WHOOP Podcast - WHOOP unveils new research on Omicron variant of COVID-19

Episode Date: January 19, 2022

Since the beginning of the pandemic, WHOOP has been conducting research to better understand how COVID can affect sleep and recovery, what physiological response vaccines produce, and perhaps most importantly, how COVID affects respiratory rate. Our latest WHOOP research shows that with the Omicron variant, like previous strains of the virus, COVID-19 infections often coincide with an increase in respiratory rate. WHOOP VP of Data Science and Research Emily Capodilupo returns to the podcast to detail our findings (3:34), why respiratory rate is so important to track (5:31), how men and women may see different data with Omicron (8:30), why you could see a respiratory rate dip after a spike (9:13), Omicron and the vaccines (14:23), factors that can increase your respiratory rate (18:34), the latest information on testing (20:07), and an update on WHOOP vaccine research (24:35). Support the showFollow WHOOP: www.whoop.com Trial WHOOP for Free Instagram TikTok YouTube X Facebook LinkedIn Follow Will Ahmed: Instagram X LinkedIn Follow Kristen Holmes: Instagram LinkedIn Follow Emily Capodilupo: LinkedIn

what's up folks welcome back to the whoop podcast we have a great one for you today covid-19 is raging and we have collected a lot more data on covid-19 i'm going to be joined by our brilliant whoop VP of data science and research emily capitalupo in a second but first a reminder the whoop podcast is where we sit down with top athletes scientists and experts to learn more about what the best in the world doing to perform at their peak and what you can do to unlock your own best performance. I'm your host Will Ahmed, founder and CEO of Woop. We're still on a mission to unlock human performance. And increasingly, that involves understanding our bodies as it pertains to health and a virus. So this week, we're diving into COVID-19, the new Omicron variant

with Emily Capulupo. And Emily and her team have done a ton of research on COVID-19 before, during and after through the lens of whoop data. Now, since the beginning of the pandemic, we've been conducting research on COVID-19. And the big difference right now is Omicron is the primary variant, especially in the United States. And we want to understand how is that affecting your whoop data? And how is it affecting your whoop data,

despite the fact that many of you may be vaccinated? So we dive into that. Emily and I discuss what we learned from 20,000, whoop members who have now shared their positive test results, their symptoms, and their whoop data with us. We talk about the respiratory rate spikes, which many of you will expect to hear is still a phenomenon. We go into great detail about that, including how it may be different by gender. We're seeing different results by gender. So pay attention to that. We talk about the Omicron variant, generally what we're hearing from public health organizations, just generally

speaking about its transmissibility, why it may be more transmissible, independent from its characteristics as a virus, given what's going on sociologically. We also talk about COVID-19 right now and being vaccinated or having already had COVID, and how that may affect then testing positive for COVID. The spoiler there is that your symptoms and your positive. And your positive, test result may come at different times. So listen to what Emily has to say on that. And we just had our vaccine research published. So Emily details what we learned about getting vaccinated and COVID-19.

So I think this is a great episode. A lot of research that we've conducted on COVID, on the Omicron variant. I appreciate you all for sharing your data, those of you that did, on testing positive. And without further ado, here is a lot of you. Lovely, Emily Capulipo. Okay, Emily, welcome back to the WOOP podcast. Thanks so much for having me. So we have now done more research.

You and your team have done more research on COVID-19. Omicron is raging in the country. And I think there's a broad question of what does Woop data say right now if you get COVID and has your body affected by it? So what has some of this latest research showed us? Yeah, it's a great question. And I think it's an important question because what we're seeing outside of loop data are all these reports that, like, the Omicron variant is more mild. You know, people are getting less severe symptoms.

And so there's this big question, you know, following up on all the research we did starting almost two years ago now, you know, where we're looking at things like respiratory rate increasing as a potential sign of COVID. You know, if Omacron's so much more mild than other variants, is that still? showing up. And so that was really the question that, you know, inspired us to take on this research project. So we pulled a sample of 20,000 Woot members who tested positive for COVID over the last two years. So really getting, you know, each of the different waves. And I should mention that almost like very few people are actually getting their COVID strains profiled. So people don't really know what variant they have. But if you look at the dates that they tested positive in aggregate, you can know at least like what the dominant variant was at the time.

