Coronavirus & Monkeypox Tidbits #210 9/11/22

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.

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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:

But hey, we don't need common sense public health measures like masking.

Kids' COVID cases rise in US

Though US COVID cases continue to fall, illnesses in children last week rose for the second week in a row, according to the latest update from the American Academy of Pediatrics. About 90,600 infections in kids were reported, up 14% from 2 weeks ago. Cases had plateaued since the middle of May, fluctuating between a low of 68,000 and 112,000 weekly cases.

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Study: Most COVID survivors had cardiac involvement nearly 1 year later

A study of 346 previously healthy COVID-19 survivors finds that 73% had cardiac signs and symptoms more than 3 months after infection, and 57% still had them at nearly 1 year.

..."Ongoing inflammatory cardiac involvement may, at least in part, explain the lingering cardiac symptoms in previously well individuals with mild initial COVID-19 illness," the researchers wrote.
Sep 5 Nat Med study

https://www.cidrap.umn.edu/news-perspective/2022/09/covid-19-scan-sep-06-2022

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More than 10 million children were affected by COVID-19-associated parental and caregiver deaths

According to a new modeling study, published in JAMA Pediatrics, the number of children estimated to have experienced the death of a parent or caregiver as a result of the COVID-19 pandemic has climbed to more than 10.5 million globally as of May 1, 2022.

https://medicalxpress.com/news/2022-09-million-children-affected-covid-associated-parental.html?

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Vitamin D doesn't prevent COVID-19, other respiratory infections, studies find

Findings from two large clinical trials published yesterday in BMJ discount the notion that vitamin D supplements protect against COVID-19 or other respiratory-tract infections, although both had notable limitations.

https://www.cidrap.umn.edu/news-perspective/2022/09/vitamin-d-doesnt-prevent-covid-19-other-respiratory-infections-studies-find

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New Omicron subvariant mutation tied to kids' neurologic complications

Researchers in Taiwan have discovered a new mutation in the SARS-CoV-2 Omicron BA.2.3.7 subvariant that they suggest may be responsible for severe neurologic complications observed in young children on the island. Their study was published yesterday in the International Journal of Infectious Diseases.

The team analyzed the medical records of five pediatric COVID-19 patients hospitalized with severe neurologic complications such as seizures, symptoms indicating involvement of the meningeal layer of the brain, and encephalopathy in May 2022, about a month after Omicron began circulating in Taiwan.

The patients were 1 to 5 years old and experienced neurologic symptoms within 1 or 2 days after the onset of respiratory symptoms and fever. All patients had elevated levels of several inflammatory biomarkers, but none of their cerebrospinal fluid samples tested positive for COVID-19.

Whole-genome sequencing revealed that all viruses were Omicron BA.2.3.7 and that they had a previously unidentified K97E mutation on the spike protein that differed from other BA.2.3.7 strains. Genome mapping of the mutation showed similar sequences in patients in Hong Kong, Japan, and the United States at roughly the same time.

One child died of acute cerebral edema, brainstem compression, and multi-organ failure. The other patients recovered fully and were released from the hospital after 4 to 9 days.

The authors said their findings suggest that the neurologic complications are related to mutation-triggered hyperimmune states rather than direct viral invasion of the central nervous system. They also noted that other mutations in the same area of the SARS-CoV-2 spike protein have been linked to immune evasion.

"The K97E mutation, which has not been observed in Taiwan previously, potentially explains the sudden increase in incidence of severe neurological symptoms in pediatric patients due to its possible effect on immune regulation," the researchers concluded.
Sep 7 Int J Infect Dis study

https://www.cidrap.umn.edu/news-perspective/2022/09/news-scan-sep-08-2022

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Examining Long-Term Health Effects of COVID-19 and Implications for the Social Security Administration: Proceedings of a Workshop

Download Free PDF

Read Free Online

'Long COVID' refers to the wide range of long-lasting symptoms experienced by some patients after a SARS-CoV-2 infection. The most common symptoms include fatigue, headache, brain fog, shortness of breath, hair loss, and pain. At this time, there are many knowledge gaps related to Long COVID, including the prevalence of the condition, the impact of the symptoms on survivors' ability to function, and the long-term course of the condition. While many individuals with Long COVID recover within one year, others experience little or no decrease in symptom severity over time.

