Coronavirus & Monkeypox Tidbits #204 8/7/22

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.

My latest:

Antibiotic-Resistant Bacteria Emerging in Community Settings

https://www.medscape.com/viewarticle/978627

Election volunteer opportunities:

NOPE Neighbors: https://www.nopeneighbors.org/volunteer

Power the Vote https://www.powerthevote.org//. I'm a fellow volunteer.
Are you interested in voter protection research? Battleground states including Arizona, Michigan and Texas need help. Volunteers would work with the voter protection program directly on research tasks. Examples include: (i) calling elections offices to get information about certain election plans, so that programs know where and when to send volunteers; (ii) calling elections offices to follow up on public records requests for needed information (such as data on ballot rejections); and (iii) reviewing elections websites to ensure information is accurate and up to date. This volunteer commitment is variable and flexible, but will require an ability to make calls during election offices' business hours. Volunteers will need to be comfortable inputting information into basic spreadsheets.
**If you are interested in joining a research team, please email volunteer@powerthevote.org.** We will be in touch with more detailed information as soon as we can.

If you like calling and talking to voters, Power the Vote is assembling weekly volunteer opportunities. These are remote opportunities that you can do from home! Click on this link to find out more: https://docs.google.com/document/d/1v3IQa3qeJMuLaa2MW0ObAoXltpLUyoKu0L7xhd-98zE/edit

 

News 

Covid:

94% of communities are classified as having high transmission, a level for which CDC recommends masking while indoors and using public transportation.

Preparedness, or lack thereof:

How the Strategic National Stockpile Fell Short

The Strategic National Stockpile gained widespread notoriety in the early months of the COVID-19 pandemic after it failed to provide healthcare workers with lifesaving resources and supplies. Those early failures were related to a series of choices about resource procurement "made by an obscure governing body" without input from healthcare workers or domestic manufacturers, according to an exclusive report by NBC News.

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Taste & Smell Loss

Most patients with smell or taste dysfunction related to COVID-19 reported complete recovery of their senses at 2 years, according to a cross-sectional survey conducted in Italy.

Among 119 patients with smell or taste dysfunction within 4 weeks of COVID onset, 88.2% reported complete resolution at 2 years, 9.2% reported a decline in symptom severity, and 2.5% reported unchanged or worsening symptoms, said Paolo Boscolo-Rizzo, MD, of the University of Trieste, and colleagues.

https://www.medpagetoday.com/infectiousdisease/covid19/100068?

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Heart disease after COVID: what the data say

Some studies suggest that the risk of cardiovascular problems, such as a heart attack or stroke, remains high even many months after a SARS-CoV-2 infection clears up. Researchers are starting to pin down the frequency of these issues and what is causing the damage.

In one study1 this year, researchers used records from the US Department of Veterans Affairs (VA) to estimate how often COVID-19 leads to cardiovascular problems. They found that people who had had the disease faced substantially increased risks for 20 cardiovascular conditions — including potentially catastrophic problems such as heart attacks and strokes — in the year after infection with the coronavirus SARS-CoV-2. Researchers say that these complications can happen even in people who seem to have completely recovered from a mild infection.

Some smaller studies have mirrored these findings, but others find lower rates of complications. With millions or perhaps even billions of people having been infected with SARS-CoV-2, clinicians are wondering whether the pandemic will be followed by a cardiovascular aftershock. Meanwhile, researchers are trying to understand who is most at risk of these heart-related problems, how long the risk persists and what causes these symptoms.

It’s a gaping hole in an important area of public health, says Katz. “We don’t understand if this changes the lifelong trajectory for risk of a heart attack or stroke or other cardiac events — we just don’t know that.” Here, Nature looks at the questions that scientists are asking and the answers they’ve uncovered so far.

https://www.nature.com/articles/d41586-022-02074-3

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Monkeypox: First, a primer on what we know:

The Number of cases Monkeypox cases around the world surpass 25,000 cases. USA accounts for 25% of all cases.

Transmission:

Old CDC: (July) monkeypox spread from person to person is principally respiratory 

Now Touching objects, fabrics (clothing, bedding, or towels), and surfaces that have been used by someone with monkeypox.

  • Contact with respiratory secretions.

