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COVID Update: NYC & The World, Flu Shot & Co-Infection Concerns, Reinfection with Possibility of ADE


There has - rightfully - been a lot of focus on the upcoming election, but I figured an update is overdue. And I feel good after I was able to see my family, allow myself some mental health restoration, and have continued to be asymptomatic and COVID negative 5 out of 5 times I have been tested (all precautionary) by continuing to follow common-sense precautions as well as science.


Now after scaring myself silly by watching Evil (highly recommend) and starting The Haunting of Hill House (just completed the 1st episode and holy crap, it is good), let us get to it.


I have been asked quite a bit about three things recently:


1. The supposed NYC shutdown that is occurring,

2. Whether or not people should get the flu shot, and

3. Thoughts on the above, amongst other things, about COVID.


TL;DR response:

No, NYC is not on the brink of a second shutdown... though many countries may be in trouble down the road if people do not follow common sense measures proven to work. GET YOUR FLU SHOT - I got mine yesterday. Genomic evidence of reinfection HAS BEEN FOUND... with a question of the possibility of ADE? Many government and sports leaders are dumb, with some notable exceptions.


Brief response for #1:

Overall, the total positivity rate for the state continues to hover around 1%. NY defines any area with 2% or more positivity as "micro-clusters", so the threshold for implementing restrictions is much lower than many other states. I am not saying whether I agree or disagree with these restrictions, nor do I know how much further this will delay the city's and state's recoveries. But for the most part, the city is continuing to open slowly and (very) safely. As a result, NY, including NYC, is one of the safest areas to visit in the entire country.


So anyone who thinks NY at this moment is still a dangerous place to travel needs to chill. It is nowhere near perfect, as seen by those small clusters contributing to an outsized contribution to the states total positive cases, as well as people still doing stupid stuff like throwing big illegal parties (see rave below), but overall we are managing pretty well.


https://www.nbcnewyork.com/news/local/cuomo-another-virus-shutdown-possible-but-not-inevitable-denies-biden-job-rumors/2663845/

https://www.nbcnewyork.com/news/local/ny-clusters-drive-state-city-hospitalizations-to-highest-levels-since-june/2666947/


https://abc7ny.com/illegal-rave-in-queens-cunningham-park-shut-down-nyc-sheriff/6945985/

Extensive response for #2 and #3 combined since there is significant overlap:

I know there are many people who are generally resistant to obtaining the flu shot. But if there was ever a year to get one, it would be this one. Let me explain.

As I mentioned in a previous post, a large swath of the Southern Hemisphere never experienced a flu season. And the most likely reason for this is due to the same protective measures we have taken here: masks and social distancing. The flu season for the Southern Hemisphere started during the peak awareness of the severity of COVID, as well as when those countries were undergoing their first wave of infections. Everyone was extremely vigilant with taking protective measures due to COVID, and so a near non-existent flu season came to pass - which makes sense.


But as we in the US are progressing into our first full flu season - COVID hit us well into last flu season, even if COVID started circulating sooner than the end of January as is expected - the habits of our country are going in the opposite direction of what occurred in the Southern Hemisphere. And we saw how shitty our last winter ended up.

People are becoming more lackadaisical about masks, about social distancing.

Some who were good about it earlier have now fallen off the cliff due to COVID fatigue and have eschewed precautions altogether. Some states have even removed ALL precautions and are doing their best to forget COVID even exists (see Florida below). But guys, here me out:

If you get infected with both the flu AND COVID, you could be in a LOT of trouble. Some data shows that being co-infected with both could increase your chance of death more than two-fold:


https://www.bmj.com/content/370/bmj.m3720.


There is data that being infected with one respiratory virus decreases your risk of obtaining another respiratory virus. But the fact is:

WE STILL DO NOT KNOW. And that could make this upcoming flu season more worrisome than most IF we get too lackadaisical with wearing masks and distancing and avoiding gatherings during the holidays. Moving indoors WILL make things worse; but how much worse will be dependent on us.


GET YOUR FLU SHOT.


No, no one knows how effective it will be this year, ESPECIALLY since we have less data to work with given what happened in the Southern Hemisphere in regards to viral strains. Yes, you may feel a little crummy after the shot. But overall, the benefit of possibly avoiding being sick with both flu and COVID simultaneously should be enough motivation for everyone to get one.


