Despite the significant reduction in Covid-19 testing, both on an individual and institutional level, it is clear that Covid case numbers continue to grow, all over the US. How do we know? Our POOP!
More specifically, monitoring the levels of virus in community wastewater. The SARS Cov-2 virus does attack the gastrointestinal cells and we do poop out the virus out. In fact, viral genetic material can be identified in our waste even months after infection. This has been a standard way to monitor how much virus there is in the community since the onset of the pandemic. It is routinely used at school dormitories. This technique was also used to monitor the fortunately small polio outbreak in some NY townships a few summers ago.
In my last post, I mentioned how despite increases in hospitalizations for Covid-19 related problems, there was no noted increase in ICU admissions. That is no longer the case. Numbers of very serious, life-threatening cases are also rising leading to increased ICU admissions. As of now, death rates have not increased significantly, but that can change since there is often a lag between hospitalizations, ICU admissions and deaths.
The lack of deaths may be a result of protection provided by broad T Cell immunity in the community from the number of people who were vaccinated and those who actually got Covid-19. Despite antibody levels waning in both situations the T Cells, which we create as a result of exposure either to the virus itself or the proteins the vaccine provides, are permanent. Unfortunately, with viral re-exposure, T Cells are not activated as instantaneously as antibodies and take a few days to come online. Antibodies are what matters in preventing infection in the first place but T Cells are involved in mitigating the severity of the infection.
Time will tell what happens with death rates.
Despite the numerous variants emerging, the T Cells seem to be keeping up and continue to provide some protection. In addition, with each exposure to a new variant, we generate even newer, more specific T Cells.
The present circulating variant is EG5. The XBB variants are also common. These are accounting for the vast majority of hospitalizations. Other variants are still circulating but to a much lesser degree. BA 2.86 (Parola), the one with the 30 mutations that we were concerned about possibly leading to a new dramatic Omicron-like variant surge in 2022, has not panned out. Fortunately.
The most recent vaccines continue to provide significant antibody production shown to be effective against the most recent variants, despite being developed for other variants which are still circulating but dropping off.
As far as vaccine risk goes, they continue to remain very low, and once again, much less common than the side effects and long-term complications of actually getting sick. There is a 0.007% risk of myocarditis with the Moderna vaccine, particularly with boosters. Other vaccines have a risk of myocarditis but it is much less. The risk of getting myocarditis remains significantly higher if you actually get Covid-19 infection! 35x greater incidence compared with post vaccine myocarditis. Once again, it’s all about mitigating the risk.
We are quickly getting into the cold, flu and now, Covid-19 season (although Covid-19 is not a seasonal disease like all other cold viruses). And once again as a reminder, Covid is spread by simply breathing whereas the flu and other viral colds are spread by larger particulates created by sneezing and coughing. I remain a strong advocate of vaccination, as well as all the other important mitigation strategies like distancing, masking and most importantly, isolation and avoiding infecting others if you are sick.
As far as timing is concerned, it’s best to wait until early October, to make sure you are covered, at least with respect to the flu. If it’s been more than 6 months since your last Covid booster, it’s time to get it. If you have never gotten it, please consider getting it.
Have a great weekend.
Stay safe and Be well.
AC