Well…

I haven’t written anything on this blog for quite some time, but that’s because I’ve spent about a solid month under water. To be sure, I normally spend a lot of time in the ocean but over December and early January, I made a gallant attempt at gaining gills.

And, as it turns out, the small number of people who spent a month underwater are the only people in New South Wales to not catch omicron. The following is a very poorly composed thinking-out-loud post that is little more than a ‘diary entry’ – something that I can refer back to when we’re hunting each other like pack animals in a few months time. Excuse the poor composition.

School is going back at the end of the month, and I have been very much on the fence about whether this is a good idea. Well, it’s a good idea – school is very important and kids like it. We’ve been far too quick to close schools and consider the impact on kids.

I have, however, resigned myself to the reality that there is no controlling omicron, and that being vaccinated gives us the best odds of staving off the most significant implications. We have skin in the game. Our teen is double vaxed, as are we (her parents).

This post is kind of like a brain dump of all the things I am worried about, and my hopefully measured response.

The first thing to note is that humans are giant meat-sacs of disease. We carry the stain of every virus and bacteria we’ve encountered. They shape us in many ways, from schizophrenia, to epilepsy to MS to Rheumatic heart disease to Parkinsons, to our microbiome and our skin and absolutely every other bloody thing. Those of us who’re older carry HPV and herpes viruses like wrinkles. The impacts are different for everyone and depends on your underlying immunity and genetics and age. And luck.

So, I’ve got some appetite for the fact that SarsCov2 might be yet another scourge that leaves a mark. The emerging research this week, after years of epidemiological suspicion, that EBV causes MS is just one example.

And, if we’re being hopeful, there’s pretty good evidence that being healthy is Generally Good. Obviously, it’s too late for the vast majority of people my age who aren’t and don’t have the choice, but at least it’s something. It really does seem that a good proportion of poor outcomes are related to ineffective clearance of the virus – having it sitting in your system, for months. This is a Bad Thing (and happens with other viruses too). It is implicated in auto immune diseases and also generally having a bad time. Vaccination is a very good thing. It’s truly incredible how effective the 2 dose regime of mRNA vaccines are against severe illness. mRNA vaccines are the way of the future.

Here’s my short list of things on the horizon I am genuinely worried about and most fall under the broad category of Long Covid and really, ME/CFS;

  • T cell death (I’m not too worried about this)/lymphocytopenia
  • Vascular/clotting
  • Parkinsons/plaques in the brain
  • Auto immune disease

I could go on about these things but I won’t. My broad interpretation is that omicron will cause long term disease burden in a small number of people, but it will have a big impact because of the number of people getting infected in a short period of time. It’s also difficult to tease out the long term impacts of omicron because it’s only been around for five minutes, and, almost all studies are carried out on unvaccinated people (pre vaccinated – most research reflects work carried out in 2021).

For me, the most interesting thing that’s happened lately is that I have come to question to current public health advice. This has only happened once before during the pandemic, when our Premier told us that outdoor masking was mandatory. This was unfounded in evidence and made no difference to the spread of Delta in Sydney (which abated due to a widespread lockdown in Aug 2021). In all other ways, our public health advice has been founded in evidence and broadly supported.

Now, it’s boosters. We’ve had our interval shortened to 3 months in Australia. That is, we are being entreated to ‘get boosted’ three months after our second shot. This will undoubtedly boost our antibody levels, the aim of which is to arrest the spread of omicron, due to the current strain on the health system. But, there is no discussion about what will happen once these antibodies wane, in about 10 weeks time (according to most data). What will happen then?

It’s well accepted that a longer interval between a second and third dose encourages the immune system to better hone its antibodies. And, that cellular immunity against severe disease remains strong after two doses for those who mount a normal response to the initial doses.

I just want to add here that were it not for vaccines, we would be seeing about 7000 admissions to hospital a day in NSW, during early Jan. Vaccines work. I might also note that a very dear friend who lives in Melbourne came to visit us over Christmas. She grew up in India. She’s a total gorgeous, no bullshit hard-arse, but a couple of her stories of the delta wave were just utterly devastating. Brings tears to my eyes just thinking about it. We are so very, very fortunate to be in the position we are in here in Australia.

Back to boosting……Boosting is an emergency response to an emergency situation brought on by chronic mismanagement of the health care system, which has had two years to prepare for a surge of infections. Most of those in hospital are older vaccinated people for whom cellular immunity is not strong, following two, or even three doses of vaccine (or unvaccinated altogether). These are people who are vulnerable, and our government knew perfectly well that the vaccine regime would not protect them well enough to prevent a surge of hospitalisations, given an increase in cases.

95% of the community got vaccinated to slow the spread, to protect the vulnerable. And that worked, with delta (although who knows how long it would have worked for?). But with omicron, vaccination does not protect against transmission or infection. To be sure, it limits the spread, but the effect is minimal.

Most Australians under the age of 60 were not at risk of severe disease from Covid19 before vaccination. Most people got vaccinated to protect the community, if not through herd immunity (a concept that was sensibly dismissed early on by our health experts) but with a general tamping down of infection. This was viewed as an acceptable cost, by most, especially given that we were in lockdown at the time.

Get vaccinated = get out of lockdown. It worked.

But now? Vaccination does not confer protection from infection. Even booster shots, that limit infection and spread, do not halt it, as they did with Delta.

And, in the case of the UK, many people’s booster shots are now waning.

(Booster shots are academic in my area anyway – there are no appointments until late Feb).

Re-boosting every ten weeks is not an option. So what is?

I have misgivings about the continued spread of omicron. On my good days, I think, ‘Well, it’s just another thing that humans take on board and deal with in our own way’. On my bad days, I worry about the long term health implications for my kid, and all the kids. I feel reasonably confident that children, especially when vaccinated, will deal with the virus in the same way they do other viruses. The evidence points in this direction. But there are unknowns. However, there are many unknowns about life. We are poorly adapted to our living conditions, and much disease arises from this alone. I read that 88% of Americans live with ‘metabolic disease’. 88%!

And one thing is for sure – we will encounter omicron, and so in a sense, the only thing to do now is research potential treatments for those who suffer its longer term effects.

Also, the peak will pass, and quite soon. And, there will be another rise in cases when school returns, but it will not be as big as the initial rise in January. And omicron is more mild, although it’s still a complete fucker. Mild is a medical term, not a colloquial one.

To finish, I’ll just add a quick story.

Last weekend we went and saw friends. The Mum had been ill with mild flu like illness, lots of coughing, sneezing, aching and generally feeling crap for about four days. She’d had three negative RA tests, but pretty classic omicron symptoms. No-one else was ill. So, we spent a couple of hours together, in their house, with her sneezing and coughing, with no precautions, although we didn’t hug each other (as we normally would!). The kids played outside, for ages. It was great. The following day, Mum tested positive on a RA test and called us.

Two days later my husbo had a sore throat and got PCR tested. And, the next day, I had sinus pain and general feeling of getting a cold. We all isolated and awaited results. Another day later the PCR came in as negative. One day later, we felt fine.

We both had our second shot Pfizer 4 months ago. I suspect we were exposed to omicron and ‘fought off’ a mild infection. And, I also suspect we’ve been exposed a few more times over the last month or so, in shops and generally through talking to people. It’s around.

I draw no conclusion from this anecdote, but it did change my outlook somewhat, which was interesting in itself. Although I consider myself not prone to anxiety about stuff in general, it made me realise that I’d probably dedicated an outsize amount to thinking about omicron (to be fair, it is tangentially related to my area of work).

And with that, I am getting back in the sea.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s