How many microbes does it take to make you sick, Covid’s damage lingers in the heart, and more
Bonus one of the best articles I’ve read on the pandemic not being over
It’s still busy around these parts, but I do want to reiterate that I understand that staying strong, believing that the pandemic is real and ongoing, continuing to mask, it’s hard. It can seem futile. But it’s not futile. “The powers that be” want us to think it is. Staying strong has consequences in our lives. But it’s worth it.
Our musical interlude and “What are we even doing?” features have returned. Enjoy!
How Many Microbes Does It Take to Make You Sick? By Tara C. Smith / Quanta Magazine
What do we know about the infectious dose for the virus that causes Covid?
We’ve learned a lot in the nearly four years since it first appeared, but much of it comes from animal models of infection and human observational studies. Most animal models require a high dose of the virus — 10,000 to 1 million “plaque-forming units” (PFUs), where each unit is enough to infect a cell in tissue culture and kill it. Observational studies in humans, however, suggest that the infectious dose may be around 100 to 400 PFU on average, though again this method offers only a very rough guideline.
These studies suggest that one reason the virus is so easily transmissible is because it has a relatively low infectious dose, similar to other respiratory viruses such as RSV and “common cold” coronaviruses (and lower than the infectious dose of most strains of influenza virus).
And when we compare the infectious dose to the amount of virus exhaled by an infected individual, it’s not surprising that the virus spreads so quickly. A recent preprint shows that infected patients can exhale up to 800 viral RNA copies per minute for about eight days after their symptoms began. Even though we can’t directly translate RNA copies into the amount of live virus particles, if even half of those RNA copies are from a currently infectious virus, it’s theoretically possible to get a dose large enough to start an infection in just a minute of close contact.
COVID’s Damage Lingers in the Heart by Charles Schmidt / Harvard Medicine Magazine
In most people — especially those who’ve been vaccinated — COVID-19 produces flu-like symptoms that typically resolve within a few days or weeks. But other people progress to a second, and more dangerous, phase of the disease, as pro-inflammatory proteins called cytokines proliferate in the blood. During this so-called cytokine storm, the immune system becomes hyperactive, “causing a different set of problems,” says Dara Lee Lewis, MD ’92, an HMS instructor in medicine at Brigham and Women’s and director of noninvasive testing and co-director of the Women’s Cardiology Program at the Lown Cardiology Group in Boston. “Patients can develop weakened heart muscles, low oxygen levels, blood clots, fluid in the lungs — problems that may require hospitalization.”
More importantly, pre-existing cardiac risk factors, such as coronary artery disease and obesity — which can predispose patients to metabolic inflammation — raise the likelihood for poor outcomes. People with vulnerable hearts, Lee Lewis explains, are more likely to succumb to COVID-19 complications than others who do not have these risk factors. In a worst-case scenario, patients could experience a type 1 myocardial infarction, which is a heart attack caused when a blood clot blocks flow in the arteries.
But COVID-19 patients are also unusually prone to a different type of heart attack called a type 2 myocardial infarction. In these cases, the problem isn’t a blockage in the arteries, but rather a mismatch between oxygen supply and oxygen demand. Fever and inflammation accelerate heart rate and increase metabolic demands on many organs, including the heart. If infected lungs are incapable of effectively exchanging oxygen and carbon dioxide, then stressed hearts might suffer damage due to insufficient oxygen.
How SARS-CoV-2 contributes to heart attacks and strokes by Brian Doctrow / National Institutes of Health (NIH) Research Matters
Infection triggered several inflammatory pathways in macrophages and foam cells. The cells also released molecules that are known to contribute to heart attacks and strokes. In arterial plaques that had been surgically removed from patients, the researchers saw an inflammatory response to SARS-CoV-2 infection like that seen in the cultured cells.
The findings suggest that SARS-CoV-2 may increase the risk of heart attacks and stroke by infecting artery wall tissue, including associated macrophages. This provokes inflammation in atherosclerotic plaques, which could lead to heart attack or stroke.
“These results shed light onto a possible connection between preexisting heart issues and Long COVID symptoms,” Giannarelli says. “It appears that the immune cells most involved in atherosclerosis may serve as a reservoir for the virus, giving it the opportunity to persist in the body over time.”
