Good morning, and happy Monday!
Today is World Refugee Day, World Productivity Day, and apparently also a National Day to celebrate Ice Cream Soda, Vanilla Milkshakes, and Kouign Amann (a fluffy French pastry – I had to look it up).
Picking up on the ROM’s new tagline, today’s stories look at a variety of things left behind: from pandemic restrictions and face masks, to Long COVID symptoms, vaccine side effects, racist disease names, the dearly departed, and plague DNA that survived, buried for 700 years! We may even have to leave behind the belief that we can ever truly leave COVID19 behind…
It’s only been a week since my last survey (“Mandates and Monkeys in the Wind”), so the amount of news should theoretically be much more manageable…
Easing the Way for Travel
Mask mandates are lifting across Canada and CdnPSE, and travellers are gaining an even greater sense of freedom. On Saturday, Quebec dropped the mask mandate for public transit riders. Last week, Ottawa temporarily suspended random COVID19 testing at airports, and as of today, vaccination is no longer required for domestic or outbound international travellers. Foreign nationals must be vaxxed to enter Canada, though, and everyone must show proof of vaccination using the ArriveCAN app to avoid testing and quarantine. (Although Ottawa is still defining full vaccination as 2 doses, which is woefully outdated in the age of Omicron.) Major airlines warn the changes aren’t sufficient to fix major delays at airports, though, and the easing of restrictions will only unleash more pent-up demand to travel. Good luck out there, everybody!
Dropping Vax Mandates
Also announced last Tuesday, and effective today, Ottawa has dropped its vax mandate for federal employees, RCMP and transportation workers (except on cruise ships). The House of Commons and Senate also announced last week that they will drop their vax mandates as of today, although the House adjourns for summer by Thursday anyway. The government expects vax mandates imposed by agencies and crown corporations will also be suspended. (Cross-border truckers, however, will still be subject to mandatory testing and quarantine if they are unvaxxed.) Ottawa is also expected to shut down its COVID Alert app, the $20M smartphone tool that used anonymized Bluetooth connections for contact tracing. (Sadly a combination of privacy concerns, inadequate testing and vaccination rendered it pointless in early 2021.)
Many Canadians are finally holding funerals and memorial services, after a 2-year pandemic wait and a “state of suspended grief.” About half the ceremonies at some funeral homes this summer are actually for individuals who died in 2020, and often who could only say their farewells via Zoom. Now that gathering limits and border restrictions have lifted, some families are able to gather en masse, while others have decided to skip the ritual altogether. Says uManitoba psychiatry prof Max Chochinov, “Grief doesn’t wear a watch or own a calendar, it takes place in its own time course, so even if it’s after the fact, having an occasion where people can gather… can be healing.” CBC
Everybody’s Getting It
New Zealand PM Jacinda Ardern tested positive last month. Anthony Fauci finally tested positive for COVID19 for the first time last week. The 81-year-old, who has received 4 doses of vaccine, reports only mild symptoms but is taking Paxlovid. Meanwhile, for the second time, prime minister Justin Trudeau also tested positive for COVID19 last week, after returning from the Summit of the Americas in Los Angeles. Fauci warned back in January that the Omicron variant is so contagious it will “ultimately find just about everybody,” and he is being proven right! (As one uGuelph researcher points out, that includes your household pets, too…) The rise of Omicron subvariants BA.4, BA.5, and BA.2.12.1 have some Canadian experts anticipating a “summer bump” in cases, and wastewater signals in Ontario are once again rising. One Toronto physician warns “it looks like we’re going to be in a world where we have waves every 2 to 3 months.” Thanks to evolving variants and waning immunity, as the National Post puts it, “we may never stop getting COVID.”
“When things become human diseases, we too often forget everything else. I think it’s important for us to recognize this virus still can move between species.” – Scott Weese, infectious diseases veterinarian, uGuelph
Although a recent peer-reviewed UK study suggests Omicron infections are 20-50% less likely to result in “Long COVID,” there’s still good reason to be concerned about the long-term repercussions of even a mild COVID19 infection. Children can develop multisystem inflammatory syndrome (MIS-C), potentially damaging their heart, lungs, kidneys or brain. Studies suggest the virus can cause problems in fetal brain development, and that people with diabetes are up to 4x as likely to develop “Long COVID.” The CDC says people who have contracted COVID19 have a 50% greater risk of blood clots, kidney failure, heart attacks, diabetes and asthma. In Canada, an estimated 390,000 “long haulers” are overwhelming the limited capacity of roughly 20 post-COVID clinics, and facing 6-month wait times for their first appointments. It remains unclear whether Long COVID will affect 2% or 30% of everyone infected, but it could be millions of people – what physician Benjamin Mazer calls a “mass disabling event of historic proportions.” So far, however, US disability filings do not bear this out (although surveys indicate slightly more people struggling with concentration and decision-making since mid-2021). Instead, Mazer warns we could be facing a “mass deterioration event” in which tens of millions are somewhat worse off than before. (Remember those 10 IQ points I mentioned last month?)