Three of four air samples collected during a bed linen change in one patient’s room were positive for DNA (didn’t culture). This is of concern because smallpox can (rarely) be transmitted by air, and monkeypox is related.

Transmission is thought to occur primarily through respiratory droplets, 

  • contagious before a visible rash appears and can continue shedding the
    virus weeks after symptoms have dissipated

See https://www.dhs.gov/sites/default/files/2022-07/22_0712_st_monkeypox_mql.pdf

In Africa, rodents are the major reservoir for infection. We need to get this under control, if we still can, before it gets into the animal population in US/elsewhere.

First compelling evidence that monkeypox virus isolated from semen of a person w infection can replicate  in cell culture. This means sexual transmission in the traditional sense is possible. Virus shedding in semen can persist for weeks after recovery.

DHS: • MPXV is resistant to desiccation in hot and cold environments.

• MPXV may be stable for days to weeks in water, soil, and on refrigerated food.

• MPXV is susceptible to inactivation under acidic conditions.

EPA recommends the use of bleach and a number of quaternary ammonium reagents for use as a disinfectant.

Treatment and prevention:

Very limited vaccine (Jynneos). Tecoviramat (TPOXX) is hard to acquire.

Prognosis:

Very painful disease and the pain sometimes requires hospitalization. Most do not.

1 mo recovery—who can afford being off work that long??? (NYC saying not to use public transportation; call health dept regarding laundry)

Full recovery is typical...but there have been 2 deaths in healthy adults from meningitis/encephalitis.

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Not The Onion--from the CDC:

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Monkeypox reported in Illinois daycare worker, US cases top 7,000

Adding another element to quickly evolving monkeypox developments, Illinois health officials today announced that they are investigating a case in an adult who has links to a daycare.

Daycare probe to assess exposure to kids, other adults

The daycare is located in Rantoul, Ill., which is isn't far from the Champaign-Urbana area, according to a local media report. Champaign-Urbana Public Health District and the Illinois Department of Public Health announced the case, saying they were working closely with the infected adult at the daycare.

So far, no other cases have been found, but assessments are underway on all adults and children at the facility.

At a briefing today, Sameer Vohra, MD, JD, state health director, said the Food and Drug Administration (FDA) is allowing vaccination for those younger than 18 who may have been exposed to the virus and that anyone with guardian approval will be vaccinated today, according to NBC News.

The virus can spread through close skin-to-skin contact with body fluids, sores, and contaminated items.

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US cases top 7,000

The Centers for Disease Control and Prevention (CDC) yesterday reported 485 more monkeypox cases, raising the national total to 7,102. The new milestone comes 1 day after the Biden administration declared monkeypox a public health emergency.

In Washington DC, the virus has spread to the homeless population, with two recorded cases. The city has the most cases per capita in the country and is launching weekly walk-up vaccination clinics to help control the outbreak.

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 US declares monkeypox a public health emergency

Today 8/4 officials from the Department of Health and Human Services (HHS) and the Food and Drug Administration (FDA) declared the ongoing monkeypox outbreak in the United States a public health emergency, paving the way for an increase in funding for tests, vaccines, and treatments for the poxvirus.

(WHO) declared monkeypox a public health emergency of international concern (PHEIC) at the end of July.

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House Homeland Security Committee leaders request details on federal monkeypox response

“We are concerned that the pace of the Federal response to monkeypox has enabled the virus to spread for two months, and delays in distributing tests and vaccines have harmed efforts to contain the virus.”

They added that the American public health system is profoundly broken – and that has opened the door to greater consequences related to public health emergencies and pandemics. They noted that, even though the United States had more than a million doses of Bavarian Nordic’s JYNNEOS vaccine ready to go at a plant in Denmark, it took two months to approve their distribution.

https://homelandprepnews.com/stories/77929-house-homeland-security-committee-leaders-request-details-on-federal-monkeypox-response/

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Polio:

Sobering article: With cases breaking out in countries thought to be free of the disease, the world's battle against polio is not over. (The Guardian)

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The  has now been found in seven different wastewater samples in two adjacent counties north of New York City,  said.

So far, only one person has tested positive for —an unvaccinated adult in Rockland County who suffered paralysis.

