By Lambert Strether of Corrente.
“”It’s common sense to take a technique and take a look at it. If it fails, admit it frankly and take a look at one other. However above all, strive one thing.” –Franklin Delano Roosevelt
As is well-known, the Biden Administration has pursued a “Vax-only” coverage from its first days in workplace (augmented, to be honest, with numerous over-hyped but worthwhile pharmaceutical therapies of less-than-stellar effectiveness; remdesivir, paxlovid). The hallmark of Administration coverage has been a thorough-going rejection of a layered technique (“Swiss Cheese Model“) that will mandate non-pharmaceutical interventions to lower airborne transmission, whether or not by way of suggestions (“3C’s“), air flow, or masking. (Such is the Democrat dedication to the bit that Acela Hall media figures at the moment are coming ahead to stigmatize mask-wearers, making them objects of derision and hatred; see the New York Times and The New Yorker.) In apply, the Biden Administration has pursued a coverage of mass an infection, for the reason that vaccines we’ve now usually are not sterilizing, and get rid of neither transmission nor reinfection.
The Biden Administration’s Covid coverage of mass an infection has thus far — I’ll assert for the needs of this submit — been cost-free politically, for a variety of causes: Enterprise help, an incoherent Republican response, denial of airborne transmission by highly effective institutional forces in healthcare and academia, a shift in focus from shared duty for public well being to “private threat evaluation” (engineered by the general public well being institution, satirically sufficient), and destruction of information gathering, however above all by way of a Goebbels-level propaganda marketing campaign, waged by all elements of the Democratic get together equipment and its self-embubbling (hegemonic) PMC class base in favor of “Vaxed and done.” (To be honest, “comfort” and “residing your life” usually are not onerous sells for People, our tradition being what it’s. Neither is working by way of sickness. Nor, in least in some strata of society, is a fandom for well-credentialed and highly-placed figures). Nonetheless, time could also be operating out.
The Biden Administration’s Covid coverage of mass an infection has at all times been susceptible to info on the bottom. One other surge equal to January 2022’s Omicron surge would do it in; so would “one thing terrible” within the type of vascular or neurological (epithelial) harm of an simple scale. (Lengthy Covid doesn’t appear to be terrible sufficient, sadly; however that would change, given a stable mechanism and probably just a few celebrities to assist with the narrative.) On this submit, I’ll first current the case for vaccine escape from current variants, after which the case for immune dysregulation as a sequel to acute covid. When it comes to info on the bottom, the primary would create a surge; the second, “one thing terrible.” In both case, even essentially the most coughing, exhausted, several-times-injected, “I’ve obtained a chilly I can’t shake” vaccine militant is likely to be gently led to the conclusion that the Biden Administration’s coverage of mass an infection has failed, and we should strive one thing else.
I began meditating this submit once I noticed the next article in Cell: “Alarming antibody evasion properties of rising SARS-CoV-2 BQ and XBB subvariants“; “Alarming” shouldn’t be sometimes a phrase that one sees in article titles for skilled journals. (I believe it interprets to “hair on fireplace”?). From the Summary (and I’ve gone a bit of overboard with the formatting simply to make the purpose:
The BQ and XBB subvariants of SARS-CoV-2 Omicron at the moment are quickly increasing, probably resulting from deriving from their extra spike mutations. Right here, we report that together with sera from people boosted with a WA1/BA.5 bivalent mRNA vaccine. Titers in opposition to BQ and XBB subvariants had been decrease by 13- to 81-fold and 66- to 155-fold, respectively, far past what had been noticed to this point. , and the accountable particular person spike mutations had been recognized. These subvariants had been discovered to have comparable ACE2-binding affinities as their predecessors. Collectively, .
For no matter motive — charitably, the December 13, 2022 publication date, too near the vacation season — this peer-reviewed research from a top-drawer medical journal has gotten nearly no play within the press.
GM advises us to take a look at Determine S3, so — regardless that I really feel I’m juggling energy instruments — right here it’s (the highlighting is mine. That is an “antigenic map.” The caption explains why the axes usually are not labeled).
Determine S3 Antigenic map of BQ and XBB subvariants in relation to SARS-CoV-2 variants and sarbecoviruses, associated to Determine 2
(B) Antigenic map based mostly on the serum neutralization information from (A). Virus positions are represented by closed circles whereas serum positions are proven as open squares. Sera are coloured by group. Each axes signify antigenic distance with one antigenic distance unit (AU) in any course similar to a 2-fold change in neutralization ID50 titer.