And so we divided the data into these different waves by the dominant variant, not actually by sequencing the DNA of each person because that wouldn't be possible. And what we saw was that we are definitely still seeing the spike in respiratory rate that we had, you know, talked about 18 months ago and, you know, repeatedly throughout the pandemic with both the original strain, the alpha strain, the Delta strain and now with the Omicron strain, we're seeing that spike. Omicron headline here is we still see a respiratory rate spike for those people who are testing positive for COVID-19 and very likely are getting Omicron versus some of the previous

variants. Yeah, and that's just based on the time that they're getting infected. So we limited this analysis to just U.S.-based members, and far in a way that's understood to be the dominant strain in the U.S. right now. So we're, you know, the Omicron data is just from like mostly the last two weeks. And what we're seeing, you know, that's really interesting is that it's following, you know, the same pattern. So even though the reported symptoms are much more mild, the data looks really similar. And we should mention that, you know, we've been really focused on this spike in respiratory rate because it tends to be the cleanest one to see because for most people, most of the time, your respiratory rate doesn't really change from night to night. But we're also seeing a spike.

in resting heart rate and a decline in heart eight variability. So all of those same vital sign changes that we saw with, you know, original COVID back in early 2020, the alpha wave, the delta wave, and now again, the And it's also worth noting that all the data we originally collected was pre-vaccine. Now we're in a post-vaccine world where many members are vaccinated, and yet we're still seeing this kind of physiological response. I think it's worth just defining for the non-woob members listening to this, what is respiratory rate? Sure. So respiratory rate quite simply is how many breaths you're taking per minute. And the reason that's important for everyone is when you get a lower

respiratory tract infection, which COVID-19 very often is, it's going to affect your breathing. And so we measure respiratory rate every single night and we're able, therefore, to capture a baseline for every individual. People's baselines vary, typically between 10 and 20 breaths per minute. And you, the individual on whoop might have the same exact respiratory rate almost to the 10th for months and months at a time. But more often than not, we've seen about 80% of cases. When you get COVID-19, there's a respiratory rate spike. Yeah. And particularly interestingly, in about 20% of those cases, the spike is statistically significantly elevated before the onset of symptoms. So it's a really interesting early warning sign of COVID, you know, especially during

times like we're actually in right now, but also really early in the pandemic when it was hard to get a test. Well, that's been the amazing thing these last two months. And I know you get a lot of messages from WOOB members. I get lots of messages from WOOB members and I appreciate all of you listening, but just to be able to use some of this whoop data, in particular respiratory rate, as a gut check on, might I have it, might I not have it, because there's a cold season, there's also a flu going around, and unfortunately in this country, there's now a lack of tests, which is crazy after, you know, the years that we've been going through this. But to be able to look at your whoop data and say, okay, I had a spike in my respiratory rate. I haven't had a spike in my

respiratory rate for two years, could this be the sign that actually I need one more test? And I'll talk about my story personally, which I've shared now online in a minute, but that was exactly what happened for me. Let's talk about the difference that we're seeing between men and women when it comes to respiratory rate spikes and when it comes to just in general whoop data with COVID. Yeah, so this was actually a super interesting finding because we did not see any gender differences when we looked at data from the earlier variance or the original COVID strain. But when we looked at the Omercron data, we were seeing that the respiratory rate spike in women is actually not quite as high, and it is in men. One thing that that potentially means

is that it might be easier to miss it for females and for males. But one thing that was interesting is that we also looked at resting heart rate, and we see similar height spikes, with with omacron for men and women and same like similar spikes to all the earlier variants. One thing that was interesting to see with omicron that we did not see in earlier variants was that following the respiratory rate spike, we're actually seeing a respiratory rate dip across the whole population, which we didn't see before. Interestingly, we actually saw this pattern following vaccination. So we were seeing, oh, and this is actually one of the things to look out for, people

are getting the respiratory rate spike after their booster shot or second shot for like modern and Pfizer and after the first one for like Johnson Johnson single dose the respiratory rate does spike it's not nearly as high as when they get actual COVID only lasts for one day but what we see typically is that on day two it dips and what's interesting is now we're seeing with Omicron that people after three or four days of a spiked respiratory rate we see this like two or three day respiratory rate dip, and that's actually more pronounced in women than in men, and can be an interesting indication that that spike was caused by COVID because we haven't seen anything like that anywhere else. Physiologically, this is explained by a concept called like super compensation

where basically like your body is trying like so hard to get, you know, your lungs back to healthy that it almost goes too far. And so you almost see this like you go better than baseline and then you bounce back to baseline. So it's an interesting. pattern and it'll be interesting you know to see hopefully we don't have any more waves but you know if we have other waves if that continues but you're definitely like an interesting and unique pattern that we didn't see with the earlier variance and just on that point so we see the respiratory rate spike we see the spike is more pronounced for men than women we then see it come back to baseline and in some cases actually dipping below baseline.

