Breath holding has a lot of uses during a pandemic spread via the respiratory route. I suspect many parents of young children are holding their breaths after Moderna's press release that their COVID-19 vaccine trial met its primary endpoint in children 6 months to under 6 years of age. A problem is that this endpoint of neutralizing antibody response has less practical meaning in the omicron era. The statement contained slightly more numbers than did Pfizer's press release for their vaccine trial in young children last December, but still too little to make much sense of it. I'll stick to my policy of mostly ignoring Big Pharma press releases and focus on actual data reviewed by impartial experts. I'm hopeful, but this will take time and certainly I can't hold my breath that long.
Variant Alphabet Soup
The Greek alphabet was nice while it lasted, but now with subvariants we're back to more letters and numbers. Some pundits have made a big deal of the new "deltacron" strain, a recombination of delta and omicron variants. However, know that this recombination of variants has been happening since day 1 of the pandemic. Any time a host, human or animal, has more than 1 strain circulating in their body at a time, the possibility for recombination exists. Coinfection is an uncommon occurrence but when in the current pandemic happens often enough to reach detection. Usually these new strains are clinically insignificant with no advantage in transmissibility or virulence, and they just die out. Again I have turned to my friends in the UK for good explanations. A news release covers this in lay language but also has a link to the hard data if you're interested. As always, we'll need to wait a while to know if/when a new variant of concern arises.
The most important practical point to all this is that the FDA now has limited use of the monoclonal antibody sotrovimab in some jurisdictions due to likely poor effectiveness against the BA.2 subvariant that is rapidly becoming dominant in the US. If you live in HHS Region 1 (CT, ME, MA, NH, RI, VT) or Region 2 (NJ, NY, PR, VI)* you won't be able to obtain sotrovimab for treatment because BA.2 predominates. Expect this list to expand in the coming weeks.
*You might ask how Puerto Rico and the Virgin Islands ended up in the same region as New Jersey and New York. I couldn't find an official answer, I think they just needed some region to pigeon-hole those far-flung geographic places, not necessarily thinking about transmissible disease analysis.
Potpourri
I made a trip to my favorite neighborhood public library for the first time in years. I was pleased to see a table with free COVID-19 rapid antigen tests and N95 masks and yes, I helped myself. Also in the realm of new things, CDC has a nice COVID-19 Isolation and Quarantine Calculator. This makes it much easier to figure out what everyone needs to do depending on local circumstances.
Speaking of holding one's breath, sewers are at the forefront these days. Pre-pandemic if someone mentioned sewers I thought of 3 things. First is the classic exploration of the London cholera epidemic of the mid-19th century by John Snow. Second is an important article about a leptospirosis in people linked to their immunized pet dogs who cavorted with sewer rats. It is especially memorable to me because one of my mentors, Ralph Feigin, loved to regale trainees with his (embellished, I suspect) tales of sewer expeditions to collect samples for the report. Lastly, The Third Man, a noir movie of old, has a great scene in the sewers of Vienna.
All that aside, sewers are a valuable predictor of what to expect for the pandemic in the coming days and weeks. The CDC has continued to ramp up their SARS-CoV-2 RNA wastewater tracking with an interactive page. You can type in any jurisdiction and see the latest, assuming they are providing data (most Maryland counties show no data from the last 15-day period). Poop patrol isn't limited to just your evening dog walks.