COVID Transmissions for 9-15-2021
Child cases in the US surging; successful vaccine responses in bone marrow transplant patients
Greetings from an undisclosed location in my apartment. Welcome to COVID Transmissions.
It has been 665 days since the first documented human case of COVID-19. In 665 in China, Wu Zetian, the Emperor’s wife, maneuvered around and eliminated her political rivals, making herself an unofficial absolute ruler. She was the only “legitimate” female ruler of China, and reigned for 40 years with impressive achievements. For a large early part of her rule, she was empowered through her children.
Today we’ll discuss COVID-19 in children in the US, and then also the quality of vaccine antibody responses in patients who have received bone marrow stem cell transplants.
As a reminder, the Jewish holidays are interfering with my schedule somewhat. Today’s issue may be the last one for this week, since Yom Kippur is tomorrow and I may take my newsletter-writing time for Friday off to recover and get back up to speed.
Bolded terms are linked to the running newsletter glossary.
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Now, let’s talk COVID.
Child COVID-19 cases in the US continue to surge
There were 243,000 child COVID-19 cases in the US between September 2nd and September 9th: https://www.aap.org/en/pages/2019-novel-coronavirus-covid-19-infections/children-and-covid-19-state-level-data-report/
I’m not really sure what parents are supposed to do with this information, because often the potential for childhood exposure is beyond the control of parents. What is a person to do in a place where children are required to be back in schools, but disease control provisions are not adequate?
I don’t have easy answers for this, but I do have concerns that with schools open around the country we are seeing the potential to create a new reservoir for SARS-CoV-2, particularly in rural areas where adults may not interact as much as they do in cities. This is my biggest worry right now.
83% of bone marrow stem cell transplant recipients generate an antibody response
One of the biggest challenges in infectious disease control nowadays is the large population of people who have suppressed immune systems due to ongoing medical treatment. These people are difficult to protect, and also generally more vulnerable.
One such population are people who have received replacement transplants of bone-marrow derived stem cells, such as patients being treated for leukemia. The entire immune system is derived from stem cells in the bone marrow, for one thing. For another, when the stem cells come from an unrelated donor (called an “allogenic” transplant), immunosuppressive drugs are often administered to prevent autoimmune problems from arising.
A single-center study reports that 83% of allogenic bone marrow stem cell transplant recipients had an antibody response to COVID-19 vaccination with the Comirnaty (Pfizer) COVID-19 vaccine: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2784061
62% of the patients in this study reached the high end of the observed range for antibody response.
This is very good news. The study is small and single-site, so it needs expansion in order to be generalizable, but it encourages me that vaccination is largely effective in a specific immunocompromised population.
What am I doing to cope with the pandemic? This:
Celebrating my wife’s accomplishments
My wife is having a busy month! We have a baby on the way, but she also recently defended her PhD dissertation and was also honored as part of the Jewish Orthodox Feminist Alliance 2021 list of “Ushpizot” (literally guests), which constitutes a list of women who have “demonstrated strong leadership, made positive change, and created lasting impact through their work.” Certainly my wife has done these things through her efforts to contribute to and lead our synagogue community in a global crisis, and I’m incredibly proud of her.
Carl Fink shared links to some other critiques of that flawed Høeg study that I critiqued last issue:
Hi, John. I thought I'd mention that Science-Based Medicine has not one, but two articles up today agreeing with you about the terrible Høeg et al. study, and going into more detail--one of them is by David "Length is a virtue" Gorski, after all.
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No corrections since last issue.
See you all next time. And don’t forget to share the newsletter if you liked it.
Always,
JS
Hi John - Happy Holidays!
My wingnut friend is now pointing out the "success" of ivermectin in India with articles like this: https://indianexpress.com/article/cities/lucknow/uttar-pradesh-government-says-ivermectin-helped-to-keep-deaths-low-7311786/ Are there any good studies of the Uttar Pradesh/India covid response and the results?