Long COVID symptoms can affect a person's ability to work and otherwise function in daily life, so people with the condition may need to utilize programs such as Social Security Disability Insurance (SSDI) and the Supplemental Security Income Program (SSI). The Social Security Administration (SSA), which administers both of these programs, requested that the National Academies of Sciences, Engineering, and Medicine host a public workshop to discuss research into the long-term health effects of COVID-19, their impacts on individuals and populations, and how the SSDI and SSI programs can support individuals who suffer disability as a result of Long COVID. This publication summarizes the presentation and discussion of the workshop.

https://nap.nationalacademies.org/catalog/26619/long-covid-examining-long-term-health-effects-of-covid-19

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Monkeypox

HIV, earlier STIs common in US monkeypox patients

Surveillance data from eight US jurisdictions found a high prevalence of HIV and other sexually transmitted infections (STIs) among people with monkeypox, a research team based at the Centers for Disease Control and Prevention (CDC) reported today.

Live virus in anal and urethral swabs

Meanwhile, in another new research development, Italian researchers writing in Eurosurveillance today described their experience testing anal and urethral swab samples from confirmed cases by PCR testing and virus isolation.

The swabs were collected within 7 days of symptom onset. Replicating virus was found in 13 of 8 anal swabs and 11 of 15 urethral swabs. Two asymptomatic secondary cases had detectable monkeypox genetic material in urethral samples, with virus isolated from one of the patients, adding support for sexual transmission as a possible virus transmission route.

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US may expand monkeypox vaccine eligibility to men with HIV

NEW YORK (AP) — U.S. officials are considering broadening recommendations for who gets vaccinated against monkeypox, possibly to include many men with HIV or those recently diagnosed with other sexually transmitted diseases.

Driving the discussion is a study released Thursday showing that a higher-than-expected share of monkeypox infections are in people with other sexually transmitted infections.

Currently, the CDC recommends the vaccine to people who are a close contact of someone who has monkeypox; people who know a sexual partner was diagnosed in the past two weeks; and gay or bisexual men who had multiple sexual partners in the last two weeks in an area with known virus spread.

https://apnews.com/article/monkeypox-science-health-sexually-transmitted-diseases-centers-for-disease-control-and-prevention-c31a9261c0bea08ccdbe7d97cfbd13c3

Diagnostics:

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Need for special diagnostic testing for blood clots in the lung:

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CDC warns of testing challenges for Monkeypox testing

Today in Morbidity and Mortality Weekly Report CDC officials and their state partners describe three case studies whereby patients with atypical signs and symptoms received false-positive real-time PCR monkeypox test results.

The patients—a pregnant woman, a child, and an infant—had no epidemiologic links to a monkeypox case or known risk factors.

"The initial diagnoses were followed by administration of antiviral treatment (i.e., tecovirimat) and JYNNEOS vaccine postexposure prophylaxis (PEP) to patients' close contacts," the authors wrote. "After receiving subsequent testing, none of the three patients was confirmed to have monkeypox."

The authors said these cases serve as a warning for clinicians, who could waste resources on patients with no need for monkeypox treatments.

"Because the positive predictive value in populations with low disease incidence is lower than that in populations with a higher disease incidence, laboratory results in persons with low pretest probability of infection should be carefully examined and reviewed, and other plausible diagnoses (e.g., hand, foot, and mouth disease; varicella; molluscum contagiosum) should be considered," they concluded.

https://www.cidrap.umn.edu/news-perspective/2022/09/monkeypox-slows-uk-us-cdc-notes-diagnosis-issues

Drugs and Vaccines:

Covid:

Neutralizing antibodies from single COVID-19 booster steadily decline

Neutralizing antibody levels against the original COVID-19 virus and omicron variants in vaccinated adults tend to decline by at least 15% per month after a single booster shot, a new study using serum from human blood samples suggests.

https://medicalxpress.com/news/2022-09-neutralizing-antibodies-covid-booster-steadily.html?

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Study finds Omicron hospital risk 10 times higher in unvaccinated

After the emergence of the Omicron variant, the rate of COVID-19 hospitalizations in the United States was 10.5 times higher in unvaccinated adults and 2.5 times higher in those who were vaccinated but received no booster than in booster recipients, according to a new study.

https://www.cidrap.umn.edu/news-perspective/2022/09/study-finds-omicron-hospital-risk-10-times-higher-unvaccinated

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COVID boosters safe and well tolerated in pregnant and lactating women

COVID vaccine boosters or third doses after an initial two-dose series are well tolerated in pregnant and lactating women, according to a large cohort study published yesterday in JAMA Network Open.

