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Various Covid Updates for January 2022

Part Two

By Gary F. Zeolla

This two-part article is continued from Various Covid Updates for January 2022: Part One.

Omicron-Specific Vaccines

      I reported previously that the vaccine companies were working on Omicron-specific vaccines. To update that report, Pfizer began its human study of its Omicron-specific vaccine on January 24, 2022. They hope to have it available in March (Newsmax. Pfizer; Trib Live/ AP. Pfizer). Moderna announced the same a few days later and hope to have theirs available by the summer (NBC News. Moderna’s).

      The company [Moderna] also announced it has started clinical trials for an Omicron-specific vaccine.

      “We are reassured by the antibody persistence against Omicron at six months after the currently authorized 50 μg booster of mRNA-1273. Nonetheless, given the long-term threat demonstrated by Omicron's immune escape, we are advancing our Omicron-specific variant vaccine booster candidate, and we are pleased to begin this part of our Phase 2 study,” Moderna CEO Stéphane Bancel said in a news release. “We are also evaluating whether to include this Omicron-specific candidate in our multivalent booster program” (iHeart. Moderna).

      The reference to a “multivalent booster” is to the hope that a booster shot could be invented that would cover all possible Covid variants.

      J&J also is working on Omicron-specific vaccine, but there is no timetable for when it might be available (NBC News. Omicron-specific).

Omicron Updates and Already a New Variant

      Omicron is still surging in the U SA, though the rate of that surge is already slowing, just as I predicted:

      Covid-19 cases are finally falling in the United States, welcome news after nearly two months of skyrocketing case counts driven by the highly infectious omicron variant….

      But the falling numbers don’t mean Americans are out of the woods.

      That’s because, as cases fall, a huge number of people will still be infected: As many people who got sick as cases soared to their peak will get infected on the downward slope, said Dr. Jonathan Li, an infectious disease physician at Brigham and Women’s Hospital in Boston.

      “It’s a great sign that the slope is going down but case rates remain very high,” he said (NBC News. ‘An optimistic).

      Cases are down, hospitalizations are leveling off, but deaths are up. That is because, deaths always lag behind hospitalizations, and hospitalization always large behind cases, as I explained previously. This is seen in the Covid ticker on the home page of the New York Times’ website:

Avg. on Jan. 29      14-day change

New cases      537,784    –33%       

New deaths        2,572    +29%

      As of Wednesday [1/26/22], the United States was reporting more than 650,000 new cases daily, on average, down from more than 800,000 two weeks ago. Deaths continue to rise, at more than 2,300 per day, on average, but hospitalizations seem to be nearing a plateau, at about 155,000 per day, on average (New York Times. Yes).

      This verifies what I said before that Omicron is not mild. It might be milder than Delta, but it is sill causing serious illness and death. That is especially the case for those with comorbidities, which half of Americans have. That is why Covid hit the USA so hard, and that includes Omicron. But once again, those who are vaccinated are less likely to suffer serious illness and death.

      Throughout the pandemic, people like Ms. Perez [who has asthma] have been at higher risk for serious illness from Covid because they have underlying medical conditions, like asthma, diabetes, heart or lung disease. More than half of American adults have at least one underlying chronic condition, and for many of them, the Omicron wave hasn’t been as mild as it has for the larger, healthier populations around the world.

      Omicron has indeed caused far lower rates of severe illness and death in the U.S. population, especially among those who are vaccinated and have received booster shots. Still, the variant’s high transmissibility did lead to record-setting case counts that resulted in pandemic-high hospitalizations.

      Dr. Rochelle Walensky, the director for the Centers for Disease Control and Prevention, warned on Wednesday [1/26/22] that this surge was still imposing a heavy burden. “Importantly, ‘milder’ does not mean ‘mild,’” she said. “And we cannot look past the strain on our health systems and substantial number of deaths — nearing 2,200 a day as a result of the extremely transmissible Omicron variant” (New York Times. When).

      The seven-day rolling average for daily new COVID-19 deaths in the U.S. has been climbing since mid-November, reaching 2,267 on Thursday [1/27/22] and surpassing a September peak of 2,100 when delta was the dominant variant.

      Now omicron is estimated to account for nearly all the virus circulating in the nation. And even though it causes less severe disease for most people, the fact that it is more transmissible means more people are falling ill and dying.

      “Omicron will push us over a million deaths,” said Andrew Noymer, a public health professor at the University of California, Irvine. “That will cause a lot of soul searching. There will be a lot of discussion about what we could have done differently, how many of the deaths were preventable.”

      Omicron symptoms are often milder, and some infected people show no symptoms, researchers agree. But like the flu, it can be deadly, especially for people who are older, have other health problems or who are unvaccinated (Newsmax. Omicron Drives).

