Ebola

Short and sweet update: no new cases, and the WHO and African CDC have set a January 10th deadline to officially call the outbreak over. If no new cases by then, they officially close the books. Uganda discharged its last known actively infected patient from the hospital this week.

Coronavirus

This will also be short and sweet, as there are only a few topics worth brief mention.

First, we have reports of credible sequencing of strains likely circulating within China. As expected, they are all omicron and omicron cousins. So far, no evidence of anything nasty mutating out of the current extremely high volumes of cases in China.

WHO is reporting that hospitals in China are being overwhelmed by cases, with “bed’s taken” situations breaking out. This is unsurprising, even with the low hospitalization of omicron, due to sheer volume of cases in a short period and limited total numbers of beds. We covered that last week if you want a quick refresher. China will likely not see the peak of the current wave until late this month.

Around the horn, activity remains mostly muted, although you have a local rise in Taiwan (given proximity to China, no surprise) and a falling peak in Japan (given proximity to China, no surprise either).

In the US, activity remains slightly elevated with early indicators showing this rise is likely to persist for a few weeks. This has led to rises in hospitalizations and the like which are attention grabbing as “percent increases” but if you had 2 cases last week, and 3 this week, that is, indeed, a 50% increase. But it’s still only 3 cases. Choose which number to report based on the clicks you need to garner. So in short, the nominal increase in COVID hospitalization cases is not nearly as impressive as previous waves. Most of the activity remains OTHER cold viruses and flu. Speaking of which, flu cases continue to come down, but activity remains quite brisk, nationwide.

Secondly, yes, some of that rise is likely attributable to the XBB.1.5 variant. This is the latest omicron cousin to get its own scare headlines. It is indeed pushing out previous versions of omicron in most states in the US (soon to be all), and may be a little more contagious. I think it is just as likely that it is as contagious, but different enough from the other omicrons to have more susceptible hosts available to it. The other omicron cousins have really got to be hurting for people they can still infect successfully at this point, and perhaps better explain or at least equally explain why they are disappearing relative to XBB.1.5. There is no evidence that XBB.1.5 is in any way more severe than previous versions.

Tangentially related, but only tangential, was the very public collapse of Buffalo Bills safety Damar Hamlin on Monday Night Football following a pretty standard tackle of a Cincinnati Bengals wide receiver. He got up straight up after the tackle, helped clear the pile for a second, and then just went straight out. The onfield medical staff quickly diagnosed cardiac arrest, and CPR had to be administered on the field. He was admitted to the University of Cincinnati cardiac ICU, and by reports today appears to be recovering well, although there are concerns about otherwise undisclosed “lung injury” (which I suspect is either a lung bruise and/or broken ribs, which are a common consequence of chest compressions in CPR).

As you might suspect, this immediately raised internet suspicions about myocarditis following COVID vaccination. To the best of my knowledge, there has been no report of Mr. Hamlin’s vaccination status, and assuming he was vaccinated, my guess is he was vaccinated and/or boosted a loooooong time ago (like preseason) and is well out of a myocarditis window by now. Regardless, there are other more common causes of sudden cardiac arrest in an athlete, especially of Mr. Hamlin’s age (24) and gender. Common being relative, because they are all still incredibly rare. For example, familial hypertrophic cardiomyopathy claims a few athlete lives every year. This is a genetic condition that causes an abnormally large heart that does not present until a sudden cardiac arrhythmia, typically with vigorous cardiovascular exercise. Other cardiac genetic defects will also need to be excluded, ranging from architectural abnormalities of the valves and heart muscle, to conduction defects that can sometimes cause acute arrhythmia and cardiac arrest. However, my best guess based on the situation and the way it looked on video is a diagnosis of exclusion, given that Mr. Hamlin made a solid wrap tackle with the wide receiver impacting his chest. This is commotio cordis, where a direct hit to the chest happens to time perfectly with a “reset” between heart beats and the “reset” never completes. Think of it as actually turning off your computer or phone when it is doing a software update, and tells you not to, because it may not complete the reboot. Most of the time, the vast majority of the time, it will. But someone is going to “win” a lottery they didn’t really want to hold a ticket for in the first place. Commotio cordis is one such “bad” lottery to win. It presents exactly like this, and is actually a little more common in baseball, where getting drilled in the chest by a line drive or throw you didn’t quite catch happens a little more often per game than a big thumping hit right to the chest in football (oddly enough). Before greater recognition of it, and wider availability of automated external defibrillators (AED), commotio cordis had a mortality rate of 70% or better. Early recognition, CPR, and AED use is still critical to outcome (thank God the NFL has well trained medical staff all over the sidelines). Even so, overall mortality from this is still somewhere between 40-50% in more recent numbers I’ve seen.

