When we think about it, this makes sense. Cloth masks were initially a stopgap measure intended to provide some protection against the D614G variety of virus, very close to the original Wuhan isolate, but we have seen a ramping up both of the contagiousness of the circulating virus as well as the ability of global manufacturing to provide high-filtration masks. It's time to move away from this emergency measure of cloth masks to options that are better at protecting people.
Relevant to the vaccine discussion -- first evidence that Omicron infection confers cross-immunity to Delta: https://twitter.com/sigallab/status/1475584463941914635. This suggests that perhaps that we wouldn't need a multi-valent vaccine to take on both Omicron and Delta. Scott Gottlieb had expressed the worry that it would be otherwise.
We still need to ask if it's really worth it to roll out a variant-specific vaccine, of course. But it should be pointed out that the primary endpoint of the original trials was prevention of symptomatic infection -- not just severe disease. Whether that goal now needs to change is a conversation scientists, government officials, and the public can have, but it won't do to just move the goalposts and hope no one notices.
That's not to suggest that preventing mild illness is *as important* as preventing hospitalization, or to diminish the hugely important role vaccination is still playing in saving people's lives. But it leaves a lot to be desired in terms of democratic accountability, not to mention respect for people's intelligence, to alter policy and messaging without even acknowledging that it is, in fact, being altered.
I think it is worth it to roll out a variant-specific vaccine, for people who have not yet been boosted, or for people who are aging into vaccine eligibility. In the latter case, a multivalent vaccine might be appropriate in the event that Delta is not totally displaced by Omicron. I think it is important that we improve the breadth of the immune response going forward, to reflect the viruses that are actually circulating. I don't know that I, as someone almost certainly recovering from Omicron, would require this specific booster, but I think there will still be quite a few people out there who might benefit from it. I did not enjoy getting Omicron, and wouldn't recommend it to others.
It's been widely reported that loss of taste or smell are less frequent with Omicron. I wonder why?
If this observation holds up, it's hard not to see it as a good thing. Loss of taste and smell has taken months to recover for some, and for others may not come back at all.
I would speculate that this is due to poor neuronal infiltration of the Omicron variant, owing to changes in the spike protein. I'd like to see that hypothesis tested.
I realize we don't know much yet about LongCovid but to suggest that there are two options - mild Covid or into-the-hospital-with-you Covid does ignore that very real third scenerio, that even people with few or no symptoms can be badly affected longterm.
Thankfully what evidence we had before indicates that vaccination also reduces long term COVID symptoms. Unfortunately, we don’t know enough about the Omicron variant to comment on any long term syndrome it may cause.
Right now, there’s nothing we can say or do about this with regard to Omicron. When there is, I’ll say something.
I actually don't know of *any* attempt to examine whether there are differences in post-acute sequelae between different variants. Important question, but one that would seem quite difficult to study.
The way this kind of thing would be done would be to look at prevalence changes of long-term symptoms when one or another variant is dominant, and then ty to control for other factors like the prevalence of vaccination. It would not be easy work but it could be done using classical epidemiology. Or at least, we could learn *something* from such a study. It wouldn’t be definitive, I don’t think.
I'm so sorry you have COVID!
Last issue you said you no longer thought cloth masks were sufficient. Could you explain that a little more?
Hi Karen! Thank you for your question.
Several studies at this point have demonstrated meaningfully better protection with N95 or even surgical masks. The filtration offered by a cloth mask just doesn't cut it anymore. this recent opinion piece by an aerosol filtration expert attempts to make the case and also includes some links to studies: https://www.theguardian.com/commentisfree/2021/dec/27/best-masks-covid-tests-cloth-surgical-respirators
When we think about it, this makes sense. Cloth masks were initially a stopgap measure intended to provide some protection against the D614G variety of virus, very close to the original Wuhan isolate, but we have seen a ramping up both of the contagiousness of the circulating virus as well as the ability of global manufacturing to provide high-filtration masks. It's time to move away from this emergency measure of cloth masks to options that are better at protecting people.
Relevant to the vaccine discussion -- first evidence that Omicron infection confers cross-immunity to Delta: https://twitter.com/sigallab/status/1475584463941914635. This suggests that perhaps that we wouldn't need a multi-valent vaccine to take on both Omicron and Delta. Scott Gottlieb had expressed the worry that it would be otherwise.
We still need to ask if it's really worth it to roll out a variant-specific vaccine, of course. But it should be pointed out that the primary endpoint of the original trials was prevention of symptomatic infection -- not just severe disease. Whether that goal now needs to change is a conversation scientists, government officials, and the public can have, but it won't do to just move the goalposts and hope no one notices.
That's not to suggest that preventing mild illness is *as important* as preventing hospitalization, or to diminish the hugely important role vaccination is still playing in saving people's lives. But it leaves a lot to be desired in terms of democratic accountability, not to mention respect for people's intelligence, to alter policy and messaging without even acknowledging that it is, in fact, being altered.
I think it is worth it to roll out a variant-specific vaccine, for people who have not yet been boosted, or for people who are aging into vaccine eligibility. In the latter case, a multivalent vaccine might be appropriate in the event that Delta is not totally displaced by Omicron. I think it is important that we improve the breadth of the immune response going forward, to reflect the viruses that are actually circulating. I don't know that I, as someone almost certainly recovering from Omicron, would require this specific booster, but I think there will still be quite a few people out there who might benefit from it. I did not enjoy getting Omicron, and wouldn't recommend it to others.
It's been widely reported that loss of taste or smell are less frequent with Omicron. I wonder why?
If this observation holds up, it's hard not to see it as a good thing. Loss of taste and smell has taken months to recover for some, and for others may not come back at all.
I would speculate that this is due to poor neuronal infiltration of the Omicron variant, owing to changes in the spike protein. I'd like to see that hypothesis tested.
I realize we don't know much yet about LongCovid but to suggest that there are two options - mild Covid or into-the-hospital-with-you Covid does ignore that very real third scenerio, that even people with few or no symptoms can be badly affected longterm.
Thankfully what evidence we had before indicates that vaccination also reduces long term COVID symptoms. Unfortunately, we don’t know enough about the Omicron variant to comment on any long term syndrome it may cause.
Right now, there’s nothing we can say or do about this with regard to Omicron. When there is, I’ll say something.
I actually don't know of *any* attempt to examine whether there are differences in post-acute sequelae between different variants. Important question, but one that would seem quite difficult to study.
The way this kind of thing would be done would be to look at prevalence changes of long-term symptoms when one or another variant is dominant, and then ty to control for other factors like the prevalence of vaccination. It would not be easy work but it could be done using classical epidemiology. Or at least, we could learn *something* from such a study. It wouldn’t be definitive, I don’t think.