(New subvariants in circle at proper; no sera. Previous subvariants in circle at left; sera.) In prose:
Our information exhibit that these new subvariants had been barely prone to neutralization by sera from vaccinated people with or with out prior an infection, together with individuals just lately boosted with the brand new bivalent (WA1/BA.5) mRNA vaccines…. . The truth is, combining these outcomes with our prior findings on the serum neutralization of choose sarbecoviruses, there are indications that XBB and XBB.1 at the moment are antigenically extra distant than SARS-CoV or some sarbecoviruses in animals… Subsequently, 
However, you say, even when the outdated vaccines don’t work for the brand new subvariants (BQ/XBB), we’ve bivalent boosters now, so maybe they’ll save us. Sadly, no. First, the Cell research says they received’t (see above), however we will additional have a look at two articles, first from the CDC, and the second from the NEJM.
The primary article asks how a lot of a lift the bivalent boosters give, given “waning immunity of monovalent doses.” From the CDC’s Morbidity and Mortality Report, “Effectiveness of Bivalent mRNA Vaccines in Preventing Symptomatic SARS-CoV-2 Infection — Increasing Community Access to Testing Program, United States, September–November 2022,” December 2, 2022:
Relative vaccine effectiveness (rVE) of a bivalent booster dose in contrast with that of ≥2 monovalent vaccine doses amongst individuals for whom 2–3 months and ≥8 months had elapsed since final monovalent dose was , 31% and 48% amongst individuals aged 50–64 years, and 28% and 43% amongst individuals aged ≥65 years, respectively.
That doesn’t sound very encouraging.
The second article is a letter within the New England Journal of Medication, written in reply to a Cell article from February 2022, amongst others, however not the article quoted above. From “Neutralization against BA.2.75.2, BQ.1.1, and XBB from mRNA Bivalent Booster, December 21, 2022:
We examined serum samples obtained from members who had obtained both one or two monovalent boosters or the bivalent booster to find out the neutralization effectivity of the booster vaccines in opposition to wild-type (WA1/2020) virus and first isolates of omicron subvariants BA.1, BA.5, BA.2.75.2, BQ.1.1, and XBB utilizing an in vitro, live-virus focus discount neutralization check (FRNT).
… Individuals who obtained the BA.5-containing bivalent booster had neutralizing exercise in opposition to all omicron subvariants (particularly in opposition to BA.2.75.2, BQ.1.1, and XBB) than those that obtained both one or two monovalent boosters, regardless that the neutralization GMT in opposition to WA1/2020 was comparable within the cohort that obtained the 2 monovalent boosters and the cohort that obtained the bivalent booster. These responses are in keeping with current observations in individuals with breakthrough omicron an infection displaying broadened neutralizing exercise in opposition to omicron subvariants. . These serologic information present an general neutralization profit with bivalent booster immunizations.
Evaluating the methodology of the Cell research with the NEJM letter is above my paygrade, however that stated I believe the Cell methodology is superior. Cell consists of as much as 4 jabs (not simply two), and consists of breakthrough infections (Determine 2), so it’s taking a look at a inhabitants that’s far nearer to the true world than the NEJM paper. I additionally don’t know what NEJM’s “higher” means when it comes to effectiveness. If it means what the MMWR research means (“30% and 56% amongst individuals aged 18–49 years”) that’s not very encouraging, both. Subsequent — and right here I’m going to juggle energy instruments once more — the NEJM letter lacks a mechanism. In the event you look once more at Determine S3, BQ/XBB have no sera. So how was the NEJM’s putative “neutralizing exercise” to have been achieved? (If we consider antibodies and antigens like a lock and a key, NEJM isn’t just attempting to open a lock with the unsuitable key, the secret is a Shlage, and the lock is a Yale.) Lastly, the NEJM research doesn’t point out that the brand new subvariants ace out monoclonal antibodies, eliminating essential therapy choices. So I stay “alarmed.”
Dr. Anthony Leonardi is the foremost proponent of Covid immune dysregulation. This deep dive within the Tyee, “What If COVID Reinfections Wear Down Our Immunity?” offers the backstory and explains the ideas.
By dysregulation Leonardi means three results of COVID:
- The hyperactivation of many T cells [“one of two white blood cells that defend the body against foreign invaders”], which might prematurely age them
- The exuberant operate of these hyperactivated T cells, which might then trigger organ harm
- The exhaustion of these hyperactivated T cells, which means they aren’t profitable the battle in opposition to viral proteins they’re presupposed to defeat.
In different phrases, argues Leonardi, T cells have gotten hyperactivated by SARS-CoV-2 and are prematurely ageing, harming organs, and changing into exhausted attempting to rid the physique of an immune-evasive virus.
