Long-COVID19 reported for 19% of breakthrough infections in study by Moriah Bergwerk et al., 2021
Long-COVID19 can apparently manifest in fully vaccinated individuals who have been infected with Delta. I know I won’t die if I’m ever unfortunately infected, but my primary concern (especially since getting my first dose) has been the risk of Long-COVID.
In the event that we have students with Long-COVID19, it may be good to make accommodations for them given the symptoms/ associated difficulties.
Another reason requiring that in-person/indoor professors teach in a mask is a wise policy decision.
Mortality concerns [vaccines can save my life…] < Morbidity concerns […more efficiently than they can save my health]
3rd Dose After 8 Months
I’ll be eligible for my 3rd Dose on Sunday, November 14th (8 months since my 2nd Dose of Pfizer), which is perfect because I wanted my 3rd Dose before in-person Final Exams.
I’ll likely choose Johnson & Johnson since I already had mRNA & some studies suggest a heterologous vaccine schedule confers additional protection (compared to getting a 3rd Pfizer; homologous vaccine schedule).
Of 39 fully vaccinated healthcare workers who had breakthrough infections, “At 6 weeks after their diagnosis, 19% reported having “long Covid-19” symptoms, which included a prolonged loss of smell, persistent cough, fatigue, weakness, dyspnea, or myalgia.
Nine workers (23%) took a leave of absence from work beyond the 10 days of required quarantine; of these workers, 4 returned to work within 2 weeks. One worker had not yet returned after 6 weeks.”
Tara Parker-Pope (NYTimes) (August 16)
“…the fact that one in five of the health care workers who had breakthrough infections still had lingering symptoms after six weeks appears to be the first indication from a peer-reviewed study that long Covid is possible after a breakthrough infection”
“I’m going to take it at face value that one in five people, six weeks after a breakthrough case, continued to feel crummy. That’s enough to make me want to wear two masks when I go into the grocery store, which is not that burdensome anyway.” (Quoting Dr. Robert M. Wachter, professor and chair of the department of medicine at UCSF)
Women More Likely to Experience Long-COVID19
David Cox (June, 2021): “Early reports of long Covid at a Paris hospital between May and July 2020 suggested that the average age was around 40, and women afflicted by the longer-term effects of Covid-19 outnumbered men by 4-to-1.
From long Covid patients monitored by hospitals in Bangladesh and Russia to the Covid Symptom Tracker app, from the UK-wide Phosp-Covid study assessing the longer-term impact of Covid-19, to the medical notes of specialist post-Covid care clinics across both the US and the UK, a picture has steadily emerged of young to middle-aged women being disproportionately vulnerable.
Dr Sarah Jolley, who runs the UCHealth post-Covid care clinic in Aurora, Colorado, told the Observer that about 60% of her patients have been women. In Sweden, Karolinska Institute researcher Dr Petter Brodin, who leads the long Covid arm of the Covid Human Genetic Effort global consortium, suspects that the overall proportion of female long Covid patients may be even higher, potentially 70–80%.
This pattern has been seen in other post-infectious syndromes,” says Dr Melissa Heightman, who runs the UCLH post-Covid care clinic in north London. “Around 66% of our patients have been women.”
Sports & Vaccinations
WNBA: #FullyVaccinated since June (per @WNBA)
NBA: ~75% (per @trieut)
NFL: “As of last Wednesday, 91.7% of all NFL players had gotten at least one dose of a vaccine” (per Charean Williams)
MLB: 85% (per @AP)
Empathic Anger: A Crisis of Courtesy
“Social Psychologists Stefanie Hechler & Thomas Kessler (2018) define it as an altruistic response to someone else’s hardship and suffering. It’s a calling to protect someone who’s vulnerable, when they’re being abused
— When your blood pressure goes up watching a grown man harass and threaten an elderly woman, that’s empathetic anger. You’re responding to the real harm he’s causing her.
— When you feel empathetic anger, you mainly just want someone who’s causing harm to stop. You want to provide safety and protection for the victim
¨ There’s a lot of people putting their own moral code ahead of everyone else’s well-being. They’re blind to their own ignorance and hatred. They’re hurting us. They’re hurting others. They’re also hurting themselves. They just don’t know it yet.
