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#SwissCheeseModel

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@Ashedryden sure:

  • be well rested and less stressed. Really! Immune systems perform better when the organism is well-rested, and worse when under stress conditions. Literally calm your system beforehand with meditation if you can?
  • have your vitamins. Results for vitamins D and C vary from "no effect" to "protective" (pmc.ncbi.nlm.nih.gov/articles/ for example), with clear evidence that low vitamin D can down-modulate immunity. Especially important for PoC in northern climes, folks who don't work outdoors, and similar. Maybe start supplementing vitamin D (through sun exposure or pills) a week+ ahead?
  • nasal sprays and mouthwashes. There is evidence for both xylitol and iota-carrageenan giving protection against SARS-CoV-2. A nice review with links to actual research from this past summer: integrativewomenshealthinstitu
  • UV light disinfection, aka Germicidal Ultraviolet. This is harder to access as most installations are for industry, but if you have time and energy perhaps you can DIY it or find a supplier.
  • explicitly say "And if you want to come but are feeling sick, let us know, and we'll drop off a get-better goodie basket and a little gift!" or similar, so folks who are ill have motivation to not come.

You've already said you will ventilate and filter. Add more filters? HEPA is great but Corsi-Rosenthal boxes with MERV-13 filters are also highly effective, relatively inexpensive, and if made with computer fans, very very quiet. They can be totally DIY - there's even a song about it youtube.com/watch?v=5XS-7vgThf !!! - , and various sellers have them available as kits or prefabbed, too.

Less likely to be useful:

  • vaccinate 2-3 weeks prior to be at peak vax-induced immunity before waning
  • PlusLife or RAT testing at the door
  • free mask basket at the door. You sound perhaps willing to use an N95 but you indicated your guests wouldn't.

I hope some of those help! None of them will guarantee no infection, but when one must face such situations, the odds can be improved.

PubMed Central (PMC)Protective Effect of Vitamin D Supplementation on COVID-19-Related Intensive Care Hospitalization and Mortality: Definitive Evidence from Meta-Analysis and Trial Sequential AnalysisBackground: The COVID-19 pandemic represents one of the world’s most important challenges for global public healthcare. Various studies have found an association between severe vitamin D deficiency and COVID-19-related outcomes. Vitamin D plays a ...
Replied in thread

@jws @MatWright

"All humoral immunities (infection-acquired, vaccine-acquired and hybrid) waned by 3–6 months. Cellular immunity was more durable but showed signs of waning by 6 months." smw.ch/index.php/smw/article/v

That is from 2024, reviewing "205 studies, of which 70 provided data on the duration of protection against SARS-CoV-2 infection" so it's better than any review I could perform, and its references better than anything I could dredge up.

Back for early Omicron, "relative protection against infection waned from 53.4% a month after vaccination to 16.5% three months after vaccination" nature.com/articles/s41467-022

Then it gets more contentious with damage to the immune system. There are several documented common(!) dysregulations. But if they don't manifest clinically (yet) then is it a problem (yet)?

Immunology inherently mostly takes time. But now some problems involving the immune system are more common, and "mounting evidence suggests a higher incidence of adverse consequences, such as disruption of the immune system" nature.com/articles/s41467-024

[edit - just juggled links]

smw.chLong-term levels of protection of different types of immunity against the Omicron variant: a rapid literature review | Swiss Medical Weekly
Replied in thread

@ai6yr @daihard yes exactly - #SwissCheeseModel defenses - stack as many modifiers as possible to every roll of the die, roll as few dice as possible

those of us who have modeled the problem rationally and using data almost all come to the same point as you, or else go full ostrich

preaching to the choir here, I know. I just wish we could help the rest of the world to understand (and de-politicize in many places).

Replied in thread

@zephyrleifrenner getting to zero covid would require protection that's currently politically unachievable

this is not about zero covid

this is about risk reduction

seat belts don't stop car deaths, but they stop some, right?

and you're glad that your kids are never offered rides in cars without seat belts, right? Like, the minivan they carpool to soccer practice in, they can't just run around.

preventing some illness is better than preventing none!

bccdc.shinyapps.io/respiratory says
"Report updated on July 25, 2024" but that was NOT the case two days ago. So I guess they held back releasing a few days for no particular reason?

Not like there's much change from the last report. Eyeballing, #Vancouver (GVRD/Lower Mainland) and #Victoria are still at approximately their 2024 highest. #PrinceGeorge, #Nanaimo and #Kelowna are roughly halfway between best and worst of 2024.

More air purifiers but also more closed windows in these smokey times.

bccdc.shinyapps.ioWastewater

I think this paper cell.com/iscience/fulltext/S25
is great. The source data includes cultures, mice, and humans.

TLDR points:
* even an up to date vaccine gives weak protection against JN.1
* variants are practically different diseases from each other, with 5x differences in spike expression, evasiveness, cell-cell fusion, and other major traits

The big dump:

* Cell-cell fusion was 2-5x more common in Ancestral, Beta, and Delta compared to currently circulating strains (Fig 1.G)

* note vaccination + BA.5 update + XBB update STILL gives almost no neutralizing antibodies against JN.1 (Fig 5)

"JN.1 is reported to be more immune evasive than its predecessors to evade the vaccine- or breakthrough infection-mediated neutralizing antibodies"

"BF.7, BA.2 and its descendants BA.2.86 and JN.1 exhibited up to 50% of lower total expression than other omicron spikes"

"BA.2.86 and JN.1, which showed 3- and 4-fold elevated viral infection than WA01/2020 pseudovirus, respectively, despite lower spike incorporations into pseudovirions than the ancestral strain"

"the JN.1 spike showed approximately 80% reduced expression compared with that of the ancestral strain"

"all variants showed improved binding affinity to ACE2 than the WA01/2020 spike, and intriguingly, the JN.1 and BA.2.86 demonstrated the strongest ACE2 binding after normalization."

