Coronavirus and Mpox Tidbits #308, August 18, 2024
Announcements:
First, there is now a Resources Page here for the most commonly asked questions I'm getting.
Happy to continue to answer your questions/concerns as best I can, so don't be shy about that.
I wrote 2 posts this week:
What you need to know about human Parvovirus
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More importantly:
Mpox And Mask Bans - A Recipe For Disaster
https://www.forbes.com/sites/judystone/2024/08/16/mpox-and-mask-bansa-recipe-for-disaster/
News
Mike Hoerger: “The U.S. now tops 1.3 million daily infections. 2.8% of the population (1 in 36) are actively infectious…Many classrooms will have a >50% chance someone is infectious.”
Wastewater levels remain very high:
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Per WHO, global PCR test positivity increased from 7.4% to 13.0% across 85 countries in the past month while new COVID cases increased 30% and deaths increased 26% during the same time period.
Dr. Fauci announces he has Covid for the 3rd time and encourages people to wear masks to prevent infection.
The CDC continues to minimize Covid and prioritize handwashing over masking/ventilation for an airborne virus. Why??? (other than it is cheaper)
Lucky Tran corrected the CDC's graphic:
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HICPAC is the CDC appointed group that sets infection control/isolation policy in US hospitals. As I've written (most recent), they have been trying to reduce masking and water down protections. They still don't meet the FACA (federal) membership guidelines. But they have invited Jane Thomason, NNU’s lead industrial hygienist to join the workgroup and Lisa Baum, NYSNA’s lead health and safety representative to join HICPAC. The HICPAC is meeting again on Th and will be available for streaming.
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Covid and atherosclerosis:
An open-access, in depth review for how #SARSCoV2 can induce platelet activation, endothelial dysfunction, pro-inflammatory effects, and promote progression of atherosclerosis #LongCovid sciencedirect.com/science/articl
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FDA appears to be slow-walking Novavax.
I'm not clear why. See Vaccines section for why Novavax might be preferable. Please contact the FDA and express your preference here:
Novavax approval ASAP. Call and tell them to pass along your message. 1-800-835-4709
Email everyone here: peter.marks@fda.hhs.gov cberocod@fda.hhs.gov OCOD@fda.hhs.gov commissioner@fda.hhs.gov
Covid mRNA (Moderna and Pfizer) might be approved next week
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Metformin:
Potential Benefits of Metformin for COVID-19 * Reduced viral load: Studies suggest metformin can lower the amount of virus in the body, potentially reducing the severity of infection. * Lower risk of hospitalization: Research indicates metformin might decrease the chances of needing hospitalization for COVID-19. * Reduced risk of long COVID: Evidence suggests metformin could lower the likelihood of developing long-term symptoms after COVID-19. * Anti-inflammatory effects: Metformin has anti-inflammatory properties, which could help combat the excessive inflammation often seen in severe COVID-19 cases. * Improved glucose control: For patients with diabetes, maintaining good blood sugar levels is crucial in fighting infections. Metformin can help with this.
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Other:
Avian flu:
"Six feline cases of Influenza A (HPAI H5N1) have been diagnosed in domestic cats in Colorado during 2024." "Two of the six cases were indoor only cats with no direct exposures to the virus." Colorado Dept of Health colovma.org/cvma-news/infl
Mpox:
WHO declares a Public Health emergency re Mpox (aka monkeypox)
The type of Mpox spreading now is the more virulent Clade 1b virus, which has a 3-5% mortality. It affects kids more than adults. The Jyyneos smallpox vaccine protects against this clade of Mpox, but Tecoviramat is not effective for Rx.
This is the first time it has been seen outside of Africa (Sweden).
Save the Children said that “70% of the DRC's nearly 15,000 cases involve children, 39% of them kids younger than 5 years old.” Per the WHO, the case fatality rate for Clade 1 for children under the age of one is 8.6%, compared to 2.4% in people aged 15 and over. In comparison, the global Clade 2 outbreak in 2022 had a fatality rate of 0.2%.
The incubation period for Mpox is 1 to 21 days of exposure and the illness lasts about 2 to 4 weeks.
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Other:
"The recombinant shingles vaccine is associated with a significantly lower risk of dementia in the 6 years post-vaccination" Also implicating the potential role of herpes zoster virus nature.com/articles/s4159
Diagnostics:
still an incredible, negligent last of testing.
