Items of recent pandemic news you may have missed: How to get the most out of home rapid testing; new evidence that breakthroughs don’t transmit much; a new WHO committee to investigate virus origins; and more. Plus a frippery.
A new WHO committee on origins
The World Health Organization has rebooted its controversial investigation into the origins of SARS-CoV-2, by way of forming a new permanent advisory committee called the Scientific Advisory Group for the Origins of Novel Pathogens, or SAGO. WHO released the names of 26 people nominated for the committee (out of 700 applicants), who will meet for the first time following a two-week comment period. This page outlines SAGO’s charter, and here is the Washington Post’s coverage.
Unlike its predecessor, SAGO is a permanent advisory committee to the WHO, and will be expected to investigate future pandemic-capable pathogens in addition to SARS-CoV-2. As far as pinning down the origins of the current pandemic: do not hold your breath. A Georgetown University professor of health law is quoted in the WaPo piece linked above: “If you believe that SAGO will answer the question… then you are sadly mistaken because there is little to no chance of them [sic] gaining access to information or on-the-ground investigation as far as China is concerned.”
One of the members of the new committee, Marion Koopmans, carries over from the WHO’s initial origins committee. You can get a sense for her and for two other SAGO nominees from their appearances on This Week in Virology over the last year: Marion Koopmans and Thea Fischer; Thea Fischer; Christian Drosten.
Breakthroughs don’t transmit much
This week brings some of the best news of late for vaccinated people: contrary to widespread popular reporting since last June’s parties in Provincetown MA, the vaccinated are unlikely to pass on a SARS-CoV-2 infection.
As one immunologist put it, “In all these cases where you have these big breakthrough infections, there’s always unvaccinated people in the room.” For example, a study of breakthrough infections in Israeli healthcare workers concluded that in “all 37 case patients for whom data were available regarding the source of infection, the suspected source was an unvaccinated person.”
It seems that the mRNA vaccines, at least, provide some mucosal immunity in the upper airway, in addition to the expected circulating antibodies and other immune system sentries. So when a vaccinated person gets infected, virons in the nose get attacked by antibodies and weakened if not disabled entirely. So while the vaccinated person may be exhaling some viral material, it is far less likely to be infectious than would be the case in the unvaccinated.
The NPR piece linked above refers to work in the Netherlands, not yet published as far as I can see, in which researchers attempted to culture active virus from the secretions emitted by infected vaccinated people. The virus did not grow well at all.
Visualizing spread over time
How to use rapid testing at home
Here is a much-needed tutorial explaining how and when to use at-home rapid testing, and when other testing modalities might be appropriate. The author is Emily Oster, an economics professor at Brown University and the author of books on pregnancy and parenting (and a newsletter). She illustrates an approach to testing with examples from her own family’s practice (Oster has two children under 12) and that of others.
The rapid testing situation in the US represents one of its most serious failures of pandemic policy. Tests here cost anywhere from $7 to $50 and they are in extremely short supply. In other countries — England, Germany, Israel, Singapore — they are widely available at a cost as low as $1 and/or mailed regularly to citizens for free by governments. Michael Mina, whom we met in July of last year, co-authored a recent op-ed in the NY Times on what the US government can do now to right the ship of rapid testing. Though Mina doesn’t say it, I will note that he called for exactly the same government action 15 months ago.
The FDA and CDC will be busy
US federal advisory committees will be active over the next two weeks deciding on a range of important issues.
- 2021-10-14: VRBPAC (FDA) meeting: Moderna boosters
- 2021-10-15: VRBPAC (FDA) meeting: Johnson & Johnson boosters, and mix-and-match boosting
Here the briefing document struck a more positive note, saying that a second J&J dose two months after the first appears to confer a benefit. (In fact it brings the efficacy up to the level of the mRNA vaccines, 94%.) But the report noted that a lack of data on people over age 60 and on the Delta variant limited the conclusions that could be drawn.
The National Institute of Allergy and Infectious Diseases posted preliminary results from an eagerly awaited study of mix-and-match boosting outcomes (NBC News writup here; the study has not yet been peer-reviewed). The upshot was that heterologous boosting appears safe and effective, and that the two mRNA vaccines produce a stronger response when used as boosters than the J&J does.
- 2021-10-20: ACIP (CDC) meeting: Moderna boosters (?)
(Note that ACIP does not appear to have posted any agenda or summary for this meeting.)
- 2021-10-21: ACIP (CDC) meeting: Johnson & Johnson boosters, and mix-and-match boosting (?)
- 2021-10-26: VRBPAC (FDA) meeting: Pfizer shots for ages 5-11
In addition to all of the above, Merck has submitted an EUA application for their Covid pill, molnupiravir, which we wrote about in some detail here and here. A meeting date on the application has not been set.
And as we noted last time, AstraZeneca has put in for an EUA for their injectable, long-lasting antibody cocktail. Again no meeting date has been announced.
As a reward for your patience, the frippery today is a marvelous collection of useful websites from Reddit. Now normally I don’t spend much time on Reddit, with the exception of /r/dadjokes, because the quality of any given subreddit varies so widely. However, this one is pure gold. It begins with a simple question: “What useful unknown website do you wish more people knew about?”
Just two examples: Try justtherecipe.com, in which you paste the URL of any online recipe, which usually contains gratuitous photos of food-porn and the rambling life journey of the chef — the result is just the recipe, in a clean, attractive, and usable form. Or how about Terms of Service, Didn’t Read — which summarizes hundreds of online terms of service and rates them for privacy.
Look for the suggestions outlined in a pink box. Those have received more than 1,000 upvotes.