Coronavirus Tidbits #125 2/28/21

February 28, 2021 /

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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.

News 

Vaccine finder now available:

https://vaccinefinder.org/

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Study finds COVID risk communication targeting younger adults may have biggest impact

A study of adults in the United States finds that – broadly speaking – the older you are, the more concerned you are about COVID-19, and the more steps you take to reduce your risk from COVID-19. The study suggests that the biggest boost in risk reduction would stem from communication efforts aimed at raising awareness of COVID-19 risks among U.S. adults under the age of 40.

https://www.eurekalert.org/pub_releases/2021-02/ncsu-sfc022321.php

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Mutant Covid strains

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BioNTech and Pfizer Begin 3rd COVID-19 Vaccine Dose Evaluation

Germany-based BioNTech SE and Pfizer Inc. announced they had begun evaluating the safety and immunogenicity of a third dose of the Pfizer-BioNTech COVID-19 vaccine (Comirnaty) (BNT162b2) to understand the effect of a booster on immunity against COVID-19 caused by the circulating and potential newly emerging SARS-CoV-2 variants.

The study will draw upon participants from the Phase 1 study in the USA who will be offered the opportunity to receive a 30 µg booster of the current vaccine 6 to 12 months after receiving their initial two-dose regimen…(also) to determine the effectiveness of the third dose against evolving variants.

Separately, to be prepared for any potential future strain changes, Pfizer and BioNTech are in ongoing discussions with regulatory authorities regarding a registration-enabling clinical study to evaluate a variant-specific vaccine having a modified mRNA sequence. This study would use a new construct of the Pfizer-BioNTech vaccine based on the B.1.351 lineage, first identified in South Africa.

This could position the Companies to update the current vaccine quickly if the need arises to protect against COVID-19 from circulating strains.

https://www.precisionvaccinations.com/2021/02/25/biontech-and-pfizer-begin-3rd-covid-19-vaccine-dose-evaluation

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Moderna, Inc. is doing similar things…

announced that it has completed manufacturing of clinical trial material for its variant-specific vaccine candidate, mRNA-1273.351, against the SARS-CoV-2 virus variant known as B.1.351 and has shipped doses to the National Institutes of Health (NIH) for a Phase 1 clinical trial.

This new study will be led and funded by the NIH’s National Institute of Allergy and Infectious Diseases.

Furthermore, Moderna is pursuing two strategies against these variants, subject to U.S. Food and Drug Administration (FDA) review.

First, the Company is evaluating booster doses of vaccines to increase neutralizing immunity against the variants of concern. Moderna plans to evaluate three approaches to boosting, including:

  • A variant-specific booster candidate, mRNA-1273.351, based on the B.1.351 variant was first identified in the Republic of South Africa, at the 50 µg dose level and lower.
  • A multivalent booster candidate, mRNA-1273.211, combines mRNA-1273, Moderna’s authorized vaccine against ancestral strains, and mRNA-1273.351 in a single vaccine at the 50 µg dose level and lower.
  • A third dose of mRNA-1273, the Moderna COVID-19 Vaccine, is a booster at the 50 µg dose level. The Company has already begun dosing this cohort with the booster.

Second, Moderna plans to evaluate mRNA-1273.351 and mRNA-1273.211 as a primary vaccination series for those who are seronegative. These candidates will be evaluated in a two-dose series at the 100 µg dose level and lower.

Consistent with the recently updated FDA Guidance for Industry, the Company plans to evaluate immunogenicity and safety in participants who have not received a COVID-19 vaccine and participants in clinical studies who previously received the mRNA-1273 vaccine.

https://www.precisionvaccinations.com/2021/02/25/nih-launches-variant-specific-covid-19-vaccine-clinical-study

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https://twitter.com/CalHealthline/status/1365833599111598082?s=20

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Long Covid reported in 1 in 10 patients

New WHO policy brief calls on decision-makers to support patients

It’s important that patients reporting with symptoms of long COVID are included as part of the COVID-19 response to mitigate some of the longer-term health impacts of the pandemic. This policy brief makes clear the need for policy-makers to take the lead on this issue.”

https://www.euro.who.int/en/health-topics/health-emergencies/coronavirus-covid-19/news/news/2021/2/new-policy-brief-calls-on-decision-makers-to-support-patients-as-1-in-10-report-symptoms-of-long-covid

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Another model to help rural hospitals–‘Bidirectional’ patient transfers helped this state protect rural healthcare from COVID

A Western U.S. state may have rescued its rural hospitals from potential financial ruin at the hands of the pandemic. In the process the state has set the bar for regional health networks facing similar threats around the country.

The Colorado Hospital Association’s VP of rural health and hospitals tells the story to the ABC affiliate in Denver via TheDenverChannel.com.

The state’s key move was making the expected rural-to-urban patient transfers a “two-way highway.”

“urban patients were being shipped in certain crisis points out to rural hospitals, (via) a well-coordinated effort to ready the rurals to handle nonemergency demand.

Other decisive actions included cross-training staff on urban- and rural-specific routines, leveraging loans from the federal Paycheck Protection Program and marshaling the will to work with unfamiliar colleagues on a broad scale.

