NO-stop testing EVERYONE unless diagnosis needed to TREAT! LTC staff AND residents still getting the nasal rape 2 x week regardless if you are twice recovered 4 x jabbed and NO SYMPTOMS. REsidents STILL being tossed into isolation for + PCR with NO SYMPTOMS despite 4x jabbed. This is RIDICULOUS and I wish you and Zdogg would shed light on how we are ALSO horribly mistreating our seniors out of "an abundance of caution" despite NOT A SINGLE PERSON ASKING IF the person WANTS to be nasal raped and isolated! CMS and FOR PROFIT nursing homes will continue to isolate residents and staff to Cover their ASS for $$$$$$$$$$$$$$$$. Oh and the residents can't understand anyone in their N95's either. But all for "their own good". Seeing increased deaths again NOT from or WITH covid but from depression/malnutrition when they quit eating from depression and constant threats that everything will be arbitrarily ripped away
So true! I’m a psych NP who goes to 11 LTC facilities per week. You speak the truth.
Except here in MD visitors and “vendors” are not required to test, only staff (2x wk) and Residents if they are “exposed” to “positive staff”. A positive, asymptomatic staff qualifies a building to enter “outbreak status” which lasts 14 days, even if no residents are affected, or if the “exposed “ staff was removed from the facility immediately on testing and was asymptomatic at time of testing (results are never confirmed by PCR, either).
By these standards, I figure I’ve been exposed at least a few hundred times over the past two years. It’s sheer insanity.
Yeah. That's definitely how my daughter felt. She missed the best week of school (end of the year) plus her friend's birthday party.
My question is - we used to have a policy of 24 hours after fever breaks, you can go back to school because you're not contagious anymore..... But she tested positive via antigen test for another 7 days. So is the CDC going to revisit that rule? Presumably you'd get the same results for the flu or other virus if you had antigen tests for them - people would continue to be positive well after their fever breaks.....
Yes they will continue to test positive, but that is not the same as being infectious to other people. Live viruses are gone by 5 to 7 days post infection, but the tests will still detect dead viruses - which are no risk to others. Testing is NOT the same as assessing your risk to others. We need to understand that and stop this neurotic nonsense.
I have been told that a positive antigen test meant recent (current or previous day) infection. I would love to know what studies have been done on this - how long after fever breaks does the antigen test stay positive, how long after fever breaks can you culture virus from a swab from the same place?
Literally my day right now. Preschooler who already had Covid in January is excluded today for 5 days and will need to wear a mask for days 6-10 (and yes, they all nap and eat together). Only way to stay in school is if the child gets fully vaccinated -for which we have zero studies proving it is beneficial/safe for kids that have already had it. This worn out mom has had enough!! The goal posts just keep moving…
You always have the best stuff that I can share with people who don’t seem to get it. Maybe I just have the wrong friends. LOL. Thanks for all your amazing work, VP.
Schools should have used the money directed at them to improve ventilation and to install UVC lamps in common areas. Improved ventilation has always been a very good thing reducing classroom CO2 levels improves alertness. The lamps are eyesafe and reduces all airborne pathogens. From appearances the money went to many other things, not the health of children. Is is OK to be mad?
Yes! Be angry. Some schools did spend some money on things that would actually help, but I'm assuming most schools just figured masking was enough.
My school invested in two air purifiers per classroom, which should be enough since the rooms are a little under 600 square feet. We also have the option of leaving the doors and windows open.
The real answer was improved HVAC air handling with higher fresh air makeup. A goal would be to ensure reduced room CO2 levels and quieter air flow. Central air delivery allows use of internal UV. While the air purifiers are a step, they require periodic maintenance adding to their costs compared to central air systems. But many school systems didn't have the skills needed to award suitable contracts. At least they tried.
Amen VP! The biggest question is why do people care about testing? Testing kids or testing in general..does anyone care? I would HOPE that your friend (or anyone else) does not require any preschool kid get tested if they have the sniffles....but I've asked myself this time and time again with 4 kids ranging in ages from preschool to HS in our house....WHY are parents choosing to test??!! WHY??!! Will it change your behavior? It shouldn't! If you have a resp. virus or your kid does & feels sick stay away from people! Common sense! Will it change treatment, especially if its a healthy child with the sniffles or a sore throat? Nope! Do what you normally do...common sense! We had a family member with Flu-Rona in our house in January. That person stayed away from the rest of us...we all felt fine, no testing necessary...everyone was sent to school & the sick family member stayed in the basement! Several other times this year someone in our family had a sore throat....if it was bad they stayed home from school & we told the school our child did not feel well & was staying home. No test necessary & the least info to them the better. Its more of a weird mental thing...people forget what 2019 & prior was like....its time to go back to common sense. If your kid had a fever and flu like symptoms but did not require urgent medical care....you kept them home & never felt the need to rush them to the MD for a "flu test" just to prove how crappy they felt & somehow satisfy your crazy desire to know. How dumb. Its time to move back to common sense & shame on the policy makers for inappropriately pushing testing on everyone for ANY time you suspect you feel sick and consequently making so many people now feel pressured to test or that its somehow "normal". Its not normal. Its time to move on.
