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Fall boosters: An update
Fall boosters: An update
Fall COVID-19 boosters will be available soon. This is a notable shift in the pandemic response, as we’ve been using the same vaccine formula throughout the pandemic—one created in early 2020 to fight against the original Wuhan variant. The FDA and CDC (and their external scientific advisory committees)
gabe70·yourlocalepidemiologist.substack.com·
Fall boosters: An update
Impact of Lifting School Masking Requirements on Incidence of COVID-19 among Staff and Students in Greater-Boston Area School Districts: A Difference-in-Differences Analysis
Impact of Lifting School Masking Requirements on Incidence of COVID-19 among Staff and Students in Greater-Boston Area School Districts: A Difference-in-Differences Analysis
Background In February 2022, following the rescinding of a Massachusetts statewide school masking mandate, only two cities (Boston and neighboring Chelsea) out of 79 school districts in the greater-Boston area, maintained masking requirements in K-12 schools. This provided an opportunity to examine the impact of removing masking on COVID-19 case rates among students and staff in the public-school setting. Methods We used difference-in-differences for staggered policy adoption to compare incidence of COVID-19 cases among students and staff in greater-Boston area school districts that lifted masking requirements to those that had not yet lifted masking requirements during the 2021-2022 school year. Results Before the statewide school masking policy was lifted, there was no statistically significant difference in case rate trajectories between school districts. However, weekly and cumulative case rates were significantly higher in students and staff in school districts that removed masking requirements, compared to districts that had not yet lifted requirements. We estimate that lifting of school masking requirements was associated with an additional 44.9 (95% CI: 32.6, 57.1) COVID-19 cases per 1,000 students and staff over the 15 weeks since the lifting of the statewide school masking requirement, representing nearly 30% of all cases observed in schools during that time. School districts that sustained masking requirements for longer periods tended to have older school buildings in poorer condition, more crowded classrooms, higher proportion of low income and English learning students and students with disabilities, and a higher proportion of Black and Latinx students and staff. Conclusions Masking is a relatively low-cost but effective intervention that can protect students and staff from substantial illness and loss of in-person days in school. Despite compelling evidence that masking significantly reduces the spread of SARS-CoV-2, political will and public adherence to masking has waned. Our study confirms that universal masking requirements can benefit all students and staff, and therefore represents an important strategy to mitigate the impacts of structural racism, ensure health equity, and to avoid potential deepening of educational inequities. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This study did not receive any external funding. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes All data utilized in this study are publicly available through the Massachusetts Department of Elementary and Secondary Education (https://www.doe.mass.edu/covid19/positive-cases/default.html#weekly-report); Massachusetts Department of Public Health (https://www.mass.gov/info-details/covid-19-response-reporting); and the Massachusetts School Building Authority (https://www.massschoolbuildings.org/programs/school_survey)
gabe70·medrxiv.org·
Impact of Lifting School Masking Requirements on Incidence of COVID-19 among Staff and Students in Greater-Boston Area School Districts: A Difference-in-Differences Analysis
Wastewater monitoring identifies polioviruses in New York City
Wastewater monitoring identifies polioviruses in New York City
New York State health authorities announced Friday that polioviruses have been found in wastewater from New York City, further amplifying the geographic range at risk of seeing polio cases in the state.
gabe70·statnews.com·
Wastewater monitoring identifies polioviruses in New York City
How effective are MPX vaccines?
How effective are MPX vaccines?
Vaccines will help control the monkeypox (MPX) outbreak. The bad news is that we desperately need more doses. And we don’t know how much the vaccines help and in what manner they help (prevention, duration of disease, severity of disease). This information is absolutely essential so people know how well they are protected and what behaviors they should (or should not) change. This information will also have major implications for controlling the outbreak worldwide.
gabe70·yourlocalepidemiologist.substack.com·
How effective are MPX vaccines?
A plan for the upcoming school year
A plan for the upcoming school year
School is starting. And, with it, the contentious debate on what schools should and should not do. While the pandemic ravages on, the landscape continues to morph, and because of that, every subsequent school year has looked very different (hopefully for the better).
gabe70·yourlocalepidemiologist.substack.com·
A plan for the upcoming school year
Why the Chair of the Lancet’s COVID-19 Commission Thinks The US Government Is Preventing a Real Investigation Into the Pandemic ❧ Current Affairs
Why the Chair of the Lancet’s COVID-19 Commission Thinks The US Government Is Preventing a Real Investigation Into the Pandemic ❧ Current Affairs
pProf. Jeffrey Sachs says he is “pretty convinced [COVID-19] came out of US lab biotechnology” and warns that there is dangerous virus research taking place without public oversight. /p
gabe70·currentaffairs.org·
Why the Chair of the Lancet’s COVID-19 Commission Thinks The US Government Is Preventing a Real Investigation Into the Pandemic ❧ Current Affairs
U.S. declares monkeypox outbreak a public health emergency
U.S. declares monkeypox outbreak a public health emergency
The Biden administration declared the ongoing monkeypox outbreak a public health emergency on Thursday, a move that comes amid growing case counts and widening concern over the virus.
gabe70·statnews.com·
U.S. declares monkeypox outbreak a public health emergency
It's the virus, stupid.
It's the virus, stupid.
