Coronavirus & Monkeypox Tidbits #216 10/23/22

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.

New post: 

Breaking The Mold: A Creative Musical Teaches About Antimicrobial Resistance

https://www.forbes.com/sites/judystone/2022/10/19/breaking-the-mold-a-creative-musical-teaches-about-antimicrobial-resistance/?sh=5cd1fd73580b

News 

Covid:

Update on cases/variants:

Of about 2.9 million new cases reported to the WHO last week, the five countries that reported the most were Germany, France, China, Italy, and the United States. (Cases also spiking in Singapore)

Omicron viruses that descend from the BA.5 lineage are still dominant, making up 78.9% of sequences, followed by BA.4 (6.7%) and BA.2 (3.9%) lineages.

The WHO said its monitoring of emerging subvariants suggests that XBB—a recombinant of BA.2.10.1 and BA.2.75 with 14 more mutations in the BA.2 spike protein—has the most immune escape properties of any SARS-CoV-2 variant. So far, XBB has been reported by 26 countries. Though the subvariant seems to have a higher growth rate, there's no evidence of any change in disease severity.

https://www.cidrap.umn.edu/news-perspective/2022/10/global-covid-19-cases-down-rising-western-pacific

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Study: 7% of children hospitalized with COVID-19 had neurologic problems

Today in Pediatrics, a study of more than 15,000 US children hospitalized with COVID-19 finds that 7.0% had neurologic complications such as seizures or encephalopathy.

A team led by Children's Hospital at Vanderbilt researchers assessed length of hospital stay, intensive care unit (ICU) admission, 30-day readmission, death, and medical costs of 15,137 COVID-19 patients aged 2 months to 18 years released from 52 children's hospitals from March 2020 to March 2022. A total of 37.1% of the patients had a pre-existing complex chronic condition, and 9.8% had one or more neurologic complex chronic conditions.

Seven percent of the children had COVID-related neurologic complications, the most common of which were febrile (fever-related) seizures (3.9%), nonfebrile seizures (2.3%), and encephalopathy (2.2%), a broad term meaning damage or disease to the brain.

Patients with neurologic complications had more ICU admissions (29.8 vs 21.8 days) and longer ICU stays (3.2 vs 2.5 days) and were more likely than those without neurologic complications to die in the hospital (1.8% vs 0.6%). They also had more 30-day readmissions, longer hospital stays, and higher hospital costs.

"Our findings emphasize the importance of COVID-19 immunization in children, especially in high-risk populations, such as those with neurologic comorbidity."
Oct 20 Pediatrics study

https://www.cidrap.umn.edu/news-perspective/2022/10/covid-19-scan-oct-20-2022

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https://twitter.com/The_dead_letter/status/1581824831539986433?s=20&t=TXixG_7wVYtQF2YPZSWTBw

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https://twitter.com/myrabatchelder/status/1582529480186556417?s=20&t=TXixG_7wVYtQF2YPZSWTBw

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https://twitter.com/MackayIM/status/1581613156648247296?s=20&t=TXixG_7wVYtQF2YPZSWTBw

Ebola: 

Uganda's Ebola cases rise amid concern over undetected spread

Uganda's health ministry today reported four more lab-confirmed Sudan Ebola cases, a day after the World Health Organization's (WHO's) top official raised concerns about undetected transmission chains and the risk to the country's capital.

On Twitter, the health ministry said there are now 64 lab-confirmed cases. Also, it reported 25 deaths among confirmed patients.

...the WHO had said the virus may have been circulating as long as 3 weeks before the first suspected cases were reported.

the most recent eight cases--initial reports indicate they were not among known contacts,

two people with confirmed infections from Mubende district sought care in Kampala, increasing the transmission risks in the city. Kampala, the country's capital, has a population of 1.7 million.

https://www.cidrap.umn.edu/news-perspective/2022/10/ugandas-ebola-cases-rise-amid-concern-over-undetected-spread

Other:

Vietnam reports 1st human case of influenza A(H5) since 2014

http://outbreaknewstoday.com/vietnam-reports-1st-human-case-of-influenza-ah5-since-2014/

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Haiti: Confirmed cholera cases 

now at 111 confirmed cases (not including the 12 confirmed cases at the Prison Civile de Port-au-Prince outbreak) through October 17.