Honestly, I'd rather take the weekly covid test if it means not getting a third shot. Luckily we had that option at my workplace, and if vaccine requirements come back I'll take the weekly nose-rapes. We also have a special covid sick pay that doesn't eat into our regular sick pay, so the silver lining is if I have to miss work because I test positive I'll enjoy some paid time off.
Still find it hilarious how many super masking, triple-vaxxed people at my workplace are catching covid and having to stay home.
I got my two jabs last spring. Had to stay home for 8 days because of flu-like symptoms. Will never get the covid vax again unless they come out with something different.
Caught covid over the holidays, felt mildly sick for one day. I never mask anymore unless required to at the clinic.
On a side note, there are still places here in Los Angeles requiring proof of vaccination. Insanity.
Please please write/do a video in response to this from the cdc website!! I copied a while section but read the first paragraph then the last one about cdc not trusting prior infection studies given they are not RCT and observational…
“ Available evidence shows that fully vaccinated individuals and those previously infected with SARS-CoV-2 each have a low risk of subsequent infection for at least 6 months. Data are presently insufficient to determine an antibody titer threshold that indicates when an individual is protected from infection. At this time, there is no FDA-authorized or approved test that providers or the public can use to reliably determine whether a person is protected from infection.
The immunity provided by vaccine and prior infection are both high but not complete (i.e., not 100%).
Multiple studies have shown that antibody titers correlate with protection at a population level, but protective titers at the individual level remain unknown.
Whereas there is a wide range in antibody titers in response to infection with SARS-CoV-2, completion of a primary vaccine series, especially with mRNA vaccines, typically leads to a more consistent and higher-titer initial antibody response.
For certain populations, such as the elderly and immunocompromised, the levels of protection may be decreased following both vaccination and infection.
Current evidence indicates that the level of protection may not be the same for all viral variants.
The body of evidence for infection-induced immunity is more limited than that for vaccine-induced immunity in terms of the quality of evidence (e.g., probable bias towards symptomatic or medically-attended infections) and types of studies (e.g., observational cohort studies, mostly retrospective versus a mix of randomized controlled trials, case-control studies, and cohort studies for vaccine-induced immunity). There are insufficient data to extend the findings related to infection-induced immunity at this time to persons with very mild or asymptomatic infection or children.”
A preprint recently dropped that has me digging into my storage closet for my leftover N95's and wanting a full respiration suit. It measures the thing that matters: Outcomes. "All-cause mortality," and other disorders, across a large cohort (US veterans).
Summary: There is no herd immunity because there is no individual immunity. Each time you face the virus, you roll the dice. While your first encounter with the disease is (quite obviously) the greatest danger of dying from COVID "proper," ancillary problems caused by the virus do NOT seem to similarly decrease. In fact, for those veterans at 3+ infections, their odds of severe outcomes start to increase.
This same group published a 1 infection vs. 0 infection study in April of 2021. This is an update that compares the stats across 2 and 3 infections, as well. The outcomes are ... depressing, frankly. Would love to have Dr. Vinay Prasad's take on it ...
I want to add to my response below a more general point. My mother, whom I love dearly, is in her late 80s. She is vaccinated but at her age still at risk of severe covid.
She has started going about her life again, frequently unmasked, including going to restaurants. I feel fine about this. Why? Because given all I know about covid, I think if her health and immune system are in poor enough condition that covid would kill her despite being vaccinated, then there is a good chance she will become seriously ill or die of something else anyway. One thing we know for sure about covid is it kills the vulnerable.
So, I don't see covid as a big risk to her beyond the existing risk of being 87 years old. Getting old is inherently dangerous and eventually leads to poor health outcomes and death in all of us. The best thing I think she can do is take good care of her health, take her Vit D supplements, and enjoy her life.
Glad your mom is living her life! And she has already beat the odds with being 87, and going out :) May you have many more healthy years together!
Absolutely continue the Vit D, when summer is over add Vit C and zinc too.
I wish all my residents had the choice to live as they choose vs having it foisted upon them for "safety".
Anecdotally-those who were in 90's or older seem to survive covid more (small sample size and extremely biased with already being in LTC)-wonder if it's because their immune system has already seen everything and also-their genetics are more "hardy"?
First, a disclaimer that my training in stats and research design is quite rusty. But, I took a quick look at the study you linked to. The first possible methodological issue that jumped out at me is that, as Prasad always discusses, this is an observational study and therefore you need to consider possible confounding - the cohorts may not be comparable.
One of the key places this could occur is that those who test positive twice in 6 months could do so because they are more suseptible to infection than average. If this is the case, then they are may be in poorer health in general and/or have a weaker immune system. So this could play a role in their worse outcomes.
You summarize the study as "each time you face the virus, you roll the dice..." But remember, the cohorts are not based on EXPOSURE to the virus (which is unknown) - they are based on positive tests. It's possible those with stronger immune systems may be exposed numerous times with no positive tests.
