Contents
Website Update
The US state graphs now have the new variants included in a data visualization. In addition, they have been slightly blurred, which will make the mind perceive them as being in the background, which makes the other data trends much more easy to follow.
COVID and Motor Vehicle Accidents (MVAs)
A very interesting study was published by the AAA Foundation for Traffic Safety this week. A single graph sums up the findings on traffic deaths related to COVID. The paper also demonstrated the accuracy of their model in predicting MVA fatalities.
We have known for some time that infectious diseases have impacts on brain function, and even have been correlated with motor vehicle accidents. One example is toxoplasmosis.
Toxoplasmosis is a parasitic disease that most people think of in relationship to changing cat litter during pregnancy, because it may be in cat feces. Flegr et al. identified a strong correlation between toxoplasma antibody titers and motor vehicle accidents.
The danger of a MVA is also heightened after a COVID infection due to the immune system damage caused by the virus. In a study in Australia by Ingram et al., “a novel finding was that motor vehicle accidents (MVAs) accounted for 78% of all trauma-related cases, suggesting MVAs should receive greater recognition as a potential precipitant of cutaneous mucormycosis.”
This is a CT image of a skull from that study of someone who had cutaneous murcomycosis.
Murcomysosis is a fungal disease that “usually, only people with weakened immune systems (lower ability to fight infections) get mucormycosis.” Maybe the CDC should add COVID to the list of risk factors for fungal diseases.
One of the factors that may drive increasing MVA rates after COVID is the impact on the brain’s ability to process and construct visual data, as measured by the Rey-Osterrieth Complex Figure Test (ROCF), which was used in a study by de Paula et al., as quoted below.
We observed significant cognitive impairment only in the ROCF, a drawing task test used to assess visuospatial abilities, executive functions and memory. The deficits observed in the ROCF could not be explained by socio-demographic factors, ophthalmologic deficits or psychiatric symptoms, suggesting cognitive deficit secondary to SARS-CoV-2 infection. Other factors which may influence performance, such as motor coordination, spatial neglect, visual attention, semantic knowledge, intelligence and executive functions were not likely to explain the observed difficulties, since we did not find any significant differences in other non-verbal (Trail Making Test and Five Points Test) and verbal tests (verbal fluency, digit span) also related to these processes…
…Visuoconstructive deficits are usually defined as an atypical difficulty in using visual and spatial information to guide complex behaviors like drawing, assembling objects or organizing multiple pieces of a more sophisticated stimuli. In drawing a complex figure, as in the ROCFT, the patient must organize visual and spatial information in a planned manner to execute the drawing per se, a processes that demand several more specific cognitive abilities related to perceiving, processing, storing and recalling visuospatial information, both regarding shape and position, as well the planning and execution of the drawing per se.
In one study on cognitive abilities that had nothing to do with viruses, the researchers happened to find Acanthocystis turfacea chlorella virus 1 (ATCV-1) in the oral swabs of the test subjects. “This family of algae-infecting viruses is common in aqueous environments but not previously thought to infect humans or animals or to inhabit human mucosal surfaces.”
“A significant association occurred between the presence of oropharyngeal ATCV-1 DNA and a lower level of performance on the Trail Making Test Part A (Trails A), a test of visual motor speed (P < 0.002), as well as the total score of the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) (P < 0.014). Within the RBANS test, there were statistically significant differences between those who had detectable oropharyngeal ATCV-1 DNA and those who did not in the domains of delayed memory (P < 0.039) and attention (P < 0.011). These differences were independent of the covariates of age, sex, race, socioeconomic status, educational level, place of birth, and current cigarette smoking. On the other hand, no differences were observed between the presence/absence of ATCV-1 DNA and scores on the Wechsler Adult Intelligence Scale (WAIS) Information subtest, a test of general knowledge.”