A team at the University of Washington conducted a US-based online survey in January 2021 to examine patterns in adults who were pregnant, lactating, or planning pregnancy at the time of COVID vaccination. They noted that, although earlier studies showed that the primary vaccine series was well tolerated and safe for pregnant and breastfeeding women, not much was known about their experiences with boosters.

The authors wrote that the frequencies of local and systemic reactions after the booster or third doses in all three groups was similar to those reported in vaccine trials for the general population, as well as for levels found in national safety surveillance systems for booster doses. They also noted that for pregnant participants, obstetric symptoms were lower after the extra vaccine dose than for the second dose in the primary series.

Sep 8 JAMA Netw Open study

https://www.cidrap.umn.edu/news-perspective/2022/09/news-scan-sep-09-2022

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Monkeypox:

Tpoxx found to be well-tolerated, safe in US monkeypox patients

Today in Morbidity and Mortality Weekly Report, researchers from the Centers for Disease Control and Prevention (CDC) provided data on safety outcomes on 369 patients who receiving the monkeypox antiviral drug tecovirimat (Tpoxx), noting that few adverse events were reported.

In related news, a study spotlighted neurologic complications such as encephalitis and seizures in monkeypox patients, Los Angeles County is investigating the death of an infected person, and federal officials are considering widening the vaccine pool to include people with HIV.

https://www.cidrap.umn.edu/news-perspective/2022/09/tpoxx-found-be-well-tolerated-safe-us-monkeypox-patients

Devices:

Epidemiology/Infection control:

Covid:

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Monkeypox:

COMMENTARY: No question monkeypox is an STI

Hunter Handsfield, MD

Whether or not monkeypox (MPX) should be labeled a sexually transmitted infection (STI) isn't much of a debate among STI experts.

So far, more than 95% of cases in the United States have been acquired during sexual contact among men who have sex with men (MSM). To not call it an STI is nearly equivalent to saying syphilis isn't an STI because exceptions to sexual transmission are common in some settings.

Pragmatically, MSM should be advised that certain sexual practices and lifestyles put them at very high risk of MPX. As well as its opposite: That modified sexual exposures can be nearly 100% protective.

Just yesterday, the Centers for Disease Control and Prevention (CDC) published a report documenting an intimate association between MPX and other STIs in MSM in the United States. The CDC has long advised screening patients who have newly diagnosed STIs for other STIs, and it recommends STI screening all persons evaluated for MPX, implicitly recognizing MPX as an STI.

Recently reported cases of MPX in persons other than MSM is similar to the course of HIV transmission in the early years of HIV/AIDS in industrialized countries. But the dominant sexual transmission of HIV among MSM, and its characterization as an STI in them, remains valid.

https://www.cidrap.umn.edu/news-perspective/2022/09/commentary-no-question-monkeypox-sti

Tips, general reading for public:

Ventilate.

Mask.

Vax.

Politics:

Covid:

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Absurd "You do you" while Covid is still raging, but Hochul declares polio a public health emergency:

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ACA/Health:

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Abortion/Reproduction/Pregnancy:

Telemedicine can give vulnerable women access to safe medical abortions 

A new study published in The Lancet shows that medical abortion can be carried out both safely and effectively via telemedicine, without a routine ultrasound examination. The study, which is a collaboration between researchers at Karolinska Institutet and the University of Cape Town in South Africa, highlights the opportunities to provide safe and effective abortion services in low-resource settings.  [like half of the u.s.]

https://medicalxpress.com/news/2022-09-telemedicine-vulnerable-women-access-safe.html?

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Airlines:

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CNN, media:

(Malone also now owns a large swath of Maine)

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Meta/Facebook:

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Jan 6/TFG/Jared:

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Worthwhile thread if you need a refresher about Trump's 9/11 lies:

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Rand Paul:

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Scotus:

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LGTBQ:

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Racism:

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Florida:

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Kentucky:

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Maryland:

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Michigan:

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New Mexico:

North Carolina:

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Ohio:

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Oklahoma:

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Pennsylvania:

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South Carolina:

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Texas:

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Queen Elizabeth:

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Other:

Feel good du jour:

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Comic relief:

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https://twitter.com/buitengebieden/status/1568610344263716864?s=20&t=t6CJSqYRU8l_Y3chX8FTtA

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Perspective/Poem

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Bits of beauty:

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