Coronavirus 14: Boosted Waves or Merely a Ripple?

[MrCynical]

Because of the blind credulity by some here about pharma industry sponsored studies, I don't want to miss pointing out a recent example of what very much looks like a deliberately harmful study - how evil they can get. The excuse of incompetence is a sorry one. And there weren't even quick tens of billions of dollars to be made on this one.

As noted above, this isn't anything to do with Covid, but it does have some relevance to earlier discussions on (mis)understanding how scientific research works. Unfortunately you've skipped over the most relevant angle. When you have a string of studies consistent with the null hypothesis, and then get an oddball one that shows a large effect, the reaction as a scientist shouldn't be "wow, it works after all!" it's instead "what's off with the oddball study?". Sound familiar?

Now, I haven't read up a ton on fish oil, and honestly the whole supplement industry's relationship to science is sketchy at best. The linked article's suggestion that the placebo used in the lone positive study was actively harmful is one which should really be easy to verify by statistical analysis. Indeed, implausibly poor placebo arm results are something which should really have been called out in a competent peer review. We had a similar issue show up in an earlier thread on proposed Covid treatment proxalutamide.

From what's printed in the article, it ought to be possible to get clear numbers from already existing data on the various placebos used, vs general population, and see if the mineral oil is inconsistent with the rest. Or, as suggested, just re-run with a different placebo. I'd agree that lone studies sponsored by companies as efficacy tests for their sole product should be regarded as dubious, especially when they give results that are "against the grain" compared to more independent studies. Do you have any studies relevant to Covid that follow this pattern, yet are carrying any scientific weight?

 

[El_Machinae]

It is pointing out the fallibility in the pharmaceutical industry. A reasonable portion of my published research is about nutraceuticals. I'm a noted Optimist when it comes to the total potential of medical research, but there is a lot of sketchy stuff that happens. The system is not well designed to elucidate truth.

People are trusting way too much. There's a reason why so many biologists have been kind of freaked out by the vaccine process. Part of that is because thresholds that we are being forced to meet aren't being met elsewhere.

So when you get a publication rejected during peer review, being held to higher standards than what you can see elsewhere, and you know that the peer review process is actually insufficient to generating strong data, skepticism will be maximized.

This is all confounded by the fact that the Skeptics who get airtime will speak with confidence, and might not have read the supplementary data on the article they are summarizing

 

[miaasma]

related: twitch released a statement mandating masks at twitchcon and the subsequent handwringing has been totally astonishing

 

[The_J]

I think the article innonimatu linked actually shows that scientific research does properly work. Thanks man .

 

[El_Machinae]

If people couldn't detect a harmful effect with a 2000 member placebo group, I'm pretty sure that a few dozen pregnant rats might not be enough information before you start vaccinating pregnant women

 

[MrCynical]

The UK has finally approved an mRNA vaccine updated for the Omicron variant.

Moderna's vaccine targets both the original strain and the first Omicron variant (BA.1), which emerged last winter. It is known as a bivalent vaccine as it takes aim at two forms of Covid.
The UK's Medicines and Healthcare Products Regulatory Agency has considered the evidence and given the vaccine approval for use in adults.
Dr June Raine, the regulator's chief executive, said: "The first generation of Covid-19 vaccines being used in the UK continue to provide important protection against the disease and save lives.
"What this bivalent vaccine gives us is a sharpened tool in our armoury to help protect us against this disease as the virus continues to evolve."
The results of experiments on 437 people showed the updated vaccine was safe and gave better immune protection against newer variants.
Levels of antibodies that were able to stick to and disable Omicron (BA.1) were higher in people given the new vaccine. Tests against more recent Omicron variants (BA.4 and BA.5), which are causing the UK's current wave, also showed higher levels of protection with the updated vaccine.

So Moderna's gone with a mixture of mRNAs for the spike protein from the original strain, along with that from the first Omicron variant. I would guess the logic is to encourage the immune system to generate more broad spectrum antibodies than can bind to either spike protein variant. Clinical trial data has been given in two press releases, from a couple of months ago. For politics, two months is a fairly speedy response I suppose.

Among seronegative participants one month after administration, the neutralizing GMT against ancestral SARS-CoV-2 for mRNA-1273.214 was 5977 (CI: 5322, 6713) , compared to GMT for mRNA-1273 of 5649 (CI: 5057, 6311). The GMT against Omicron for mRNA-1273.214 was 2372 (CI: 2071, 2718), compared to GMT for mRNA-1273 of 1473 (CI: 1271, 1708).

Binding antibody titers (MSD) were also significantly higher (nominal alpha of 0.05) against all other variants of concern (Alpha, Beta, Gamma, Delta, Omicron) for mRNA-1273.214 when compared to mRNA-1273.