That all being said, I too would like to see a critique of this study by someone with stronger and more current data analysis skills than I currently possess - and also someone who puts in more than the 10 minutes or so I just devoted to it.
P.S. This isn't a reason to close schools. Kids still have the least likelihood to catch Long COVID despite how the media portrays it. And even then, they also seem more capable of eventually clearing it than adults. No vaccine that we have developed is going to fight PASC. So, we need "some other effort" to figure it out and treat it. However, "treatment" became "politically incorrect" in relation to COVID, so I fear that most Long COVID research is outside the US. And if Resia Pretorius is correct about Long COVID, and her team figures out a treatment, I wonder if we'll even accept the answer in the United States. After all, our first reaction to her country telling us Omicron was Mild was to ban all travel from South Africa. Which makes me think the FDA or CDC might even explicitly block it because "all interventions must be PREventions," here! Lock it down, baby!
That's why I posted it, here, btw! Everything I see about this study tells me it is as legit as you can get in US medical stats. And it tests for "outcomes we care about" as Dr. Vinay Prasad likes to point out. These aren't just some titers and assays - this is a collection of veterans' health in this period.
The VA is one of the only large, integrated systems in the US - but, that selection bias is not trivial. I appreciated that they try to control for those factors against other veterans who were not reporting infections, but ... I would love to see comparisons to Israel, Denmark, UK, or other countries with universal care and a penchant for spreadsheets.
There are two things that concern me: (1) COVID is still REALLY NEW! 2 years is NOTHING! Have we come to learn everything about COVID that there is to learn, already? Of course not. As more and more cohorts of people have multiple exposures/infections/recoveries, then we will really start to see patterns across broader populations. It seems to me that this paper is "early" only in that they have a trackable cohort of people with 3+ reported infections to compare with a massive cohort of people with 0 reported infections. (As you say, this doesn't mean they didn't have it - they simply weren't symptomatic or formally diagnosed.) The CDC is PLENTY HAPPY to publish data on antibody titers for 4th and 5th boosters, but not outcomes for that group. They don't collect that data, and they don't collect data for people with 4th or 5th infections. The only folks likely to have had 4 or 5 infections ... are front-line care workers, who are yet another confounding cohort to study. So, this could be a warning sign or it could be related to the veteran cohort, but we won't know conclusively for maybe another 6-12 months (imo). Unless there is some statistical trick I didn't see ... that perhaps Doc's well-trained eye will pick out quickly, I feel the stats are sound.
(2) My second concern is me. It has been widely observed that most "research is me-search." When I had my first vaccine, it was delivered intravascular. I could taste it. There was no draw-back on the needle. I had a host of side effects. It was life-changing. But, I still got my 2nd vax. My primary care ignored it. A few months later, I went to the hospital with heart palpitations that wouldn't quit, and some bout of weird tachycardia every few days. I was told I was having panic attacks. It wasn't until 6+ months later and meeting another vax-injured person that it dawned on me that this is what it was. Dr. Prasad was one of the few (trustworthy) people expressing a legit nod toward myocarditis and pericarditis signals in VAERS. Suddenly, I had answers: A heart echo showed swelling. I got a few different drugs. I quit stressing my heart. Basically, once I knew what it was, I was able to clear the symptoms. But ... I'm still very bitter. I have no doubt whatsoever that some thousands of vax injured people were quite literally gaslit TO DEATH by their own care providers who spent months ignoring any possibility of myocarditis ... only for them to engage in strenuous yard work, weightlifting, or other activities and have a stroke or heart attack. I'm glad that didn't happen to me, but it could have. I had many, many days of clutching my chest along the way, wondering if I should dial 911. In January, I caught Omicron - like millions of others. I beat it like an ugly stray dog. Afterward, I felt like Superman! The mental weight lifted off of me, I quit wearing my mask, and I was FREE! In May, my energy started to drain. I looked for reasons for this, but found none. By June, I was up to 2 naps/day. Last week, the familiar heart-flutters returned. Also in May, I was exposed to COVID, again. I was 100% asymptomatic, but my doctor tells me, "I think you have long COVID." And I just want them to be wrong like they were, last time ... but ... I have a better doctor, now. 6 weeks after asymptomatic COVID, I'm a long-hauler with low blood oxygenation, a heart murmur, and fatigue.
Shouldn't I be "immune?"
And the answer seems to be: I am ... kinda. I had zero symptoms of COVID. My body cleared the virus, again. I have no lung scarring. But my pulmonary numbers are bad - out of the blue. Much like the vax reaction, I had never had high blood pressure or any history of anxiety or anything remotely like my symptoms, before. I even had one of my own kids telling me it wasn't the vax, it was just some coincidence and my flawed human brain was attributing it to the vax "because that's how brains work," according to him.
Okay, but ... don't immune systems ... make you immune? Well, yes and no. To COVID? Yes. To any damage it may do while your immune system fights it? Not so much. It's a roll of the dice ... apparently. Maybe. Possibly. Probably? We don't know ... that's the problem. WE DON'T KNOW.
