Crawling out from a week in which the War in Ukraine has felt a lot more compelling than Covid...
but I thought I'd review the big stories from the past week.
There actually was some interesting news. 1/7 #1: CDC managed to release mask recommendations based on case & hospitalization rates that pissed EVERYONE off. Maskers distressed that US overnight became low risk; non-maskers vs implication we will keep doing this; everyone noted that when hospitals fill, it's too late. 2/7

Since most virologists I follow are being pretty technical about the B.1.1.529/“Omicron” variant that is feeding a MSM headline frenzy, I will add my non-technical thoughts.
I don’t usually get too fussed over new variants, as they mostly flame out.
Am I concerned?
Yes. 1/9 Omicron is loaded with mutations that *might* make it more resistant to immunity of all types (bearing in mind that S AFrica where it is spreading prob has a little more immunity from infections than vaccinations). 2/9

https://twitter.com/jbloom_lab/status/1464005676842184705

The reaction to the recent CDC MMWR on immunity after covid infection being 5X less protective than vaccination shows off everything that has been wrong about science communication through this pandemic.
cdc.gov/mmwr/volumes/7…
“Told ya so” -
Seriously? Public Health voices got their Gotchas in for anyone in anti-vax, anti-mandate, or just anti-establishment camps who ever dared to argue that we should consider immunity from prior infection on par with vaccination in terms of protection from disease.
But what DID the study show?

This Lancet study from the UK has fueled a lot of “gotchas,” only some of which are appropriate. It’s interesting, though:
thelancet.com/journals/lanin…
The take-away: vaccinated ppl with “breakthrough” infections were as likely to spread to household members as unvaccinated ppl. Take w/ a grain of salt, as even a smart, prospective study like this cannot avoid major confounders, esp when this small (163 cases, 232 household contacts). The index cases captured in this study might not represent average folks.
Still - this is as good as we’ve got.

I appreciated the kind words of Prof Morris:
And, more reluctantly, the observation of one of his numerically-literate followers that I’d mis-characterized a CDC study on odds of getting myocarditis from Covid-19.
The “you’re 16X more likely to get myocarditis from covid” study.

https://twitter.com/jsm2334/status/1453217817738809350

I have seen that figure referenced twice in the last 24 hr, despite the study being 2 mo old.
It’s relevant now, in that lots of people are trying to assess the risk of myocarditis in kids if they choose/are mandated to have the vaccine vs if they do not.
My mistake?

#ivermectin for covid has been in heavy-play mode in the media again.
Why?
A new trial report, and 3 meta-analyses.
As usual, half the world thinks these are proof of the #ivermectincure and half thinks it's bogus.
Why can't we all get along?

foxnews.com/media/biologis… @DrAndrewHill released his team's meta-analysis right on the heels of 2 other meta-analyses, one positive & one negative. Dr Hill, who has been a bit of an ivermectin cheerleader, had a positive conclusion:
academic.oup.com/ofid/advance-a…

Another look at long covid out in a pre-print, from @mlipsitch&co:
medrxiv.org/content/10.110…
I'm not surprised, but at last someone had the notion to compare folks post-covid to folks post-viral-infection, non-covid.
The headline is "14% had sequelae" but they buried the lede! 1/6 First, the limitations:
1) totally based, not on survey/exam, but on MD-reported ICD-10 codes; so these are "long," possibly random, symptoms bad enough to see an MD and have them code it.
2) retrospective cohort, so all the usual bias & matching concerns.
3) only age 18-65. 2/6

I am not terribly excited about the "clot" concerns for AZ/Ox in Europe:
medscape.com/viewarticle/94…
Both because it's not in the US, and I didn't like their data or how they collected it very much;
and because I am not sure this is a story. 1/3 I mean, if the avg vaccinated pop would have about a 1/6000 risk per mo of a VTE as the background rate;
and 5M ppl got the AZ/Ox in the past mo;
we'd expect >800 VTEs in any circumstance, not 30! 2/3

I missed this disturbing/fascinating bit on leaked docs w/ quality control issues from the Pfizer vaccine:
bmj.com/content/372/bm…
A reminder that just because Big Pharma hits a home run, they (& the medical-industrial complex) are not suddenly warm and fuzzy trusted friends. 1/3 I wish I understood mRNA vaccines better, but the bottom line appears to be:
these mRNA particles tucked in those lipid nanoparticle membranes are frail;
they degrade easily;
and you want them to be intact when they hit our cells, so the proper protein complexes are formed. 2/3

A few patients have asked me to look into the research on ivermectin for Covid-19.
You know, that video of congressional testimony and all, from that Pulmonologist.
IVERMECTIN SOUNDS FABULOUS! 1/20

Now, when I see a gray-haired, highly-confident, white dude speaking strongly on a matter outside his own field of expertise, I get this comfortable feeling:
"That is MY demographic!"
But when he goes on about his own credentials;
and calls a re-purposed med "miraculous"... 2/20