Coronavirus & Monkeypox Tidbits #217 10/30/22

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:

The Fetterman-Oz Debate Highlights GOP's Disdain for the Disabled

Mushed words and all, I would vote for John Fetterman, who had the courage to get up and debate.

Elections should be about character rather than making debating points. Consider which candidate you would want having your back.

https://www.medscape.com/viewarticle/983142

News 

Study shows temporary isolation wards provided effective protection against health care-associated COVID-19 transmission

https://medicalxpress.com/news/2022-10-temporary-isolation-wards-effective-health.html

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Omicron keeps finding new evolutionary tricks to outsmart our immunity

https://www.npr.org/sections/health-shots/2022/10/25/1129196088/covid-new-omicron-variants-immunity

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Humans transmit SARS-CoV-2 to their pets, household study finds

Among a sample of 107 households with pets and at least one COVID-19–infected adult in Idaho and Washington state, 21% of dogs and 39% of cats had signs of infection, 40% of dogs and 43% of cats had SARS-CoV-2 antibodies, and 5% and 8%, respectively, tested positive on polymerase chain reaction (PCR) testing, finds a new study in Emerging Infectious Diseases.

University of Washington researchers led the study of households with a total of 119 dogs and 57 cats. Households were recruited through COVID-19 clinical trials and community studies, social media, word of mouth, community partners, and contact tracers. The team surveyed a member of each household, reviewed COVID-19 test results, and, when possible, visited the home to collect pet blood and nose-throat and fecal swabs.

Oct 26 Emerg Infect Dis study

https://www.cidrap.umn.edu/news-perspective/2022/10/covid-19-scan-oct-27-2022

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Republican Senate staff tout lab-leak theory of the pandemic’s origin

The mysterious origin of the COVID-19 pandemic, like so many aspects of the response to it, has created deep divides along party lines in the United States. Today, the Republican minority staff of a bipartisan Senate committee set up to probe the origin of SARS-CoV-2 issued an “interim report” arguing for the narrative that the virus entered humans because of a lab-related incident and not a natural jump from animals to humans. Many virologists and evolutionary biologists who have studied the origins of outbreaks dismiss the lab-leak hypothesis, but other scientists have complained that the possibility was too readily downplayed, and it has become increasingly popular among conservative media outlets and some Republican politicians.

“Based on the analysis of the publicly available information, it appears reasonable to conclude that the COVID-19 pandemic was, more likely than not, the result of a research-related incident,” the minority staff concludes in its 35-page report. That conclusion stands in sharp contrast to those of other panels, including from the World Health Organization and U.S. intelligence agencies, which have deemed a zoonotic jump more likely or remained neutral given the lack of direct evidence on the origin of the virus.

https://www.science.org/content/article/republican-senate-staff-tout-lab-leak-theory-pandemics-origin

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Alpha, Delta, and Omicron patients may exhale more viruses

A study today from researchers at the University of Maryland determined that patients infected with COVID-19 variants Alpha, Delta, and Omicron—including those fully vaccinated and boosted—shed significantly more viral RNA copies into exhaled breath aerosols than patients infected with ancestral strains and other variants.

The study appears in Clinical Infectious Diseases and adds to evidence of increased transmissibility of the Alpha, Delta, and Omicron variants. The study used 30-minute respiratory samples collected via a Gesundheit-II exhaled breath aerosol sampler from 93 participants who had confirmed COVID-19 infections. Of those, 32 were fully vaccinated and 20 boosted. The participants were tested from June 2020 through March 2022.

According to the authors, 4 Alpha, 3 Delta, and 29 Omicron patients shed significantly more viral RNA copies into exhaled breath aerosols than the 57 people infected with ancestral strains and variants.

The increase in viral shedding may have been at least partly due to participant behavior while in the Gesundheit machine. The authors said Delta and Omicron patients coughed more frequently than those infected with Alpha, ancestral strains, and other variants. Omicron patients also generally reported more upper and lower respiratory symptoms than the other volunteers.