We can OBSERVE long COVID, but we can't EXPLAIN long COVID. There's not even consensus on whether it exists simply BECAUSE we don't have a "universal test" that can say if you have it or not. Which just reminds me of the initial infection when so many people denied it was even real. Remember when it was all supposed to be 5G towers? We eventually all came to know someone who died or had severe consequence. Then there was no vax reaction ... until there were 10,000's of us out there just trying to figure out what our next move should be. And Long COVID doesn't feel any different, to me. If you know people that have it or you work on it, you know it is real. If you don't, you suggest is psychosomatic. Heck, fluvoxamine (an SSRI) seems to help some people get over it, which makes me wonder if there isn't some insight into the placebo effect going on, here, in real-time: If you think you can get better, maybe your immune system quits over-reacting? Maybe that's enough to stop some % of long COVID all by itself?
While prior infection or vaccine are 97% effective against the virus, proper (you won't catch the COVID pneumonia that kills you), the effectiveness of prior infection or vaccine against PASC (post acute sequalae of COVID) seems to be around 15%. And ... that's starting to scare the holy crap out of me. Does this mean I have to fight myocarditis every year at "COVID season?" Or maybe it is just every other year? I seemed to beat Omicron just fine ...
Was the vaccine mandated for Veterans in order to get care? There's a question of antigenic original sin that Dr. Prasad mentioned at some point - if people are getting vaccinated, their immune systems may not adapt well to fighting new versions of Covid.
You said: "When I had my first vaccine, it was delivered intravascular. I could taste it. There was no draw-back on the needle. I had a host of side effects. It was life-changing. "
This is exactly what John Campbell, PHD has been saying - the intravascular injections may be a large part of the cause of myocarditis and that aspirating before injecting can prevent this. Your vaccine had direct access to your heart. I hope you'll make a full recovery in the long run, but I can see why you're worried... That said, it doesn't mean that catching Covid will have the same effect because it would have to reach your heart. I assume that means going from your nose/lungs into your blood first. There's at least a barrier to pass.
My symptoms from vax injury were simple myocarditis. Once I had a doctor who was willing to listen to me for more than 30 seconds, we figured this out and treated it. I was fully recovered as of February. I did 15 minutes of cardio stress-test with no trouble in February.
My symptoms from Long COVID are quite different. Lower blood oxygen. One of the prevailing LC theories is "microclots." (Follow #teamclots on Twitter for researchers in that area.) The theory here is that the capillary action between heart and lungs is not working properly. So, my lungs are not scarred, but my heart is working really hard to keep my blood O2 up ... and with exercise, it is greatly exacerbated. This also might explain various other folks with "brain fog" - anywhere you have capillary action, you might have decreased function. Not necessarily blockages, although that is a higher risk post-infection, but enough to just make "something" behave a little differently. Trying to figure out if I can get a VQ scan (insurance won't pay for Long COVID testing). A similar scan can be done in Europe called SPECT-CT.
Would make sense that those who are using VA healthcare are lower-income, lower-resourced - more stress, probably worse diet. I looked into having my dad get care through the VA, and he had too high an income even though he was retired.
Short answer, yes, but ... they were also using veterans as a control arm for the study. This isn't perfect, but the size of the cohort makes the findings statistically significant.
I would say that reading this study challenged me quite a bit on how I feel about COVID. However, I will wait for corroborating data from other countries like Denmark or Israel with national health care that is really on top of collecting COVID data before I get too freaked out. When Israel publishes their paper on 3 and 4 infection cohorts, I'll be super eager to get my eyes on it.
I no longer believe immunity is possible - much less HERD immunity. The real question is: What is the mechanism that keeps mucking stuff up in the body? My chips are on the spike protein. As I believe this was probably cooked up in a lab, and they chose the ACE2 receptor on purpose, it may prove that the spike is the real antagonist and the viral infection/respiratory infection is just a delivery mechanism.
Single spike proteins can enter cells (detached from virus) and trigger apoptosis of a wide variety of cells in the body. And I'm not sure if it survives cell death, but it may: So, the cell triggers suicide, but do the enzymes dissolve the spike protein that caused the problem? I don't know. In which case, it is free to find a new cell and potentially trigger apoptosis if that one, too.
Good thing the mRNA vaccine teaches your muscle tissue how to make spike proteins, eh?
The ones who did this paper ... do. If you are curious, this is a talk the lead researcher gave before the latest data was publishable: https://videocast.nih.gov/watch=45629
Also, realize they are working on veterans in St. Louis. This isn't a "blue state COVID hand-wringing" nest by any stretch of the imagination ...
