COVID-19 Update, Wednesday, October 14

Reinfection, hearing loss, vaccine update, flying and misleading headlines.

1. Let’s talk about reinfection. Some people believe, wrongly, that once they have COVID they cannot get it again and therefore don’t need to take precautions. But we have seen enough cases to know that that is not true. A Dutch woman died from her second infection, and we have seen enough reinfections to know that reinfection is possible. The real question is how long you are immune, and we don’t have a solid answer. A 25-year-old male in Nevada who was otherwise healthy got COVID a second time only a few months later, his second infection was worse than the first – proving again that having it once does not equate to a lesser infection the second time. Of course, this was his experience and is not indicative of everyone. We have to remember that all of our bodies will respond differently.

You can read a study in the latest Lancet regarding reinfection. Based on our current knowledge, it looks like the viral mutations are the reason for reinfection. Remember RNA viruses like COVID and the flu, mutate at a faster rate than DNA viruses and that makes it harder to vaccinate against them (it is possible and has been done but it is harder) and it is less likely that getting the disease will provide long term immunity because the virus changes and you are vulnerable to the new version – which appears to be what is happening here. We need to learn more, but it does complicate things. Lancet article: https://www.thelancet.com/journals/laninf/article/PIIS1473-3099%2820%2930764-7/fulltext

2. A new symptom is emerging regarding COVID – hearing loss. There have only been a few incidences of this, but some have been irreversible. You can read more about it here: https://casereports.bmj.com/content/13/11/e238419?utm_source=Global+Health+NOW+Main+List&utm_campaign=063832c01c-EMAIL_CAMPAIGN_2020_10_13_04_24&utm_medium=email&utm_term=0_8d0d062dbd-063832c01c-3016733

3. Pfizer is going to enroll children as young as 12 years old in their vaccine trials. This is completely unprecedented. In related news, Moderna has had to pause their trials due to one of the participants getting sick. Adverse reactions happen and detecting them at this stage is much better than being surprised later, but it does mean they need to pause the trial to determine how severe this risk is and how common it may end up being. And Eli Lilly has also had to pause their work on an antibody treatment due to quality control issues. You may recall they are working on the treatment that Donald Trump received.

4. Two new studies came out conflicting the one I reported on last week (at least I think it was last week – they all run together these days) suggesting that flying is not as safe as that study suggested. The difference seems to be the length of the flight. Both of these studies looked at long flights and found that outbreaks were associated with long flights. This seems like a good time to remind you that this is a shifting situation where information changes not because people don’t know what they are talking about or “got it wrong” but because we are still very much in the learning phase of this disease. While we have learned a lot since January, there is still much we don’t know so information shifts and changes as we learn more. For example, there was a time when we thought cholesterol was all bad. Then we learned there were different types and some of it was actually good (HDL). Based on our current knowledge, it appears that short flights may not pose too significant of a risk whereas longer flights do. That may change as we learn more. You can read more in the journal of Emerging Infectious Diseases.

5. A study came out in JAMA that has resulted in some misleading headlines. The headlines say things like, “Americans are dying at a much higher rate from COVID than in other countries” or something similar. The JAMA study they are referring to looked at all-cause mortality – not just COVID mortality. Our case fatality rate for COVID is lower than in many other countries. Certainly not all, but many. The study in question looked at overall death rates during the pandemic and found we had more excess deaths than many other countries. But that is not the same as saying more of us are dying from COVID.

FINAL THOUGHTS: It’s Wednesday and chances are you could use a nap, I certainly could. I want you to know that you have done well this week. Oh, sure you may not have handled every little situation perfectly, we didn’t do that before the pandemic. Apologize where you need to, forgive yourself and others, and then move on. I wish I could say that this would all be over soon, but I would be lying. Instead, I will say that we are going through it together, and therefore should be supporting each other and lifting each other up instead of tearing each other down. So, reach out to those who could use a hand, and raise a hand if you need a little help. We have to work together. Sure, we will stumble and fall, but we get up, dust off, and keep moving. You are doing great.