      But if Omicron remains the dominant variant remains to be seen, as new variants are sure to arise. In fact, we already have a new variant, a sub-variant of Omicron (BA.2), circulating in the USA. It has already been found in 22 states, according to NBC Radio News on January 29, 2022. This new variant has been dubbed the “stealth variant” for reasons related to a point I reported previously:

      Unlike what its nickname might suggest, the BA.2 subtype isn’t known as “stealth” omicron because it’s difficult to find. The nickname comes from a shortcut that helped researchers quickly identify omicron in PCR tests.

      Because of a quirk in omicron’s genetic sequence, PCR test results looked different from typical positive tests, essentially providing researchers with an easy way to spot the variant without sequencing the samples. (PCR tests generally aren’t used to determine what variant people have, only whether they are infected with the coronavirus.) One of BA.2’s mutations got rid of the genetic quirk, meaning that shortcut is no longer available (NBC News. What).

       This new Omicron-sub-variant is looking to be even infectious than Omicron itself (BA.1):

      Worldwide, the “original” BA.1 subvariant accounts for more than 98% of omicron cases, but its close cousin BA.2 has quickly become the dominant strain in Denmark, dethroning BA.1 in the second week of January.

      “We conclude that omicron BA.2 is inherently substantially more transmissible than BA.1, and that it also possesses immune-evasive properties that further reduce the protective effect of vaccination against infection,” the study’s researchers said….

      The study also showed that BA.2 was relatively better than BA.1 at infecting vaccinated and booster-vaccinated people, indicating greater "immune evasive properties" of the subvariant.

      But vaccines still played an important role, the study underlined, since both booster-vaccinated and fully vaccinated individuals were less like to get infected and transmit either subvariants, compared to those not vaccinated.

      Preliminary analysis by SSI has shown that there is no difference in the risk of hospitalization for BA.2 compared to BA.1 (Newsmax. Omicron Subvariant).

      If this new BA.2 variant does become prominent, I would think the developing Omicron-specific vaccines would be more effective against a sub-variant of Omicron than the original vaccines. But more research will be needed to determine if that is the case if in fact this new variant takes off. But if not it, then again, another is sure to arise. That is why we need to remain vigilant, even as the current surge abates.

      “All it takes is one new variant,” [Katriona] Shea [a professor of biology at Pennsylvania State University] said. “There was no indication of omicron and there were other variants that did not take off. Omicron made a huge change and it’s definitely possible it could happen again” (NBC News. ‘An optimistic).

Natural Immunity Revisited Again

      People who had previously been infected with COVID-19 were better protected against the Delta variant than those who were vaccinated alone, suggesting that natural immunity was a more potent shield than vaccines against that variant, California and New York health officials reported on Wednesday [1/19/22]. Protection against Delta was highest, however, among people who were both vaccinated and had survived a previous COVID infection, and lowest among those who had never been infected or vaccinated, the study found.

      Nevertheless, vaccination remains the safest strategy against COVID-19, according to the report published in U.S. Centers for Disease Control and Prevention (CDC) Morbidity and Mortality Weekly Report.….

      But acquiring immunity through natural infection carries significant risks. According to the study, by November 30, 2021, roughly 130,781 residents of California and New York had died from COVID-19 (Reuters. Prior).

      CDC officials noted other limitations. The study was done before the omicron variant took over and before many Americans received booster doses, which have been shown to dramatically amplify protection by raising levels of virus-fighting antibodies. The analysis also did not include information on the severity of past infections, or address the risk of severe illness or death from COVID-19. The study authors concluded vaccination “remains the safest strategy” to prevent infections and “all eligible persons should be up to date with COVID-19 vaccination” (Yahoo!/ AP. Prior).

      This study helps to settle a major debate that has raged since the vaccines became available. It also shows why vaccine mandates that do not allot for natural immunity are flawed and unscientific. Though I disagree with vaccine mandates in general, if you are going to have them, such an allowance needs to be made. That is seen in Austria’s latest mandate:

      Austria’s parliament has voted to introduce a covid-19 vaccine mandate for adults from Feb. 1, the first of its kind in Europe.

      Lawmakers voted 137 to 33 Thursday evening [1/20/22] to approve the mandate, which will apply to all residents of Austria aged 18 and over. Exempted from the mandate are pregnant women, individuals who for medical reasons can’t be vaccinated, and people who have recovered from a coronavirus infection in the past six months (Trib Live/ AP. Austrian).

      It is also seen in the NCAA’s latest Covid guidelines, “A person who has had a documented COVID-19 infection in the past 90 days is considered the equivalent of ‘fully vaccinated’” (NCAA).

      Those time limitations make sense, as we still do not know how long natural immunity lasts. It also fits with my recommendation that people should get one dose of a mRNA vaccine three months after they recover from a Covid infection. But I doubt even mandates with exceptions for natural immunity but with time limits would take that natural immunity into account once the time limit is up. They will probably require full vaccination, meaning two doses of a MRNA vaccine, then a booster as warranted. But, in my opinion and as shown by numerous studies, the infection should count as the first dose.