Drugs and Vaccines:
Preprint: Interesting study from Korea comparing homologous NVX (Novavax) and BNT (Pfizer) COVID vax. One of the few places where there are enough NVX doses to do this analysis. Slightly better effectiveness (16% better) with NVX after primary series medrxiv.org/content/10.110
NVX effectiveness is 35% higher than BNT comparing after the 1st homologous booster. There have been suggestions that homologous NVX boosts can uniquely improve antibody avidity, affinity maturation, & epitope spreading
Side note/reminder: the data for heterologous boosting strategies (mix-and-match) remain very compelling as well nature.com/articles/s4154
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From @Friesin:
Parents: The FDA is putting you in an extraordinarily unfair position on COVID vaccine selection. Right as school is starting, they're going to force you to choose between vaccinating your child with mRNA now or waiting an unspecified amount of time for Novavax.
The mRNA option offered is a bit too specific, and should have been targeted to JN.1 instead of KP.2 (the mutational trunk, not a branch). The WHO presented reasoning in favor of selecting JN.1 instead of a KP sub-lineage since it was broader and more likely to be a common denominator with future variants. The VRBPAC committee agreed with this rationale and voted accordingly.
During the meeting, Dr. Peter Marks (director of the CBER) had tried and failed to propose selection of KP.2, knowing that only the mRNA providers would be able to meet that goal. The committee didn't agree with his reasoning.
Instead of adopting the WHO guidance and committee vote, the committee was circumvented and a press release was issued after the committee vote to select JN.1, announcing that providers would be able to target KP.2 instead at their discretion. Then after doing all of this, as they have done before, they delayed approval of Novavax for an unknown reason, right as school starts.
To add to the frustration, Novavax's JN.1 vaccine has shown to be more efficient at neutralizing KP.3.1.1 (the dominant strain that is fueling the current wave) than other outdated KP lineages, but it is sitting in a warehouse unused. The fact that we do not already have access to this vaccine, and the fact that FDA will likely not make it available for at least another month (after school has started) is, frankly, negligence at best.
No parent should have to choose between a potentially more effective vaccine and a less effective one because the less effective one happens to be available. We are on the third formulation of Novavax's COVID vaccine, and every single time the FDA has tipped the scale so that mRNA comes out before Novavax. This needs to stop.
We need access to the best remedies and prevention for COVID as soon as possible. Novavax would have been ready to provide the updated vaccine in July if FDA were able to meet that deadline. Safety is not the driving factor in these delays. The clinical characteristics and safety profile of Novavax remains the same in spite of an altered strain selection.
If you are angry, just as I am, I am asking you to write and call the FDA to express your frustration. I will provide contact details on the following tweets. Let's put them in the hot seat. Make them explain why they're playing games with our kids' safety and limiting our choices. If we do not get a satisfactory answer, then other options should be pursued.
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Also:
1-year durability data for Novavax 2-dose primary series. Though there is some expected waning, there was >65% efficacy at 1y (mRNA options typically wane to this level by ~4-5 months). Also fewer waning differences by age. sciencedirect.com/science/articl
Devices and Masks:
N95 Masks Nearly Perfect at Blocking COVID
So-called “duckbill” N95 masks scored highest in the study...
according to the study published in eBioMedicine.
cloth masks outperformed the specific brand of KN95 mask that was tested. Surgical masks brought up the rear in performance out of the four types, but even they blocked 70% of the virus, the tests showed. (To reflect the general public's use of masks, study volunteers were not fit-tested for their masks or trained how to properly wear them.)
https://today.umd.edu/n95-masks-nearly-perfect-at-blocking-covid-umd-study-shows
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wear N95 masks when infections are high
New study suggests healthcare workers should wear N95 masks when respiratory infections are high. Wearing an N95 reduced viruses in exhaled breath by 98% vs ~70% for surgical masks. Will CDC look at this data + WHO updates in its upcoming guidelines? - Amy Maxman
https://www.thelancet.com/journals/ebiom/article/PIIS2352-3964(24)00192-0/fulltext
Epidemiology/Infection control:
Harvard researchers documented transmission of SARS-COV-2 from asymptomatic patient to new patient 4.45 hours after index patient left the room. Virus RNA sequences identical. Air turnover 6x per hour (6 hrs prior to outbreak)
https://www.ajicjournal.org/article/S0196-6553(24)00162-7/abstract
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Avian flu/ Covid/ Rabies and more Zoonoses!
Fascinating: This venture into one of Cambodia’s lost caves is part of an innovative mission for disease surveillance conducted as part of a joint project between the Food and Agriculture Organization of the United Nations (FAO) through its Emergency Centre for Transboundary Animal Diseases (ECTAD) and the Institut Pasteur du Cambodge (IPC).
Their goal today is to collect bat DNA samples. Utilizing a non-invasive technique, the team employs drones to pull environmental DNA (eDNA) — traces of genetic material from hair, feathers, saliva and even pollen — from the air itself.
