Ebola–

No new cases have been documented, and at this point, if the contacts lost to follow up actually had Ebola, at least a couple infection chains should have announced themselves. We’ll close the books on yet another Ebola outbreak. Availability of vaccines and now several choices of antibodies as acute Ebola treatments should help to control Ebola outbreaks in the future. The biggest challenge remaining will actually be diagnosis of the index cases to get treatment and vaccinations started as soon as possible.

So, -some- good news on the “dangerous diseases of man” front to end the year.

Coronavirus–

–I’ll keep this quick since New Year’s and all. In the US, even California appears to have hit a peak. Most of the country is in the green (Rhode Island is an outlier), and even with holidays, if there was going to be a post-Christmas bump, it should have happened earlier this week. The -real- holiday test will be tonight. Christmas is typically time for family and close friends. New Year’s is the “get lit for the ball drop with enormous numbers of strangers in packed bars and clubs” holiday. From a pandemic perspective, New Year’s is a little more challenging.

At least around here, public health response has been, shall we say, proactive. Indy has a midnight last call in place; some of the suburbs started ordering bars and restaurants closed by 10 pm.

I know, I know–I hear the gasps of our European readers wondering how they can possibly order restaurants closed before dinner. But it’s true!

I am willing to bet that tonight will be less crowded than most New Year’s, but I also bet there are still plenty of souls out there looking to bury a long year this evening and willing to engage in civil disobedience for it. Enforcement of some of the proactive public health measures in the world will probably be challenged this evening, at least in some places.

–Around the world, mixed bag, as you might expect. Cases are going higher in the UK. There is, again, no evidence to suggest the new strain there is causing more severe disease, or at a higher rate, and still no reports of significant re-infections of those who already caught COVID. It remains far more likely than not this is simply a more contagious version, but the spike protein mutation is not sufficiently novel to impair the immune response to the virus. Vaccine tests against are still on going; odds are more likely than not that the current vaccines will not be affected by this strain.

One case of it has been identified in Colorado. No other data available on that right now.

–There is another new variant of SARS-CoV-2 recently identified. This one is descended from the D614G variant (the more infectious, less severe version that is the dominant strain globally right now). It has some mutations in common with the UK variant, but a couple additional ones too, and they are cousins at best. This strain, the 501.V2 strain, is the dominant strain in South Africa right now. It first emerged in October, and like its UK cousin, is believed to be the result of accumulated mutation in a patient who essentially had low grade chronic infection with SARS-CoV-2, where it mutated just fast enough to stay ahead of the immune system, and then became this more contagious variant.

Like its D614G progenitor, it is a more infectious version of SARS-CoV-2. As mentioned, like the UK variant, it has displaced the “usual” D614G to become the major circulating strain in South Africa. There have been some reports that it may be presenting with a higher rate of severe disease in patients with no known risk factors–however, NONE of those reports are published scientific data. Currently, the CDC is stating that there is no evidence that the 501.V2 South Africa strain is causing more severe disease, or severe disease at a higher rate.

It is worth mentioning that South Africa looks to be starting the downslope of the recent spike in cases driven by this variant.

That said, the 501.V2 has a mutation profile that is a little more worrisome than the UK version. Some of them have been reported as interfering with the binding of some monoclonal antibodies to the spike protein. That said, there is NO reason to suspect they will interfere with vaccine response. The body does not make just one antibody and/or one specific T-cell response to the spike protein. It will attack as much of the protein as it can, with a variety of antibodies and specific T-cell responses. Odds are more likely than not that they will not interfere with vaccine efficacy.

Regardless, expect close monitoring of these strains.

–The CDC is also watching a third variant, this one in Nigeria, and only because it has one mutation (out of 23) in common with the UK variant. Again, no indication right now it is causing more severe disease, or severe disease more often, and no suggestion it will escape vaccination or treatment.

–There is video smuggled out of China in the last couple days showing Hazmat suit teams sealing shut apartments again, and long, long lines for compulsory COVID testing in several cities. The CCP has reluctantly acknowledged “small” clusters of new cases, AND that they are local transmission instead of “contaminated” food from the US or Mexico.

I will let you draw your conclusions about how many cases might be active in China right now. I have no idea, and again, trust no numbers there.

(and hi to our Chinese “readers”, who always seem to manage to find the online version of these updates whenever China gets mentioned!)

And no, I am not making that part in the parentheses up. We’ve had dedicated “readers” checking in every so often from China ever since reposting the report of CCP crimes against humanity against the Uighurs here (still ongoing as of this writing).

–Last, I finally got my number called for the vaccine. Got the Pfizer version yesterday evening. No fever, no allergic reaction. They did make us all sit for 15 minutes in an observation room after the vaccine just to watch for any possible allergic reaction. My shoulder is sore where they did the injection, but no worse than a standard flu shot, and definitely not as bad as my last DTaP booster. I’m really tempted to get antibodies done through one of the big national labs in the next couple days. Not for any medical reason–just scientific curiosity. If I -have- been exposed to SARS-CoV-2 before (as I suspect) and was asymptomatically infected, the vaccine should basically be a booster, and there should be a rapid IgG response (with little to no IgM) in 24-72 hours. That would be far too quick to see IgG if the vaccine is the first time my immune system has run into the SARS-CoV-2 spike protein, and would suggest I -had- been an asymptomatic infection.

So I’m tempted. If temptation gets the best of me (and I can get it scheduled in the next day or two), I’ll let you know here.

–Your chances of getting coronavirus are equivalent to the chances you are excited to be done with 2020, and ready to party like a rock star

That said, don’t get your hopes up too high about 2021 just yet. I expect the first half at least to continue to be at least a little unusual, but hopefully thawing.

Happy New Year all.

<Paladin>