“Since the early days of the pandemic, we have known that people who had COVID-19 have an increased risk for cardiovascular disease or stroke up to one year after infection,” says Dr. Michelle Olive of NIH’s National Heart, Lung, and Blood Institute. “We believe we have uncovered one of the reasons why.”
The Covid-19 pandemic is not over: The rich know it. You should, too. by Lizwhatsherface / Normalcy Fugitive
What would the world look like if the pandemic never ended, if Covid was causing widespread, long-term illness, and if all this was being covered up by the government?
You might expect to see record levels of sickness and disability. You might expect to see hard evidence that the ‘herd immunity’ plan failed, with children continuing to die at staggering rates. You might expect record numbers of absences in schools and workplaces, tons of canceled concerts and airline flights, more sudden/unexplained deaths in all age groups, and a rise in opportunistic infections (caused by damaged immune systems), like fungal infections or strep A. There would be a coordinated effort to hide data from the public to obscure the truth of the threat. Hospitalizations, cases, and transmission numbers would all be hidden or manipulated. The government probably wouldn’t try to hide the data all at once, because it would be easier to dismantle reporting over the course of several months or years.
Can We Still Contain, and Possibly Eliminate, COVID-19? Yes, and Here Is How by William Haseltine / Inside Precision Medicine
At this point, we seem to have accepted that we will be living with COVID-19 for the foreseeable future; such complacency is very dangerous. “Living with the virus” is no different from living with a pet lion; there is never any guarantee of safety. We know SARS-CoV-2 can change rapidly, we know it can become far more virulent, and we have no idea of the determinants of pathogenesis.
Our single-minded reliance on vaccines, at the expense of developing novel drug therapies, has left us fighting with one hand tied behind our back. Our current antivirals are anemic at best: they are either no longer effective, like most monoclonal antibodies, or they simply cannot prevent infection in the first place. If we ever hope to control COVID-19, we need to join the battle fully. This means a dramatic increase in resources to fund drug development efforts. The problem is not a lack of tools; it is a lack of political, scientific, and economic will. It is time to change that.
What follows is a summary of the shortcomings of our currently available antiviral drugs as well as a brief overview of some promising, up-and-coming contenders.
Global COVID vaccination saved 2.4 million lives in first 8 months, study estimates by Mary Van Beusekom / CIDRAP
The COVID-19 vaccination campaign in 141 countries averted 2.4 million excess deaths by August 2021 and would have saved another 670,000 more lives had vaccines been distributed equitably, estimates a working paper from University of Southern California (USC) and Brown University researchers.
The National Bureau of Economic Research circulated the non–peer-reviewed working paper for discussion and comment this week. The researchers estimated the real-world effectiveness of the global COVID-19 vaccine rollout on all-cause death rates, including both the direct and indirect effects of the pandemic.
Study: Regardless of variant, half of long-COVID patients fail to improve after 18 months by Stephanie Soucheray / CIDRAP
More than 50% of long-COVID patients failed to improve 1.5 years after their initial diagnosis, according to a new study based on cases seen at a Danish post-COVID clinic, both before and after the Omicron variant period. The study was published yesterday in the International Journal of Infectious Diseases. …
"In some patients, long COVID may last for more than 2 years after infection, which is supported by our data," the authors concluded.
What do we know about covid in immunocompromised people? by Katharine Lang / The BMJ
What we don’t know is the difference in risk between different types of immunocompromised states. The evidence is not clear cut, says Arturo Casadevall, professor of molecular microbiology and immunology at Johns Hopkins Bloomberg School of Public Health in Baltimore, Maryland. “The data on [how at risk different immunocompromised people are] is fragmentary, since this group is very heterogeneous,” he says. “For example, a patient on corticosteroids is very different from a transplant recipient, who in turn is very different from a person with leukaemia.” Studies suggest that patients with malignancy or solid organ transplants are at greater risk of severe covid-19 and death.
Immunocompromised people in general are also at risk of prolonged infection. “Some of these patients cannot clear infection once they get it, and that interferes with other therapies that they need,” says Casadevall. “They remain PCR positive, often for months—a phenomenon called ‘smouldering covid,’ where the patients are chronically infected.” These individuals pose a risk for the development of new variants and could theoretically serve as sources for new rounds of infection.