When the vaccines were first introduced in December 2020, the virus they were designed against was altogether different from what it is today. SARS-CoV-2 had little substantive functional evolution from late 2019 until we saw the Alpha variant in the first months of 2021. It was, in retrospect, an easy target with a fraction of the immune escape and transmissibility that we are dealing with now. Had the virus not subsequently evolved so profoundly, its containment would have been straightforward and we wouldn’t be talking about a pandemic right now in the present tense. Breakthrough and reinfections wouldn’t be commonplace. Population-level (“herd”) immunity would have been possible. The 95% efficacy of the mRNA vaccines against symptomatic infections, hospitalizations and deaths, exhibited waning in latter half of 2021, during the Delta wave, but was fully restored with a 3rd shot. Reinfections were less than 1%. We were prevailing over the virus.
gabe70·erictopol.substack.com·
It's the virus, stupid.
Novavax is here! Just not the silver bullet we need
Novavax is here! Just not the silver bullet we need
Yesterday, ACIP—CDC’s external scientific advisory board—unanimously voted to authorize the Novavax vaccine (called NVX-CoV2373) in the U.S. This was big news for the small, underdog Maryland company who had a long road to authorization. After rigorous clinical trials, FDA and CDC scientific meetings, and more than
gabe70·yourlocalepidemiologist.substack.com·
Novavax is here! Just not the silver bullet we need
Whose breath are you breathing?
Whose breath are you breathing?
How much of the air you're breathing is air someone else exhaled? And in the midst of a pandemic caused by an airborne virus, where are the riskiest places to be?
gabe70·rnz.co.nz·
Whose breath are you breathing?
How to Reduce Risk of Getting Long COVID
How to Reduce Risk of Getting Long COVID
This article was originally posted in the Montreal Gazette. There is still a great deal that is uncertain about the persistent symptoms that we have taken to calling long COVID. Why it happens, how common it is and how to treat it are all still somewhat unclear. But a research letter recently published in the Journal of the American Medical Association provides at least some hints on how we can prevent it. Up until now, there was ambiguity about whether vaccination prevented long COVID or not. Data from the U.S. Department of Veterans Affairs suggested that persistent symptoms were lower in vaccinated individuals, but not all the early data was entirely consistent. Part of the problem in studying long COVID is that different groups use different definitions. The U.S. Centers for Disease Control and Prevention defines it as symptoms that persist for four weeks after infection whereas, the World Health Organization uses three months after the onset of COVID infection. Depending on which definition you use, you can get very different estimates for how common long COVID actually is. The risk of long COVID is also going to differ depending on whether you consider people who were hospitalized for severe infections, people with only mild infections, or a combination of the two. When different studies use different methodologies, comparing them becomes an apples to oranges problem. The most recent data, from researchers in Milan, provides some useful information. Researchers analyzed health-care workers from nine medical centres in Italy and compared the COVID recovery of vaccinated and unvaccinated employees. Workers were being screened for COVID every one to two weeks, so virtually all cases would have been picked up. If mild cases were to go undiagnosed, that would provide a falsely elevated estimate of long-COVID risk. Researchers also limited their analysis to non-hospitalized COVID patients, which again guarded against overestimating the risk of long COVID by mixing together milder and more severe cases. Perhaps unsurprisingly, older patients and those with pre-existing medical conditions were more likely to have persistent symptoms one month after infection. That being said, I’ve anecdotally seen many younger patients with persistent symptoms, and it is important to remember that lower risk does not mean zero risk. Interestingly, the risk of long COVID did not differ significantly by wave, which argues against the notion that the newer variants are less likely to cause severe disease. What did make the largest difference was vaccination status. Getting two or three doses reduced the odds of developing long COVID by 75 and 85 per cent respectively. Receiving a single dose did not. Since the data was largely derived from infections that occurred in 2021, many health-care workers had only received two doses at that time. Intuitively, it seems logical that vaccination would reduce the risk of long COVID, and many of us assumed that would be the case. Vaccination reduces the severity of disease and also prevents infection. Despite what people say online, multiple studies have shown that vaccination with three doses plays an important role in preventing infection. While the vaccines are less protective against Omicron than they were against the Delta variant, three doses still reduced the odds of infection by 76 per cent. Many aspects of long COVID still defy simple answers. There is no clear diagnostic test or treatment; people have very different symptoms that may not all be due to the same cause. Symptoms do improve with time, but it is hard to predict who will improve and how long it will take. The one thing we can say with slightly more certainty is that vaccination seems to reduce the risk of persistent symptoms. Of course, the best way to avoid long COVID is not get COVID in the first place, and the vaccines can help with that, too. So can wearing a mask and just being careful. @DrLabos
gabe70·mcgill.ca·
How to Reduce Risk of Getting Long COVID
Masks for COVID: Updating the evidence
Masks for COVID: Updating the evidence
Notes taken whilst preparing a paper on mask efficacy from Nov to Jan 2022. My previous paper on this was written in April 2020 and published in the Proceedings of the National Academy of Science
gabe70·fast.ai·
Masks for COVID: Updating the evidence
Settling in for the long haul
Settling in for the long haul
A couple of tweets flicked across my screen in the past week or so from people I don’t know asking how, perhaps a year or two in, the knowledge settles across your shoulders that you’re not recover…
gabe70·crookedtimber.org·
Settling in for the long haul