More perils and pitfalls of RATs, Is getting Covid good for you, Debunking Covid myths, and more

Plus bonus “What are we even doing?”

Oct 12, 2023

books on the shelf photograph — Photo by Paul Melki on Unsplash

It continues to be a very busy time in my little corner of the academic librarian world. As such, this issue will be pretty brief in terms of commentary.

But fear, not. I’m still watching out for the best information and readings about Covid! And a musical interlude! And “What are we even doing?”

I did notice how popular the issue focusing on Rapid Antigen Tests was a couple of months ago. Since then a few more good articles on the relative strengths and weaknesses of those tests have been published. They explore how to best make use of RATs at this stage of the pandemic.

The Perils and Pitfalls of Rapid Antigen Tests

Evolving peak SARS-CoV-2 loads relative to symptom onset may influence home-test timing by Mary Van Beusekom / CIDRAP

In a group of adults in the state of Georgia tested for both COVID-19 and influenza A, most of whom were vaccinated and/or previously infected, median SARS-CoV-2 viral loads peaked on the fourth day of symptoms, while flu loads peaked soon after symptom onset.
The authors of the study, published today in Clinical Infectious Diseases, say the findings have implications for the use of rapid antigen tests for COVID-19 and flu.

Here’s How Long to Wait to Take an At-Home COVID Test by Shishira Sreenivas / The Messenger

At-home COVID-19 tests might be most accurate four or five days after first developing symptoms, according to a new study.
Researchers from Emory University, who published their findings in Clinical Infectious Diseases, took nasal swabs from nearly 350 people who had recently tested positive for COVID. The researchers found that viral loads steadily rose from day one of having symptoms and peaked around day four.

Home tests still work to detect Covid-19, but here’s why your test may not pick up an infection by Brenda Goodman / CNN

The CDC recommends that people take a rapid test five days after a known virus exposure.What you should do if a household member tests positive for Covid-19, according to an expert.
“If you look at viral kinetics … on average, it usually takes three, four or five days for the virus to go from being very low levels to getting high enough for any test to pick up,” Mina said.
That hasn’t changed, even with new variants, he said.
The new variants may copy themselves a little faster in the body, but it’s a difference of hours, rather than days with the original virus, he said.

What Does a Faint Line on a COVID Test Mean, and Does It Still Mean You're Positive? by Korin Miller and Madeleine Haase / Prevention

Doctors generally agree that this means you have COVID-19. “A faint line on a COVID test means the test is positive,” says infectious disease expert Amesh A. Adalja, M.D., a senior scholar at the Johns Hopkins Center for Health Security.
This is especially true if you have been exposed to a known infection and/or are experiencing symptoms, a faint line means you have COVID, says Linda Yancey, M.D., an infectious diseases specialist at Memorial Hermann Hospital. “You can retest in 48 hours to confirm this, but a positive home test is positive even if the line is faint,” she adds.
Thomas Russo, M.D., a professor and the chief of infectious diseases at the University at Buffalo in New York, agrees. “It’s sort of like when you take a pregnancy test,” he says. “A ‘little pregnant’ is the same as being a lot pregnant.”

New Normal: Delayed Peak SARS-CoV-2 Viral Loads Relative to Symptom Onset and Implications for COVID-19 Testing Programs by Jennifer K Frediani, Richard Parsons, et al. / Clinical Infectious Diseases

In summary, our data remind us that viral load kinetics relative to duration of symptoms can change over time with exposure to an initially novel virus, and that data collected early in a pandemic should not be assumed to still apply in the months to years that follow. Capture of duration of symptoms data at the time of testing is both simple and high yield, and should be incorporated into testing programs so that these trends can be monitored and continue to guide testing practice going forward.

Is the Hygiene Hypothesis True? by Caitlin Rivers / Johns Hopkins | Bloomberg School of Public Health

I THINK THERE’S SOME CONCERN AMONG PARENTS WHO HAVE HEARD ABOUT THE HYGIENE HYPOTHESIS THAT THERE IS A DOWNSIDE TO ALL THOSE STUFFY NOSES THAT DIDN’T HAPPEN [DURING THE COVID-19 PANDEMIC]. ARE THERE ANY UPSIDES TO VIRAL INFECTIONS? DO THEY HELP THE IMMUNE SYSTEM IN SOME MEANINGFUL WAY?
I don’t think so.
You mentioned the hygiene hypothesis, which was postulated back in the ‘80s. German scientists noticed that families with fewer children tended to have more allergic disease. This was interpreted [to mean] that allergic disease was linked to experiencing fewer infections. I have explored this idea in my research for a couple of decades now.
This phenomenon has helped us to understand the immune system, but our interpretation of it has grown and expanded—particularly with respect to viruses. Almost no virus is protective against allergic disease or other immune diseases. In fact, infections with viruses mostly either contribute to the development of those diseases or worsen them.