NO-stop testing EVERYONE unless diagnosis needed to TREAT! LTC staff AND residents still getting the nasal rape 2 x week regardless if you are twice recovered 4 x jabbed and NO SYMPTOMS. REsidents STILL being tossed into isolation for + PCR with NO SYMPTOMS despite 4x jabbed. This is RIDICULOUS and I wish you and Zdogg would shed light on how we are ALSO horribly mistreating our seniors out of "an abundance of caution" despite NOT A SINGLE PERSON ASKING IF the person WANTS to be nasal raped and isolated! CMS and FOR PROFIT nursing homes will continue to isolate residents and staff to Cover their ASS for $$$$$$$$$$$$$$$$. Oh and the residents can't understand anyone in their N95's either. But all for "their own good". Seeing increased deaths again NOT from or WITH covid but from depression/malnutrition when they quit eating from depression and constant threats that everything will be arbitrarily ripped away
So true! I’m a psych NP who goes to 11 LTC facilities per week. You speak the truth.
Except here in MD visitors and “vendors” are not required to test, only staff (2x wk) and Residents if they are “exposed” to “positive staff”. A positive, asymptomatic staff qualifies a building to enter “outbreak status” which lasts 14 days, even if no residents are affected, or if the “exposed “ staff was removed from the facility immediately on testing and was asymptomatic at time of testing (results are never confirmed by PCR, either).
By these standards, I figure I’ve been exposed at least a few hundred times over the past two years. It’s sheer insanity.
"And if you have it, we will screw up your life."
Yeah. That's definitely how my daughter felt. She missed the best week of school (end of the year) plus her friend's birthday party.
My question is - we used to have a policy of 24 hours after fever breaks, you can go back to school because you're not contagious anymore..... But she tested positive via antigen test for another 7 days. So is the CDC going to revisit that rule? Presumably you'd get the same results for the flu or other virus if you had antigen tests for them - people would continue to be positive well after their fever breaks.....
Yes they will continue to test positive, but that is not the same as being infectious to other people. Live viruses are gone by 5 to 7 days post infection, but the tests will still detect dead viruses - which are no risk to others. Testing is NOT the same as assessing your risk to others. We need to understand that and stop this neurotic nonsense.
I have been told that a positive antigen test meant recent (current or previous day) infection. I would love to know what studies have been done on this - how long after fever breaks does the antigen test stay positive, how long after fever breaks can you culture virus from a swab from the same place?
Literally my day right now. Preschooler who already had Covid in January is excluded today for 5 days and will need to wear a mask for days 6-10 (and yes, they all nap and eat together). Only way to stay in school is if the child gets fully vaccinated -for which we have zero studies proving it is beneficial/safe for kids that have already had it. This worn out mom has had enough!! The goal posts just keep moving…
You always have the best stuff that I can share with people who don’t seem to get it. Maybe I just have the wrong friends. LOL. Thanks for all your amazing work, VP.
2 thumbs up Vinay
Schools should have used the money directed at them to improve ventilation and to install UVC lamps in common areas. Improved ventilation has always been a very good thing reducing classroom CO2 levels improves alertness. The lamps are eyesafe and reduces all airborne pathogens. From appearances the money went to many other things, not the health of children. Is is OK to be mad?
Yes! Be angry. Some schools did spend some money on things that would actually help, but I'm assuming most schools just figured masking was enough.
My school invested in two air purifiers per classroom, which should be enough since the rooms are a little under 600 square feet. We also have the option of leaving the doors and windows open.
The real answer was improved HVAC air handling with higher fresh air makeup. A goal would be to ensure reduced room CO2 levels and quieter air flow. Central air delivery allows use of internal UV. While the air purifiers are a step, they require periodic maintenance adding to their costs compared to central air systems. But many school systems didn't have the skills needed to award suitable contracts. At least they tried.
Amen VP! The biggest question is why do people care about testing? Testing kids or testing in general..does anyone care? I would HOPE that your friend (or anyone else) does not require any preschool kid get tested if they have the sniffles....but I've asked myself this time and time again with 4 kids ranging in ages from preschool to HS in our house....WHY are parents choosing to test??!! WHY??!! Will it change your behavior? It shouldn't! If you have a resp. virus or your kid does & feels sick stay away from people! Common sense! Will it change treatment, especially if its a healthy child with the sniffles or a sore throat? Nope! Do what you normally do...common sense! We had a family member with Flu-Rona in our house in January. That person stayed away from the rest of us...we all felt fine, no testing necessary...everyone was sent to school & the sick family member stayed in the basement! Several other times this year someone in our family had a sore throat....if it was bad they stayed home from school & we told the school our child did not feel well & was staying home. No test necessary & the least info to them the better. Its more of a weird mental thing...people forget what 2019 & prior was like....its time to go back to common sense. If your kid had a fever and flu like symptoms but did not require urgent medical care....you kept them home & never felt the need to rush them to the MD for a "flu test" just to prove how crappy they felt & somehow satisfy your crazy desire to know. How dumb. Its time to move back to common sense & shame on the policy makers for inappropriately pushing testing on everyone for ANY time you suspect you feel sick and consequently making so many people now feel pressured to test or that its somehow "normal". Its not normal. Its time to move on.