The total suspected cases have risen to 996 (Total suspected cases-725 and 271 from the prison outbreak) and deaths are now 37 (23 and 14 respectively).

http://outbreaknewstoday.com/haiti-confirmed-cholera-cases-top-100/

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Influenza:

https://twitter.com/drswlong/status/1583499177446604801?s=20&t=TXixG_7wVYtQF2YPZSWTBw

Diagnostics:

Prolonged COVID test positivity in symptomatic, Omicron BA.2 infections

Among a group of vaccinated college athletes who tested positive for COVID-19 and underwent rapid antigen testing 7 days later, 27% were still positive—a proportion that climbed to 35% in symptomatic athletes and 40% in those infected with the Omicron BA.2 subvariant.

The findings, published yesterday in JAMA Network Open, suggest that rapid antigen testing may help prevent still-positive people from leaving isolation while still infectious, the Stanford University authors said. The US Centers for Disease Control and Prevention (CDC) currently recommend 5 days of isolation followed by 5 days of wearing a well-fitting mask after a COVID-19 diagnosis.

"These findings could call into question the current guidelines allowing for exit of isolation after 5 days without requiring additional testing to prevent further spread, particularly in the setting of newer variants, such as BA.4 and BA.5," the researchers wrote.
Oct 18 JAMA Netw Open study

https://www.cidrap.umn.edu/news-perspective/2022/10/news-scan-oct-19-2022

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Saliva Covid test

The FDA issued an emergency use authorization to the first at-home COVID-19 test that includes a saliva sample --to Aptitude Medical Inc. for their Metrix COVID-19 Test.

Drugs and Vaccines:

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ACIP adds COVID vaccine to pediatric immunization schedule

The vaccine advisory group for the Centers for Disease Control and Prevention (CDC) today approved changes to the child and adolescent immunization schedule, which adds COVID-19 vaccine to the recommended immunizations. The recommendation by the Advisory Committee on Immunization Practices (ACIP) passed on a unanimous 15-to-0 vote.

The vote came a day after ACIP approved adding COVID vaccines to the Vaccines for Children (VFC) program, which provides free vaccines to children who don't have health insurance or who can't afford them.

Ahead of the vaccine schedule vote today, some media outlets falsely claimed that the ACIP's vote would mandate the COVID vaccine for school children, according to the Washington Post. However, states decide what vaccines are required for school attendance.

Oct 20 ACIP webcast
Oct 19 Washington Post story
NCSL background information

https://www.cidrap.umn.edu/news-perspective/2022/10/covid-19-scan-oct-20-2022

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WHO: COVID-19 vaccination rates have dropped 50% in Africa

The number of COVID-19 vaccine doses given in Africa has dropped by more than 50% over the last three months, the World Health Organization said Thursday, even though less than a quarter of all Africans have been vaccinated.

https://medicalxpress.com/news/2022-10-covid-vaccination-africa.html?

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Study debunks use of antidepressant Fluvoxamine as COVID treatment

A study testing drugs that are used for other conditions for their potential in treating COVID-19 has found that the antidepressant fluvoxamine (brand name Luvox) offered no benefit, at least at an initial smaller dose.

https://medicalxpress.com/news/2022-10-debunks-antidepressant-luvox-covid-treatment.html?

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Ebola vaccines:

Serum Institute to produce Ebola vaccine for use in Uganda outbreak

Oct 17 (Reuters) - The Serum Institute of India plans to manufacture 20,000 to 30,000 doses of an experimental Ebola vaccine by the end of November for use in trials against an outbreak in Uganda, its developers and a company source said.

The response to Uganda's outbreak has been blunted by the absence of a proven vaccine against the Sudan strain of the virus.

There have been 54 confirmed cases and 19 deaths since last month and the first case in the capital, Kampala, was recorded last week. But health authorities believe the actual numbers could be higher.

Vaccines against the more common Zaire strain of Ebola have proven highly effective during recent outbreaks in neighbouring Democratic Republic of Congo.

Oxford University, which developed a COVID-19 vaccine with AstraZeneca (AZN.L), has an Ebola vaccine that has been shown to induce an immune response to both the Sudan and Zaire strains in Phase 1 trials.

Its developers said they were working with the Serum Institute to manufacture doses that could be deployed in Uganda as part of a clinical trial once the authorities there gave regulatory approval.

"We are hoping to have a large number of doses, approximately 20,000 to 30,000 or more by mid-to-end of November," Teresa Lambe, the chief scientific investigator on Oxford's Ebola vaccine, told Reuters.

