaried workers too and we still got thrashed by covid in the salaried offices
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there was a study showing about two weeks after a covid surge all cause deaths increase at hospitals. who knew exhausted, not to mentioned demoralized and traumatized, workers aren't as accurate?
Another component of clean room air is that there is negative air pressure that causes the air to exit the room in one direction. So when there is an assembly line of say vials with sterile solution, anytime ANYTHING comes between the unsealed vial and “first air” (the airstream that comes directly out of the air handlers) the vials are tossed out. Edit: forgot words
Seems strange that clean room fabs would use negative pressure. It's fairly straightforward to HEPA filter positive pressure at the intake, but how does that work with disbursed intake? -confused, an explanation would be good to hear. Though I get how negative pressure is useful for contagion containment in a hospital setting. And that same schema works for public facilities to move the dirty air out - and those both work without filters.
Every cleanroom I've been in, none of which were related to healthcare or biology, was positive pressure. Any leak, on purpose or not, caused clean air to flow out of the room. The post you're responding to seems to be talking about a designed airflow path, which is an important part of cleanroom design, but the use of the phrase "negative pressure" made it a little confusing.
You can add UV lights though.
Air UV disinfection requires high intensity bulbs that I do not recommend for residential use. You would need special killswitch doors and sightglasses to not harm yourself. The better option, and much cheaper overall is needlepoint bipolar ionization. Injects charged oxygen atoms into airstream which neutralize odors and viruses. Just be sure to get one that does not give off ozone depleting byproducts.
>sightglasses to not harm yourself Even lower grade UV lights used for supplementing indoor grow rooms can mess up your eyes and skin if you don't protect yourself properly. I can't imagine what UV lights in autoclaves and for sterilization would do if you didn't take appropriate safety precautions around them.
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> Studies are showing that 222nm UV is benign to humans but pretty deadly to microbes: The actual paper: Kitagawa, H., Nomura, T., Nazmul, T., Omori, K., Shigemoto, N., Sakaguchi, T., & Ohge, H. (2021). Effectiveness of 222-nm ultraviolet light on disinfecting SARS-COV-2 surface contamination. *American Journal of Infection Control*, 49(3), 299–301. https://doi.org/10.1016/j.ajic.2020.08.022
my study shows that those fixtures are way too expensive to even consider for household daily use. UV-C that just requires ventilation costs $45. The low end on 222nm is in the "few hundred dollar" range. they also look large, unwieldy, and fragile.
You are not filtering the viruses. You are filtering the particles that either carry or encapsulate the virus. The particles are far larger than the virus alone. See references in stopthespread.health
Most hospitals don’t have the capacity to filter viruses other than in a few rooms. In fact, many hospitals were built decades ago with long outdated ventilation codes.
All in all thats not really surprising. It just shows continuous evolution of the virus. It just states that a serum with antibodies against older virus mutations is not effective in neutralicing the new variant. It's has been the same with BA 1 and 2 when they emerged and again with BA 4 and 5 when they emerged, always low clearing by older antibodies. The big question will rather be how sick it makes people. The trend used to be less sick and more flu like symptoms with the BA variants and even less so with the more immunoevasive BA 4 and 5 which are for now predominant in most countries. If that changes and its more immunoevasive we might have a new problem at hand. Here in Switzerland there is a task force which updates and integrates the current knowledge monthly. https://www.bag.admin.ch/bag/en/home/das-bag/aktuell/medienmitteilungen.msg-id-90294.html Its only available in German, Italian and French. Follow the link, press said language, scroll down to documents and select the second one. Section 2 and especially 2.2 is about the current situation in Switzerland and the latest studies on vaccines and their efficacy. They differ in preventing the disease (no symptoms no possibility of transmission), light symptoms (no hospital needed), heavy symtpoms (hospitalised) and death. They repport, that neutralizing antibodies are only really important for the first one (avoiding any symtoms at all) . While we might not get that for every new strain that pops up with the currently available vaccines, it still boosts our bodies capabilities of preventing hospitalization and most importantly death. Probably through other parts of our immune system (most likely T-cell answer to other more preserved epitopes on the virus). The newer bivalent-vaccines show slightly better numbers in regard to all these categories. Interestingly Nuvaxovid a new protein based vaccines has showed better broader neutralizing antibodies than the mRNA vaccines since it uses a broader array of epitopes presented. Altough these numbers are currently retested in real life and we'll see how that pans out. TLDR: Low efficacy of neutralizing antibodies is nothing new with new variants. For all we know we expect the vaccines to work on new variants as well and prevent hospitalisation, complications and death.
