Thanks to the extensive bubble created by the NBA and daily testing that included genomic analysis scientists were able to take a detailed look at the variants.
Lineage B.1.1.7 (also called 501Y.V1) is a phylogenetic cluster that is rapidly spreading in southeastern England
Their early work with the SWISH study (Surveillance with Improved Screening and Health), the study validated the saliva test for SARS-CoV-2, (I’m sure millions of noses thank them!) but they have found some useful and relevant insights on the B117 Variant of Concern (VOC) (first identified in the UK). There are many theories on why this variant is more transmissible but as of today, we don’t know for sure. There is some suggestion the variant may also be deadlier but we don’t know that either. In the NBA ‘Bubble’ cohort, there were a total of 65 players who tested positive of which 7 had the B117 variant. The B117 variant players had longer illnesses (13.3 days vs 8.2 days for the non-B117) and the variant infections took longer to reach peak viral concentrations (5 days vs 2 days in non-B117)
What does this all mean – the B117 ramps up over a longer period of time, before the carrier who has caught COVID19 may be aware hence providing a longer opportunity for the virus to spread. Also found in the data was the fact the B117 infected individuals had slightly lower viral loads which disproves one of the theories that higher viral loads were making the virus more transmissible
So not only are we learning more about the variants, but this new data may well inform a different isolation protocol for individuals who are found to be infected with one of the new variants pushing isolation protocols back to the longer 14 days or maybe even more
We also talk about Long COVID and the need to deal with disability and the current lack of guidance on how people qualify for disability post suffering a COVID19 infection.
Join Dr Luis Saldana, Fred and myself for our COVID Insights to Action Discussion webinar taking place every Wednesday at 4pm ET. Our training modules are available to help businesses, education facilities and employers get their employees, staff, customers and students back to work and school safely in the context of COVID19.
Raw Transcript
Nick van Terheyden
Hi, this is Dr. Nick, I’m the incrementalist here with incremental insights for better business and better health.
Fred Goldstein
And I’m Fred Goldstein with accountable health here helping employers look at their overall health improvement programs, and how do you keep a healthy population of employees? So one of the fascinating issues has been going on the NBA obviously put a lot of money, resources, thought and time into trying to keep themselves open, and did it. I understand you’re a big NBA fan, maybe a team or two out there you’re thinking of, is it something you follow Nick?
Nick van Terheyden
So sorry, folks, it’s it’s just not my sport, and I have watched it occasionally. The closest I got to the NBA was hanging out with Shaq O’Neal, believe it or not years ago, when we were in a hotel in LA with some terminally ill kids that we brought to the US and their team showed up in the hotel. We were carrying all this luggage and the thing that really struck me was the fact that these guys picked up not two suitcases, but for this for the wheelie days. They put one under each arm and count they were just delightful people. We didn’t even know who they were, and just wonder why they were really tall. So sorry, but no, but I love the data that they have. produce. And here’s what’s really interesting. They created a bubble. They did it successfully. But more importantly, what did they do? They did daily testing. And they tracked and followed and captured all that data. Now they had 65 positive cases in their cohort, I don’t know what the denominator is off the top of my head. But whatever that number was, from daily testing, all those 65 interesting, the B 117. Very, which let’s be clear, originated in a finding. So the first time it was identified was the UK, that doesn’t make it a UK variant, I just think it’s important to make that point is the B 117 berries. And they found seven of them in that population. And they tracked them over time. So they have this enormous wealth of data, not only testing them daily, but also tracking their symptoms, how they progress, the viral load, all of those things, are some really useful and interesting insights. And this is the beauty of the NBA, and all the fantastic stuff that I love watching and following of them. And that’s the science that we get out. And, you know, what did they discover? Well, first of all, with those individuals that had the B 117 variant, they had a longer illness. In fact, it was averaging over 13 days were those that didn’t have the B 117. Were about eight days. Now, the peak viral concentration occurred later in the B 117. So it was a longer ramp up, which goes some way to explaining why this is more effective, you’ve got a longer period of time that you’re effective, you don’t develop symptoms as early so you’re essentially out without being tested if we’re not doing daily testing and knowing everybody’s status over time. So that introduces essentially an increased opportunity for infectivity. And the other thing that showed up was that the viral load was not quite as high. Now bear in mind, this is early data. It’s a small number, but it was a pretty well studied group, not as high. So that puts to bed, or suggests that this idea that the reason it was more effective was because there was more virus to be found. That’s probably not the case is this extended. But here’s the kicker afraid. And you and I both know this, because we talked to institutions, educational facilities, and this is one of the things that we keep on saying you need to keep on top of this, because the inflammation is changing. If that disease is extending for 30 days, that means that the isolation for those people that tested positive, especially if you had been 117 needs to be longer, because if you’re getting out at 10 days, and you’re still infected, you’re potentially spreading, so we’re gonna have to rethink some of that.