"These data indicate that a characteristic of highly transmissible variants is a high rate of viral shedding into aerosols," the authors concluded. "This evidence for convergent evolution of increased viral aerosol shedding is consistent with a dominant role for airborne transmission (inhalation of viral aerosols regardless of distance that the aerosol traversed) in the spread of COVID-19."
Oct 26 Clin Infect Dis 
study

https://www.cidrap.umn.edu/news-perspective/2022/10/news-scan-oct-26-2022

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Black Veterans Hospitalized with COVID-19 Less Likely to Receive Treatments Than White Veterans

Black veterans hospitalized with COVID-19 were less likely to receive evidence-based treatments than their white counterparts but did not have higher rates of death or readmission, according to new research led by University of Pittsburgh School of Medicine physician-scientists that was published today in JAMA Network Open

The study, which examined two years of data from 130 Department of Veterans Affairs Medical Centers (VAMCs), found that the disparities in treatment were driven by differences in care that occurred within and between hospitals. In other words, individual hospitals were providing different rates of treatment to their Black and white patients, in addition to there being differences in care between hospitals that treat a disproportionate number of Black patients compared to those that treat mainly white patients.

https://globalbiodefense.com/2022/10/25/black-veterans-hospitalized-with-covid-19-less-likely-to-receive-treatments-than-white-veterans/

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Monkeypox:

CDC emphasizes testing, treating monkeypox in pregnancy

Today during a Clinician Outreach and Communication Activity call, officials from the Centers for Disease Control and Prevention (CDC) recommended that pregnant women, breastfeeding women, and children who have been exposed to monkeypox be tested promptly if they show symptoms.

The officials also said pregnant or breastfeeding women should be offered the Jynneos vaccine as post-exposure prophylaxis (prevention) if they have a known close exposure to the virus.

Yesterday the CDC has reported 26 more monkeypox cases, raising the US total to 28,087.

In global news, Brazil reported its eighth death related to monkeypox infection. The country has 9,026 cases.

In Europe, case counts continue to drop according to the European Centre for Disease Prevention and Control (ECDC). A total of 25,282 cases have been reported to date in the region. Six percent of patients have required hospitalization (747 cases), 5 patients have been admitted to intensive care units, 4 of whom died.
Oct 26 CDC 
tally
Oct 26 Brazilian 
news report
Oct 26 ECDC 
report

https://www.cidrap.umn.edu/news-perspective/2022/10/news-scan-oct-27-2022

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Researchers warn of severe monkeypox in some patients

Today in Morbidity and Mortality Weekly Report, researchers from the Centers for Disease Control and Prevention (CDC) and their state colleagues detail clinical consultations for 57 hospitalized patients with severe manifestations of monkeypox, most of whom were Black men with AIDS.

The 57 patients included 12 men who died, and the CDC attributes 5 of those deaths directly to the virus.

Patients were seen from Aug 10 through Oct 10, 2022, and 47 (82%) had HIV infection, 4 (9%) of whom were receiving antiretroviral therapy before monkeypox diagnosis. Most patients were male (95%), and 68% were Black. Seventeen patients (30%) received intensive care unit–level care.

Two patients (4%), one of whom had HIV, were undergoing chemotherapy for a hematologic malignancy, 3 (5%) were solid organ transplant recipients, and 3 (5%) were pregnant. In addition, 13 patients (23%) were homeless.

The authors detailed three cases of men with HIV and monkeypox, one of whom, a Hispanic man in his 20s, died. Two others—a Black man in his 30s and White man in his 40s, both with AIDS—are still receiving tecovirimat (Tpoxx) antiviral treatment.

Treatment delay in some

Notably, the authors found a significant delay in antiviral treatments for patients with severe infections. "Most patients eventually received tecovirimat, but some experienced delays of up to 4 weeks between initial care-seeking for monkeypox symptoms and initiation of monkeypox-directed therapy," the authors wrote.