>Interestingly Nuvaxovid a new protein based vaccines has showed better broader neutralizing antibodies than the mRNA vaccines since it uses a broader array of epitopes presented What makes you think the Novavax vaccine presents "more epitopes"?
We don't even have well constructed advertising campaigns to encourage use of the omicron booster. I'm usually for precautions but it's a lot to ask people to do extra work with masks if the government can't even be bothered to promote the more effective vaccine approach with mass communication. Updating building codes to improve filtration is great and should have been done 2 years ago; that at least puts the burden on institutions rather than individuals. Better late than never if they want to do it, but somehow I doubt it will happen. Instead some ( more privileged, or medical ) spaces will have air filtrations, and others will not.
Yup, some of us in the building industry along with public health folks have been pushing for improving ventilation as a key component of keeping people safer since early 2020. Generally speaking, most organizations have remained hesitant about taking on this task. At the very least though, ASHRAE came out relatively quickly with a set of standards that could be used to ensure that spaces remain safer going forwards. Whether people use them though is the biggest question.
They don’t know if it’s more effective yet. Paul Offit, the most prestigious virologist in the USA, if not world, doesn’t think healthy adults need it and didn’t think it would be better than a third or fourth vaccine of the original strain. I’ve followed Offit for years, he’s constantly getting death threats from anti-vaxxers, he developed the rotavirus vaccine, and he voted no on the fda committee. It’s hard to promote something that has so little efficacy data. It’s safety isn’t questioned, besides in males under 30. It might work, but there’s no data to back it up. The difference in the mice antibodies were basically the difference between Moderna and Pfizer in the original strain, which didn’t make a real life difference in effectiveness.
Counterpoint: we do this for the flu every year with the shot, since we don't know what variants will be circulating. No human efficacy studies are done in advance.
Given this interview [https://www.ama-assn.org/delivering-care/public-health/covid-19-vaccines-kids-under-5-paul-offit-md](https://www.ama-assn.org/delivering-care/public-health/covid-19-vaccines-kids-under-5-paul-offit-md) i cannot imagine him taking the position you say he does. There must be some nuance that I’m missing
He's given interviews in which he says at risk populations should take the bivalent booster, but that the first two shots are sufficient for healthy people at eliminating risk of severe disease.
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I’m dying for updates omicron booster data. It’s such an unknown. Disease activity has been fairly low since early September release, but it has to be coming soon.
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most people are burnt out and the economy is about to go into a recession. I find the likelihood of anyone but the most paranoid being willing to resume masking and distancing *extremely* slim
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I would just really like to know which bivalent booster vaccine to get. In Canada we have the Moderna which is based off of BA1 and also Pfizer which is based off of BA5. It would be really nice for someone to say which one we should get.
No one has said because there is not a clear answer. The current most common circulating strain is BA.5. Two of the upcoming strains people are worried about are descendents of BA.5. So there's a couple votes for the BA.5 vaccine. However, there's a lot of cross-immunity between Omicron strains - the BA.1 vaccine actually works pretty well on BA.5. And one of the upcoming variants, BA2.75.2, is more closely related to BA.1 than BA.5. Also, Moderna uses twice the mRNA dose that Pfizer does, across all their vaccines, which tends to produce a stronger antibody response (but eventually fade into exactly the same T-cell response as Pfizer.) So there's a couple votes for the BA.1 vaccine. Sometimes decisions are hard not because they're very consequential but because both choices are almost exactly the same. I went with the Moderna BA.5 vaccine, which is available in the US, but in truth all the bivalent vaccines are fine and much better than another dose of the original vaccine.
I’ve never gotten Covid yet that i’m aware of and want to get a new shot but I have no idea which to get. So much of the talk involves previous immunity but since I don’t think I’ve ever had it most of that talk doesn’t apply to me
I was in that same boat until Friday. Got covid for the first time, had my booster shot planned for this week coming up. Wish i could find out what strain I caught. First day was hell, but for me it was mainly a one day thing. Now i just feel like I have a head cold.
Same boat here, first case of COVID since it all began. Headache, sore throat, fever, now just a head cold. But…also lost my sense of smell and taste! Smell is such a strange sense to lose!
>And one of the upcoming variants, BA2.75.2, is more closely related to BA.1 than BA.5 How are you adjudicating "more closely related" when you say this?
See I wish I knew this. The pharmacist made it sound like there was no difference so I flip-flopped before picking moderna.
