Dr. Bow Tie
COVID-19: BOOSTER UPDATE, MASKS (STILL) WORK, MORE DISPROVING INFERTILITY, AND RETRACTIONS
The United States is not in the best place right now. Eric Topol recently pointed out how the US is only about 60% vaccinated, while the fifth wave is starting to surge here (after already rising in Europe). We are seeing over 100,000 cases per day nationwide. With breakthrough cases, that does not necessarily correlate to severe cases, BUT we are still seeing up to 900 hospitalizations a day (predominantly in those not vaccinated). Canada, on the other hand is at 76% vaccination and is seeing <4x the amount of cases, less than three times the hospitalizations, and less than five times the deaths!
Vaccines and mitigation measures WORK!
COVID-19 spread remains persistent, and we are about to enter peak flu/RSV/cold season in the northern US as people move indoors to get away from the cold. This winter is not going to be fun for the healthcare system. Please take measures to protect yourself from COVID-19 and these other respiratory illnesses, because hospitals are already overwhelmed with cases, and it makes it harder to treat other non-pandemic health issues.
There have been some updates on the vaccination front, as well as further proof agains the myths around them, and some developments on the grifter front as well, so let's dive in:
BOOSTERS FOR EVERYONE (18+)!
So recently I posted about boosters and who would qualify. At that time I emphasized that boosters were still a question of exposure risk. However, since then as more data has been reported, and given the fact that risk is still high for everyone in many areas, and to avoid confusion regarding eligibility, the FDA has authorized (and the CDC has approved) COVID-19 booster vaccines for all fully-vaccinated Americans 18 and older. If you received an mRNA vaccine, the booster can be given 6 months after your second dose; if you received J&J, it's two months (that was already approved).
Stay with me. I must reiterate, this does not mean that the vaccines aren't working. It also does not mean that we are going to need yearly boosters based on the data so far. We have multiple other vaccinations for other diseases that require multiple doses (two- or three-dose regimens) - this is not a first.
The booster/third-dose effect appears excellent in the data so far, increasing antibodies higher than either two-dose or infection-mediated immunity, including against delta.
In addition, as I have stated before, boosters are important, but what is more important is establishing the blanket of protection with as many people as possible getting their first and second doses.
MASKS WORK! (WE KNEW THAT ALREADY, BUT HERE'S MORE PROOF BECAUSE PEOPLE STILL REFUSE TO ACCEPT THAT)
A new systematic review just came out in the British Medical Journal, one of many MANY studies and articles that show how, even though the virus is airborne, good masks (multiple layers, thick weave) will slow the spread and lessen your chances of catching/spreading the virus. KN95 masks are superior, but even cloth masks will help. The paper acknowledges that places such as Australia, New Zealand, Singapore, and China experienced substantial benefits from universal lockdowns, but hat those are not sustainable, and so other measures continue to be required to prevent spread. Masks showed a 53% reduction in COVID-19 incidence, across multiple studies! There was also an evident reduction in transmission and mortality from COVID-19: 45.7% fewer mortalities where mask mandates were in place! These studies were mostly observational (one was a randomized-controlled trial), which aren't the strongest of evidence on their own, but in a meta-analysis can provide great insight. The meta-analysis looked at many different interventions, including school and/or business closures, physical distancing, and hand-washing and disinfecting. All had varying levels of reduction, but of these, hand-washing and mask-wearing are far and away the easiest to implement. Not all employers can create distance between workers (or students in schools) or close down the physical business, but in times of high transmission and case load (not the best measure of danger, but still correlates with increase in hospitalizations for now while not enough people are vaccinated), mask mandates in schools and businesses (alongside handwashing and hygiene) are the best non-pharmaceutical measure we have against COVID-19.
INFERTILITY MYTH-SPREADING PAPER RETRACTED
There was a recent article where two New Zealand scientists tried to reanalyze data from a study published in the New England Journal of Medicine which had showed the safety of mRNA vaccines in pregnancy. The NZ scientists basically just changed the denominator to make it look like there were a lot more miscarriages, by only including people whose pregnancies “finished” in the 3-month follow-up period of the renalysis, and excluded folks who got vaccinated in their third trimester. So they only had folks in their 1st or 2nd trimester and only the ones who “completed” their pregnancy in 3 months - most of those would be miscarriages, and not from the vaccine - that’s a really biased denominator. The paper (published in a low-quality journal) was harshly criticized after it was used to spread disinformation, and it has been retracted by the authors now after its flawed analysis was discussed. This is yet further confirmation that rumors and myths about infertility associated with the vaccines are NOT backed up by any real science.