"For patients with suspected or laboratory-diagnosed monkeypox who are at risk for severe disease (particularly those with AIDS and other types of severe immunocompromise), health care providers should consider starting monkeypox-directed therapy early, potentially before receipt of monkeypox testing results or before severe manifestations are observed," the authors said.

"Monkeypox and HIV have collided, with tragic effects," said CDC Monkeypox Incident Commander Jonathan Mermin, MD, MPH, in a CDC statement emailed to reporters. "Today's report reminds all of us that access to monkeypox and HIV prevention and treatment matters—for people's lives and for public health."

The CDC said healthcare providers should consider prompt monkeypox treatment for all patients who have probable or confirmed monkeypox and are at risk for severe disease, especially those with advanced HIV. And all patients with suspected monkeypox should be tested for both HIV and monkeypox.

The agency added, "The high proportion of people with severe monkeypox who were experiencing homelessness (23%) underscores a need for innovative, creative solutions for providing health services to people who are unstably housed."

https://www.cidrap.umn.edu/news-perspective/2022/10/researchers-warn-severe-monkeypox-some-patients

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Monkeypox cases are plummeting. Scientists are debating why

Models suggests rising immunity in a small group of people with many sexual contacts is key

Science BY KAI KUPFERSCHMIDT  26 OCT 2022

When monkeypox cases in Europe began to decline this summer, researchers’ first question was: Is it real? Some worried that people might not be getting tested because of receding fears of the virus, coupled with strict isolation requirements for patients. “They might be reluctant to be confirmed and be told not to go out at all,” says Catherine Smallwood, monkeypox incident manager at the World Health Organization’s (WHO’s) Regional Office for Europe.

But the decline is now unmistakable. WHO Europe, which reported more than 2000 cases per week during the peak in July, is now counting about 100 cases weekly. In the Americas, the other major epicenter of the outbreak, numbers have dropped by more than half (see graphic, right). “We’re seeing a true decline,” Smallwood says.

Vaccines, behavior change among the most affected group—men who have sex with men (MSM)—and immunity after natural infection are all playing a role in that decline, says Erik Volz, an infectious disease modeler at Imperial College London, but how much each factor has contributed is unclear. “This is something we’ve debated a lot internally.”

The answer is important because it determines the likelihood of a resurgence of the virus. Knowing what has driven down cases so far will also help shape strategies to eliminate the virus outside endemic countries in Africa, a goal WHO Europe is already pushing for.

https://www.science.org/content/article/monkeypox-cases-are-plummeting-scientists-are-debating-why

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Other:

Listen: Anti-science at the polls, a biotech odd couple, & the stakes of the midterms

STAT's Sarah Owermohle shares how shutdowns, vaccines, and the prospect of arresting Fauci have become midterm campaign rallying cries.

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RSV: A pediatric disease expert answers five questions about the surging outbreak of the virus

Respiratory syncytial virus, more commonly known as RSV, sends thousands of children to the hospital every year in the U.S. But during September and October 2022, health professionals across the country have watched an unprecedented spike in the number of cases of this usually mild, but occasionally dangerous, respiratory infection in children.

https://medicalxpress.com/news/2022-10-rsv-pediatric-disease-expert-surging.html?

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With hospitalizations ticking up, flu season appears off to an early start

https://www.statnews.com/2022/10/28/flu-season-2022-health-cdc/?

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WHO identifies life-threatening fungal pathogens

The World Health Organization (WHO) today released its first-ever list of fungal "priority pathogens," identifying 19 fungi that have emerged as significant public health threats because of their ability to cause severe invasive infections and their growing resistance to antifungal drugs.

https://www.cidrap.umn.edu/news-perspective/2022/10/who-identifies-life-threatening-fungal-pathogens

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46% of Americans have been in debt due to hospital bills

The ever-rising cost of healthcare in the United States is having a crippling financial impact on many Americans, according to a recent survey.