Here’s a research from Nature, which is alarming as a result of it means that Covid could cause immune dysregulation not solely in T Cells, however in monocytes, “a type of immune cell that [can] encompass and kill microorganisms, ingest international materials, take away useless cells, and increase immune responses.” Or, as the Cleveland Clinic places it, “Monocytes are your cell’s firefighters.” They represent between 2% and eight% of your white blood cell depend. That’s so much! From “Transcriptional reprogramming from innate immune functions to a pro-thrombotic signature by monocytes in COVID-19,” December 26, 2022:
Right here, we look at the operate of classical CD14+ monocytes in sufferers with gentle and reasonable COVID-19 in the course of the acute section of an infection and in wholesome people. Monocytes from COVID-19 sufferers show altered expression of cell floor receptors and a dysfunctional metabolic profile that distinguish them from wholesome monocytes…. .
On this paper, Leonardi feedback:
It seems like Covid suppresses innate immunity towards different viruses and Micro organism
This does not bode nicely for the severity of different infections that are not even covid
Consider all of the individuals saying “The worst chilly of my life”
— Anthony J Leonardi, PhD, MS (@fitterhappierAJ) December 30, 2022
Oh. Oh good. (Leonardi would possibly nicely have talked about the cases of Strep and resulting sepsis in the UK as nicely.)
I don’t use the phrase “break” within the headline frivolously. On the very starting of our Covid journey, on January 26, 2020 (!!), Nassim Nicholas Taleb and his co-authors wrote “Systemic Risk of Pandemic via Novel Pathogens – Coronavirus: A Note” (PDF):
The overall (non-naive) precautionary precept delineates situations the place actions should be taken to cut back threat of break, and conventional cost-benefit analyses should not be used. These are break issues the place, over time, publicity to tail occasions results in a sure eventual extinction. Whereas there’s a very excessive chance for humanity surviving a single such occasion, over time, there may be finally zero chance of surviving repeated exposures to such occasions. Whereas repeated dangers will be taken by people with a restricted life expectancy, break exposures must not ever be taken on the systemic and collective degree.
Taleb defines a “break downside” as “one the place outcomes of dangers have a non-zero chance of leading to unrecoverable losses.” I suppose it will be attainable for some to contemplate 1,000,000 individuals useless from Covid not ruinous — in any case, we will at all times breed extra — however taking such dangers repeatedly appears like a really unhealthy concept, particularly since we’re taking that threat “on the systemic and collective degree.” And taking the identical threat repeatedly is precisely what a coverage of mass an infection does.
If the papers I’ve offered are appropriate, the Biden Administration’s coverage of mass an infection has introduced us to the brink of break. Vaccine escape is the direct results of the Administration’s mass an infection coverage. GM writes:
[N]ever earlier than has such a virus obtained the chance to duplicate so quick and a lot. We’re speaking a number of orders of magnitude extra replication than standard. And these are the outcomes.
Within the worst case state of affairs, the well being care system is true again the place it was in Spring 2020, with no working vaccines. Furthermore, it is going to be overwhelmed not merely with Covid circumstances — bear in mind “flattening the curve”? Again when collective motion was a factor? Good instances! — however with all types of latest infections led to by Covid’s immune dysregulation skills, as is occurring within the UK now.
Even worse, the subvariants with demonstrated immune escape capabilities (BQ/XBB) are peaking and changing into dominant in the course of the Christmas and New Yr’s vacation interval, particularly on the East Coast, the fons et origo of the primary Covid wave in early 2020 (a bit of within the Hudson Valley and Lengthy Island, as these New Yorkers who might flee did do, and so much in the remainder of the nation through air journey, as individuals who obtained contaminated in New York checked Covid in as a part of their baggage). Worse than that, the Southwest Airways debacle has meant that there have been total households, nationwide, staying 24/7 in airports, that are Covid hotspots, for days. Worse than that, opening up China will — in all probability already has — expose us to no matter variants have been brewing in immunocompromised Covid sufferers in that nation.
Can’t anyone here play this game? “The pandemic is over.” No, it’s very not. It’s deja vu all over again! What number of instances do we’ve to repeat? Perhaps strive one thing new? Earlier than it’s actually too late?
 No less than as a putative public well being measure.
 Readers will observe we’ve been following the enlargement of the The BQ and XBB subvariants in Water Cooler, utilizing each CDC and Walgreens information. (The information for each comes from Pango however we will use Walgreens as a test on CDC’s tendency to cover up-and-coming subvariants in aggregated information). BQ is at present dominant, however XBB is arising quick. CDC’s NOWCAST mannequin predicts that XBB will dominate quickly, which is why many are saying it’s already dominant.
 There follows some qualifying language that claims vaccines work in precept, however for us the purpose of the research is that they aren’t prone to work now, which is after we want them.
 Having defined the idea, I don’t need to get deeply into the stability of the Tyee article, which it is best to learn you probably have not. Suffice to say that the Tyee seems at “six key points, evaluating his statements with what the scientific literature now says or suggests.” In each case, Leonardi was both on the cash or nonetheless within the operating. So he has kind. Leonardi has been early and proper, not (as NC readers know) at all times essentially the most snug place to be in.