COVID-19: Weekly Update (October 31, 2022)

The White House advisor warned of “tripledemic,” as three viruses are rising at the same time. A small study suggests that new bivalent COVID-19 booster shots do not offer significantly superior protection than first-generation vaccines.

As of October 26, the 21-day average of weekly new cases decreased by 25.1% compared with the previous average, according to the Centers for Disease Control and Prevention (CDC).

There was a 13.7% decline in the 21-day average of new deaths and a 1.0% drop in the 7-day daily average of hospitalizations.

As of October 27, three-fourths (75.8%) of counties are with a low COVID-19 community level, 21.9% of counties with a medium, and 2.3% with a high community level.

Warnings over “tripledemic”

The White House COVID-19 response coordinator, Dr. Ashish Jha, warned of “tripledemic,” as three viruses — SARS-CoV-2, influenza, and respiratory syncytial virus (RSV) — are currently on the rise.

“But there is good news that we are not powerless against it,” Dr. Jha said in an interview with CBS News and encouraged people to vaccinate against flu and COVID-19 to avoid hospitalization.

However, there are no vaccines for RSV, a common virus in children that causes infections of the lungs and respiratory tract. Since summer, there has been a surge in RSV cases, leading to hospitalizations. Last week alone, over 5,447 positive RSV tests came back positive.

This is a common respiratory virus which tends to cause more severe disease in infants younger than 1 year old and older adults over 65 years. Infants have detectable maternal antibodies for approximately 5 to 6 months, and most children develop immunity by age 5.

To prevent children from contracting RSV, Dr. Jha recommends avoiding sick contacts, maintaining hand hygiene, and getting children seen by a doctor if they experience difficulties with breathing.

New boosters are not significantly superior

A small study from Columbia University that has not been peer-reviewed looked at whether new bivalent COVID-19 booster vaccines offer better protection than the first-generation vaccines.

The US Food and Drug Administration (FDA) approved new boosters targeting the original strain of SARS-CoV-2 and the Omicron subvariants BA.4/5 in September. The agency’s decision was based on the clinical studies of a bivalent vaccine targeting the Omicron variant BA.1 and the preclinical trials in mice from the Omicron BA.4/BA.5-adapted vaccine.

Columbia University researchers collected sera — part of the blood that contains antibodies — from people after three or four doses of the original monovalent mRNA vaccine, individuals receiving the new bivalent vaccines as a fourth dose, and people with BA.4/BA.5 breakthrough infection following ancestral (original) mRNA vaccination.

The study found that at approximately 3-5 weeks after the booster shot, people who received the fourth dose of bivalent vaccine had similar neutralizing antibody titers against all SARS-CoV-2 variants, including BA.4/BA.5, as those receiving a fourth monovalent mRNA vaccine. Those who had BA.4/BA.5 breakthrough infection on top of original mRNA vaccination (the study does not specify 2 vs 3 doses) had the highest neutralization.

When given as a fourth dose, a bivalent mRNA vaccine targeting Omicron BA.4/BA.5 and the original SARS-CoV-2 strain did not induce superior neutralizing antibody responses in people, compared to the original monovalent vaccine formulation, the authors concluded.

Although further study is needed, this observation could point to the efficiency of the immune system — responding rapidly with antibodies to the antigen it first encountered, otherwise known as “imprinting.”

Symptoms depend on vaccination status

New data from the ZOE Health Study suggests that COVID-19 symptoms depend on the number of vaccines you have received. Using the ZOE Covid Study app, researchers analyzed data provided by more than 4 million people worldwide.

Researchers ranked the most common COVID-19 symptoms reported after two doses of vaccine. The sore throat was reported most often, followed by a runny nose, blocked nose, persistent cough, and headache.

The study suggests the previous “traditional” symptoms, such as loss of smell, shortness of breath, and fever, rank in the list at 6, 29, and 8, respectively.

Among those who received one vaccine dose, the most common symptom was headache, followed by a runny nose, sore throat, sneezing, and persistent cough.

Meanwhile, the most common COVID-19 symptoms developed by non-vaccinated people were ranked in this order: headache, sore throat, runny nose, fever, and persistent cough.

Changes in symptom frequency should also be considered in light of shifting COVID-19 variants and in the demographics of people participating in the app. Additionally, many upper respiratory viruses are currently in circulation, and having more than one at once is certainly possible.

Common sense suggests that when sneezing or coughing, experiencing a fever, headache, muscle aches, or other symptoms of viral illness, it is smart to take precautions against exposing others.

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