Debunking COVID-19 myths and misinformation / The Peak

“COVID-19 has mutated to become more mild and seasonal, like ‘the flu’”
COVID-19 continues to produce far more mortality rates — around five times more — than the flu, and circulates all year round. It’s in the name — SARS-CoV-2 stands for “severe acute respiratory syndrome coronavirus 2.” In fact, the Government of Canada classifies the virus as a Risk Group 3 human pathogen, which “are associated with serious or lethal human or animal diseases.” Tuberculosis is also in this category. Risk Groups range from one to four, with four being the highest, which includes pathogens like Ebola and smallpox.

Influence of Prior SARS-CoV-2 Infection on COVID-19 Severity: Evidence from the National COVID Cohort Collaborative by Nathaniel Hendrix, Hythem Sidky, et al. / medRxiv

Meaning Prior infection alone is likely not enough to avert the worst public health harms of endemic SARS-CoV-2. Interventions to avoid infection and reduce the severity of COVID-19 will still be important in the post-pandemic era.

Study suggests higher risk of new-onset post-COVID autoimmune, autoinflammatory disorders by / CIDRAP

Today in JAMA Network Open, South Korean researchers identify a significantly higher risk of multiple new-onset autoimmune and autoinflammatory connective-tissue disorders after COVID-19 infection, some associated with illness severity, but vaccination lowers the risk. …
"These findings suggest that autoimmune and autoinflammatory connective tissue disorders may manifest as post–COVID-19 sequelae, highlighting the potential long-term health ramifications associated with COVID-19," the researchers wrote.

Should you pick Novavax’s COVID-19 shot over mRNA options? By Jennifer Couzin-Frankel / Science

For cardiologist Eric Topol, this week’s vaccine news presented a personal dilemma. Topol, who directs the Scripps Research Translational Institute and is a popular commenter on COVID-19 research, had hoped to get an updated COVID-19 vaccine from Novavax, rather than a messenger RNA (mRNA) shot from Pfizer or Moderna. Novavax relies on an older, protein-based approach that has shown long-lasting effects against other pathogens, and Topol wondered whether it might produce more durable protection. On Tuesday, it seemed he might get his chance: a drugstore he visited for an mRNA vaccine ran out of doses, and hours later the U.S. Food and Drug Administration authorized a Novavax shot well-matched to current COVID-19 variants. The green light marks the first time Novavax will be widely available to teens and adults.

This MacArthur 'genius' knew the initial theory of COVID transmission was flawed by Gabriel Spitzer / NPR Goats and Soda

To understand why the MacArthur Foundation singled out Linsey Marr for one of this year's fellowships – the so-called "genius grants" – you have to go back to the first days of the COVID-19 pandemic and recall how uncertain everything was. The early guidance from health experts emphasized washing hands and keeping six feet from others with no recommendation to wear masks or avoid gathering indoors.
Linsey Marr, an aerosols expert and professor of civil and environmental engineering at Virginia Tech, became convinced that advice was based on a flawed idea of how respiratory viruses spread. Her groundbreaking research and tireless advocacy showed that the virus is airborne as opposed to traveling in large droplets that fall with gravity.

Covid inquiry: Disabled people an ‘afterthought’ in Covid response by James Harrison / openDemocracy

The UK’s Covid-19 inquiry today heard knowledge of the risks posed to some of the country’s most vulnerable groups was “very well known or should be well known” by top decision-makers. But despite this, ministers were accused of overlooking concerns, prompting campaigners to call for an overhaul at the heart of Westminster.
“Disabled people were an afterthought,” Thomas Shakespeare, a disability researcher at the London School of Hygiene and Tropical Medicine, told the latest evidence session.
“In many of the provisions, they were not centrally thought about, and therefore they were excluded from measures that were taken to protect the general population.”

Covid is evolving – but the UK is not doing enough to evolve with it by Sheena Cruickshank / The Guardian

It may feel like we should all be done with Covid-19, but sadly Covid-19 is not done with us. At the moment, cases in England are rising again, with a 10% rise overall in hospital admissions and the greatest increase in the north of England. With testing reduced, national monitoring paused, the ONS infection survey paused since spring and only recently relaunched, we have much less data about Covid than we ever had before. We know Covid hasn’t stopped evolving, and we have a good idea about what sort of situations might result in new and dangerous mutations, but with less surveillance of emerging variants and spread, we are losing what used to be a near real-time picture of the situation. …
The vaccine-only strategy that the UK is using for vulnerable populations is an insufficient approach. Even with boosters, not everyone will have as effective a response to the vaccine – for example if they are immunocompromised or on drugs that affect the function of their immune system. Any person considered more vulnerable to Covid should be able to access well-regulated treatments, including monoclonals and antiviral drugs, to enhance their likelihood of tackling the virus – and head off the possibility of a chronic infection that could incubate new variants. In reality, access in the UK is patchy, with a “Goldilocks effect” whereby patients requesting them must be deemed ill enough to warrant the drug(s) yet not so ill the drugs would no longer be effective.

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.

Want to buy me a coffee?

What are we even doing?

One of my favourite live blues performances of all time! Enjoy! RL Burnside doing Goin’ Down South from the Burnside on Burnside album. She said what?

The Covid-Is-Not-Over Newsletter

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