Coronavirus & Monkeypox Tidbits #215 10/16/22

October 15, 2022 /

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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.

New Post:

CDC's New Mask Guideline Says Vulnerable People Are Expendable

https://www.medscape.com/viewarticle/982329

News 

Covid:

Study: Long-COVID symptoms burdened 29% of survivors

A German study published today in BMJ finds a considerable burden of long-COVID symptoms, especially fatigue and neurocognitive impairment ("brain fog"), at 6 to 12 months—even among young and middle-aged adults who had mild infections.

A team led by Ulm University researchers parsed responses to a mailed survey from 11,710 adults aged 18 to 65 years living in southwestern Germany who tested positive for COVID-19 from Oct 1, 2020, to Apr 1, 2021, a period dominated by the wild-type virus.

Average participant age was 44.1 years, 58.8% were women, 56.8% were employed full-time before the pandemic, 77.5% didn't require medical care for their infection, 19.0% needed outpatient care, and less than 4% were hospitalized. Pre-existing chronic conditions included musculoskeletal disorders (28.9%), cardiovascular disease (17.4%), neurologic and sensory disorders (16.2%), and respiratory illnesses (12.1%).

The survey was fielded in August and September 2021, and the average interval between the initial positive COVID-19 test and survey completion was 8.5 months.

Most at risk: Women, those who needed medical care

The researchers sorted 30 new-onset long-COVID symptoms into 13 clusters. Respondents reported fatigue (37.2%) and brain fog (31.3%), a symptom cluster that the researchers said contributed most to reduced health recovery and working capacity. Other symptoms contributing to reduced work capacity included chest symptoms (30.2%), impaired taste or smell (23.6%), and anxiety and depression (21.1%).

Assuming at least moderate impairment in activities of daily living and 80% or less recovery of general health or working capacity, the estimated rate of long-COVID was 28.5% among participants (extrapolated to 8.4% for all women and 4.6% for all men in the community, if all nonrespondents had recovered completely).

Women reported more impairment than men for most new symptoms.

https://www.cidrap.umn.edu/news-perspective/2022/10/study-long-covid-symptoms-burdened-29-survivors

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U.S. FDA Considers Another COVID-19 Antiviral

Veru Inc. today announced that positive data from the Phase 3 trial of sabizabulin for hospitalized moderate to severe COVID-19 patients who required supplemental oxygen has been accepted as a late-breaker oral presentation on October 19-23, 2022, in Washington, D.C.

Treatment with sabizabulin 9 mg once daily, an oral, first-in-class, new chemical entity, microtubule disruptor with dual anti-inflammatory and antiviral properties, resulted in a clinically meaningful and statistically significant 55.2% relative reduction in deaths compared to placebo.

Based on a planned interim analysis of the first 150 randomized patients, the Independent Data Monitoring Committee unanimously halted the study for clear clinical efficacy, and no safety concerns were identified.

Additionally, the U.S. FDA has informed the Company that FDA’s Pulmonary-Allergy Drugs Advisory Committee will meet on November 09, 2022, to discuss the Company’s sabizabulin for COVID-19 request for emergency use authorization.

Sabizabulin is an orally bioavailable bis-indole that binds to the “colchicine binding site” of alpha and beta tubulin and inhibits tubulin polymerization at low nanomolar concentrations.

Sabizabulin disrupts the microtubules, the central mechanism contributing to their antiviral and anti-inflammatory activities.

Drugs like sabizabulin that target microtubules have broad antiviral activity by disrupting the intracellular transport of viruses such as SARS CoV-2,

https://www.precisionvaccinations.com/2022/10/13/us-fda-considers-another-covid-19-antiviral

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Study finds >40% mislead others about their use of Covid precautions

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So much for the pandemic being over:

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Monkeypox:

US hits 27,000 monkeypox cases as Siga tests Tpoxx in clinical trials

The CDC updated its case count yesterday, and the United States has 244 more monkeypox cases, raising the national total to 27,022.

The European Centre for Disease Prevention and Control (ECDC), meanshile said 24,973 cases have been identified in that region since spring, when the largest global outbreak of the virus was first detected in the United Kingdom.