Among participants without prior infection, bivalent mRNA-1273.214 resulted in significantly higher neutralizing titers against BA.4/5 compared to the currently authorized booster, with a geometric mean ratio of 1.69 (95% CI: 1.51-1.90)1. One month after booster, BA.4/5 neutralizing titers were 776 (95% CI: 719, 838) for mRNA-1273.214 and 458 (95% CI: 421, 499) for the currently authorized booster. The BA.4/5 geometric mean fold rise (GMFR) from pre-booster levels was 6.3-fold (95% CI: 5.7, 6.9) for mRNA-1273.214 recipients, and 3.5-fold (95% CI: 3.2, 3.9) for mRNA-1273 recipients. Consistent results were demonstrated across subgroups, including in those age 65 and older. The complete data has been submitted for peer reviewed publication and shared with regulators.

The numbers are an improvement against Omicron, although not a spectacular one. Looks like a rough doubling of response from most metrics. They also note an increased effectiveness against variants other than the original and Omicron. While not of direct practical value (you are highly unlikely to encounter the original strain, or the early variants due to them being functionally wiped out by Delta and then Omicron), it's an encouraging sign that the resulting antibodies are broader response than those generated by the monovalent original.

I'm not sure how much of a wide scale deployment of this booster we're actually going to see in the UK. I suspect it may end up only being rolled out to the elderly and high risk groups of the population. Take up during the last major round of boosters (before Christmas) was substantially down, and that will have got even more pronounced given the general attitude that Covid is "over and done with" by the vast majority.

 

[amadeus]

gimme gimme gimme gimme now

 

[Takhisis]

I think the article innonimatu linked actually shows that scientific research does properly work. Thanks man .

I accuse you of anti-Chinese sentiment.

 

[innonimatu]

I think the article innonimatu linked actually shows that scientific research does properly work. Thanks man .

What optimist. I suppose you think Candide is a travel guide.

 

[Samson]

How much virus does a person with COVID exhale?

People infected with the highly transmissible Alpha, Delta and Omicron variants of SARS-CoV-2 spew out higher amounts of virus than those infected with other variants, according to a new study1. Further, individuals who contract COVID-19 after vaccination, and even after a booster dose, still shed virus into the air.​

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The work was posted on the medRxiv preprint server on 29 July. It has not yet been peer reviewed.​

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“This research showed that all three of those variants that have won the infection race … come out of the body more efficiently when people talk or shout than the earliest strains of the coronavirus,” says John Volckens, a public-health engineer at Colorado State University in Fort Collins.​

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Study co-author Kristen Coleman, who researches emerging infectious diseases at the University of Maryland in College Park, says this means that people should be “pushing governments to invest in improving indoor air quality by improving ventilation and filtration systems”.​

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The study also highlights the variation between individuals in the amounts of exhaled virus, which ranged from non-detectable levels to those associated with ‘superspreaders’. One Omicron-infected participant, for example, shed 1,000 times as much viral RNA through fine aerosol as the maximum level observed in those with Alpha or Delta. The researchers say that the root of these discrepancies remains a mystery but could be related to biological factors such as a person’s age. Behaviour might play a part, too: the study’s superspreader coughed more frequently than others.​

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If new variants are more prone to superspreading, that might drive them to dominate COVID-19 cases. The team notes that people infected with SARS-CoV-2 exhale much lower amounts of viral RNA than people infected with influenza, a comparable airborne disease. This suggests that SARS-CoV-2 could spin off variants that transmit even more virus.​

Writeup Paper (not yet peer reviewed)

Mostly I just liked the machine they use:

 

[Kaitzilla]

Well, in that case I'm voting for monkey pox not just because of that but because we also risk screwing up over monkey pox as badly as we did with covid-19, and this time around we are already in a crisis and stretched to breaking point.

Looks like the US botched the monkey pox response.

There were 20 million doses of a pox vaccine, but they expired and were not replaced.
When monkey pox hit there were only 2400 of them left.

Fauci and other health ‘experts’ are messing up monkeypox just as they did COVID, Ebola and AIDS

We’d like to live in a world where we can trust the experts, both to know what to do and to promote policies that will help us. But we don’t live in that world.

nypost.com

“I want people to know how poorly this went given the amount of money and resources put into it,” declares former CDC official Dr. Ali S. Khan.

Monkeypox was declared a public health emergency on August 4th.

One of these days, the US needs to create an agency that focuses only on disease and nothing else.
One that manages stockpiles of vaccine and medical supplies for when disaster strikes.

Monkey Pox, which will be renamed soon, is so painful people have reported nearly fainting.

 

[innonimatu]

Monkeypox seems quite capable of spreading to and between other animals. This could and should have been strangled at birth, transmission cut off. But again what was necessary was not done. Same mistakes, over and over again. Soon enough the excuse is "it's too widespread".
At least there should be actually vaccines (that work!) for this one. And it looks like the smallpox vaccine should not have been stopped. These pox virus spread cross-species easily enough, and (most) states in the world as it is today discarded the necessary sanitary controls (that once existed and enabled the piece by piece eradication of diseases) to quash the spread of new infections diseases in human populations.