Denver Channel coverage here.

[Financial benefit to rural hospitals and eases the crowding and burden of urban ones]

https://www.healthexec.com/topics/covid-19/bidirectional-patient-transfers-helped-state-protect-rural-healthcare-covid

Diagnostics:

still an incredible, negligent lack of testing.

New COVID-19 Semi-quantitative Serology Test Service Launches

Quest Diagnostics introduced a new COVID-19 testing service that aids in providing insight into an individual’s immune response as a result of a recent or prior infection with SARS-CoV-2 or to the immune response observed in connection with COVID-19 vaccination.

The test service provides a positive/negative result and a numerical result that may provide the basis for assessing relative changes in antibody blood levels.

The new service can also aid in assessing blood levels of antibodies produced to structural proteins of the SARS-CoV-2 spike protein.

According to the U.S. Food and Drug Administration, serology tests can help ‘to identify individuals who have developed antibodies that may protect from future infection as well as identify those still at risk.’

https://www.precisionvaccinations.com/2021/02/24/new-covid-19-semi-quantitative-serology-test-service-launches

Drugs and Vaccines:

FDA has granted Emergency Use Authorization for Johnson & Johnson’s Covid-19 vaccine.

Across all trial sites, the Johnson & Johnson vaccine also showed 85 percent efficacy against severe forms of Covid-19 and 100 percent efficacy against hospitalization and death.

This one-dose vaccine will allow states to rapidly increase the number of people who have been fully inoculated. Unlike the other two vaccines, it can be stored at standard refrigeration temperatures for at least three months.

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Good explainer on J&J’s Covid-19 vaccine:

https://www.nytimes.com/interactive/2020/health/johnson-johnson-covid-19-vaccine.html

Johnson & Johnson’s – Janssen’s COVID-19 Vaccine Shows Efficacy in Phase 3 Data

The Ad26 platform has been used in vaccines administered to nearly 200,000 real-world and clinical trial participants

This article was originally published in ContagionLive.

Phase 3 data for coronavirus disease 2019 (COVID-19) vaccine candidate Janssen Ad26.COV2.S shows the one-shot adenovirus prophylaxis provided 66.1% efficacy (95% CI, 55.0 – 74.8) in preventing COVID-19 versus placebo ≥28 days after administration.

The Vaccine

Janssen Ad26.COV2.S is an intramuscular injection vaccine consisting of a replication-incompetent recombinant adenovirus type 26 (Ad26) vector which expresses the SARS-CoV-2 spike (S) protein.

The Ad26 platform is prominent in use with Ebola vaccines, and is being used for investigative prevention of Zika virus, filovirus, HIV, HPV, malaria, and respiratory syncytial virus (RSV) in other vaccine forms.

Since December 2020, the Ad26 platform has been used in vaccines administered to nearly 200,000 real-world and clinical trial participants, and has been associated with an overall “acceptable clinical safety profile,” the FDA wrote.

https://www.hcplive.com/view/janssen-covid-19-vaccine-efficacy-phase-3-data

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Is more simply better? Why Pfizer thinks a booster of its Covid vaccine might work against new variants

https://statnews.us11.list-manage.com/track/click?u=f8609630ae206654824f897b6&id=1b76de43b9&e=f4c6ea30a0 ~ ~ ~

FDA Allows More Flexible Storage, Transportation Conditions for Pfizer-BioNTech COVID-19 Vaccine

FDA is allowing undiluted frozen vials of the Pfizer-BioNTech COVID-19 Vaccine to be transported and stored at conventional temperatures commonly found in pharmaceutical freezers for a period of up to two weeks. This reflects an alternative to the preferred storage of the undiluted vials in an ultra-low temperature freezer between -80ºC to -60ºC (-112ºF to -76ºF).

Pfizer Inc. submitted data to the FDA to demonstrate that their COVID-19 vaccine remains stable after storage of the undiluted vials for up to two weeks at standard freezer temperature. The alternative temperature for storage of frozen vials is not applicable to the storage of thawed vials before dilution (which can be held in the refrigerator for up to 5 days), or on the storage of thawed vials after dilution (which can be held at refrigerator temperature or room temperature for use within 6 hours).

The updated Fact Sheets for Health Care Providers Administering Vaccine (Vaccination Providers) are intended to help frontline workers understand the new alternative transportation and storage temperatures. The Fact Sheets are available on the FDA website.

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Vaccine attitudes/acceptance

Trends Among Key Groups

More than half of U.S. adults (55%) now say they have already received at least one dose of the COVID-19 vaccine (18%) or they want it as soon as possible (37%). This is an increase from 47% in mid-January and up from 34% in early December before vaccine distribution began. About one in five adults (22%) say they will “wait and see” how the vaccine is working for others before getting vaccinated themselves, a share that is down from 31% in January and 39% in December. The remaining public say they will get the vaccine “only if required for work, school, or other activities” (7%) or that they will “definitely not” get vaccinated (15%), shares that have not changed much over the past two months.

https://www.kff.org/coronavirus-covid-19/poll-finding/kff-covid-19-vaccine-monitor-february-2021/?utm_source=

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Arthritis drugs may reduce mortality and time in ICU for sickest COVID patients – Tocilizumab

Treating critically ill COVID-19 patients with drugs typically used for rheumatoid arthritis may significantly improve survival, a landmark study has found.