Oh, and let us finally put to rest that being infected with COVID means you cannot get reinfected again. Lo and behold, The Lancet just published the first case report that demonstrates definitively reinfection can occur, where researchers found a gentleman from Nevada who tested positive twice months apart, but with viruses that were genetically too dissimilar to have been caused by the same strain of virus:


https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30764-7/fulltext

Disclaimer: MUTATIONS ARE NORMAL with any virus. There is NO evidence SARS-CoV-2 is mutating at a faster rate than expected. Could this affect vaccine development? Possibly, but a great deal of vaccine research has been focused on the formation of a vaccine to limit the possibility of this being an issue.

But the thing that concerns me the most is this man's illness was WORSE the second time around. The simplest explanation could be the person was hit with a greater inoculation of the virus the second time around, and therefore, got sicker. OR another explanation could be something I discussed at length many months ago and has been seen with coronaviruses before (with Dengue being the most well-described):


Antibody-Dependent Enhancement (ADE). Please read the link below if you want an in-depth refresher:


https://www.therealestmd.com/post/covid-crisis-post-36-antibody-dependent-enhancement-original-post-april-21-2020

In short: some infections the second time around show a proclivity for a more severe expression of disease when infected with an alternate strain due to ADE. ADE may still be rare, but if I were someone who had been infected previously or are positive for antibodies, I would really reconsider being lax with protections.


Finally, I know there has been a lot of back-and-forth about whether lockdowns have caused more net harm than good. I think it was needed earlier on to keep hospital systems from being overwhelmed, but I also thought they were needed because most adults act more like toddlers than toddlers themselves. Just like everyone else, even the thought of a second lockdown makes me cringe.


But if chunks of the country continue to pretend this is not a big deal, then do not be surprised if next year is a reasonable facsimile to this year - at least until a vaccine is developed.


If we look at Europe, the number of positive cases have spiked throughout the continent. Yes, hospitalizations and deaths are nowhere near what they were in the Spring, but being responsible and adjusting course by taking measures to limit further spread is important regardless.


Though some of the measures being instituted make absolutely NO SENSE to me.


Take France for example.


Macron today instituted a curfew for the areas with the greatest spike in COVID cases.


But what the hell is the point of a curfew??


The majority of people are not out and about between 9pm and 6am.


COVID is not the fucking boogieman who only comes out at night.


People out in the wee hours of the night is NOT leading to the spike in cases - it is people not adhering to common sense. And even if so, then prohibit large indoor gatherings! Policies should be directed towards common sense and social responsibility, especially with all that we know at this point, and not as some weak-ass window dressing.

Can we please just have women running the world so idiot male egos stop fucking things up? Yes? Cool.


Whether more lockdowns come or not is up to us.

Bonus round: I just want to do a special shout out to Dan Mullen, Florida's football coach, mimicking the absolute STUPIDITY of DeSantis. Mullen went off earlier this week stating Florida should be able to fill their stadium to capacity - or "Pack the Swamp", which would be 90 THOUSAND spectators - during their LSU game since DeSantis had allowed the state to essentially 100% reopen, COVID be damned.


Now the game has been postponed because 23 people in the Florida program - 21 players and 2 coaches at most recent count - have tested positive for COVID. And shockingly, Mullen backtracking from his comments and said they will follow university health protocols as instituted:


https://www.espn.com/college-football/story/_/id/30115340/saturday-game-lsu-tigers-florida-gators-postponed


The issue with all of these sports organizations is the same: relying on rapid tests, when the risk of false positives AND false negatives are still great. These tests may say someone is positive when they are not, but negative tests only work well when people are symptomatic, NOT when asymptomatic:

https://www.therealestmd.com/post/abbott-s-new-rapid-test-let-s-pump-the-brakes-a-bit-on-the-excitement

The NBA, unlike the NFL, college football, baseball, etc, recognized this by instituting the Bubble and, as a result, they had ZERO cases of COVID while in the Bubble.


https://www.npr.org/2020/10/12/923064484/lakers-win-nba-finals-no-coronavirus-cases-reported-in-bubble

Lesson? LISTEN TO SCIENCE.

Not DeSantis. Or Mullen. Or our "leaders" in government. Or people who tout herd immunity via infection. THEY ALL ARE STUPID.

That is all.


#covid19 #nyc #flushot #getit #rapidcovidtests

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