Current public health is not fit for purpose. Nothing was learned from the covid experience yet. More of the same will happen.

 

[Samson]

This could and should have been strangled at birth, transmission cut off.

You mean the west doing something useful for health in Africa? Madness.

 

[Takhisis]

I'm reading that Antony Fauci has announced his resignation!

 

[Samson]

Twice as many people killed by covid this summer than last

Twice as many deaths involving Covid occurred this summer compared with last summer, according to analysis of new data – though rates have fallen in recent weeks as the latest wave decreases in severity in the UK.​

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Although the overall number of deaths of people with Covid in 2022 remains far below last year, the summer months have bucked that trend. More than 5,700 Covid deaths have been registered since 8 June when two Omicron subvariants became dominant. This is 95% higher than in the same period last year when there were 2,936 deaths involving Covid across the UK.​

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The fact that more people are dying this summer than last is most pronounced in the older age groups, a trend that has been consistent throughout the Covid pandemic. Almost half of the deaths recorded this summer in England and Wales were among people aged 85 and over compared with 27% of the deaths in 2021.​

 

[El_Machinae]

Dying with and dying from is going to become harder and harder to distinguish in the richer countries. At any point in time, a certain number of people are dying. At any point in time, a certain fraction of the population will have covid.

We expect a non-equal distribution between those two cohorts. The elderly should have a lower incidence of covid than younger people. But detecting the signal will still be difficult.

Pg. 2 of this document shows kinda how hard it is

Microsoft Power BI

app.powerbi.com

 

[tjs282]

I'm reading that Antony Fauci has announced his resignation!

He is (nearly) 82, you know...

As a physician with the National Institutes of Health (NIH), Fauci has served the American public health sector in various capacities for more than fifty years and has acted as an advisor to every U.S. president since Ronald Reagan.[3]

Anthony Fauci - Wikipedia

en.wikipedia.org

 

[Takhisis]

He is (nearly) 82, you know...

So are you, and you are not retiring from the CDC.

 

[Samson]

Previous infection still reasonably good at protecting against latest variant

We found that previous SARS-CoV-2 infection had a protective effect against BA.5 infection (Figure 1B and Table S1 in the Supplementary Appendix, available with the full text of this letter at NEJM.org), and this protection was maximal for previous infection with BA.1 or BA.2. These data should be considered in the context of breakthrough infections in a highly vaccinated population, given that in Portugal more than 98% of the study population completed the primary vaccination series before 2022.​

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The study design cannot eliminate all confounders (see the Discussion section in the Supplementary Appendix). In addition, one limitation is the putative effect of immune waning in a population with hybrid immunity (previous infection and vaccination). We found that BA.1 or BA.2 infection in vaccinated persons provided higher protection against BA.5 than infection with pre-omicron variants, in line with a recent report with a test-negative design.5 However, BA.1 or BA.2 infections occurred closer to the period of BA.5 dominance than infections with previous variants. There is a perception that the protection afforded by previous BA.1 or BA.2 infection is very low, given the high number of BA.5 infections among persons with previous BA.1 or BA.2 infection. Our data indicate that this perception is probably a consequence of the larger pool of persons with BA.1 or BA.2 infection than with infection by other subvariants, and it is not supported by the data.​

Spoiler Legend :

As shown in Panel A, we identified the periods (in different colors) when one variant was represented in more than 90% of sample isolates (data from the national severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2] genetic diversity surveillance4). The periods in gray represent times when more than one variant was in circulation. Given the relatively slow transition between dominance by the omicron BA.1 subvariant and dominance by the omicron BA.2 subvariant, we pooled BA.1 and BA.2 in the analysis. We did not include anyone infected in the 90 days before dominance by the omicron BA.5 subvariant. Panel B shows protection efficacy against infection during the period of BA.5 dominance (from June 1, 2022) among persons with one infection in the periods of dominance of different variants, as represented in Panel A, as compared with persons without any documented infection until June 1. Persons with two infections before June 1 were not included in the study. 𝙸 bars represent 95% confidence intervals.

 

[Samson]

Variant vaccines very slightly better than originals

In a population where half of people are already protected against a symptomatic SARS-CoV-2 infection through previous vaccines and infection, an updated vaccine booster bumped protection up to 90%, compared with 86% protection provided by an extra dose of the original vaccine. For protection against severe disease, the differences in protection were a few tenths of a percent.​

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At a population level, updated vaccines could make sense. Cromer’s team estimated that, for every 1,000 people, a booster campaign based on updated vaccines would result in 8 fewer hospitalizations, on average, than one based on older vaccines. “If that translates to hospital beds saved and severe cases averted, that might be a sufficient level to warrant that the recommendation for a variant modified booster,” she says.​

Writeup Paper