Honestly, I'd rather take the weekly covid test if it means not getting a third shot. Luckily we had that option at my workplace, and if vaccine requirements come back I'll take the weekly nose-rapes. We also have a special covid sick pay that doesn't eat into our regular sick pay, so the silver lining is if I have to miss work because I test positive I'll enjoy some paid time off.
Keep the wisdom coming.
Still find it hilarious how many super masking, triple-vaxxed people at my workplace are catching covid and having to stay home.
I got my two jabs last spring. Had to stay home for 8 days because of flu-like symptoms. Will never get the covid vax again unless they come out with something different.
Caught covid over the holidays, felt mildly sick for one day. I never mask anymore unless required to at the clinic.
On a side note, there are still places here in Los Angeles requiring proof of vaccination. Insanity.
Please please write/do a video in response to this from the cdc website!! I copied a while section but read the first paragraph then the last one about cdc not trusting prior infection studies given they are not RCT and observational…
“ Available evidence shows that fully vaccinated individuals and those previously infected with SARS-CoV-2 each have a low risk of subsequent infection for at least 6 months. Data are presently insufficient to determine an antibody titer threshold that indicates when an individual is protected from infection. At this time, there is no FDA-authorized or approved test that providers or the public can use to reliably determine whether a person is protected from infection.
The immunity provided by vaccine and prior infection are both high but not complete (i.e., not 100%).
Multiple studies have shown that antibody titers correlate with protection at a population level, but protective titers at the individual level remain unknown.
Whereas there is a wide range in antibody titers in response to infection with SARS-CoV-2, completion of a primary vaccine series, especially with mRNA vaccines, typically leads to a more consistent and higher-titer initial antibody response.
For certain populations, such as the elderly and immunocompromised, the levels of protection may be decreased following both vaccination and infection.
Current evidence indicates that the level of protection may not be the same for all viral variants.
The body of evidence for infection-induced immunity is more limited than that for vaccine-induced immunity in terms of the quality of evidence (e.g., probable bias towards symptomatic or medically-attended infections) and types of studies (e.g., observational cohort studies, mostly retrospective versus a mix of randomized controlled trials, case-control studies, and cohort studies for vaccine-induced immunity). There are insufficient data to extend the findings related to infection-induced immunity at this time to persons with very mild or asymptomatic infection or children.”
Yet all their studies to keep restricting us are crap and no RCTs.
A preprint recently dropped that has me digging into my storage closet for my leftover N95's and wanting a full respiration suit. It measures the thing that matters: Outcomes. "All-cause mortality," and other disorders, across a large cohort (US veterans).
Summary: There is no herd immunity because there is no individual immunity. Each time you face the virus, you roll the dice. While your first encounter with the disease is (quite obviously) the greatest danger of dying from COVID "proper," ancillary problems caused by the virus do NOT seem to similarly decrease. In fact, for those veterans at 3+ infections, their odds of severe outcomes start to increase.
This same group published a 1 infection vs. 0 infection study in April of 2021. This is an update that compares the stats across 2 and 3 infections, as well. The outcomes are ... depressing, frankly. Would love to have Dr. Vinay Prasad's take on it ...
https://www.researchsquare.com/article/rs-1749502/v1
I want to add to my response below a more general point. My mother, whom I love dearly, is in her late 80s. She is vaccinated but at her age still at risk of severe covid.
She has started going about her life again, frequently unmasked, including going to restaurants. I feel fine about this. Why? Because given all I know about covid, I think if her health and immune system are in poor enough condition that covid would kill her despite being vaccinated, then there is a good chance she will become seriously ill or die of something else anyway. One thing we know for sure about covid is it kills the vulnerable.
So, I don't see covid as a big risk to her beyond the existing risk of being 87 years old. Getting old is inherently dangerous and eventually leads to poor health outcomes and death in all of us. The best thing I think she can do is take good care of her health, take her Vit D supplements, and enjoy her life.
Glad your mom is living her life! And she has already beat the odds with being 87, and going out :) May you have many more healthy years together!
Absolutely continue the Vit D, when summer is over add Vit C and zinc too.
I wish all my residents had the choice to live as they choose vs having it foisted upon them for "safety".
Anecdotally-those who were in 90's or older seem to survive covid more (small sample size and extremely biased with already being in LTC)-wonder if it's because their immune system has already seen everything and also-their genetics are more "hardy"?
First, a disclaimer that my training in stats and research design is quite rusty. But, I took a quick look at the study you linked to. The first possible methodological issue that jumped out at me is that, as Prasad always discusses, this is an observational study and therefore you need to consider possible confounding - the cohorts may not be comparable.
One of the key places this could occur is that those who test positive twice in 6 months could do so because they are more suseptible to infection than average. If this is the case, then they are may be in poorer health in general and/or have a weaker immune system. So this could play a role in their worse outcomes.
You summarize the study as "each time you face the virus, you roll the dice..." But remember, the cohorts are not based on EXPOSURE to the virus (which is unknown) - they are based on positive tests. It's possible those with stronger immune systems may be exposed numerous times with no positive tests.