A source at the Serum Institute, the world's biggest vaccine maker and part of a conglomerate run by Indian billionaire Cyrus Poonawalla, confirmed this information. The source said the Ebola vaccine doses would be supplied free of cost.

https://www.reuters.com/world/africa/serum-institute-produce-ebola-vaccine-use-uganda-outbreak-2022-10-17/?rpc=401&

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Cholera:

Unprecedented outbreaks prompt shift to 1-dose cholera vaccine strategy

An unprecedented rise in cholera outbreaks straining the global cholera vaccine supply has prompted the International Coordinating Group (ICG), which manages emergency cholera vaccine supplies, to temporarily suspend the standard two-dose regimen, the World Health Organization (WHO) announced today. To stretch vaccine supplies, outbreak response campaigns for now will use a single dose.

Since January, 29 countries have reported outbreaks, including Haiti, Malawi, and Syria, which are experiencing large outbreaks. For comparison, the WHO said that over the previous 5 years fewer than 20 countries on average reported outbreaks. The WHO said cholera outbreaks are becoming more numerous, widespread, and severe due to floods, droughts, population movements, and other fators that limit access to clean water.

The WHO said the one-dose strategy is known to be effective, though evidence is limited on the duration of protection. Also, protection with one dose appears to be much lower in children. Officials added that the benefit of supplying one dose still outweighs no doses and will allow more people to be protected in the near term...

Producers are already making vaccine at maximum capacity, leaving no short-term solutions to increase production.
Oct 19 WHO press release
Oct 19 MSF press release

https://www.cidrap.umn.edu/news-perspective/2022/10/news-scan-oct-19-2022

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Devices:

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Epidemiology/Infection control:

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Long Covid:

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Tips, general reading for public:

Ventilate.

Mask.

Vax.

Politics:

Covid:

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(referring to John Conly)

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https://twitter.com/SWinstonWolkoff/status/1581738646608433152?s=20&t=TXixG_7wVYtQF2YPZSWTBw

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https://twitter.com/duty2warn/status/1582113599572484096?s=20&t=TXixG_7wVYtQF2YPZSWTBw

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Biden:

GOP

Huge problem:

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https://twitter.com/lindyli/status/1581791137672572928?s=20&t=TXixG_7wVYtQF2YPZSWTBw

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https://twitter.com/vanessajones/status/1582019171281301505?s=20&t=TXixG_7wVYtQF2YPZSWTBw

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TFG:

https://twitter.com/lindyli/status/1582132822957252610?s=20&t=TXixG_7wVYtQF2YPZSWTBw

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https://twitter.com/duty2warn/status/1582840118632910850?s=20&t=TXixG_7wVYtQF2YPZSWTBw

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Greed/National Security:

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https://twitter.com/michaelzlin/status/1583518648576053248?s=20&t=TXixG_7wVYtQF2YPZSWTBw

Student loans:

Abortion/reproduction:

Powerful ad:

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https://twitter.com/DJRN0255/status/1581367352389615618?s=20&t=TXixG_7wVYtQF2YPZSWTBw

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https://twitter.com/NickKnudsenUS/status/1583184283216515072?s=20&t=TXixG_7wVYtQF2YPZSWTBw

Climate change:

Good news!

https://twitter.com/PeterBosshard/status/1577970179740409856?s=20&t=TXixG_7wVYtQF2YPZSWTBw

Economy:

Floriada/DeSantis:

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LGBTQ:

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Medicare/Medicaid

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Oz/Fetterman:

https://twitter.com/DataDrivenMD/status/1581791268295745536?s=20&t=TXixG_7wVYtQF2YPZSWTBw

Racism:

Texas:

UK:

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Iran:

https://twitter.com/UNILAD/status/1582323035402833921?s=20&t=TXixG_7wVYtQF2YPZSWTBw

Russia:

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https://twitter.com/OlgaNYC1211/status/1583436929747496960?s=20&t=TXixG_7wVYtQF2YPZSWTBw

Feel good du jour:

https://twitter.com/Happydog___/status/1577930122937745408?s=20&t=TXixG_7wVYtQF2YPZSWTBw

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Comic relief:

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https://twitter.com/TheFigen_/status/1583129644772884482?s=20&t=TXixG_7wVYtQF2YPZSWTBw

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https://twitter.com/buitengebieden/status/1583554342187327488?s=20&t=TXixG_7wVYtQF2YPZSWTBw

Perspective/Poem

Bits of beauty:

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