The findings, which were announced in January and have now been peer-reviewed and published in the New England Journal of Medicine, come from the REMAP-CAP trial, which evaluates the effect of treatments on a combination of survival and length of time patients need support in an intensive care unit (ICU).

Initial findings reported in November showed that tocilizumab, a drug used to treat arthritis, was likely to improve outcomes among critically ill COVID-19 patients. But the impact on patient survival and length of time on organ support in ICU was not clear at that time.

The full, peer-reviewed analysis shows that tocilizumab and a second drug called sarilumab – both types of immune modulators called IL-6 receptor antagonists – have a significant impact on patient survival, reducing mortality by 8.5%.

Furthermore, the treatment also improved recovery so that on average patients were able to be discharged from the intensive care unit (ICU) about a week earlier.

https://www.eurekalert.org/pub_releases/2021-02/icl-adm022521.php

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Lilly’s Bamlanivimab and etesevimab monoclonal antibody cocktail

Eli Lilly said the federal government has ordered 100,000 doses of its two-antibody cocktail for treating nonhospitalized patients with mild-to-moderate COVID.

Bamlanivimab and etesevimab together recently received emergency use authorization for the treatment of recently diagnosed, mild to moderate COVID-19 in patients who are at high risk of progressing to severe COVID-19 and/or hospitalization

Devices:

New Ventilation Recommendations for Schools

open windows; increase air exchanges; use HEPA filters where possible. Ensure restroom and kitchen exhaust fans are on and operating at full capacity

https://www.cdc.gov/coronavirus/2019-ncov/community/schools-childcare/ventilation.html

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Masking does not affect oxygen saturation in patients with asthma

Wearing a mask does not affect oxygen saturation in patients with or without asthma, according to research presented at this year’s virtual American Academy of Allergy, Asthma and Immunology Annual Meeting.

“This data reinforces that wearing a mask, whether it is a surgical mask, cloth mask, or N95, is completely safe,” Alan P. Baptist, MD, MPH, FAAAAI, assistant professor in the department of internal medicine and health behavior and health education at the University of Michigan School of Public Health, said in a press release.

https://www.healio.com/news/primary-care/20210225/masking-does-not-affect-oxygen-saturation-in-patients-with-asthma

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Epidemiology/Infection control:

Gym users should wear masks, even during intense workouts

The Centers for Disease Control and Prevention on Wednesday urged gym users to wear masks during intense workouts — even when socially distanced — and asked gyms to improve ventilation and push for outdoor activities when possible.

The new research is a reminder that working out indoors with other people carries a significant risk of infection.

In Chicago, the CDC found an outbreak was tied to a gym that was operating at 25 percent capacity. Although gym members brought their own weights and mats to high-intensity classes, remained six feet apart and were screened for symptoms, including temperature checks, upon arrival, two major basic guidelines to curb the spread of the virus were not met, the report found.

https://www.washingtonpost.com/nation/2021/02/25/gyms-coronavirus-masks-cdc-ventilation/

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CDC: Nursing Home Cases Suggest COVID Reinfection

— Offer possible epidemiologic clues about immune response to the virus

https://www.medpagetoday.com/infectiousdisease/covid19/91360?

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Vaccine shown to reduce asymptomatic transmission of Covid:

Note that this is a pre-print, meaning not yet peer-reviewed.

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Superspreading events

may give scientists clues about how to contain the virus.

https://www.nature.com/articles/d41586-021-00460-x

 

HEPA filters and School Reopenings

https://twitter.com/LonnieRhea/status/1363342148209315841?s=20

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Thoughtful thread on vaccinated people perhaps getting back to normal?

Tips, general reading for public:

StayAtHome

Wash your hands.

Rinse and repeat.

“Nerd immunity”- Wearing Glasses cuts Covid risk

A new study suggested that wearing glasses for at least eight hours a day cut the risk of COVID-19.

Politics:

GOP Senators Rake Murthy, Levine at Hearing

— Levine attacked for pandemic response and stance on transgender medicine for teens

https://www.medpagetoday.com/washington-watch/washington-watch/91372?

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https://twitter.com/AmoneyResists/status/1365491907749675012?s=20

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There are now 13 Republicans we have counted who signed letter saying they can’t attend votes today because of pandemic – but are listed as CPAC speakers. Many of them critics of voting by proxy. (GOP points to House Dems who’ve done similar in the past.)

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Insults, Threats of Violence Still Imperil Public Health Leaders

— Nearly 200 have left their jobs during pandemic

https://www.medpagetoday.com/special-reports/exclusives/91357?

Feel good du jour:

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https://twitter.com/CBSSunday/status/1365436412372389888?s=20

Comic relief:

https://twitter.com/Raymond_LLM/status/1364699218741501957?s=20

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https://twitter.com/nickyforvictory/status/1365588719072387072?s=20

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This video is quite funny and uplifting: Jerusalema dance

Perspective/Poem

Bits of beauty:

 

Contrast in textures

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