COVID 19: November 22

Two New Sub-Variants of Interest

There are two that seem to be “winning the race.” XBB which is in Southeast Asia right now, and BQ1 which is taking over in Europe and the United States. It is evading our immunity so you can get infected again. It’s finding ways to move from person to person; therefore, it is unticking.

What is driving so many coexisting mutations is one mutation comes from the previous mutation. It is figuring out the best way to survive, and Omicron seems to be it …. so there is a “ladder like” pattern of mutation. Good news: we can finally start to know where it is heading to just see Omicron. Let’s be hopeful that we can create future vaccines that will focus on Omicron and this will work. Pray that a variant doesn’t pop out of nowhere!!!

What I have heard about mutation is that a serious variant pop-up could come from a mutation that lives inside a seriously immunocompromised person, and then eventually begins spreading from that person. Recently, there was a big mutation from Delta (ugh). We just need to get ahead of it instead of one step behind.

A Tripledemic?

We have three viruses of concern at the moment (November 15). A lot more groups are vulnerable now. And as of November 15, medical experts don’t know how these different viruses will interact with each other. And the viruses are hitting a less protected and less immune population. They are:

COVID 19
respiratory syncytial virus (RSV)
Parainfluenza viruses

COVID 19: There are lots of Omicron variants out there, all competing for hosts and “attention.” And it is unknown whether any of them will mutate to the point where it becomes a serious threat. COVID is four times more contagious than the flu. It hasn’t started to surge … yet.

RSV: Currently, pediatric healthcare is full of children infected with RSV, who are at a higher risk for serious illness. It is more contagious than the flu, but not as contagious as COVID. Typically it takes 3 RSV infections for a child to develop an immunity to far less serious disease. That hasn’t happened over the last few years, so some kids are getting really sick with it. Theoretically, there are a whole generation of toddlers that didn’t get that “3-spike bump” in immunity. And some older children that weren’t completely immune from it are getting hit hard as well, even healthy kids.

RSV Lasts on surfaces a whole lot longer than other aerosol viruses. Spreads through heavy droplets in the air and surfaces. So disinfection crib beds, toys, etc to help prevent other children from getting infected. There is no vaccine. Don’t know yet if masks work. Not sure how long the droplets stay in the air.

FLU: Flu wanes about every two years. It has been on sabbatical, and now is back as another Big Gun. Part of the reason is that it had a two-year break as the spread of flu was inhibited by the measures people were taking due to COVID restrictions, mandates, etc. Flu is a bit behind RSV. It’s unclear if it is just going to be early, or if this will be a really bad flu season. Kids and older adults are most at risk.

It is fair to blame the COVID 19 pandemic on the current multi-virus situation, particularly the risk to children.

We have become “used” to airborne transmission (as in COVID) … RSV is different, and a lot of things are …. quite frankly … “up in the air” yet. So people have come to believe that because COVID 19 is more risky for older adults and is spread through the air, that this is the case for ALL airborne transmitted viruses. This is not so. We rationalize our existing belief by what we can cherry-pick from our minds.

I learned a few new things … the difference between aerosol and airborne. Airborne means that the virus “hovers” in the air for a while. Aerosol means that droplets start to drop after entering the air which means it makes a difference how close someone is to an infected person (an argument for social distancing).

The current flu virus is a distant descendent of the 1918 Flu. Over time, it became less severe. We were lucky. Flu mutates quickly. COVID 19 mutates four times more quickly than the flu.

We forecast how the flu shot is working by what occurs in the Southern Hemisphere, which is ahead of us season-wise. Looking at their stats gives us an idea as to how to proceed with the next flu vaccine. However, sometimes it works very well; other times, not so much. But this is the strategy. Fortunately, according to recent data from the Southern Hemisphere, the current flu vaccine appears to be working very well.

And a bottom line … this is all confusing. We will be very careful over the holidays, but we aren’t going to completely stop living our lives. We are grateful that there ARE things we can do to mitigate the spread.

Learning Loss During the Pandemic

Now that we are well into in-person learning for kids, along with no masking required, school performance measuring is being evaluated. There are different opinions on this. Some of the points appear below …. I think we still have to wait a few years to really know what did and didn’t work during the pandemic pertaining to school age children.

The National Assessment of Educational Progress (dubbed the Nation’s Report Card) shows that since the pandemic began. students in most states and across all demographic groups have experienced setbacks in both math and reading. The math results are particularly troubling.

Some say that for those who mandated policies that kept children out of school, it’s time for be accountable. Remote classes may have made sense in the pandemic’s early days, when the virus was little understood. But some officials kept schools closed long after we knew children were at very low risk of serious COVID illness. Virtual learning caused damage and the role of teachers’ unions didn’t help (they advocated for teachers that didn’t want to risk illness to teach in person). (Michael Petrilli ([New York Post]).

Others say that the statistics don’t fit the above narrative. Students in states that reopened schools in the fall of 2020 fared slightly worse in math than those in other states that kept children home much longer. During the time prior to the vaccine being available, a brutal pandemic upended nearly every aspect of our lives. Decisions to protect school children were made amid uncertainty and anxiety, and no one knows how many adults kids would have infected if schools had stayed open. Kids lost ground in school because of “a generational and global public health trauma.” It’s easy, and wrong, to blame schools or teachers. (David Wallace-Wells ([New York Times]).

Vaccines?

The flu vaccines are helping a lot so far. It’s too bad that not enough people are choosing to get the flu shot. EVERYONE should get the flu vaccine!!!!

Oh, the myths. And NO the vaccine cannot give you the flu! “Correlation does not mean Causation.” The shot can prevent you from getting really sick and infecting others. We collectively will get less flu if more are vaccinated. This isn’t diabetes!! Long flu is much less likely than Long COVID, but it does happen. Just go get your flu shot.

The COVID vaccines. It is STILL the case that the majority of people getting very sick and dying are unvaccinated, primarily younger adults. This is because older people are vaccinated (with very few exceptions). Don’t know yet how effective the current Omicron-focused virus is going to be. Waiting for real-time data. They do know that it will be more effective than the prior booster. We need to do what we can for older people, who are still “in this pandemic.” Just go get your COVID booster.

A Note About Masks

A clear argument is that masks still do work. What should the policy currently be? We don’t want our health systems to crumble. So, wear a mask when you are sick AND when you are around those that are sick. Make good decisions when in large group situations (I see this happening outside of where we reside). Don’t assume someone is wearing a mask for political reasons. They could be sick (like we were when we flew home from Canada last August).

Precautions to Take for the Holidays

The experts recommended the following precautions to stay as safe and well as possible:

Get the Omicron Booster. Get it by the end of October to be good through the end of 2022.
Take a rapid test before gathering to avoid unknowingly spreading the virus to others. At-home tests now take newer variants. But if you are negative and have classic symptoms, stay home.
Regarding travel, masks aren’t required anymore, but it’s recommended that one be worn, at least for certain portions of your trip. Airplane air quality is better on planes than on trains or buses. But mask in the airport and during taxiing.
Don’t forget about the other viruses that are bad right now. Avoid high risk settings, wear a mask when you should, and keep in mind anyone that’s vulnerable or at risk.

Go to: COVID 19 – December 2022