Currently in the United States, United Kingdom, and the Democratic Republic of the Congo (DRC), drugmaker Siga is conducting clinical trials on its antiviral Tpoxx, which is being used to shorten the duration of the virus in patients around the world under emergency use authorizations. The trials will assess the safety and efficacy of the drug in monkeypox patients; investigators aim to enroll 500 participants each at US and UK sites and 450 participants in the DRC.

Oct 12 CDC report
Oct 12 ECDC report
Oct 12 Siga press release
Oct 12 Exp Dermatol study

https://www.cidrap.umn.edu/news-perspective/2022/10/news-scan-oct-13-2022

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New study finds that monkeypox virus can spread widely within specialist hospital isolation rooms

Monkeypox virus can be shed into the surrounding environment by people who are infected, particularly in shed skin particles and in debris from monkeypox skin lesions and scabs. The virus is relatively hardy and under appropriate conditions can remain infectious on surfaces for weeks, creating a potential infection risk to others.

The UK Health Security Agency (UKHSA) recommends that patients with monkeypox who have severe disease requiring hospital admission are cared for in isolation rooms, with infection prevention and control (IPC) precautions that aim to contain potentially infectious virus within the room and protect staff who enter. However, to date it has been unclear whether these measures are proportionate to the potential virus exposure risks.

To investigate this, researchers from the Liverpool School of Tropical Medicine, the University of Oxford's Nuffield Department of Medicine and the UKHSA conducted a study which collected samples from the rooms of patients hospitalized with monkeypox. The findings have been published in The Lancet Microbe.

The research team assessed the extent of virus shedding onto surfaces in specialist isolation rooms containing patients admitted to hospital for the management of severe monkeypox. They also investigated whether the virus was detectable in air samples from the rooms.

The researchers found that viral DNA shed by the patients could be found on multiple surfaces throughout the isolation rooms (56 (93%) positive by PCR out of 60 samples). Monkeypox virus DNA was also found on personal protective equipment (PPE) worn by healthcare workers caring for these patients, and in the anterooms where they remove their PPE. Monkeypox virus DNA was also detected in five out of twenty air samples taken within these isolation rooms.

Changing bed linen was an activity particularly associated with detection of monkeypox virus DNA in air samples in the room. This suggests that viral particles, probably in shed skin particles, can become suspended in the air when bed sheets are changed. Monkeypox virus capable of replicating in cells under laboratory conditions (an indicator that the virus could infect other people) was identified in two of four PCR-positive samples selected for virus isolation. This includes air samples collected during the bed linen change.

https://medicalxpress.com/news/2022-10-monkeypox-virus-widely-specialist-hospital.html

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Ebola:

Uganda to test 2 Ebola vaccines during current outbreak

The Uganda Ministry of Health announced that it will try two vaccines against the Sudan Ebola strain currently causing cases in that country.

The vaccines include one developed at the University of Oxford in the United Kingdom, and the other manufactured by Sabin in the United States.

According to the latest report from the World Health Organization (WHO) on the current outbreak in Uganda, there have been 20 suspected cases, all fatal. Between Sep 19 and Oct 9, 68 cases of the virus were detected, including the 20 suspected cases and 48 lab-confirmed cases.

"Thirty-seven fatalities have been registered including 17 confirmed cases, for an overall case fatality ratio of 54.4%, and 35.4% among confirmed cases," the WHO said.

The WHO said cases seem to be declining, though deaths are increasing. Authorities have also begun testing bats in the outbreak regions, and so far, four species have been identified and 52 samples taken.

Finally, according to Ugandan news media, Uganda's president has told traditional healers and herbalists not to treat people with suspected Ebola; he also directed security officials to arrest people with suspected infections who refuse to isolate.
Oct 13 The Observer story
Oct 13 WHO weekly bulletin
Oct 13 The Star story

https://www.cidrap.umn.edu/news-perspective/2022/10/news-scan-oct-13-2022

Note:

About 140 travelers from Uganda arrive in the U.S. daily. These passengers are now funneled into five U.S. airports for SUDV screening. These travelers are followed-up post arrival by the U.S. government.

However, since SUDV infection incubation periods can reach seven days, airport screening may miss infected passengers, said the CDC team.