      In any case, the line in the first block quote about vaccines being a safer way than infection to attain immunity is demonstrated by the following sad story:

      A folk singer from the Czech Republic has died after intentionally contracting COVID-19 so she could get a health pass to access sports, entertainment, and dining venues.

      Hana Horká, 57, a vocalist for folk band Asonance, was unvaccinated and died on Sunday [1/16/22], her son Jan Rek told Czech radio news outlet iRozhlas.cz. He said his mother deliberately caught the coronavirus from him and his father, both of whom contracted COVID over Christmas but had previously received their vaccines. Horká chose not to isolate from her family but to “live normally” together, Rek said. “She decided that she would rather have the disease than be vaccinated,” Rek said (Yahoo!/ Insider. An anti-vax).

      Such is why I previously warned against purposely getting infected in order to get immunity. No matter how healthy you think you are, you cannot be sure about how your body will react to a Covid infection, especially since you cannot control the viral load by which you are infected. That is why there are vaccines.

Long Haulers

      I’ve mentioned previously about “long Covid,” with those who suffer from the condition being called “long haulers.” The possibility of this condition is another reason why it is not wise to purposely get infected to attain natural immunity. Even if you do not die or even have a serious illness from a Covid infection, you could still end up with this condition:

      While there’s no firm list of symptoms that define the condition, the most common include fatigue, problems with memory and thinking, loss of taste and smell, shortness of breath, insomnia, anxiety and depression.

      Some of these symptoms may first appear during an initial infection but linger or recur a month or more later. Or new ones may develop, lasting for weeks, months or over a year….

      Long COVID affects adults of all ages as well as children. Research shows it is more prevalent among those who were hospitalized, but also strikes a significant portion who weren’t....

    Two recently released studies, one from the U.S. and one from Israel, offer preliminary evidence that being vaccinated before getting COVID-19 could help prevent the lingering illness or at least reduce its severity. Both were done before omicron emerged (Newsmax. Omicron).

      Long haulers often suffer from chronic and debilitating conditions for months or years after the initial COVID-19 infection. They often require additional medical care, and some long haulers are unable to work because of the condition.

      With the current high case numbers in some areas across the country, health leaders said many more people are likely to come down with long COVID-19….

      “It’s the second pandemic,” said Dr. Leonard Weinstock at Missouri Baptist Medical Center in St. Louis. “This is going to disable you; it’s going to make it very hard to work” (WTAE. ‘Tomorrow).

      Possible treatments are now being studied. But still, it is best to not get infected in the first place, so as not to risk suffering with this condition.

Monoclonal Antibodies

      I’ve mentioned about monoclonal antibodies several times in recent articles, saying they are an effective treatment for Covid. But sadly, the two most popular versions of the treatment are proving to not be effective against Omicron, so much so that the FDA revoked its emergency use reauthorization for them. A third version is proving to be effective, but it is in short supply. None of that is good.

      COVID-19 antibody drugs from Regeneron and Eli Lilly should no longer be used because they are unlikely to work against the omicron variant that now accounts for nearly all U.S. infections, U.S. health regulators said Monday [1/24/22].

      The Food and Drug Administration said it was revoking emergency authorization for both drugs, which were purchased by the federal government and given to millions of Americans with COVID-19. If the drugs prove effective against future variants, the FDA said it could reauthorize their use….

      Doctors have alternate therapies to battle early COVID-19 cases, including two new antiviral pills from Pfizer and Merck, but both are in short supply. An antibody drug from GlaxoSmithKline that remains effective also is in short supply…

      Both Regeneron and Lilly previously announced they were developing new antibodies that target omicron (Newsmax. FDA Revokes).

      There is also remdesivir, but there are limitations to its use:

      The move comes days after regulators broadened the use of remdesivir — the first drug approved for covid-19 — to treat more patients.

      On Friday [1/21/22], the FDA expanded the antiviral’s approval to include adults and children with early covid-19 who face a high risk of ending up in the hospital. Remdesivir previously had been limited to hospitalized patients.

      An influential panel of federal experts had already recommended using the infused drug to try to head off hospitalization. The same guidelines from the National Institutes of Health panel recommend against continued use of Lilly and Regeneron’s antibody drugs due to their reduced effectiveness against omicron.

      Still, many hospitals will face challenges in ramping up remdesivir treatments. The drug requires three consecutive IV infusions over three days, when used for nonhospitalized patients. That time-consuming process won’t be an option for many over-capacity hospitals facing staff shortages (Trib Live/ AP. FDA).

      If I were a conspiracy theorist, I would say it looks like Biden’s CDC and FDA are conspiring to eliminate all medical means of preventing serious illness from a Covid infection, except for vaccines, in order to force people to get vaccinated.

