
Coronavirus Tidbits #148 7/11/21
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
Long Covid: Persistent symptoms in adult patients one year after COVID-19: a prospective cohort study
Jessica Seeßle, et al. Clinical Infectious Diseases, ciab611, https://doi.org/10.1093/cid/ciab611
Background
Long COVID is defined as the persistence of symptoms beyond 3 months after SARS-CoV-2 infection. To better understand the long-term course and etiology of symptoms we analyzed a cohort of COVID-19 patients prospectively.
Methods
Patients were included at 5 months after acute COVID-19 in this prospective, non-interventional follow-up study. Patients followed until 12 months after COVID-19 symptom onset (n=96, 32.3% hospitalised, 55.2% females) were included in this analysis of symptoms, quality of life (based on a SF-12 survey), laboratory parameters including antinuclear antibodies (ANA), and SARS-CoV-2 antibody levels.
Results
At month 12, only 22.9% of patients were completely free of symptoms and the most frequent symptoms were reduced exercise capacity (56.3%), fatigue (53.1%), dyspnoea (37.5%), concentration problems (39.6%), problems finding words (32.3%), and sleeping problems (26.0%). Females showed significantly more neurocognitive symptoms than males.
ANA titres were ≥1:160 in 43.6% of patients at 12 months post COVID-19 symptom onset, and neurocognitive symptom frequency was significantly higher in the group with an ANA titre ≥1:160 compared to <1:160. Compared to patients without symptoms, patients with at least one long COVID symptom at 12 months did not differ significantly with respect to their SARS-CoV-2-antibody levels, but had a significantly reduced physical and mental life quality compared to patients without symptoms.
Conclusions
Neurocognitive long COVID symptoms can persist at least for one year after COVID-19 symptom onset, and reduce life quality significantly. Several neurocognitive symptoms were associated with ANA titre elevations. This may indicate autoimmunity as cofactor in aetiology of long COVID.
https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciab611/6315216
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https://twitter.com/0bj3ctivity/status/1411337784565157896?s=20
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@MackayIM made an excellent figure that’s been running through my mind a lot again this week pic.twitter.com/4r7RtnrSov
— Jason Kindrachuk, PhD (@KindrachukJason) June 30, 2021
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Can COVID-19 cause lasting erectile dysfunction?
— Los Angeles Times (@latimes) July 6, 2021
This is now the topic of some discussion among doctors and health experts as they try to better understand the effects of the coronavirus.https://t.co/dAFutNQekG pic.twitter.com/3wom4EX2yr
Diagnostics:
still an incredible, negligent last of testing.
Drugs and Vaccines:
Mix-and-match COVID vaccines: the case is growing, but questions remain
A slew of studies suggests that mixing vaccines provokes potent immune responses, but scientists still want answers on real-world efficacy and rare side effects.
Nature Dyani Lewis 01 July 2021
Mixing COVID-19 vaccines is emerging as a good way to get people the protection they need when faced with safety concerns and unpredictable supplies. Most vaccines against SARS-CoV-2 must be given in two doses, but multiple studies now back up the idea that mixing the Oxford–AstraZeneca jab and the Pfizer–BioNTech vaccine triggers an immune response similar to — or even stronger than — two doses of either vaccine.
Results announced on Monday 1 by a UK group suggest that the combination sometimes outperforms two shots of the same vaccine, and a similar picture is emerging from German studies2,3.
People can now “feel a bit more comfortable” with the idea of mix-and-match, says immunologist Leif Erik Sander at Charité University Hospital in Berlin.
The results are also giving researchers confidence that combining other COVID-19 vaccines, that haven’t yet been tested together, might also work. But at least 16 vaccines have been approved for use in one or more countries, and mix-and-match studies so far have been small, so more extensive trials and long-term monitoring for side effects are sorely needed.
https://www.nature.com/articles/d41586-021-01805-2
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India's Covaxin quite effective
Efficacy analysis demonstrates COVAXIN® to be 77.8% effective against symptomatic COVID19, and 93.4% effective against severe symptomatic COVID-19,
https://www.
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Vaccine Diplomacy - Mexico's Government Launches Sputnik V Vaccine Production
Mexico became the first country in North America to register Sputnik V and launch local production.
To date, Sputnik V has been registered in 67 countries globally.
The Sputnik V vaccine is based on human adenoviral vectors and uses different vectors for the two vaccine doses. The price of Sputnik V is less than $10 per dose.
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U.S. Donated COVID-19 Vaccines Distributed in Pakistan
About 2.5 million doses of Moderna (SpikeVax) COVID-19 vaccines donated by the United States are being distributed by the Government of Pakistan to vaccinate priority groups across the country, in line with the National Deployment and Vaccination Plan.
So far, three million people have been fully vaccinated and 13.5 million partially vaccinated in Pakistan, using vaccines that the Government procured through COVAX or bilateral agreements.
More than 960,000 cases of COVID-19 have been reported in the country since the start of the outbreak, and at least 22,379 people have succumbed to the disease.
https://www.precisionvaccinations.com/2021/07/06/us-donated-covid-19-vaccines-distributed-pakistan
(US is also donating vax to India)
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COVAX Demands Equal Recognition of Covid-19 Vaccines
The global COVAX Facility says not recognising certain shots for travel will create a two-tier system and exacerbate the inequity already seen in vaccine distribution.
the European Union’s (EU) Digital Covid Certificate — a vaccine “passport” which aims to facilitate free travel across the bloc’s 27 member nations, plus Switzerland, Iceland, Norway and Liechtenstein — did not recognise Covishield, the AstraZeneca vaccine manufactured by the Serum Institute of India, the world’s largest vaccine maker.
https://codeblue.galencentre.org/2021/07/04/covax-demands-equal-recognition-of-covid-19-vaccines/
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Israel reported a drop in Pfizer-BioNTech vaccine effectiveness
against infections and symptoms amid Delta (B1617.2) variant spread and relaxed restrictions, though it is still highly effective against serious illness. Since Jun 6, efficacy against infection and symptomatic disease declined to 64%, with efficacy against serious illness and hospitalization at 93%, according to the country's health ministry.