In the U.S., the CDC has mobilized various resources, such as multi-disciplinary CDC Ebola Response Teams and coordinating with the 10 Regional Special Pathogens Treatment Centers. Currently, nine laboratories can test SUDV samples.

https://www.precisionvaccinations.com/us-prepares-sudan-ebolavirus-potential-arrival

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Influenza:

https://twitter.com/michaelzlin/status/1578659654086770688?s=20&t=tbUGqzSwyJDmBgrtr6oBtw

Diagnostics:

Monkeypox: FDA authorizes Abbott test

The Food and Drug Administration has issued an emergency use authorization for Abbott's monkeypox test, which will offer real-time polymerase chain reaction (PCR) test results for clinicians. The test relies on swabs of lesions. This is the first commercial test to be authorized for monkeypox detection.

Drugs and Vaccines:

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Pfizer and its partner BioNTech reported its updated booster generated a strong immune response against the currently circulating BA.5 and the BA.4 subvariants of Omicron.

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Antiviral molnupiravir purchased by UK government does not lower risk of hospital admission, trial shows

BMJ 2022; 379 doi: https://doi.org/10.1136/bmj.o2441 (Published 11 October 2022)

Molnupiravir, a covid-19 antiviral drug bought by the UK government in the amount of 2.23 million doses, is no better than placebo at lowering the risks of death and hospital admission, a pivotal UK trial has found.

Preliminary results released from the Panoramic trial of 25 783 people who were randomly assigned to open label treatment with molnupiravir plus usual care or to usual care alone found no significant difference between the two groups for the primary endpoint of death or hospital admission.1 The study has been published as a preprint and has not yet been peer reviewed.

The UK was the first country to authorise Merck Sharp and Dohme’s molnupiravir (Lagevrio) for the treatment of mild to moderate covid-19 in adults with at least one risk factor for severe illness, in November 2021.2 The European Medicines Agency has still not approved the drug.

https://www.bmj.com/content/379/bmj.o2441

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Devices:

Epidemiology/Infection control:

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both from this excellent Covid resource: https://www.kff.org/coronavirus-covid-19/dashboard/kff-covid-19-vaccine-monitor-dashboard/

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https://twitter.com/DataDrivenMD/status/1579128777690742789?s=20&t=tbUGqzSwyJDmBgrtr6oBtw

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Monkeypox:

https://twitter.com/MackayIM/status/1581069112201334786?s=20&t=jqulX57vMjaIRvrWTf7BpQ

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Influenza:

Tips, general reading for public:

Ventilate.

Mask.

Vax.

Politics:

Covid:

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https://twitter.com/CPita3/status/1574177983346184198?s=20&t=tbUGqzSwyJDmBgrtr6oBtw

Elections:

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GOP/misc:

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Common tactic:

TFG/Jan 6:

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https://twitter.com/duty2warn/status/1580624129912602624?s=20&t=tbUGqzSwyJDmBgrtr6oBtw

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Guns:

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Thread about violence against women:

https://twitter.com/MaryKoCo/status/1578901970177642496?s=20&t=tbUGqzSwyJDmBgrtr6oBtw

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Reproductive health/Abortion:

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Antisemitism:

https://twitter.com/leahmcelrath/status/1579129970672439297?s=20&t=tbUGqzSwyJDmBgrtr6oBtw

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Book bans:

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Climate:

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Greed:

Thread about denials of medical care by insurers--the most ordinary possible story about healthcare:

LGBTQ:

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Racism/Georgia:

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Medicare:

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Voter registration:

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Arizona:

Florida:

Great takedown of Ladapo:

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Georgia:

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Nevada:

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Pennsylvania:

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Texas:

https://twitter.com/RexChapman/status/1580594164726919168?s=20&t=tbUGqzSwyJDmBgrtr6oBtw

Saudi Arabia:

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Ukraine:

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Feel good du jour:

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Comic relief:

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https://twitter.com/Yoda4ever/status/1579131571856183297?s=20&t=tbUGqzSwyJDmBgrtr6oBtw

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https://twitter.com/thepuppiesclub/status/1580576593881092096?s=20&t=tbUGqzSwyJDmBgrtr6oBtw

Perspective/Poem

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https://twitter.com/arealmofwonder/status/1579498322716676096?s=20&t=tbUGqzSwyJDmBgrtr6oBtw

Bits of beauty:

 

 

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