On Mpox in air:
"A 2013 study in the Journal of Virological Methods carried out in a BSL3 lab found that mpox remains infectious in the air for up to 90 hours." #Mpox2024 #Airborne #MPoxIsAirborne sciencedirect.com/science/articl
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Tips, general reading for public:
Ventilate
Mask
Vaccinate
Best CO2 monitors: https://breathesafeair.com/carbon-dioxide-monitors/
Emergency kit items rec by Violet Blue:
- Low effort comfort items to pass the time: things to watch, podcasts, audiobooks, coloring books, games.
- Paxlovid: it works.
- Consider Metformin: a two-week course has been shown to reduce the incidence of long covid, reduce viral load, and potentially limit contagiousness. [I would put Metformin over Paxlovid at this point unless you are at very high risk--Paxlovid has many drug interactions and some unpleasant side effects. My biggest concern about Covid at this point, after multiple vaccinations, is getting Long Covid. Metformin has shown a 40% reduction in trials to date]
- Antihistamines: per NIH, “a number of Covid‐19 patients improved significantly when on antihistamines due to their antiviral and anti‐inflammatory properties. Moreover, antihistamines have shown to be effective in the management of long term symptoms post‐Covid‐19 infection.”
- Antiviral/antimicrobial nasal spray (experimental): Some nasal sprays have been studied to treat covid, like nitric oxide nasal spray (Enovid, FabiSpray, VirX), ethyl lauroyl arginine hydrochloride (Covixyl), xylitol (Xlear), and Iota-carrageenan (Agovirax, Betadine Cold Defense, Epothex, Flo Travel, Lontax Gola, NoriZite).
- Lozenges: the BLIS K12 oral probiotic has been shown to produce antibodies that help clear the virus.
- Mouthwash: Mouthwashes with CPC can decrease covid infectivity.
Politics:
Covid:
While the CDC pushes handwashing for Covid (which is airborne):
Mask Bans:
Nassau County, NY just signed off on a mask ban law that is effective immediately. It's critical to know your rights! Here's a great resource from @NYCLU clarifying what the law is, and what rights you have: nyclu.org/resources/know
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GOP/TFG
https://twitter.com/maddenifico/status/1824093567133868314
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TFG:
8/15 Trump: You're all going to be thrown into a communist system. You will be thrown into a system where everybody gets health care.
Chevron Doctrine:
The US Air Force is refusing to comply w/ an EPA order to clean up drinking water it polluted with toxic #PFAS, claiming the agency lacks authority since “Chevron doctrine” was struck down by the Supreme Court. theguardian.com/us-news/articl“Chevron doctrine”
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Project 2025
Texas:
Feel good du jour:
Baby beavers in urban London! The birth of the first baby beavers in urban London in over 400 years marks the latest milestone for this groundbreaking community project. https://theealingbeaverproject.com/
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Heman Bekele. Time just named him their "Kid of the Year"
after he invented a bar of soap that can treat skin cancer. It all started when received a chemistry set as a gift when he was 7 years old. After his family immigrated to America, he noticed that back home in Ethiopia people would work for long hours outdoorsy exposing themselves to dangerous amounts of UV rays, without any protective covering. That made him curious about skin cancer. At 14 years old, he developed a bar of soap that has nanoparticles containing a drug called imiquimod, which is approved to treat some forms of cancer. His soap helps ensure that the drug stays on the skin at a "very molecular level" even when the soap is washed off. Rather than making millions of dollars, his bar of soap costs just 50 cents, and he plans to create a non-profit to distribute it to communities in need. When he's not attending high school, he does research at Johns Hopkins Bloomberg School of Public Health in Baltimore He's only 15.
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https://twitter.com/ClaudetteGGibs1/status/1822977497488642547
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Did you know that tennis balls used at Wimbledon are donated to animal rehabilitation centres around Britain for harvest mice. pic.twitter.com/5IGzdiNpvZ
— Hannah Bourne-Taylor (@WriterHannahBT) August 12, 2024
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A teacher sent this note home to parents, and I am just overwhelmed with how special educators truly are. pic.twitter.com/zASoo6AkqE
— Travis Akers (@travisakers) August 13, 2024
Comic relief:
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Snoop dog!
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Have you ever seen a butterfly playing with a puppy before? well now you have🐶🦋 pic.twitter.com/omK3UKgv8g
— Nature is Amazing ☘️ (@AMAZlNGNATURE) August 12, 2024
Perspective/Poem
— Neil Findlay (@Neilsocialist) August 9, 2024
Bits of beauty:
