Ebola–

There are four suspected cases in Guinea under observation, but no new confirmed cases. If these rule out, we are still on pace to declare an official end to this current outbreak in mid June.

Coronavirus–

–So the big news, at least stateside, has been the debate over the CDC changing its mask guidance. Which is predictable, especially given a lot of the messaging over last year and earlier this year. The obvious is that everyone is basically on their honor to be fully vaccinated when they drop the mask, and gasp, what happens if the unvaccinated lie and quit wearing a mask too? Human nature being what it is, you can guarantee that some of the unvaccinated will do exactly that.

Here’s the thing. If you are already fully vaccinated, the risk that unvaccinated person poses to you is minimal. That’s really a risk they are taking on themselves by dropping the exposure protection of a mask. And the chance that you will spread SARS-CoV-2 to them is minimal–you have a better shot at this weekend’s half a billion dollar Mega Millions draw.

Which, if you win, you hereby agree to split 50:50 with me. That’s the rules, guys. Yes, I make them up, but those are the rules.

“But won’t this risk another wave, and if so, isn’t that just more chances for the virus to mutate past the vaccines and then it’s 2020 all over again?” you ask me, Hypothetical Reader.

Yes, there is a chance of that. That chance is in every measure bringing us back to pre-COVID normal, including the changes to recommendations before this one. And based on data we do have, courtesy of the federal government system of the Good Ole’ U.S. of A., that risk appears to be pretty minimal.

Texas COVID Case Tracker Via Epiforecasts.io

As a reminder, Texas dropped its social distancing requirements (including masks for much of the state) back on March 2nd. There was no new wave in Texas. Even as Michigan got hammered recently, there has been no new wave in Texas. Texas, at 31.21% total population vaccinated, is in the bottom third of the state vaccination tables.

Now, your results may vary from Texas’. In fact, local variation on this is likely. But the odds are far better than not that relaxing the mask requirement for the vaccinated (which follows the science) will have minimal impact on the rate of new COVID cases among the unvaccinated, even if they lie through their teeth (no pun intended) to stop wearing a mask too. We are, indeed, closing in on sufficient herd immunity.

In fact, the same CDC director who just a few months ago was “losing sleep” over the possibilities of a fourth wave is now “cautiously optimistic” that the end is in the sight for the US.

–“So what are you doing about masking?” asks Hypothetical Reader. Pretty easy question. I’m fully vaccinated, and feel quite safe without a mask. Outdoors, I don’t wear one at all. Indoors, my rule of thumb is simple. If the business is still asking folks to mask up, I mask up. I just keep a mask in my pocket and throw it on based on the sign on the door. If they have adopted local or CDC recommendations and dropped mask requirements, I go happily without a mask. It’s a pretty low inconvenience factor at this point, and I figure I owe the business (or homeowner or whomever I happen to be visiting) the respect of their wishes for their “house.” Especially since that will continue to gradually shift to mask optional as 2021 grinds along.

–Around the horn, protests in Japan over the re-scheduled 2020 summer games set to open here in a few months. Japan is in the midst of another mini-wave of COVID, but appears to be cresting. India is still getting slammed. While new cases continue to trend down (and I think the official count is directionally accurate), deaths, a lagging indicator as we have mentioned, continue to ramp. They could still use your help, if you are so inclined. Other parts of Asia are also getting at least mini-waves.

–India’s cases are now majority SARS-CoV-2 B.1.617, which we will henceforth refer to as the variant first identified in India. This family has a new branch, B.1.617.2, which is reportedly 50% more infectious than the variant first identified in the UK. Again, more contagious as we have been expecting, but no indication of greater severity of disease or severe disease more often. They are also outcompeting the other strains of increased concern, particularly the UK variant. Again, this is expected direction of mutation. The virus will have to shift to capitalize on the increasingly rare chance it meets an unvaccinated or nonimmune person, or the virus will die out.

In vitro testing suggests that the mRNA vaccines, at a minimum, can handle this variant first identified in India, so very likely there is no major threat there.

–Following up news from last week, new cases on the Sychelles are abating. There are still some questions about the efficacy of the vaccines they used, particularly Sinopharm which accounted for a majority of the inoculations on the islands. Their government is supposedly considering a booster requirement targeted for August.

–In other vaccine news, the US donated an additional 20 million vaccine doses abroad. The world average for % of population vaccinated is between 5-6% at the moment, which has room for improvement. Access to vaccines for developing nations will likely be a focus through the rest of the year. Nations with both a high burden of disease in previous waves and high vaccination rates will exit the pandemic fastest. The US, I believe, is still on pace for July-ish, at least in terms of COVID as a threat to collapse local healthcare systems. Other nations may be looking at later this year to sometime next depending on vaccine access and distribution within their borders. 1.56 billion doses of vaccines have been administered worldwide total; your actual number of successful vaccinations hovers a little under that, because not everyone has gotten their second shot of those requiring a second shot.

–Another common question has been “when will the vaccine be available for those under age 12”? At least for the mRNA vaccines, those studies are open and fully enrolled. It will just take time for enough patients to have a long enough follow up for that data to be parsed and announced. If the vaccine is looking safe and effective in that age group based on that data, eligibility for the elementary school and down set should open up.

–The University of California reported this week in a pre-print article that T-cell responses against the variants first identified in the UK and South Africa are robust following vaccination with the mRNA vaccines. The second shot increases the quantity of T-cells responding, but not how effective they are–you simply get MOAR virus specific T-cells mopping up the variants wherever they are found. They also found that those who had been previously infected benefited in the number of active T-cells following a single dose of the mRNA vaccines, but a second shot didn’t really do much for quality or quantity, another soft argument that the previously infected may really need only one dose of the mRNA vaccines at most as a “booster.” Small numbers, but confirms studies done by the companies making mRNA vaccines themselves. And T-cell activity is tough to measure population wide at the best of times, so small numbers is no big knock here.

–Your chances of catching Ebola this week are equivalent to the chances the oddsmakers gave, before the men’s NCAA soccer tournament started, that the unranked, unheralded Marshall University Thundering Herd would beat, in succession, the number 1 ranked team in the nation, last year’s national champion, and an undefeated squad on its way to a golden goal overtime win in the championship over Indiana University–an 8 time national champion itself.

–Your chances of catching coronavirus are equivalent to the chances that when the Thundering Herd did just that to win its first national championship, Matthew McConaughissuperhardtospellalrightalrightalrightey would have something to tweet about it:

And why not an action shot of your humble author when he saw his med school roommate on TV rushing the field after the winning goal?

<Paladin>