      The FDA had previously disallowed the use of Hydroxychlotoquine (HCQ) and Ivermectin for treating Covid, even threatening doctors with forfeiture of license if they prescribed them for Covid. Now it is withdrawing support for two monoclonal antibody treatments, even though many think they still are effective. And the only available treatments are in short supply or difficult to administer.

      I would also say the CDC ad FDA are trying to worsen the Covid responses of Florida and Texas, both red states and both of whom have relied heavily on monoclonal antibodies in lieu of an emphasis on vaccinations.

      The U.S. government temporarily stopped distributing the two drugs in late December, as omicron was racing across the country to become the dominant variant. But officials resumed distribution after complaints from Republican governors, including Florida’s Ron DeSantis, who claimed that the drugs continued to help some omicron patients.

      DeSantis has heavily promoted antibody drugs as a signature part of his administration’s COVID-19 response, setting up infusion sites and lauding them at news conferences, while opposing vaccine mandates and other public health measures. Texas Gov. Greg Abbott has also launched state-sponsored infusion sites (Newsmax. FDA Revokes).

      However, Fauci defended the rescinding of authorization for the two monoclonal antibody treatments:

      National Institute of Allergy and Infectious Diseases director Dr. Anthony Fauci on Tuesday [1/25/22] defended the Food and Drug Administration’s decision to rescind emergency-use authorizations for two monoclonal treatments used for the coronavirus.

      Fauci said on MSNBC’s “José Díaz-Balart Reports” that there is a “risk of a potential adverse effect with essentially no benefit” because the antibodies “don’t work” on the Omicron variant….

      He added, “There is a monoclonal antibody, sarilumab, that actually does work against the Omicron, and that’s a monoclonal antibody made by GSK” (Breitbart. Fauci).

      I am sure there are some risks of negative side effects with monoclonal antibodies treatments, as there are with any medical treatment. But I never heard of any serious side effects from the treatments. But then, the same goes for HCQ and Ivermectin. For those at high risk of serious illness from Covid, you would think the slight risk of side effects would be worth trying one of these treatments.

      That has been my thought with HCQ throughout the pandemic, little risk but a possibility of benefit, so why not try it? That is especially the case with HCQ given how inexpensive it is. But monoclonal antibodies treatments are quite expensive, so I can see insurance companies being reluctant to pay for them, while the vaccines are “free.” Thus, insurance companies would prefer the latter.

      But again, I am not a conspiracy theorist, so none of this is probably true.

Lack of Availability of Therapeutics

      However, if it is true only the GSK antibody treatment works against Omicron, then Biden should invoke the Defense Production Act and ramp up production and distribution of it. But Biden has such a myopic focus on masks and vaccines, he does not seem to even be aware of the importance of therapeutics. And his lack of focus on them is one of the many serious defects of his Covid response that has led to more Americans dying under him than under Trump (see Trump vs. Biden on Covid).

      In fact, we will soon pass the half million mark of Covid deaths under Biden’s administration. That horrid number is totally inexcusable and was preventable for all of the reasons I have discussed previously. But you can now add to them the Biden’s administration lack of focus on the production and distribution of therapeutics.

      The drugs against Covid are in short supply and restricted to people at the highest risk of severe disease….

      Unlike all other FDA-authorized Covid treatments, which need to be given intravenously or by injection from a health care provider, the two antiviral pills — Pfizer’s Paxlovid and Merck’s molnupiravir — can be picked up at a pharmacy and taken at home….

      To be sure, the process for obtaining the pills is more complex than for Covid vaccines and other treatments, and both drugs come with risk of side effects for certain groups of people.

      Additionally, finding the pills won’t be easy for everyone, health experts say, as they are currently in short supply in the U.S.….

      Doctors may look at the availability of the treatments in the area before prescribing the pills, but because the pills are so hard to find, some doctors are putting the burden on sick patients.

      Roy Nwaisser, a Los Angeles resident who sought the Pfizer pill for his father who suffers from a heart condition, said a pharmacy he called didn’t even know about the pills. “It was shocking to me that when I called the pharmacy that, in the middle of Covid and an omicron surge, that they don’t even know that there is a pill for Covid,” he said.

      Experts hope that will change as the supply of tests and pills become more readily available (NBC News. Tested).

      It truly amazes and disgusts me that almost two years into this pandemic we still do not have treatment plans in place. After my surgery for my Rotator Cuff Injury, I was given several stapled together papers detailing what I would need to do over the next six months to facilitate my recovery.

References:

See Various Covid Updates for January 2022: References.

Various Covid Updates for January 2022: Part Two. Copyright © 2022 by Gary F. Zeolla (www.Zeolla.org).

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The above article was posted on this website January 30, 2022.