And is that happening more for men or women, or we're seeing that for both men and women? We're seeing it for both men and women, slightly more pronounced in women, so like a deeper dip. So women are more likely to have a slight respiratory rate spike, but then actually a deeper dip. Got it.

Yeah, and we don't yet understand those gender differences. One thing that came out really early in the pandemic and has been very widely documented throughout, is that broadly men are getting hit harder by COVID than women. Their hospitalization rate and death rates have been higher throughout. There's been a lot of speculation as to why this might be, including things like men are more likely to have, you know, essential jobs. And so might just be getting exposed more to various different physiological theories,

although haven't been definitively explained. So it's interesting that we're only with this variant seeing a meaningful gender difference, but it's definitely there. The other big difference, not a gender difference, but difference between Omicron and earlier variants that we're seeing is that the spike does last much shorter. We're seeing the return to baseline, which the recovery from COVID is much faster. So, you know, people are getting back to baseline after like four or five days on average instead of like what we were seeing with like the original COVID variant where, you know, 10 days out, they were almost always like still above baseline. What is the generally accepted research that we're now seeing on Omicron in comparison to other variants? Obviously, it seems to be more transmissible.

What else do we know about it? Yeah, so definitely seeing that it's more transmissible. This might also be related to the fact that the symptoms are more mild and that people are just extremely fatigued by the whole thing. So I think we're seeing less social distancing and more risk-taking behaviors, which is likely supporting its higher transmissibility. when you're bed ridden and can't move, it's harder to get other people sick. If you're super over it and going to try and push and like, you know, trying to get it to the new normal and move on with your life, you're more likely to take that risk, show up to work a little bit sick and then get people sick.

That's an interesting point of view. There could be some sociological aspects that are making it more transmissible, independent from how transmissible the virus is. Yeah, there definitely is research that seems to suggest it is, in fact, more transmissible. But I also think that, you know, especially in the U.S., we're also not behaving as well as like when we were really scared. You know, I think a lot of people who are vaccinated feel immune or safe. And I think that a lot of people feel, you know, just empowered by the fact like,

oh, this has been going on for two years and I've been fine. So at some point you have to like get back to normal. So, you know, I think there's a lot of different things going on there. But for the most part, yeah, it is more mild. It's doing some interesting things that we haven't seen in other variants. Like we're seeing kids get affected more. It's hard to tell how much that is related to, you know, a bigger push to keep schools open and like less social distancing and all of those kinds of things

more risk-taking behavior around that but for the most part it just seems pretty familiar most of the same symptoms you know much a higher survival rate but kind of familiar COVID and it does seem omicron is more effective at what you'll call breaking through so to speak on vaccines yeah so And that's kind of the nature of the mutating. So Omercron has a lot of different mutations compared to the original strain, which is why it's able to sort of evade our vaccines because it's sufficiently different from the strains that we got vaccinated for. And so we're seeing it break through.

What we are seeing is that people who are, especially people who are boosted, but definitely people who are vaccinated as well, are getting much, much more mild cases. even when it does break through, there does seem to be some amount of protection because they don't get a sick and then they recover faster. Yeah, and I know people listening to this will be pro-vaccine or anti-vaccine or whatever. I think the clear data shows that the status of COVID-19 today is such that you can certainly get COVID if you're vaccinated. So it's not necessarily going to stop the spread of COVID-19.

However, it is much more likely to be hospitalized if you're unvaccinated versus vaccinated. Yeah, which is actually one of the interesting things because the fact that people are getting breakthrough cases means that there's also a lot of transmission from vaccinated people, both to other vaccinated people as well as from vaccinated people to unvaccinated people. And one of the things that we've as a society relied on for a long time is this concept of herd immunity, right? That if we get vaccinated, then, you know, there's enough protection within the community that people who are unable to get vaccinated or, you know, to young to get vaccine and stuff like that don't get sick because vaccinated people. people don't transmit diseases. You know, that's how we got rid of things like polio. But we're seeing that even vaccinated people are contracting and transmitting COVID. And so you can't rely on herd immunity as much as with some other things. And so that definitely means that there's much more importance that like people who aren't vaccinated are pretty careful. Well,

that was exactly what happened to me. I'll give you my story as I recently got COVID. I was feeling lousy on a Sunday in Manhattan. It was obviously breaking out in Manhattan in December, which is when I was there. I went and got an antigen test, which came back negative on that Sunday. I kind of had cold-like symptoms. I hadn't been sick in three years, so getting a cold was sort of a meaningful event for me. And then I wake up on Monday, and I've got the huge respiratory rate spike. My average respiratory rate is typically between 12 and 13 breaths per minute. That's been my baseline for years. All of a sudden, I've got a reading of 16.0, which is my highest reading ever. I get a PCR test, and sure enough, that comes back negative. And then the next day,