¨They’re offended when Quaker Oates gets rid of Aunt Jemima. They care more about the perceived loss of their “childhood memories” than the actual harm done by racial stereotypes.”
Covid-19 has impacted women in unique and disproportionate ways. These impacts have the potential to be long-lasting and disturb advances in gender equality (Canadian Women’s Foundation, 2021; Alon et al., 2020;Milligan et al., 2020; Qian & Fuller, 2020).
Handwashing Flow Physics
“Amazingly, despite the 170+ year history of hand washing in medical hygiene, we were unable to find a single published research article on the flow physics of hand washing.
T cells — a group of cells important to the immune system which seek out and destroy virus-infected cells — are much more active in women than men in the early stages of infection. “Women have two copies of the X chromosome,” says Iwasaki. “And many of the genes that code for various parts of the immune system are located on that chromosome, which means different immune responses are expressed more strongly in women.”
But it is also linked to a theory called the pregnancy compensation hypothesis, which suggests that women of reproductive age have more reactive immune responses to the presence of a pathogen, because their immune systems have evolved to support the heightened need for protection during pregnancy.
This robust immune response is thought to be one of the reasons why women are much less likely to die from Covid-19 during the acute phase of the infection — but it comes with a catch. One of the major theories for long Covid is that fragments of the virus manage to linger in remote pockets of the body, known as reservoirs, for many months. Iwasaki says that remnants of Sars-CoV-2 have been discovered in almost every tissue from the brain to the kidneys.
Because women react so strongly to the presence of a virus, some scientists think that these viral reservoirs are more likely to trigger waves of chronic inflammation throughout the body, leading to the symptoms of pain, fatigue and brain fog experienced by many with long Covid.
Evidence to support this idea has been found in studies of chronic Lyme disease. The bacterium Borrelia burgdorferi, which causes Lyme disease, is also capable of burrowing into tissue and nerves and hiding out in the body, leading to chronic symptoms. Research has shown that women have a more intense response to the presence of B burgdorferi, producing much higher levels of inflammatory cytokines — small proteins — than men.
“There’s increasing evidence that women respond more to this kind of persistent, low-grade infection than men,” says Dr Raphael Stricker, a Lyme disease researcher based in San Francisco. “And so they’re much more likely to have chronic inflammation.”
This is unlikely to be the sole explanation, however. Many scientists studying long Covid believe that, in a proportion of cases, the virus may have triggered an autoimmune disease, causing elements of the immune system to produce self-directed antibodies known as autoantibodies, which attack the body’s own organs. Since December last year, Iwasaki and others have published studies that have identified elevated levels of more than 100 different autoantibodies in Covid-19 patients, directed against a range of tissues from the lining of blood vessels to the brain. While the level of some of these autoantibodies subsided naturally over time, others lingered. Iwasaki believes that if these self-directed antibodies remain in the blood of long Covid patients over the course of many months, it could explain many of the common symptoms, from cognitive dysfunction to clots, and dysautonomia — a condition where patients experience an uncomfortable and rapid increase in heartbeat when attempting any kind of activity.
There have previously been indications of this in studies of ME/CFS. Female patients have been found to be far more likely to experience autoimmune-related ailments, ranging from new allergies to muscle stiffness and joint pain, a similar symptom profile to many of those with long Covid.
Iwasaki is now conducting another study looking to examine whether certain autoantibodies are present in particularly high levels in female long Covid patients. If this proves to be the case, it would not come as a complete surprise. Viruses have long been linked to the onset of autoimmune diseases ranging from type 1 diabetes to rheumatoid arthritis, and all of these conditions are far more prevalent in women, with surveys finding that women comprise 78% of autoimmune disease cases in the US
“Viral infections prompt the immune system to respond,” says Nusbaum at NYU. “And for many women, particularly if they’re genetically predisposed, that immune response can be so robust that you enter into this kind of dysregulated immunity, which doesn’t get turned off even after the virus is cleared.”
Women are more prone to autoimmune problems for a number of reasons, ranging from a molecular switch called VGLL3, which women have in far higher levels than men and which can tip the immune system into overdrive, to the sex hormone oestrogen, which can increase inflammation. Men on the other hand are more protected against developing autoimmune-related problems due to their higher levels of testosterone, which suppress the number of autoantibody-producing cells called B cells. Iwasaki believes that this tendency may well be the major factor that explains the long Covid gender skew.