In fact, almost half (46%) admitted healthcare bills have put them in debt, according to research conducted on behalf of Babylon, a digital-first primary care service. The survey queried 5,000 U.S. adults by One Poll between August 8-15, 2022.

Another one-third (34%) said they will struggle or are struggling to pay their healthcare maintenance costs, emergency needs and private health insurance. The findings come as healthcare costs, including premiums and out-of-pocket expenses, are set to increase again this year, Babylon stated.

https://healthexec.com/topics/healthcare-management/healthcare-economics/46-americans-have-been-debt-due-hospital-bills

Diagnostics:

still an incredible, negligent last of testing.

Schrödinger's COVID: Infected without testing positive?

https://medicalxpress.com/news/2022-10-schrdinger-covid-infected-positive.html

Drugs and Vaccines:

China launches a COVID-19 vaccine inhaled through the mouth

medicalxpress.com/news/2022-10-c 

study published by the peer-review journal The Lancet on May 30, 2022, showed that using Convidecia Air™ as a heterologous booster generated much more robust immune responses than those induced by a homologous inactivated vaccine booster.

https://www.precisionvaccinations.com/2022/10/27/inhaled-covid-19-vaccine-launches-shanghai

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Opinion | The Updated COVID Boosters Could Have Been Better

https://www.medpagetoday.com/opinion/second-opinions/101432

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Cancer therapy shows potential to treat severe COVID-19 in pre-clinical trials

https://medicalxpress.com/news/2022-10-cancer-therapy-potential-severe-covid-.html

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Regular use of common cholesterol-lowering drug linked to reduction of COVID-19 severity, risk of death

Commonly used cholesterol-lowering statins may reduce the risk of death and severity of COVID-19 disease, suggests a study of more than 38,000 patients being presented at the Anesthesiology 2022 annual meeting.

"While there is no 'magic bullet' to help patients who are very ill with COVID-19, statins decrease inflammation, which may help reduce the severity of the disease," said Ettore Crimi, M.D., MBA, lead author of the study and professor of anesthesiology and critical care medicine, University of Central Florida, Orlando. "Results of our study clearly showed regular statin use is associated with reduced risk of death and improved outcomes in hospitalized COVID-19 patients."

https://medicalxpress.com/news/2022-10-regular-common-cholesterol-lowering-drug-linked.html

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Devices:

Epidemiology/Infection control:

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Global COVID cases and deaths continue overall decline

Last week, COVID cases continued to decline, with cases down in some regions and stabilizing in others, including the Western Pacific, where infection levels have been on the rise, the World Health Organization (WHO) said yesterday in its latest weekly update.

Cases dropped 15% last week compared to the previous week, and deaths decreased by 13% over the same period. For fatalities, WHO reported declines for four regions, stabilization in the Americas, and an increase in the Eastern Mediterranean region.

Of more than 2.6 million cases reported to the WHO last week, the five countries reporting the most—though all with declining cases—include Germany, France, China, the United States, and Italy.

The WHO said the Omicron BA.5 lineages make up 77.1% of cases, followed by BA.4 lineages, and then B.2 lineages, which have risen in prevalence. It said genetic diversification of SARS-CoV-2 continues, with 390 Omicron sublineages reported so far, along with 48 recombinants.

As of Oct 25, 35 countries have reported the XBB and XBB.1 variants, and 65 have reported BQ.1—a BA.5 subvariant—and its descendant lineages.

The WHO said its virus evolution technical group met on Oct 24 to discuss XBB and BQ.1, with a statement on its assessment to come.
Oct 26 WHO COVID situation report

https://www.cidrap.umn.edu/news-perspective/2022/10/covid-19-scan-oct-27-2022

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Contact tracing data sheds light on COVID-19 spread in New York City

A study led by researchers at Columbia University Mailman School of Public Health uses contract tracing data to produce a detailed map to date of SARS-CoV-2 spread in New York City. They found that the city's contact tracing program was efficient and produced data that can inform neighborhood-level interventions like vaccination and reactive restriction on business capacity.

https://medicalxpress.com/news/2022-10-contact-covid-york-city.html?