I wake up, and I'm starting to feel a little bit better. But again, I have that huge respiratory rate spike. Now it goes to 16.4 breaths per minute. Again, range 12 to 13. So this is like 30 to 40% above my baseline. But I've now had two negative tests. I call my doctor. My doctor says, oh, you probably have the flu. There's a bad flu season. I wake up Wednesday and then I wake up Thursday. And at this point, I'm completely fine. You know, I don't have any symptoms virtually. And I'm deciding whether I should go see my parents for Christmas, because it's a couple days from Christmas. And I do one more test, which I probably wouldn't have done if it wasn't for the respiratory rate spike, because the respiratory rate, spiking has been ingrained in my mind. And sure enough, that comes back positive. So I was able to

isolate and not give it to my family, which I feel good about. I think there's two interesting phenomenons to take from that story. The first is the respiratory rate spike, right? Which we've now seen just over and over again. I can't emphasize enough. If you wear whoop, monitor your respiratory rate. It's in the health monitor page. So you will actually get an alert from the health monitor page that will say that your respiratory rate is elevated. We actually built the whole health monitor feature in part because we were inspired by the COVID-19 research. And we wanted people to really know if there was that deviation. So again, if you're within that really elevated range, you'll get an alert through the health monitor like I did that says your respiratory rate is

elevated. Now, to make sure we're not too alarmist, what are the things, Emily, that could raise your respiratory rate that are not COVID? Yeah, so being at altitude is one of the big ones that's going to make it, you know, spike up overnight. And, you know, the first night that you get in, you know, Colorado for that ski trip or whatever, you're definitely going to see an elevated respiratory rate. And that's just because the air literally has less oxygen in it at altitude. And so we need to breathe more times per minute to get the same oxygen into our bodies. But also environmental factors in general, like, you know, there's wildfires going on in a couple different places right now, you know, decreased air quality. Again, it's that same concept. If there's less

oxygen in the air, we're going to breathe more in order to get the same amount of oxygen into our bodies. So you'll see an increased respiratory rate. And then, of course, like other lower respiratory tract infections could definitely increase your respiratory rate, you know, things like pneumonia and whatnot. We've also seen, like, unusual lifestyle decisions. You know, if you decided to smoke one night and you don't normally smoke you started to drink a lot of alcohol you don't normally drink whatever those things can cause an elevated respiratory rate obviously the main driver of elevated respiratory rate that we've seen especially in the last three months has been COVID-19 yeah so keep an eye out for the health monitor I think it's really helpful it certainly

helped me get that additional test now testing I did a lot of research on this Emily because I was so confused how could the days that I had the worst symptoms be the days that I also tested negative for the antigen test and the PCR test. And it turns out if you've gotten COVID before or you're vaccinated. So I had two doses from Pfizer and I got a Moderna booster, probably four weeks before being exposed to COVID. All of that means that your body's going to respond very quickly to being exposed to COVID. It actually will respond much faster than if you were unvaccinated or if you had never gotten COVID. So what that means is the onset of your symptoms is much faster. At the same time, your body actually has not built up a viral load

to test positive. So there's this disassociation folks between your symptoms and whether or not you're actually going to test positive or sort of the degree to which you have a high viral load. For me, that was feeling worse on Monday and Tuesday and testing negative. And then by the time I was feeling better, I was actually the most infectious. And that's when, I tested positive. So this is, I think, just a really important thing for people to understand. I'm shocked that we haven't heard more from public health organizations about this, but the bottom line is if you are vaccinated or you've previously gotten COVID, and then you get sick and you test negative, keep in mind there's still a chance you might test positive two days later or three

days later. Yeah, and I think, you know, you put that so well because there's a couple of interesting things that are going on there, right? Like, you wouldn't have gotten that third test if it wasn't for the respiratory rate spike. And I think so many people, like you said, like you were the most infectious. That's when you had the highest viral load built up, which is why you finally did test positive. But I think most people, it's like, well, I had two negative tests. So I'm fine. And now I feel better. So that's when you go out and infect all your friends and everything. And part of the reason why, you know, this is such a problem. And I think that one of the other things that you're experience and sort of this interesting counterintuitive physiological phenomenon point