Just this year, Serafim et al. found “The data indicate higher percentages of cognitive difficulties in the severe group, followed by the moderate group, compared to the mild group. Notably, even within the mild group, 11% of participants exhibited difficulties in at least one assessed cognitive function 18 months after COVID-19 infection.”
Of course, we’ve known all of this for well over 30 years. “Profound changes in behaviour are observed following infection of the central nervous system by some viruses. Irritability, insomnia, hyperactivity and learning disability are some of the behavioural disturbances that have been described in both humans and animals with central nervous system infection.”
What I really would like to know is how the impairment compares to that who are driving under the influence. I also wonder if DMVs should be performing a cognitive test as part of driver’s license exams and renewals to make the roads safer.
The data from The Insurance Institute for Highway Safety (IIHS) also shows a marked increase in traffic deaths since the start of the pandemic. The red line indicates the 2020 data points. The sharp increase
This is data from FRED combined with the IIHS data. The purpose was to determine if changes in passenger air miles would account for the increase in MVA deaths.
The black line is road miles, the light blue is air miles, and the red is MVA deaths per 100,000 population per 100,000 miles. The orange line is simply to make it easy to look at the year 2000 on all three. The drop in air and road miles is expected, but the big jump in mortality is telling. Part may be due to higher speeds on empty roads, but that also might be related to increased risk-taking behavior as a result of COVID infection. Now the highways are congested again, but the mortality hasn’t dropped. It’s another argument that COVID is driving up MVAs.
In addition, we could have expected MVA deaths to drop on less congested roads because those driving at significantly excess speeds at the time could have been outliers, which makes it even more suspicious since fatalities should have dropped during 2020.
Some of the MVA deaths may be a result of increased risk-taking behaviors. First, boredom can drive risk-taking behaviors. “Recent research has demonstrated that a state of boredom increases risk-taking across domains.“
Social media may also play a role in risk-taking behaviors due to a concept known as relative deprivation. A simple example is when a child complains that all of their friends are doing something that they are not allowed and the child proclaims “It’s not fair!” This kind of thinking is promoted on social media due to the biased nature of posts of people only showing the good things in their lives, which leads to some people thinking that their lives are substandard, and inevitable depression if they dwell on it.
Humans are notoriously bad at calculating risk/benefit ratios. Part of this is due to temporal discounting, but in addition, “prior research on “perceived scarcity” shows that the unavailability of an object or experience leads to higher valuation and desire for that object.”
It is also very possible that the virus may directly alter human behavior. There are many examples of this in the animal world as it relates to parasites. Circling back to toxoplasma, we see that happen in its intermediate hosts, including humans. It is certainly possible that SARS-CoV-2 may act in a similar way, with many different purposes:
- Possible behavioral changes in humans that could promote the transmission of SARS-CoV2 prior to showing symptoms
- Possible changes in infected children that function to increase the risk of infection in older people such as parents and caretakers
- Possible long-term changes in unborn children
- Possible mutations that could drive further transmission
Redelmeier et al. studied COVID vaccine hesitancy and MVA risk and had some pretty stunning results from a large study population.
“A total of 11,270,763 adults were identified. Overall, 9,425,473 (84%) had received a COVID vaccine and 1,845,290 (16%) had not received a COVID vaccine at study baseline (July 31, 2021). The 2 groups spanned a diverse range of demographics, with comparable general health care utilization. The largest relative differences were that those who had not received a COVID vaccine were more likely to be younger, living in a rural area, and below the middle socioeconomic quintile. Those who had not received a vaccine also were more likely to have a diagnosis of alcohol misuse or depression and less likely to have a diagnosis of sleep apnea, diabetes, cancer, or dementia. About 4% had a past COVID diagnosis, with no major imbalance between the 2 groups.”
In that analysis, “living in a rural area” really stood out to me, particularly because I had picked up on how COVID was impacting Republicans and Democrats very differently, which is very fascinating if it weren’t so sad. Most people realize that Republicans dominate rural areas, as this voting map from 2020 shows.