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Long COVID reported in 15% of US adults with prior infection; vaccination lowers risk

Approximately 15% of U.S. adults with a prior positive COVID-19 test report symptoms of long COVID, according to data published in JAMA Network Open.

The researchers further concluded that women and older patients demonstrated a greater risk for long COVID, while those who completed a primary vaccination series before they were infected were less likely to report long COVID symptoms.

“If high-risk individuals could be identified, it might be possible to develop strategies to mitigate or prevent symptom persistence, prompting calls for increased emphasis on investigation of post-acute sequelae of COVID-19,” Roy H. Perlis, MD, MSc, of Massachusetts General Hospital, and colleagues wrote. “A prior self-report study identified older age and female gender as correlates of greater risk for persistent COVID-19 symptoms; associations with gender were further supported in a U.K. survey.”

https://www.healio.com/news/rheumatology/20221027/long-covid-reported-in-15-of-us-adults-with-prior-infection-vaccination-lowers-risk

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Survey: A third of US military find exercise difficult 1-month post-COVID

A third of US active-duty military service members who tested positive for COVID-19 reported new-onset or more difficulty with exercise and daily activities 1 month after diagnosis, but these symptoms diminished to pre-infection levels after 6 to 9 months, according to research presented at this week's Infectious Diseases Society of America (IDSA) ID Week in Washington, DC.

The surveys also revealed COVID-19 vaccines' protective effect. "Vaccinated individuals, even if they had breakthrough infections, did not experience as much of a long-term effect on exercise and daily activities," said senior author Simon Pollett, MBBS, also of the Uniformed Services University of the Health Sciences. "These results underscore the value of vaccination, not just for preventing death and disease but for preserving long-term quality of life."
Oct 20 IDSA news release

https://www.cidrap.umn.edu/news-perspective/2022/10/news-scan-oct-21-2022

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Ebola:

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Influenza:

Flu disparities persist for vaccination and hospitalizations

The message is clear: Everyone should get a flu shot today, the CDC says, especially with an early start to the flu season. But “everyone” has not been the reality. A CDC analysis released yesterday tracks inequities in who gets flu vaccine and who is hospitalized with severe flu. Vaccination has been lower among Black, Hispanic, and American Indian/Alaska Native adults since 2010: Last flu season, vaccination coverage was 54% among white and Asian adults but only 42% among Black adults, 38% among Hispanic adults, and 41% among AI/AN adults.

Compared to white adults, hospitalization rates were nearly 80% higher among Black adults, 30% higher among AI/AN adults, and 20% higher among Hispanic adults.  The reasons behind lower vaccination rates include barriers to affordable health care, while more severe flu outcomes may follow higher rates of asthma, diabetes, obesity, and other chronic conditions.

https://mailchi.mp/statnews/tk-tncyc6de8v-620004?e=5c09ee46b1

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RSV:

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Tips, general reading for public:

Ventilate.

Mask.

Vax.

Politics:

Covid:

So why have they been doing nothing re masking, improving ventilation, etc., and are still deflecting to "personal responsibility." ???  I assume it is because of liability issues and cost to business to improve ventilation, but still, why the gaslighting?

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Jan 6/TFG/Secret Service

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GOP:

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Abortion/Reproduction:

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Antisemitism:

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Climate/Environment:

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Economy:

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Gas:

Guns:

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and many others...

Healthcare workforce/burnout:

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Race/Disparities:

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Arizona:

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Florida/DeSantis:

Pennsylvania: Oz/Fetterman:

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Texas/Abbott:

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Hungary:

Russia:

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Feel good du jour:

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Comic relief:

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Perspective/Poem

Full thread about Vasili Arkhipov at https://threadreaderapp.com/thread/1585524746799796224.html

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Bits of beauty:

Boston Gardens

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