It’s been a busy week on the pharma front…
Antivaxxers will doubtless celebrate the release of PHAC data showing that there were 45,149 documented “adverse events” following COVID19 vaccination in Canada, as of May 12. Of those, 9,515 were considered “serious” (0.011% of all doses administered). Canada’s Vaccine Injury Support Program, launched a year ago, has so far received 774 claims from Canadians who say they suffered serious and permanent complications. The review process is painstaking, and so far just 8 claims have been validated by the Medical Review Board. Financial support will be determined on a case-by-case basis, retroactive to the date of injury or death. In the US this week, the CDC reported a 19% greater risk of heart inflammation among young males after Moderna’s COVID19 shot than Pfizer-BioNTech. In males aged 18-39, incidences of myocarditis or pericarditis were 97.3 cases per million doses of Moderna, and 81.7 cases per million Pfizer.
Shots for Tots
On Wednesday, the 21-member FDA advisory panel on vaccines unanimously recommended both the Pfizer-BioNTech and Moderna vaccines for American children under 5, based on results from new clinical trials. On Friday, the FDA authorized both for emergency use. And on Saturday, the CDC recommended both. COVID19 vaccines will now be available to US children this week. (Health Canada is doing its own due diligence, and a decision is anticipated in the “coming weeks” on the Moderna shot for children. Pfizer has yet to file its submission in Canada.) The Moderna series consists of 2 doses, each a quarter of the adult dose, with apparent efficacy against symptomatic disease of up to 50.6%; the Pfizer series uses 3 doses, each one-tenth of an adult dose, with 80.4% efficacy. Neither clinical trial reported any cases of myocarditis or pericarditis (which is a side effect reported among some adolescent males). The Omicron variant was in circulation during the trials, so the efficacy rates are actually comparable to adult protection. (Experts say the n sizes were too small for the efficacy rates to be conclusive, but it sure looks like Pfizer is the way to go!) More than 2M American children under age 4 have already caught COVID19, and tragically 440 have died. The big question now is: how many parents will actually vaccinate their kids? Scientific American | TIME | Axios | Politico
“I think Omicron has brought us to the point where we need to redefine what the primary series of vaccination against COVID19 should be. We are in completely uncharted territory and in a very dynamic situation, since the virus and its evolution is really what is driving the bus here.” – Kristin Moffitt, infectious disease specialist, Boston Children’s Hospital
“This is a huge milestone in the pandemic, not because it changes the trajectory of the virus but because of the way we as a country can think about where we are.” – Leana Wen, medicine prof, George Washington University
The sharing of preprint research and the development of new COVID19 vaccines and therapies have significantly accelerated the pace of medical science in its race against the evolving virus. A new clinical trial of a reformulated Moderna vaccine found, as a 4th dose, it raised neutralizing antibodies 8-fold against the Omicron variant, outperforming Moderna’s original shot. (If approved by regulators, the new vaccine could be available by August.) The biggest challenge now is that, after 2 years of breakneck research, it’s getting increasingly difficult to recruit enough seriously ill COVID19 patients to conduct effective clinical trials. The most at-risk are unvaxxed and already distrust medical science. And the numerous proven treatments already available, from steroids and synthetic antibodies to antiviral tablets, make it ethically difficult to recommend experimental alternatives. “It just takes a much more adventurous person to step onto that third drug.” Yet, if new strains of COVID19 arise that are resistant to Paxlovid, we’re going to want to have a replacement in the wings. Nature
Maybe I should start calling my Monday issues “the Cassandra Report”?
Allergies with a Vengeance
As we lift restrictions and drop our masks, we face not only emerging disease threats like Lyme disease, Meningitis, Norovirus, Avian Flu, and drug-resistant “super Gonorrhea,” but also resurgent old favourites like Influenza and even allergies! After 2 years spent indoors and behind masks, even if the airborne pollen is measurably less intense, sufferers will be hit harder. “Once the masks are off, the allergies come back with what feels like a vengeance.”
Monkeypox No More?