at is that like when you are like feeling sick and experiencing a lot of those symptoms is actually a lot of that comes from the inflammation of your immune system responding and so because you were vaccinated like you said your body knew exactly what this was and like mounted a really quick response because it'd been three times at that point you know exposed to the spike protein through your you know two vaccinations and then the booster and so you knew what to do immediately and your immune system responding actually causes some of the symptoms that make you feel bad, not just the virus itself. And so your viral load was likely too low to be detected. And I think that that's something that a lot of people don't realize that these tests aren't

crazy sensitive. And they were optimized and designed, you know, before we were all getting vaccinated for the original variant. And now Omercron's like this sufficiently different variant. And it's, you know, totally different dynamics at play, like the fact that so many people have had prior COVID or been vaccinated, been boosted and all these things, that, like, it's actually not super well optimized to the case that a lot of people like yourself are actually in now. If we want to shift for a second to at least some of the positives to take from this moment, although the virus is more transmissible, hospitalizations are way down. So that's a sign at least that, you know, the vaccine's working and the virus is, like,

less deadly. And I think if you now look at the data, we're recording this in mid-January, you're starting to see the peaks coming down as well from just cases. And I would encourage people to look at the difference between cases and deaths because that starts to tell a story on how well we as society are responding. Yeah. And I do think that that's really important. And I think that there's some interesting early indicators that were on a good path. One really interesting early indicator about where the wave is headed has been wastewater. So they look at viral load just like in the sewer systems in different large cities. And that's a good indicator because a lot of people aren't getting tested because like we were talking about earlier, these tests aren't

really available or they don't get sick enough to get tested or they're asymptomatic or whatever. And we're seeing that wastewater viral load has actually gone down in major cities, including Boston where we are, but across the U.S. And so that does suggest that we are hopefully about two weeks away from seeing like a major decline in cases and hopefully getting to the other side of this omicron wave well we're going to keep doing research on it emily i really appreciate all the research that you and team have done on it and speaking of research this is an exciting week for whoop and you and your team because we just had peer reviewed published research journal of applied physiology tell us about the data that was just published yeah so the paper's title was biometrics from a wearable

device reveals temporary effects of COVID-19 vaccines on cardiovascular respiratory and sleep physiology. So we looked at just shy of 70,000 Woot members who were fully vaccinated and this data came now close to eight months ago. So before the boosters were a thing. But we were looking at how they were responding. And this research was inspired by so many of our members posting 1% recoveries to social media after getting vaccinated and saying like, you know, am I dying or is this the shot? And, you know, we looked into it and actually it wasn't just, you know, a handful of noisy people on social media, but it was actually, you know, one of the worst tankers of your recovery score that we've ever seen. Basically, people were getting something that looked a lot like

COVID, but, you know, lasting only 24 hours. And for this analysis, we looked at gender differences, age differences, but most importantly, we looked at the different vaccine manufacturers. So, you know, differences between the Pfizer vaccine, Johnson Johnson, Moderna. And what we saw was that very consistent with all the reports of everybody's experience. You know, for the two-dose vaccines, the Pfizer and Moderna, really mild, like almost insignificant effects after the first vaccine, but very significant effects after the second one with Johnson-Johnson, kind of looking similar to the second Moderna Pfizer vaccines. And

you know, we saw that the response to the Pfizer one was more mild than the response to the Moderna one. But you know, significant hits to recovery that lasted for 24 hours and then pretty normal recovery scores two days later. Where can

people find that research? We'll link it in the show notes. And for people who are looking to listen to more podcasts on specifically the vaccine, you can check out podcasts 109 and 121. I also want to give a big thank you to all of our WOOP members listening to this, especially those of you who have shared your data with us or when you tested positive for COVID or what your symptoms were. We look at this data in a completely de-identified and

aggregated way, and that's how we're able to provide these feedback loops back. So we report on what the data says and then, you know, hopefully the WOOP membership base and I think now even a larger population are going to get some learnings from this data and hopefully it makes the world a little safer. As always, deeply appreciative of all this research and coming on the podcast, thank you, Emily. Thanks for having you. Okay, thank you to Emily Capalupo for coming on the WOOP podcast and her amazing team for all the research that they're doing.

Thank you again to WOOP members who share their data for de-identified research purposes. If you like this podcast, we've got a bunch more as they relate to COVID-19. as a pandemic as they relate to COVID-19 as WOOP data and also how the vaccines affected WOOP data. So check out the archive of podcasts and content at WOOP.com slash the locker. A reminder, you can find us on social at WOOP. I'm at Will Ahmed. You can get 15% off a W-W-Membership by using the code Will.

That's W-I-L-L. And with that, folks, stay healthy. Watch that respiratory rate. And we'll be back next week.