"The ancestral WA01/2020 and early variant strains Beta and Delta showed strong cell fusion capacity, while omicron variants showed much reduced cell-cell fusion"

"Overall, the JN.1 spike appears to show reduced expression and incorporation into the pseudovirions, but demonstrated surprisingly greater viral infectivity."

"homologous immunizations with BQ.1.1 elicited a strong binding antibody titer against BA.4/5, XBB, and EG.5.1, while homologous immunizations with XBB elicited binding antibodies only against XBB strain"

"Of particular interest, none of the immunization combinations were able to induce binding or neutralizing antibodies against BA2.86 and JN.1."

"It is noteworthy that none of these vaccines induced cross-antibody against BA.2.86 and JN.1."

"Again, none of the groups induced cross-mucosal antibodies against BA.2.86 and JN.1, even though Ad5-BF. 7 induced modest NAb titers against JN.1"

"We noted a clear booster effect for all variants except JN.1 by BA.5 and/or XBB breakthrough infections. In general, JN.1 showed a rough 3.3- and 5.5-fold reduced NAb in breakthrough-infected individuals when compared with BA.2.86."

"relatively balanced and cross-reactive antibody responses were induced by XBB- and EG.5.1-adapted boosters, which were, however, less reactive against BA.2.86 and JN.1"

"immune imprinting, a phenomenon where previous exposure could limit the generation of de novo immune responses against variant infections or the response to the next-generation vaccines, further completes the situations and therefore requires a discrete assessment"

"Despite that homologous BQ.1.1+BQ.1.1 and heterologous WA01/2020 and BA.5 prime-boost immunization elicited binding antibody titers, none of the combinations resulted in cross-reactive antibodies against BA.2.86 and JN.1. In line with this, human cohorts with three inactivated vaccine or two adenoviral vectored vaccine immunizations showed minimal serum neutralizing capacity against JN.1 (Figure 5), indicating the susceptibility of this population to JN.1 breakthrough infections."

So stack those #SwissCheeseModel defenses!

h/t to @CastlTrAstonDrs; thanks Doc!

Reminder that in BC 👉 you can just walk in and ask the pharmacist for a COVID-19 booster 👈

You do NOT need to wait for the (broken) notification system to (maybe) text you (or maybe not).

Worried about this summer surge? Want a booster for you or your kids?

Just walk in*!

It's still FREE!

*or roll in!

We should stop caring about whether or not the #LabLeak hypothesis is true.

This is NOT like the fight around #airborne transmission. Knowing will NOT change what protections work and should be used, nor help us assess risk.

It is both wise to ban gain-of-function research on human-transmissible pathogens AND it is wise to ban large wildlife markets.

#MaskUp, #CleanTheAir, layer more #swissCheeseModel defenses, and look to the future.

1/🧵

Continued thread

And did you notice the other layer of protection?

Yup - look at the size of that doorway to outside! It must be open as wide as a quarter of the width of the apartment.

#SwissCheeseModel keeps projects on schedule!

thetyee.ca/Culture/2024/06/27/

The Tyee · In ‘The Eviction,’ Vancouver Plays Itself | The TyeeBy Dorothy Woodend
Replied in thread

@windrunner

Rapid tests are an excellent layer; you could make sure they know that dates will be extended without penalties if they have people off sick.

That won't catch lower viral loads, and the threshold for transmission is around 1-8 virus particles, so it's only one good layer, not perfect.

So! The safest route?

Is to treat it like avoiding in-house transmission from infectious housemates, regardless of test result.

More #SwissCheeseModel layers you could employ include:

* Windows open (air exchange, ACH)

* air filters (ACH equivalent)

* fans pulling air to outside, from the rooms they're in (negative pressure)

* separate living space from worked-in space, including blocking under and around doors

* disinfectant UV (beyond most people's ability)

* keep air safety defenses remain in place for at least 1h after departure

* N95 source control (or fit-tested KN95, or the best you can convince them to use)

* fit-tested elastomeric P100 or N95 use for intake control (you and your bubble)

* boosted vaccination all around

* carrageenan nasal spray within your bubble (easy to forget)

* zinc lozenges (these may be unwise to use day after day; I'm not a doctor)

* if they insist on face to face interactions, or eg. to give them water and snacks or paperwork or cheques, do it outside

* provide a comfortable break spot outside so that when they unmask to eat, it's outdoors

* be firm that symptomatic people must not enter, regardless of test status

Suggest you search "Swiss Cheese Model for COVID" to find more layers of protection to consider stacking.

Looking to stack another layer in your #SwissCheeseModel defenses?

Nasal spray studies are piling up. Some sprays add an effective layer of defense!

Here's a good roundup of the current state of knowledge around them: okdoomer.io/nose-sprays-offer-

h/t zeroes.ca/explore/links

OK Doomer · Nose Sprays: A Last Line of Defense in a World Hellbent on Giving You CovidHere's what we know.

Her "most recent piece looked at historical [US] mortality data and found that, even looking only at death certificate deaths (a sure undercount), COVID deaths more than outmatched the deaths that would result from bringing back #measles, #mumps, whooping cough, #diphtheria, and #polio.

Even picking a year when deaths were unusually high for each virus and adjusting for 2024 population, all deaths from all 5 viruses combined in a vaccine-free world would be 43,079.

Last year’s official #COVID death toll was 75,603."

referring to thegauntlet.news/p/covid-lulls

#CovidIsNotOver #SARS2 #COVID19 COVID #vaccines #SwissCheeseModel

The Gauntlet · COVID lulls aren't being earned by policy; they're being bought with infections and deathsBy Julia Doubleday