Oh, don’t get me wrong, Monkeypox is continuing to spread globally. Canada now has 168 confirmed cases (141 in Quebec). The WHO is convening an Emergency Committee meeting this Thursday “to assess whether this outbreak represents a public health emergency of international concern.” But the WHO has also announced that the disease will be getting a rebrand, since the name is stigmatizing, racist and inaccurate. (Although first noticed in monkeys in the 1950s, it is now more commonly spread by rodents, can certainly be transmitted by humans, and increasingly appears to be sexually transmitted too.) Expect to see new names for the 2 main variants, too, currently called the “Congo” and “West African” clades. LGBTQ+ advocates are concerned that the link between most current cases and homosexual activity could scapegoat the community, while others want an end to the use of photos of African patients to illustrate the pox lesions. Although containment of the outbreak currently looks possible, if Monkeypox establishes itself in wildlife outside Africa, it would be “nigh impossible to eradicate.”
“There’s always been this kind of existential threat about what could potentially happen with a poxvirus. Were it to get into a population where it could spread efficiently, we could see extended chains of transmission, providing this virus with a runway that it hasn’t had previously.” – Anne Rimoin, epidemiology prof, UCLA
“Public health infrastructure is barely built to deal with the response to one virus, let alone two.” – John Brownstein, medicine prof, Harvard
As we desperately hope we can put this pandemic behind us (knowing full well more waves will come this Fall), research published in Nature sheds new light on one that started 7 centuries ago…
Bubonic Ground Zero
14th century tombstones and genetic material unearthed in northern Kyrgyzstan may point to ground zero of the Black Death, the plague that wiped out 30-60% of the population in Western Europe and the Middle East. A “mysterious pestilence” arose there in 1338, about 7 years before the bubonic plague entered the Mediterranean via trade ships. Gene sequencing of exhumed DNA in buried teeth found a strain of Yersinia pestis that appears to be the earliest direct ancestor of a so-called “big bang” of viral evolution in humans – which would make the Chu Valley near Lake Issyk-Kul the plague’s origin point. To this day, the most similar strains are found in wild rodents living in the nearby Tian Shan mountains, and it could be that the bacteria jumped from marmots to humans. Nearby Balasagun, along the Silk Road, was a “centre of economic, political and cultural life in Central Asia,” with strong trade connections across the continent. Scientific American | CTV | Discover
“Already in medieval times we see the high mobility and fast spread of a human pathogen. We should not underestimate the potential of pathogens to spread around the world from rather remote locations, likely due to a zoonotic event.” – Johannes Krause, director, Max Planck Institute for the Science of Human History
Speaking of digging up fresh insights from historical artefacts, here’s an impressive brand campaign with lessons for marketing the humanities more broadly…
The Royal Ontario Museum launched a new brand platform last week with an epic 6-min film that aims to “modernize” the museum, and make history more relevant to young, diverse audiences by connecting it to topical and pressing issues of our day. (A 90-sec version will run in cinemas.) The cinematic vid evokes 2001: A Space Odyssey, apparently narrated by a newborn baby floating in an underwater dreamworld, telling a story that spans 4 billion years and suggests much of humanity’s history, from woolly mammoths to astronauts, from Martin Luther King to the fall of the Berlin Wall. Roman centurians and Napoleonic soldiers fight amongst WWI troops and riot police. “I will be a girl. I will be shamed. I will live through a pandemic… or die in one.” The vid evokes racism, innovation, genocides and colonialism. (Globe columnist Marcus Gee asks, “what’s more colonial than a building filled with the artifacts of colonized people?”) It poetically alludes to the arts: “I will sing, dance, paint, be deaf yet write symphonies. I will tattoo beautiful images upon my skin. Write Journey to the West, 1984, Song of Solomon… I will burn them all.” As an inflatable Donald Trump doll floats by, she says “I will amuse myself to death.” The tagline really resonates too: “We live on in what we leave behind.” (Sounds like a donor appeal, huh?) After 14 months of pandemic closure, the ROM is trying to rebuild its audiences – rather like humanities programs, come to think of it! YouTube | Globe & Mail | Strategy
As always, thanks for reading!
Rest assured that, even though these pandemic summaries can sometimes be a bit depressing, the overall situation is vastly improved thanks to vaccines and treatments. I’m “getting back out there,” delivering conference keynotes in person, attending plays at Stratford, and scheduling campus retreats this summer and fall. I don’t believe the future is so much defined by COVID19, as by many other pre-existing megatrends. Many of the “surprises” for CdnPSE have been just how little the pandemic has actually changed our turbulent environment!
I hope your week gets off to a smooth start!
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