But based on earlier polio outbreaks, "New Yorkers should know that for every one case of paralytic polio observed, there may be hundreds of other people infected," the state's health commissioner, Dr. Mary T. Bassett, said in a statement.

40% of kiddies in Orange and Rockland counties are not vaccinated vs Polio

Other:

Back-to-school may mean back-to-outbreaks -- and not just of COVID. (Axios)

Get your kids vaccinated and up to date!

Global vaccination rates plummeted during the pandemic and have yet to rebound, leaving more kids and teens vulnerable.

  • Worldwide measles cases increased 79% for the first two months of 2022 compared to 2021.
  • New York health officials confirmed the first case of polio in the United States in almost a decade, in Rockland County, where the current polio vaccination rate among two-year-olds is 60.5%, compared to statewide average of 79.1%, per the New York health department.
  • COVID vaccination rates lag in teenagers and children, and a recent Kaiser Family Foundation survey found more than four in 10 parents will not vaccinate their children under 5 years old against the virus.
  • Reality check: Politics is fanning anti-vaccine sentiment in the U.S. and around the world, writes Peter Hotez, a vaccine researcher at the Baylor College of Medicine in Nature.

Diagnostics:

still an incredible, negligent last of testing.

Drugs and Vaccines:

Covid:

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Monkeypox:

FDA to consider fractional dosing of Jynneos vaccine

FDA Commissioner Robert Califf, MD, said the FDA was considering authorizing fractional dosing of Bavarian Nordic's Jynneos, the only vaccine approved for use against monkeypox in the United States.

Intradermal injection at one-fifth the dose strength, as opposed to intramuscular injection, would stretch the supply of vaccine, which has been in high demand in virus hot spots such as New York City, Chicago, and San Francisco.

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Call for Tpoxx trials

In other news, an editorial in the New England Journal of Medicine today asks officials to consider clinical trials of tecovirimat (Tpoxx)—an antiviral drug approved for treating smallpox—to test for efficacy against monkeypox.

Scientists from the FDA, CDC, and National Institute of Allergy and Infectious Diseases asked for the drug to be tested under the FDA's Animal Rule.

"This pathway allows for approval of drugs for serious or life-threatening conditions when it is not ethical to conduct efficacy studies in humans and not feasible to conduct field trials to study the effectiveness of a drug or biologic product," they wrote. "Under the Animal Rule, efficacy is established on the basis of adequate and well-controlled studies in animal models of the human disease or condition of interest; safety must be adequately evaluated in people."

Drawing comparisons to the antiretrovirals used to fight HIV, the authors said these trials will provide data needed for clinical and regulatory decision making in the United States.

https://www.nejm.org/doi/full/10.1056/NEJMp2210125?

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Devices and Masks:

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https://twitter.com/trishgreenhalgh/status/1554398753192296450?s=20&t=Xj0axlz5Z7Cyux-K4hNgEA

Epidemiology/Infection control:

COVID-19 infection in crucial brain regions may lead to accelerated brain aging

A new study by Houston Methodist researchers reviews the emerging insights and evidence that suggest COVID-19 infections may have both short- and long-term neurological effects. Major findings include that COVID-19 infections may predispose individuals to developing irreversible neurological conditions, may increase the likelihood of strokes and may increase the chance of developing persistent brain lesions that can lead to brain bleeding.

The coronavirus infection can cause long-term and irreversible neurodegenerative diseases, particularly in the elderly and other vulnerable populations. Several brain imaging studies on COVID-19 victims and survivors have confirmed the formation of microbleed lesions in deeper brain regions related to our cognitive and memory functions. In this review study, researchers have critically evaluated the possible chronic neuropathological outcomes in aging and comorbid populations if timely therapeutic intervention is not implemented.

https://medicalxpress.com/news/2022-08-covid-infection-crucial-brain-regions.html

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Most reliable estimates to date suggest one in eight COVID-19 patients develop long COVID symptoms

One in eight adults (12.7%) who are infected with SARS-CoV-2 experience long term symptoms due to COVID-19, suggests a large Dutch study published in The Lancet.