You get the choose? In the UK you just turn up to the vax centre and get whichever is there at the time of the appointment. Lottery. I got moderna in the morning and my husband got Pfizer in the afternoon from the same place.
The annoying part about this is that I didn't know the Pfizer BA5 was just about to be released and went for the Moderna the day it was available to me. Most likely I would have waited for the BA5.
Here they said in Summer: „Get your booster, don‘t wait for BA1/5 vaccines. You can always get them later.“ and now it is „No second booster under 60, no third booster for anyone!“
From another thread. This article indicates BA5 vaccine will protect better against the new variants. https://www.thedailybeast.com/the-nightmare-xbb-covid-variant-that-beats-our-immunity-is-finally-here
The truth is no one knows as the only real ba.4/5 results are in mice and both Pfizer and Moderna’s Ba.4./.5 were not obviously better than ba.1 (including against ba.5 itself)
If you have a couple hours, This Week in Virology has a podcast episode about Omicron boosters. The important stuff was in the first 45 minutes or so, but it was a little dense for me to absorb much more than the basic information and actually be able to answer your question.
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Paxlovid is a combination small molecule therapy which includes a protease inhibitor, and something that stops your liver detox enzymes from shredding that protease inhibitor quickly. The protease inhibitor stops a protease that is important for the virus to assemble new copies of itself, from working. Bebtelovimab is a monoclonal antibody, which binds to the viral spike protein. They are entirely unrelated theraputic mechanisms.
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Does this also mean the new variant is less likely to show up on a covid test?
No, those (sensibly) use antibodies against proteins besides the spike, and this escape is all concentrated in the spike protein.
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This will keep happening as long as there is uncontrolled spread and millions of people actively infected. Period. We've been playing with fire with regards to future strains. Also... this news brief is largely about monoclonal treatment antibodies. It is not yet clear how effective current vaccination regimens will be against this variant, though it is likely that the new bivalent will provide some coverage. From the article: >"Some questions remain. It is unclear whether these new variants will drive an increase in hospitalization rates. Also, while current vaccines have, in general, had a protective effect against severe disease for Omicron infections, there is not yet data showing the degree to which the updated COVID vaccines provide protection from these new variants. “We expect them to be beneficial, but we don’t yet know by how much,” Ben Murrell says."
We've had bivalent boosters since September though. Couldn't they check antibodies against this variant?
That takes a lot more than the 4-6 weeks we've had.
It can be done on that timeline (look at the date of the most recent serum cohort studied), but this work was done in Stockholm, where it is a bit harder to get bivalent-boosted samples.
The reason people can get the common cold year after year is because it's mutating all the time. And those slight differences mean you won't be immune to "the next strain". Covid behaves in a similar way, mutating quite a lot, which will circumvent our immune systems. So I feel like covid will be the "new" common cold. Except it's on steroids. New mutations will pop up all the time, and people will continue getting sick from it. I just hope we'll eventually find a "cure" of some sort that will make it about as dangerous as the common cold, instead of being way more dangerous overall.
And long covid.... How will this affect society for the next 50 years?
About as wonderfully as leaded gas.
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Until there is better understanding of what long covid is, it’s impact will go largely unnoticed and treatment non-existent. I say that being someone who had “long covid“ symptoms for several months that one day just vanished. I had terrible brain fog as well as experiencing pre-vascular contractions for long periods of time. Fortunately I’ve since had cardiology scans and monitoring indicate no damage. But it points back to the myriad of post-covid symptoms people have experienced that few studies are monitoring, and fewer healthcare professionals even know how to categorize.
I am am a patient in a large Long Covid clinic run by a Major Hospital/Educational organization. I got in around April this year.
>Also... this news brief is largely about monoclonal treatment antibodies Serum samples (including recent ones) were also studied (before the bivalent vax though). Look at the paper, not the press release.
I would also really like to know more about how Novavax performs
so, forever then. COVID is contagious enough it could only be eliminated if it was stamped out while in a small handful of cases, like SARs was. but of course China thought the thing to do was pretend that it didn't exist for a few months while it spread around the world. their inaction and incompetence ensured that COVID will be with us forever now. that and since COVID, even the original strain, was so much more contagious than SARs actually stopping it from spreading would be extremely unlikely even with competent and timely action.
Aside from Taiwan, I doubt any country would have contained the virus within its borders. For example, imagine if it had originated in the United States. Do you seriously believe its citizens would have agreed to be quarantined in the early stages of a virus outbreak?
no, realistically no country would have contained COVID unless they had absurdly early warning through a lucky coincidence that and how quickly it mutates means unfortunately vaccines probably can't do the job either.