“In the case of long Covid, the virus may tip the balance towards autoimmunity in people who already have that tendency to begin with,” she says.
Some scientists have already begun to describe long Covid as an oestrogen-associated autoimmune disease, calling for more research dedicated to identifying both personalised and gender-specific long Covid treatments.
“In general, there’s not as much research money and attention on conditions that primarily affect women,” says Julie Nusbaum, an assistant professor at NYU Long Island School of Medicine. “That’s just a general disparity in medical research. I think certain biases persist that when women present with a lot of body aches or pains, there’s more often an emotional or personality component to it than medical origin.”
Worryingly, signs of these age-old biases have crept in over the past year with long Covid. There are anecdotal reports of female patients complaining that their persistent symptoms have been dismissed or attributed to anxiety. Dr Janet Scott, an infectious diseases specialist at the University of Glasgow, says that there remains a school of thought within the academic community that the long Covid gender skew may simply be an artefact of women being more likely to report symptoms than men.
Why are women more prone to long Covid?
n June 2020, as the first reports of long Covid began to filter through the medical community, doctors attempting to…
[A lot of them were in full-time jobs, have young children, and now more than a quarter of them are completely unable to work because they’re so unwell. Economically, it’s a bit of a catastrophe.”
As Heightman points out, this is not a new trend when it comes to infectious diseases, rather one which has historically been neglected. Women are known to be up to four times more likely to get ME/CFS (myalgic encephalomyelitis, or chronic fatigue syndrome)]
July 2022 Update
Biden Diagnosed with Omicron (Evan Blake, 2022, July 22)
Biden’s bout with COVID-19 has been presented almost as a cause for celebration.
Typical of this trend is an op-ed in the Washington Post by Leana Wen, one of the chief minimizers of the Omicron variant who has supported all of the Biden administration’s unscientific policies. Wen writes, “President Biden’s covid-19 diagnosis is an opportunity for his administration to demonstrate the success of his leadership on the pandemic and what living with the coronavirus looks like.” She adds, “Biden should use his illness as an opportunity to inform the public that covid-19 is a manageable disease for almost everyone, so long as they use the tools available to them.”
Instead of reflecting on their disastrous mishandling of the pandemic — which has now killed over 600,000 Americans in just the first 18 months of his administration — the Biden White House is promoting this same line and stressing that he will continue working while sick with COVID-19, with the implication that all Americans should do the same when infected.
Jean-Pierre stated, “With the photo, he took off his mask so that the American people can see him, and see directly, see the work that he’s doing and sitting at his desk, continuing to do his work.” Later in the press conference, she said bluntly, “We knew this was going to happen. As Dr. Ashish Jha (White House COVID Response Coordinator) said when he joined me in the briefing room not too long ago, he said, ‘At some point, everyone’s going to get COVID.’”
[No thank you]
The Washington Post commentary concludes that becoming repeatedly infected with COVID-19 will be “the new normal going forward,” even for the president. “Indeed, this is almost certainly not the only time Biden will get the coronavirus. He, like the rest of us, could contract the virus once a year or more.”
An article by Apoorva Mandavilli in the New York Times states, “President Biden’s coronavirus infection is a stark illustration that the Covid vaccines, powerful as they are, are far from the bulletproof shields that scientists once hoped for.” She adds, “even booster doses offer little defense against infection, particularly with the most recent versions of the virus. What protection they do offer wanes sharply and quickly, several studies have shown. In the president’s case, the booster shot he received nearly four months ago is likely to have lost most of its potency at preventing infection.”
Mandavilli notes, “Earlier in the pandemic, experts believed that the vaccines would be enough to forestall not just severe disease, but also the vast majority of infections… But the Omicron variant upended those hopes. As more of the population gained some immunity, whether from infection or vaccines, the virus evolved to dodge those defenses… Each subsequent avatar of the virus has become still better at sidestepping immunity.”
August 5th Update
The COVID-19 pandemic’s origins remain controversial.Two new studies provide more evidence that the pandemic originated in a Wuhan, China market where live animals were sold. One study co-author, Joel Wertheim, a viral evolution expert at UC San Diego, explains that there were two lineages that marked the start of the pandemic, one genetically similar to bat coronaviruses and another that appears to have begun spreading earlier in humans.