Another important piece to tie this story together is education level. The data is very clear that Democrats have achieved a much higher level of education than Republicans.
Circling back to the original article, we can see the impact that education has on the severity of MVAs, and particularly during the pandemic.
Sadly, it’s not just those in vehicles who are impacted, but cyclists and pedestrians have been harmed in higher numbers as well.
When someone says “What do you care if I wear a mask or get vaccinated or not?” I get irritated. I care because it impacts others, whether through traffic injuries or fatalities, the loss of healthcare, and higher auto insurance and health insurance rates.
H5N1
Vectors
One study showed that blowflies are a potential vector of H5N1 in Japan. Guess what blowflies like. “Blowflies are well-known for their necrophagous habits, being attracted to deceased animals and birds to feed on decaying flesh. They are also attracted to feces, making them commonly observed insects around livestock facilities.”
Should this be of concern in North America? Yes.
A One Health Investigation into H5N1 Avian Influenza Virus Epizootics on Two Dairy Farms (2024)
This preprint is a bit alarming.
“Farm B first noted dairy cattle illnesses on March 20th with the illnesses increasing over the next 13 days, eventually affecting an estimated 14% of the milking herd. On March 22, illnesses were first noted in the Farm B’s feral cats with cats showing lethargy, paralysis, and increased respiratory rate. Farm B estimated that 15-20 of their ∼40 feral cats died during the next 14 days.” That’s pretty suggestive of nearly a 50% mortality rate in felines.
“We identified several mutations that alter host cell specificity, target drug binding sites and known to cause antigenic shifts or cause mild drug resistance.” This in itself isn’t surprising since mutations readily happen in influenza viruses, but it does point to just how dangerous mutations are for the human population.
This is what is most concerning. “The second worker had a MN of 1:80. She worked in the Farm A’s cafeteria. She reported experiencing fever, cough or sore throat during that last 12 months as well as being around others at work with similar respiratory signs and symptoms. She had just recovered from a respiratory illness when we enrolled her.”
Given that she was a cafeteria worker, that means that she likely had little or no exposure to the cattle. This implies one of two possibilities. First, that somehow an airborne spread occurred from the location of the cattle into the cafeteria, which seems pretty unlikely. Much more alarming is that this case may represent human to human transmission. This is very problematic in that we are not doing much testing, just like early in the COVID pandemic, so we are unable to characterize what is really happening in the field.
Studies Added
Masking Policies at National Cancer Institute–Designated Cancer Centers During Winter 2023 to 2024 COVID-19 Surge (2024) in Respiratory Protection Works
COVID-19 policies were confirmed at all 67 patient-serving NCI-designated cancer centers. 28 cancer centers (41.8%) required universal masking in at least some clinical areas, with 12 (17.9%) requiring universal masking in all areas. Only 14 (20.9%) had accurate up-to-date policies flagged on the home page of their websites. In 8 cancer centers (12.0%), policies posted on websites differed from those noted by telephone. Cancer centers were more likely to require universal masking in at least some areas if they were located in the Northeast (11 [78.6%]), had longer NCI designation duration (first quintile: 10 [83.3%]), had more program funding (first quintile: 11 [84.6%]), or had a higher care ranking (first quintile: 11 [84.6%])
Cognitive performance of post-covid patients in mild, moderate, and severe clinical situations (2024) in Neurological
The data indicate higher percentages of cognitive difficulties in the severe group, followed by the moderate group, compared to the mild group. Notably, even within the mild group, 11% of participants exhibited difficulties in at least one assessed cognitive function 18 months after COVID-19 infection.
We showed that cognitive symptoms persist in mild cases and are even more prevalent in individuals with severe manifestations. Furthermore, we confirmed our central hypothesis: people with severe forms of COVID-19 show diminished cognitive performance 18 months after infection compared to those with mild to moderate forms.