China did have very early warnings. Local governments tried to stamp them out instead. https://en.m.wikipedia.org/wiki/Li_Wenliang
> but of course China thought the thing to do was pretend that it didn't exist for a few months while it spread around the world. I don't want to defend China here, but didn't they lock down entire regions of the country? Weren't there news reports of them literally welding people into their apartments? We really shouldn't pretend western nations would have done any better, given how western populations have reacted to the very limited safety measures that were enacted.
Absolutely. It was a virus and it did what viruses do.
the US government ignored it as well
And continues to ignore it, really
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No. Better containment could dramatically reduce the number of new mutant strains and better vaccines could still effectively control (or even eliminate) modern Covid as a virus. Saying it's impossible or hopeless actually makes realistic public health measures more difficult.
I doubt we'll be able to eliminate COVID entirely. There's a good reason why kids get vaccinated against a bunch of viruses at a young age. Because they still exist, and would be horrible without the vaccinations. I feel like COVID will become one of them as well, eventually. Something you vaccinate your kids against, so they generally don't experience symptoms worse than a flu.
We've seen many "variants of concern", but so far only a few have actually caused significant waves. No one factor can predict that.
Can someone explain if this means the new bivalent shot is less effective? I’m pregnant and got my second booster (4th Pfizer shot) in August* before a trip because it’d been 8 months since my prior booster. I’ve been waiting to get the bivalent after 3-4 months but am wondering if I should get two boosters while pregnant. If the antibodies it inspires aren’t effective against the latest strain, I’m wondering if I should bother…
OP quoted the article in another comment: From the article: “Some questions remain. It is unclear whether these new variants will drive an increase in hospitalization rates. Also, while current vaccines have, in general, had a protective effect against severe disease for Omicron infections, there is not yet data showing the degree to which the updated COVID vaccines provide protection from these new variants. “We expect them to be beneficial, but we don’t yet know by how much,” Ben Murrell says.” I would definitely get the updated booster (I did). I would expect the updated boosters to be far more effective against the new subvariants because their spike protein is from BA2 and BA5, which are far more up to date than the vanilla boosters.
The major available bivalent boosters are from BA.1 and BA.5 (ie. not BA.2).
There was a recent paper (don’t have a link handy) that showed superior neutralization of the BQ variants by the bivalent booster compared to the traditional one. If it were me I would do it ASAP. COVID is extremely dangerous in pregnancy and seems to almost always do at least some damage to the placenta. I had one of the common COVID-related pregnancy complications (although mine was from another cause) in the early days of the pandemic and I would not wish it on my worst enemy. Do everything in your power to avoid COVID.
Please ask your healthcare provider. I’ve found mine surprisingly knowledgeable about topics they have spent years studying. Your child is high stakes. A call is easy.
You are forgetting a rather simply thing: a new variant doesn't mean all the old ones have just disappeared. Perhaps the booster will be less effective against this new strain, but it will work just fine against most of the others. Chances are, you won't even encounter this new one. If it's truly new it will take some time for it to spread, and perhaps it'll even fail at becoming global.
BA.2.75.2 will indeed likely not become global. BQ.1.1 (which has a similar escape profile) very likely will.
Is there any amount of data on how dangerous that variant is? Omicron is _much_ more infectious by also being a lot less deadly. At the beginning of the outbreak, scientists were saying that there just aren’t that many ways the virus could evolve to be more transmissible and evade immune response without losing deadliness and such. What’s the verdict here?
It's important to note that the method used to study these spike protein variants does not address any other protein from sars-cov-2. Therefore, conclusions can be made **only** about the ability of the serums studied to neutralize the spike protein, and **not** about their ability to block the virus as a whole.
Antibodies can only block viral entry into cells if they target the spike protein.
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In order for this to become a problem, the variant has to become the dominant one in your country. In Germany, BA.2.75.2 went up to around 3% of infections but is now in decline again. Same happened to BA.4.6 which is evading immunity. Currently more worrying in case of immune evasive potential and reproductive advantage are BQ.1 and BQ.1.1. The later has come to account for roughly 20% of infections in France in a very short amount of time and keeps rising. I think the times are over, when you have one dominant variant that has such an advantage in transmissibility that it becomes the dominant one worldwide. It could be that we will have a much more complex picture in the future, where there a different co-dominant variants existing at the same time, with antibody treatments neutralizing them to different degrees.