Fred Goldstein
That’s just fascinating. And I’m waiting to see the day because obviously the NBA is all about statistics that they put up there on the screen as I’m watching my favorite team, the Boston Celtics on what’s going on, what’s the variance are, it’s fantastic that you’ve dug into that study, Nick, but he’s really in some unique stuff.
Nick van Terheyden
You mean they don’t do that? I didn’t know that. And I give you one other thing that they got to thank the NBA for those of you that all cursing the nasal pharyngeal swabbing, especially the elephant long device that’s used. The validation of the spit protocol came from the MBA process. And it was then that studied that and showed that it was valid so we can all thank them for not having our noses scraped all the time.
Fred Goldstein
Absolutely fantastic. bit of work there. And I really appreciate that you always find these unique things, dive into them highly relevant, everyone’s talking variants. What does it mean? How does it spread? And this is some really good data that we can use. It also points to the whole thing. Look, the NBA was able to create an ultimate bubble tighter than most groups could do. But it worked, even though they had be 117 in there,
Nick van Terheyden
right. It worked.
Fred Goldstein
Yeah. And that’s important.
Nick van Terheyden
So what about you, Fred, what have you been looking at?
Fred Goldstein
So one of the things I find interesting for employers to consider is what do you do now around disabilities, we do have this group of long COVID folks, long haulers. But long COVID is a much better term to use. And it’s really difficult and sad. They’re seeing a lot of different symptoms, impacting people for a considerable amount of time. They don’t know if ultimately it’s 3%, it’s 5%. But given the number of people in the United States who have been infected, it’s going to be a substantial number of individuals who are potentially working for companies that may need to file for disability. And so now there really isn’t clear guidance yet on whether or not qualifies, and we’re gonna have to watch this. And employers are gonna have to watch this over time to say, Wow, is my disability insurance gonna have to be adjusted, because I’ve had a number of individuals that are struggling with this, and now are not able to function. And you’re seeing a number of employers consider that and hear from their employees. And they’ve said, Look, this person can’t come back to work, whether it’s brain fog, you know, some of the issues around respiration, being able to breathe well enough to be able to function. All of these will impact work. So we’re going to have to watch what the Social Security Administration does with this, a number of members of Congress are looking to create, asking the Social Security Administration to study this specific issue, because we’re still learning this needs more data, just like the NBA is supplying, and maybe we’ll begin to see that come out of some of the workforce as well. So something for employers to keep up with.
Nick van Terheyden
I think what’s interesting That to me is that it’s not just the individual challenge here. This is an employer challenge that thinks about that disability insurance, you cover based on that. These are questions that need to be answered, because obviously, this is now a new, prevalent disease, it’s pandemic, it will move to some sub version of that at some point, and will continue to affect and, you know, clearly, we have to take account of this and we don’t know, but we really need to be sure that we’re supporting our population so that they can essentially recover from this. It seems like there’s this very long tail for some folks, I’ve seen it personally with some friends of mine takes a long time and you know, you want them to be covered. Absolutely.
Fred Goldstein
So as employers Think about this, if you have questions about your benefits, package, your insurance, how to operate with within the current COVID, pandemic, open, etc, or even look more broadly at your employee health needs and costs for your insurance, etc. please reach out to us at veiling health.com, and we’ll be happy to answer any questions you have. So thanks so much. This is Fred Goldstein with accountable health and we really appreciate you joining us this week.
Nick van Terheyden
Hi. And this is Dr. Nick, I’m the incrementalist here with incremental insights for better business, better NBA and better health.