I would consider all of these more probable than vaccine related injuries. For all the hype about soccer players in Europe with well publicized cardiac events in the last two years, there was not a single on field incident of it at the recent World Cup, and frankly, it’s been a minute since I have seen headlines of other athlete cardiac collapses. I never did see any estimates or correlation of those to vaccination status (although again, based on reporting around the time that was happening, a large percentage of professional european soccer players were NOT vaccinated). Given the video of what happened, and the multitude of congenital causes that need to be ruled out first, there are many other good explanations, and more likely explanations, than vaccine injury in Mr. Hamlin’s case. All of those would need to be excluded first.

Socioeconomic

After the US cold spell, it has been unseasonably warm in both the US and Europe, which is a fortunate turn of events that hopefully will continue. Europe has taken advantage of dropping LNG demand to top off storage a bit as well, so if the weather does turn in the next couple months, they have a little bit of extra runway.

In other news, we finally got an answer to all those times we have asked in this section of the update “if the aliens show up, and ask to be taken to your leader, who are you taking them to?”

“A Vegas strip club” may not have been the answer we were expecting to our rhetorical question, but perhaps, after 2020, 2021 and 2022, it is the one we deserve.

Surveying the “leadership” and state of the world since 2020, and, well, I’m not convinced, a priori, that it’s a wrong answer either…

However, in reporting exclusive to our update, the alien delegation was asked for comment as they were leaving Sapphire in the early morning hours, as the club closed. They blinked in the early morning sun, as if to try to reorient themselves, but stated that “We were only there for the wings.” Then they shuffled quickly past, heads down, to beam back up to their ship. Independent contractors working at the club, questioned later, would say only that the aliens “spent heavily” and were “great tippers”…

I suppose we are lucky that they came in peace for a piece?

Regardless of the dimming prospects of my second career in stand up comedy, your chances of catching coronavirus this week are equivalent to the chances that at some point this weekend, you will find yourself suddenly distracted by the mental image of a group of little green aliens, bee bopping to a club beat, while waving $20s down by the stage at a Vegas strip club.  Next to Elvis.  Because of course next to Elvis.**

And you’ll shrug. First, because it’s Vegas, and aliens feeding bills in g-strings next to Elvis around a stripper pole just means it’s Tuesday there. Second, because after 2020, 2021, and 2022…what even is a surprise anymore?

But for that image friends, which is inevitable now, -you’re welcome-.

<Paladin>

**Special post script. Just for kicks, I decided to try out a free version of a popular AI program that is supposed to re-work and improve your writing. You submit your writing, and the AI will rework it for clarity, style, and synonyms to make your writing more clear and impactful. I used this paragraph as the test (the free version limits to 125 words), with the context of the few sentences above it. Here is the copy/paste of its suggestion for the paragraph (the capitalization errors near the end were its own):

“Your chances of contracting coronavirus this week are equal to the likelihood that at some point this weekend, you will find yourself unexpectedly distracted by the mental image of a group of little green aliens bee-bopping to a club beat while waving $20s down by the stage at a Vegas strip club, regardless of the dimming prospects for my second career in stand-up comedy.
after [sic] Elvis. because [sic] , of course, Elvis was nearby.”

Let me know which you prefer, as I might perhaps be a little biased…

For the now, though, I think the powerful human play will go on.