On a related note, a new paper has been uploaded as a preprint showing that vaccination during pregnancy results in higher amounts of antibodies crossing the placenta (remember, that's always been a thing, with or without vaccination - parental antibodies providing passive protection up to 6 months has been a long-known phenomenon). They measured anti-Spike IgG antibodies in infants born to birthing people who were vaccinated vs. those who developed COVID-19 infections during their pregnancies. The vaccinated-parent infants had durable and detectable antibodies at 2 months (94% of them) and 6 months (dropped to 60%), while of the infants born to parents who had been infected, only 8% showed antibodies at 6 months. This is consistent with what we already know about antibodies in adults (1: Vaccine-mediated immunity is still natural, it's still your immune system, and 2: Vaccine-mediated immunity is more stable and reliable than infection-mediated immunity).
Further, a new CDC MMWR shows that among over 1.2 million deliveries in hospitals during March 2020-September 2021 in the United States, birthing people who were infected by COVID-19 were at a substantially increased risk of stillbirth compared to those who did not have COVID-19. If you recall, we showed with multiple studies that in birthing people who received vaccines (compared to placebo), there was NO increase in stillbirth.
Bottom line: COVID-19 remains extremely dangerous to both parent and fetus during pregnancy, while vaccines make both safer. If you are pregnant and have none of the extremely rare contraindications to the vaccine, you should get vaccinated.
A REMINDER ABOUT EXEMPTIONS
There are very few real medical exemptions to getting the vaccine, and there are no established religions that exempt people from the vaccine. If a doctor is writing a lot of these exemptions, and if any kind of religious leader is writing them, they are probably fake.
THE FLCCC IS STILL TRYING TO ACT LIKE THEY CARE ABOUT PEOPLE AND NOT MONEY
There is a group called the Frontline COVID-19 Critical Care Alliance composed of physicians and journalists who tout themselves as an authority on treating COVID-19 (that name certainly makes it sound that way). They are led by two physicians, Paul Marik and Pierre Kory, who were previously known as eminent critical care (ICU) physicians but who have bought into extremely problematic myths. Their group offers a regimen of medications and submitted a paper showing how it reduced mortality by 75%. This regimen now includes ivermectin, which I have discussed multiple times before. Marik and Kory went through training similar to my own (and then some) but seem to have forgotten how to evaluate research, and despite the utter lack of evidence for ivermectin, they insist that it be used. The FLCCC’s original paper (pre-ivermectin) was just retracted because the data was shown to have been manipulated (and the mortality rate dramatically underreported in the involved hospitals). I have also previously mentioned how Kory's paper on ivermectin was recently retracted.
Marik is now trying to sue to be able to use ivermectin and their regimen in hospitals, despite all the evidence to the contrary, after multiple hospital systems banned the use of ivermectin against COVID-19 (it is still utilized in treatment of the conditions for which there is evidence). They have supporting testimony from members of the Great Barrington Declaration (that was the document where they claimed so many doctors were speaking out against mitigation measures like masks and lockdowns, except it turned out they faked a bunch of their signatures) - not exactly good company.
In slightly older but still recent news, America's Frontline Doctors (the Breitbart-sponsored group composed of a handful of doctors and other healthcare providers, none of whom are really on the frontline and multiple of whom had tried to grift in other ways; they are led by Dr. Simone Gold who, among other things, participated in the white supremacist attacks on the Capitol on January 6th) was found to have made millions in profits from people paying high fees for "consultations" and prescriptions of hydroxychloroquine and ivermectin and other medications that do not work.
There remains a lot of disinformation out there, and a lot of people/groups trying to make a name or money for themselves using junk science. There are even physicians doing so, which makes this all the more frustrating. That is why I keep making these posts, and why I follow (and recommend you follow) the better-quality scientific communicators out there.
That is why I keep urging everyone to get vaccinated. If you (and now your kids 5 and up) get vaccinated NOW, you can be fully protected in time for the December holidays like Christmas. This winter is already shaping up to be rough as we have dropped many mitigation measures and upper respiratory infections, RSV, and influenza have returned, along with persistent COVID spread. Think of your loved ones and protect them as well as yourself - please get vaccinated and utilize these other important measures.
As always, I welcome your questions.