Let them eat old vaccines AND plague by Nate Bear / ¡Do Not Panic!
Normalisation is the most powerful sociological force in the world today. Through a captured media, the ruling class can make us absorb a pandemic, accept climate collapse and shrug at apartheid. Change is unnecessary because nothing is wrong. It is just the natural order, flowing.
We also found out this week that just 2% of Americans have stepped up for the new covid jab, a rate of uptake that can be traced back to the early over-hyping of vaccines and the manufacturing of a narrative that says covid is mild and we’ve all achieved immunity now anyway.
I didn’t know where we’d be nearly four years on from the start of the pandemic, but I didn’t think we’d be here. New waves, millions being infected, thousands dying every week. And a media and public knowledge blackout of Novavax, the most effective vaccine. A vaccine we’ve known is the most effective for over two years.
It is tiring to keep up, to keep bearing witness to these fuck-ups, to this cruelty.
But we have to.
Because to believe in change means documenting the incompetence, the failure, the lies and the indifference that eventually compels that change to come.
Parents issued grim health warning for any children who test positive for Covid by Monica Charsley / Mirror Online
Parents have been warned that the majority of children who tested positive for Covid-19 could suffer from blood vessel damage which can lead to several frightening conditions.
Scientists in the US conducted research into kids with the bug and found that a "high proportion" of those with the infection had raised levels of a biomarker linked to vascular trauma - a blood vessel injury.
Joe Biden Has Already Lost by Jessica Wildfire / OK Doomer
The Biden administration failed to end the pandemic. They simply hid it. They caved to corporate pressure. They've spent nearly three years dismantling every single tool we had. The CDC even changed how they calculate excess deaths to cover up the toll it's taking on us. Liberal universities toss air purifiers in the dumpster while telling us infection control "costs too much." Under Team Biden, we get Paxlovid at $1,400 per course and a few expired Covid tests.
Many liberals have become anti-mask. They've become anti-vaxx by default, neglecting their boosters. They don't do it with the same energy as the right. Instead, they complain about "vaccine fatigue." They come down with "summer flu."
They don't see the double standard.
Risk of Guillain-Barre syndrome 6 times higher after COVID infection, study suggests by Mary Van Beusekom / CIDRAP
A new study from Israel ties COVID-19 infection to an increased risk of a diagnosis of Guillain-Barre syndrome (GBS) within 6 weeks, while mRNA vaccination was linked to a decreased risk of the rare but serious autoimmune disease. …
A chronic illness with no known cure, GBS occurs when the immune system attacks the nerves, causing symptoms such as weakness and tingling in the hands and feet that spreads to the upper body and may lead to paralysis, shortness of breath, abnormal blood pressure, and difficulty walking. Most people recover with few residual effects.
COVID-19 mortality risk higher for people with severe mental illness, study shows by Lily Ramsey / News-Medical
"These are stark findings and highlight the health inequalities that exist for people living with severe mental illness, people from racialized groups and people from different regions of the country. We still need to learn more about the experiences of these groups which we are doing through in-depth interview research and we also need to understand the gap in how our services provide for these vulnerable people. The pandemic shone a light on these inequalities, and we must learn from this to develop new policies and improve service provision."
As most have probably noticed, there is no paid subscription option for this newsletter. However, Substack does have an option where subscribers can pledge to subscribe “just in case” and a few kind subscribers have made that pledge. I very much appreciated the vote of confidence in what I’m doing here.
What I’ve decided to do on a trial basis is to set up a “tip jar” on the Ko-fi platform. This will allow people to leave me a small gratuity. The tips start at $3.
I’m not anticipating a huge surge of income from using Ko-fi but whatever revenue I do end up with, I plan to spend on popular science books for this ongoing project and to support artists on Bandcamp.
What Are We Even Doing?
18 COVID-19 cases not called an outbreak at Vancouver Island hospital - Nanaimo News Bulletin
Hospital trust apologises for telling staff not to test for Covid-19 - Birmingham Live
Our last musical interlude two issues ago was pretty sombre so I thought I’d mix things up with something a little more lively. One! Two!