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Asteroids......and Covid XBB


Are Vaccines Fueling New Covid Variants?


From a Wall Street Journal article with a concern about Covid variants; this came as an informational bulletin and editorial for those with an interest in business. Many articles have surfaced since with similar concerns about the rapid spread of variant XBB.


Many articles on the variant XBB topic surfaced after I read this specific one. It poses a question as yet not answered: how worried should we be about new variants when we have immediate but limited information available about them—other than their existence and spread?


Reflecting on this article, I thought of two scenarios for comparison. We occasionally hear of large asteroids coming “close” to earth raising concerns about surveillance and possible interventions should “the big one” appear to be coming our way. I do not lose sleep with news like this. I hope you do not either.


A second thought is this: soon, sewage outflows will be tested for polio. If you become aware in your community that there is “lots” of polio in the community, how concerned should you be (but first, are you vaccinated for polio?). What if in addition to telling you this, the news reports that there are new variants of polio in the community? I can assure you, the technology of testing for variants in viral genetic lines will be applied to common virus infections like polio, measles, mumps, and so on—-because the technology exists to make virologists want to scratch that itch—not because there is a new strain sending kids to the hospital with these virus infections. I can also assure you that modern polio virus found in sewage is probably a variant from that which was used to develop the polio vaccines currently in place. They appear to be working just fine, since I got my first one somewhere in 1954 or so.


The WSJ article raises this same issue about XBB variant of Covid. They point out:

1) It is spreading rapidly

2) It seems to be spreading more rapidly in areas with heavy vaccination coverage for COVID, raising the concern that somehow vaccinations are responsible for this new strain’s spread.

3) Non vaccination strategies—paxlovid among others and monoclonal antibodies do not appear to have much affect on the XBB variant.

4) This variant appears to be different enough that its spike protein is not affected ie antibodies against it do not exist in those of us vaccinated for COVID (or previously infected by older strains of COVID).


Should we worry? See my two scenarios above. Yes, there is potential for 2020 to be revisited with a new variant ie people dying of respiratory failure rapidly after becoming infected—just as an asteroid might hit the earth and extinguish life as we know it. So far, even in places where this is the predominant strain infecting people, there is no appreciable worsening of how sick people get with COVID. If you are one of those people who never thought COVID was that bad (bless your little hearts) then this changes nothing. If you are prudent, it (like asteroids and new polio strains) is perhaps good to be aware of, but you need more to make an informed decision if decreasing your risk of getting COVID is a priority.


Of note:

1) Isolation, masking, and and not sharing air with other people is old tech but effective if you do it.

2) Many of the medications that worked initially are no longer used because the variants changed their effectiveness. This happened a year ago…….before XBB

3) The most recent bivalent vaccine that is remarkable for being underutilized by the population, does not seem to change much for most people unless they are VERY old ie over 75 or have impaired immunity. With or without the bivalent vaccine, your risk of needing a hospital, an ICU, or dying is not changed significantly with this last vaccine or this newest variant.

4) The variant targeted by the bivalent vaccine was present in a minority of COVID infections by the time it was made available ie too little too late, with millions of vaccines still sitting on the shelf. Any controversy about that in my mind falls to a failure of stewardship of our collective resources and not the population ignoring a risk. The data does not support a dramatic change in risk with or without the vaccine.

The WSJ article ends with the question—addressing the points above— “Why doesn’t that worry the experts?” The Biden administration is singled out as depending too much on vaccines. It may well be worrying them and they may well not have a satisfactory answer (see masking, isolation, and not sharing air above) as chasing the variants with expensive technologies is not clearly improving things (new monoclonals against XBB could be made and marketed but by that time, we may have moved on to yet another variant not clearly affected by such antibodies) AND we may well have to live with the reality that this virus will produce variants for some time to come. Until this is a tangible public health crisis, people will vote with their arms. My


question? Why isn’t the Biden administration paying more attention and worrying about asteroids heading our way?


The hardest thing for all of us—scientists, doctors, school teachers, and pundits is that this disease is not amenable to immediate gratification, something our brains in this modern age crave and all too often succeed in achieving.


RAM





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