That all being said, I too would like to see a critique of this study by someone with stronger and more current data analysis skills than I currently possess - and also someone who puts in more than the 10 minutes or so I just devoted to it.
P.S. This isn't a reason to close schools. Kids still have the least likelihood to catch Long COVID despite how the media portrays it. And even then, they also seem more capable of eventually clearing it than adults. No vaccine that we have developed is going to fight PASC. So, we need "some other effort" to figure it out and treat it. However, "treatment" became "politically incorrect" in relation to COVID, so I fear that most Long COVID research is outside the US. And if Resia Pretorius is correct about Long COVID, and her team figures out a treatment, I wonder if we'll even accept the answer in the United States. After all, our first reaction to her country telling us Omicron was Mild was to ban all travel from South Africa. Which makes me think the FDA or CDC might even explicitly block it because "all interventions must be PREventions," here! Lock it down, baby!
That's why I posted it, here, btw! Everything I see about this study tells me it is as legit as you can get in US medical stats. And it tests for "outcomes we care about" as Dr. Vinay Prasad likes to point out. These aren't just some titers and assays - this is a collection of veterans' health in this period.
The VA is one of the only large, integrated systems in the US - but, that selection bias is not trivial. I appreciated that they try to control for those factors against other veterans who were not reporting infections, but ... I would love to see comparisons to Israel, Denmark, UK, or other countries with universal care and a penchant for spreadsheets.
There are two things that concern me: (1) COVID is still REALLY NEW! 2 years is NOTHING! Have we come to learn everything about COVID that there is to learn, already? Of course not. As more and more cohorts of people have multiple exposures/infections/recoveries, then we will really start to see patterns across broader populations. It seems to me that this paper is "early" only in that they have a trackable cohort of people with 3+ reported infections to compare with a massive cohort of people with 0 reported infections. (As you say, this doesn't mean they didn't have it - they simply weren't symptomatic or formally diagnosed.) The CDC is PLENTY HAPPY to publish data on antibody titers for 4th and 5th boosters, but not outcomes for that group. They don't collect that data, and they don't collect data for people with 4th or 5th infections. The only folks likely to have had 4 or 5 infections ... are front-line care workers, who are yet another confounding cohort to study. So, this could be a warning sign or it could be related to the veteran cohort, but we won't know conclusively for maybe another 6-12 months (imo). Unless there is some statistical trick I didn't see ... that perhaps Doc's well-trained eye will pick out quickly, I feel the stats are sound.
(2) My second concern is me. It has been widely observed that most "research is me-search." When I had my first vaccine, it was delivered intravascular. I could taste it. There was no draw-back on the needle. I had a host of side effects. It was life-changing. But, I still got my 2nd vax. My primary care ignored it. A few months later, I went to the hospital with heart palpitations that wouldn't quit, and some bout of weird tachycardia every few days. I was told I was having panic attacks. It wasn't until 6+ months later and meeting another vax-injured person that it dawned on me that this is what it was. Dr. Prasad was one of the few (trustworthy) people expressing a legit nod toward myocarditis and pericarditis signals in VAERS. Suddenly, I had answers: A heart echo showed swelling. I got a few different drugs. I quit stressing my heart. Basically, once I knew what it was, I was able to clear the symptoms. But ... I'm still very bitter. I have no doubt whatsoever that some thousands of vax injured people were quite literally gaslit TO DEATH by their own care providers who spent months ignoring any possibility of myocarditis ... only for them to engage in strenuous yard work, weightlifting, or other activities and have a stroke or heart attack. I'm glad that didn't happen to me, but it could have. I had many, many days of clutching my chest along the way, wondering if I should dial 911. In January, I caught Omicron - like millions of others. I beat it like an ugly stray dog. Afterward, I felt like Superman! The mental weight lifted off of me, I quit wearing my mask, and I was FREE! In May, my energy started to drain. I looked for reasons for this, but found none. By June, I was up to 2 naps/day. Last week, the familiar heart-flutters returned. Also in May, I was exposed to COVID, again. I was 100% asymptomatic, but my doctor tells me, "I think you have long COVID." And I just want them to be wrong like they were, last time ... but ... I have a better doctor, now. 6 weeks after asymptomatic COVID, I'm a long-hauler with low blood oxygenation, a heart murmur, and fatigue.
Shouldn't I be "immune?"
And the answer seems to be: I am ... kinda. I had zero symptoms of COVID. My body cleared the virus, again. I have no lung scarring. But my pulmonary numbers are bad - out of the blue. Much like the vax reaction, I had never had high blood pressure or any history of anxiety or anything remotely like my symptoms, before. I even had one of my own kids telling me it wasn't the vax, it was just some coincidence and my flawed human brain was attributing it to the vax "because that's how brains work," according to him.
Okay, but ... don't immune systems ... make you immune? Well, yes and no. To COVID? Yes. To any damage it may do while your immune system fights it? Not so much. It's a roll of the dice ... apparently. Maybe. Possibly. Probably? We don't know ... that's the problem. WE DON'T KNOW.
