If you feel sick, is it likely to be a new COVID variant or something else?
A couple of months ago if you got sick there was a good chance it could have been RSV or Flu that was making you feel ill, or possibly the Omicron BQ.1.1 variant which was rising quickly. 🧵1/
A couple of months ago if you got sick there was a good chance it could have been RSV or Flu that was making you feel ill, or possibly the Omicron BQ.1.1 variant which was rising quickly. 🧵1/
An unrolled one-page web view for this long thread that may be easier to read or share can be found here (
https://twitter.com/jeffgilchrist/status/1624515669285912576). 2/
Now, RSV is at much lower levels and Flu A is no longer being detected from wastewater samples in Ottawa so it is much less likely you can blame your sniffles, congestion, or fever on those two viruses. 3/
There is a virus that is increasing fast in Ontario now, the new XBB.1.5 "Kraken" COVID variant. It has now overtaken BQ.1.1 "Cerberus" to become the variant with the highest frequency of sequenced genomes from PCR testing at more than 27% now. 4/
Throughout the pandemic Dr. Graber has observed when an emerging variant reaches 50% of the wastewater signal, it is followed by a rapid increase signalling the beginning of a new wave which we may be starting to see now with XBB.1.5 (
https://twitter.com/rnaguru/status/1623100538924503040). 5/
Looking at the wastewater COVID signal over time, the baseline lows keep getting higher and higher so ever since Omicron BA.1 hit a year ago, we have never gone back to low levels of COVID community transmission and now those minimum transmission levels keep getting higher. 6/
As @TRyanGregory likes to say, we are seeing increasingly higher tide levels which aren't going back down to levels they used to be. If we keep doing nothing about transmission, pretty soon our "islands" are all going to be under water. 7/
In Ottawa, the baseline wastewater viral signal we had when the BQ.1.1 variant wave switched over to the XBB.1.5 wave is the highest yet and almost as high as the peak of the first Omicron BA.1 wave! 8/
You have probably already heard of the XBB.1.5 "Kraken" variant but how is it different from previous variants? 9/
This is a descendant of the XBB.1 recombinant variant which means that it is actually a combination of two different variants BJ.1 and BM.1.1.1 which are both descendants of BA.2 (
https://twitter.com/dfocosi/status/1621466393899057153). 10/
That is why the variant designation starts with "X" for XBB because it is a cross "X" of two different variants. 11/
This can happen when someone is infected with two different variants at the same time and while the viruses are copying inside the body recombined to create XBB (
https://twitter.com/firefoxx66/status/1587762412110974976). 12/
The mutations that XBB.1.5 has picked up make it more immune evasive but also bind to ACE2 receptors much better (higher affinity) which the virus uses to enter and infect cells (
https://twitter.com/yunlong_cao/status/1607915567696203776). 13/
The bad news is that ACE2 binding affinity seems to be a predictor for how sick variants can make people so XBB.1.5 having higher binding affinity is not something we want to see. 14/
Immune evasion means that even the most recent bivalent vaccines have hard time neutralizing the virus against XBB.1 and also BQ.1.1 (
https://twitter.com/jeffgilchrist/status/1621844047341015040). 15/
A reminder that more people are now eligible for PCR testing and antivirals in Ontario so you may be able to get a PCR test to confirm if your illness is COVID. Please see this thread for details (
https://twitter.com/jeffgilchrist/status/1620191020708397058). 16/
This includes people who are former smokers, pregnant, or had their last COVID vaccine dose more than 6 months ago. 17/
The Ontario government said that students would have a "stable" school year but since they haven't acknowledged that COVID is airborne, no real changes have been made to schools to address indoor air quality. 18/
As a result in the Toronto District School Board (TDSB) there were 205,000 student absences due to illness in just 3 weeks during November ( thestar.com/news/gta/2022/… ). H/T: @DrKateTO 19/
Absences were much lower in Nov. 2021 and Nov. 2020 when additional COVID protection measures were in place such as masking and cohorting. 20/
In comparison, before the pandemic in Nov. 2019 TDSB had 95,500 student absences due to illness compared to the same three week period in 2022 with 205,000 where now more than twice the number of students were ill. 21/
Clean indoor air isn't just about COVID, but it can help protect against other pathogens and air pollutants linked to various health problems which you can learn more about here (
https://twitter.com/jeffgilchrist/status/1607379781892575234). 22/
The Ontario Society of Professional Engineers (@O_S_P_E) have released evidence-based guidance around indoor air quality and transmission of COVID-19 ( ospe.on.ca/indoor-air-qua… ). 23/
The wealthy also believe it is important to clean the air of indoor spaces as they went out of their way to do for the recent WEF conference in Davos, Switzerland. The conference space before was not good enough so they upgraded it to be #DavosSafe (
https://twitter.com/jeffgilchrist/status/1618223851212767232).24/
If we don't upgrade indoor air quality for everyone, we will continue to have high levels of community transmission, new variants produced that can keep evading immunity, and increasing numbers of people with long-term complications and disability from infections. 25/
Hannah Davis (@ahandvanish) and others have put together and published major findings, mechanisms and recommendations on Long COVID ( nature.com/articles/s4157… ). 26/
It may be helpful to learn about some real life examples of people suffering from Long COVID after they had a mild initial infection. 27/
The first is @ahandvanish who was brave enough to share her experience of how it impacted her brain among other things (
https://twitter.com/jeffgilchrist/status/1617492887461318656). 28/
The second is the impact of COVID infection from cardiovascular complications in a young man (
https://twitter.com/jeffgilchrist/status/1586043132134576128). 29/
The third is a young woman 28 years old disabled from the pandemic, infected in March 2020 before the vaccines were available with only a mild illness at first but then she never got better ( thetyee.ca/Analysis/2023/… ). 30/
Not sure how I missed this, but the Variant graphs are from here ( app.powerbi.com/view?r=eyJrIjo… ) created by @Mike_Honey_
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