The study provides one of the first comparisons of long-term symptoms after SARS-CoV-2 infection (often called 'long COVID') with symptoms in an uninfected population, as well as measuring symptoms in individuals both pre- and post-COVID-19 infection. The inclusion of uninfected populations enables a more accurate prediction of long-term COVID-19 symptom prevalence as well as improved identification of the core symptoms of long COVID.

Prof Rosmalen continues, "Our study approach looks at the symptoms most often associated with long COVID, including breathing problems, fatigue and loss of taste and/or smell, both before a COVID-19 diagnosis and in people who have not been diagnosed with COVID-19. This method allows us to take pre-existing symptoms and symptoms in non-infected people into account to offer an improved working definition for long COVID and provide a reliable estimate at how likely long COVID-19 is to occur in the general population."

https://medicalxpress.com/news/2022-08-reliable-date-covid-patients-covid.html

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Monkeypox:

The Centers for Disease Control and Prevention (CDC) today shared new epidemiological details about US cases, which said 99% were in men, especially those who had recent male-to-male sexual contact and that ethnic minority groups are the disproportionately affected.

The CDC detailed epidemiologic and clinical characteristics of US cases, based on 2,891 that were reported as of Jul 22. Writing in the Morbidity and Mortality Weekly Report (MMWR), the CDC said of the men who reported their sexual partners in the 3 weeks before they got sick, the majority had multiple partners. Of 88% cases with available information, 28% were among Hispanic of Latino people, 26% in Black people, and 41% in White people.

Though a febrile prodrome and rash are typical symptoms, the team found that 42% didn't report any prodromal symptoms. Rashes appeared on various parts of the body, including the genitals, arms, face, and legs.

Officials from the World Health Organization yesterday provided more details on the outbreak in Africa. Household transmission—not sexual contact—is the likely route of exposure for most cases, and 60% of cases are in men.

https://www.cidrap.umn.edu/news-perspective/2022/08/monkeypox-reported-illinois-daycare-worker-us-cases-top-7000

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Apologies:

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https://twitter.com/Boghuma/status/1554607447192571906?s=20&t=Xj0axlz5Z7Cyux-K4hNgEA

 

Tips, general reading for public:

StayAtHome

Wash your hands.

Rinse and repeat.

Politics:

Covid:

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Monkeypox: 

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Polio:

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Medicine:

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Climate:

Biden/Dems:

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GOP/CPAC/Orban/Rising fascism:

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Trump:

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https://twitter.com/RonFilipkowski/status/1555310680152186883?s=20&t=Xj0axlz5Z7Cyux-K4hNgEA

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Wang/3rd party:

SCOTUS/Kavanaugh:

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Abortion/Contraceptives:

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LGBTQ:

Guns/Jones:

Veterans:

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https://twitter.com/JodiePP1948/status/1554745204397453312?s=20&t=Xj0axlz5Z7Cyux-K4hNgEA

Florida:

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Michigan:

https://twitter.com/BarbByrum/status/1555552623159398405?s=20&t=Xj0axlz5Z7Cyux-K4hNgEA

Mississippi:

Missouri:

https://twitter.com/annieschulte/status/1553738845383950338?s=20&t=Xj0axlz5Z7Cyux-K4hNgEA

Pennsylvania:

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Good thread on Fetterman:

https://t.co/Rhiw8SsIRB Thread

Tennessee:

Texas:

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Russia/Racism:

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Feel good du jour:

https://twitter.com/DailyBee_/status/1553217685420478472?s=20&t=Xj0axlz5Z7Cyux-K4hNgEA

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Comic relief:

https://twitter.com/buitengebieden/status/1555894144974848000?s=20&t=Xj0axlz5Z7Cyux-K4hNgEA

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Very funny thread:

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whole thread at https://t.co/TJfJS66uOo

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https://twitter.com/nowthisnews/status/1555605301235048449?s=20&t=Xj0axlz5Z7Cyux-K4hNgEA

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https://twitter.com/buitengebieden/status/1555658086710493192?s=20&t=Xj0axlz5Z7Cyux-K4hNgEA

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https://twitter.com/buitengebieden/status/1555535163030994945?s=20&t=Xj0axlz5Z7Cyux-K4hNgEA

Perspective/Poem

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Bits of beauty:

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