We can OBSERVE long COVID, but we can't EXPLAIN long COVID. There's not even consensus on whether it exists simply BECAUSE we don't have a "universal test" that can say if you have it or not. Which just reminds me of the initial infection when so many people denied it was even real. Remember when it was all supposed to be 5G towers? We eventually all came to know someone who died or had severe consequence. Then there was no vax reaction ... until there were 10,000's of us out there just trying to figure out what our next move should be. And Long COVID doesn't feel any different, to me. If you know people that have it or you work on it, you know it is real. If you don't, you suggest is psychosomatic. Heck, fluvoxamine (an SSRI) seems to help some people get over it, which makes me wonder if there isn't some insight into the placebo effect going on, here, in real-time: If you think you can get better, maybe your immune system quits over-reacting? Maybe that's enough to stop some % of long COVID all by itself?
While prior infection or vaccine are 97% effective against the virus, proper (you won't catch the COVID pneumonia that kills you), the effectiveness of prior infection or vaccine against PASC (post acute sequalae of COVID) seems to be around 15%. And ... that's starting to scare the holy crap out of me. Does this mean I have to fight myocarditis every year at "COVID season?" Or maybe it is just every other year? I seemed to beat Omicron just fine ...
Was the vaccine mandated for Veterans in order to get care? There's a question of antigenic original sin that Dr. Prasad mentioned at some point - if people are getting vaccinated, their immune systems may not adapt well to fighting new versions of Covid.
You said: "When I had my first vaccine, it was delivered intravascular. I could taste it. There was no draw-back on the needle. I had a host of side effects. It was life-changing. "
This is exactly what John Campbell, PHD has been saying - the intravascular injections may be a large part of the cause of myocarditis and that aspirating before injecting can prevent this. Your vaccine had direct access to your heart. I hope you'll make a full recovery in the long run, but I can see why you're worried... That said, it doesn't mean that catching Covid will have the same effect because it would have to reach your heart. I assume that means going from your nose/lungs into your blood first. There's at least a barrier to pass.
My symptoms from vax injury were simple myocarditis. Once I had a doctor who was willing to listen to me for more than 30 seconds, we figured this out and treated it. I was fully recovered as of February. I did 15 minutes of cardio stress-test with no trouble in February.
My symptoms from Long COVID are quite different. Lower blood oxygen. One of the prevailing LC theories is "microclots." (Follow #teamclots on Twitter for researchers in that area.) The theory here is that the capillary action between heart and lungs is not working properly. So, my lungs are not scarred, but my heart is working really hard to keep my blood O2 up ... and with exercise, it is greatly exacerbated. This also might explain various other folks with "brain fog" - anywhere you have capillary action, you might have decreased function. Not necessarily blockages, although that is a higher risk post-infection, but enough to just make "something" behave a little differently. Trying to figure out if I can get a VQ scan (insurance won't pay for Long COVID testing). A similar scan can be done in Europe called SPECT-CT.
Here's "the latest," although I would love for us to give up all the "prevention" bullshit that's already failed and move on to treatment/therapy research. https://www.science.org/content/article/what-causes-long-covid-three-leading-theories
Wonder if veterans are an increased risk group with higher stress levels that decrease immunity.
I wonder what these "bandwagon" researchers would find if they studied other coronaviruses/adenoviruses/rhinoviruses/flu like they do covid!
Would make sense that those who are using VA healthcare are lower-income, lower-resourced - more stress, probably worse diet. I looked into having my dad get care through the VA, and he had too high an income even though he was retired.
Short answer, yes, but ... they were also using veterans as a control arm for the study. This isn't perfect, but the size of the cohort makes the findings statistically significant.
I would say that reading this study challenged me quite a bit on how I feel about COVID. However, I will wait for corroborating data from other countries like Denmark or Israel with national health care that is really on top of collecting COVID data before I get too freaked out. When Israel publishes their paper on 3 and 4 infection cohorts, I'll be super eager to get my eyes on it.
I no longer believe immunity is possible - much less HERD immunity. The real question is: What is the mechanism that keeps mucking stuff up in the body? My chips are on the spike protein. As I believe this was probably cooked up in a lab, and they chose the ACE2 receptor on purpose, it may prove that the spike is the real antagonist and the viral infection/respiratory infection is just a delivery mechanism.
Single spike proteins can enter cells (detached from virus) and trigger apoptosis of a wide variety of cells in the body. And I'm not sure if it survives cell death, but it may: So, the cell triggers suicide, but do the enzymes dissolve the spike protein that caused the problem? I don't know. In which case, it is free to find a new cell and potentially trigger apoptosis if that one, too.
Good thing the mRNA vaccine teaches your muscle tissue how to make spike proteins, eh?
The ones who did this paper ... do. If you are curious, this is a talk the lead researcher gave before the latest data was publishable: https://videocast.nih.gov/watch=45629
Also, realize they are working on veterans in St. Louis. This isn't a "blue state COVID hand-wringing" nest by any stretch of the imagination ...
St Louis IS solidly blue though. the districts with schools remote the longest, masked the longest