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In US, 11% of people have missed second COVID-19 vaccine dose
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Can we stretch existing Covid vaccines to inoculate more people? Experts are divided
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Should We Be Concerned About the Lambda Variant?
https://www.medpagetoday.com/special-reports/exclusives/93458?
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Superb piece by doctors @jeremyfaust @celinegounder & Katie Dickerson Mayes.
— Prof. Gavin Yamey MD MPH (@GYamey) July 5, 2021
Covid infection poses a much greater risk to adolescents than Covid vaccines (which are astoundingly safe & efficacious).
I support vaccinating 12-17 year olds. https://t.co/muGcGwR4Cb
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Pfizer and its vaccine partner BioNTech will seek FDA authorization for a third dose of COVID-19 vaccine, citing positive data from an Israeli study; in response, the CDC and FDA issued a joint statement saying data do not yet support the need for a third dose. (The Hill)
Devices:
Details on how filtration can be added for an affordable cost is given in series of tweets by @CorsIAQ himself. These will filter out >99% of the aerosols of the size produced in speech/singing.https://t.co/UJfm79UIXF (2/2)
— Kimberly Prather, Ph.D. (@kprather88) July 9, 2021
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Belgium imposes ventilation rules for businesses to combat new Covid surge
— Jose-Luis Jimenez (@jljcolorado) July 6, 2021
Carbon dioxide monitors must be on public display so customers can see level of fresh air
[My comment: An example for every other country to follow]https://t.co/l9kkKoR4Yc
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If you're fully vaccinated, should you wear a mask indoors?@WHO, LA Health Dept say yes
— Ashish K. Jha, MD, MPH (@ashishkjha) July 7, 2021
CDC says no
Who is right?
Well, it turns out, its nuanced
It depends largely on where you live...and your risk tolerance
My latest op-ed in @BostonGlobe https://t.co/qJGglht4Df
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We need something to go viral pic.twitter.com/l4uaiy1Kpm
— pedroBigE (@pedroBigE) July 1, 2021
Epidemiology/Infection control:
COVID vaccines to reach poorest countries only in 2023 — despite recent pledges
Amid a COVID surge in Africa, vaccine promises from richer nations are not enough to bring an early end to the pandemic, experts say.
Nature V. Padma
Around 11 billion doses are needed to fully vaccinate 70% of the world’s population against COVID-19. As of 4 July, 3.2 billion doses had been administered. At the current vaccination rate, this will increase to around six billion doses by the end of the year, researchers from the International Monetary Fund, based in Washington DC, project.
But so far, more than 80% of the doses have gone to people in high-income and upper-middle-income countries. Only 1% of people in low-income countries have been given at least one dose, according to the website Our World in Data.
Last month, the leaders of the G7 group of wealthy nations pledged extra doses for low- and middle-income countries (LMICs) by the end of 2022, at a summit in Cornwall, UK. The centrepiece was a promise from US President Joe Biden to donate 500 million doses of the vaccine made by pharmaceutical company Pfizer of New York City and biotechnology company BioNTech in Mainz, Germany. This is in addition to 87.5 million previously pledged. The United Kingdom pledged 100 million, and France, Germany and Japan have pledged around 30 million each.
China has shipped around 30 million vaccine doses to at least 59 countries, according to data published on 2 July by researchers from the Duke Global Health Innovation Center in Durham, North Carolina.
Andrea Taylor, a health policy researcher and the centre’s assistant director, says these pledges are unlikely to get more vaccines to the world’s poorest people more quickly. In March, her group projected that the world would be vaccinated in 2023; Taylor says that date still stands.
https://www.nature.com/articles/d41586-021-01762-w
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COVID-19 affects men and women differently. So why don’t clinical trials report gender data?
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Really incredible findings in this recent study of ER patients:
— Ryan Marino (@RyanMarino) July 8, 2021
•65% used ER as main source of care
•39% were vaxx hesitant
•47% w/o access to other care sources were vaxx hesitant
But
•95% would accept the COVID19 vaxx as part of their care in the ED!https://t.co/KXzcVzf3oK
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The #COVID19 situation globally is very dangerous with high levels of transmission driven by 4️⃣ major factors:
— World Health Organization (WHO) (@WHO) July 8, 2021
1️⃣ virus variants
2️⃣ increased social mixing and mobility of people
3️⃣ inappropriate use of public health & social measures
4️⃣ vaccine inequity
- Dr @mvankerkhove pic.twitter.com/BKBuTXHbBU
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Too Much, Too Late: Health Groups Pan OSHA Rule on COVID Precautions
— Applies to any healthcare setting, including nursing homes and home health
https://www.medpagetoday.com/infectiousdisease/covid19/93488?
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https://twitter.com/jneill/status/1409595081104007168?s=20
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With help from WHRY @Johnsonlab_yale established a collaboration with @VirusesImmunity who led a research team this summer in identifying significant differences in how the immune systems of women & men respond to the virus that causes COVID-19 @YaleSPH https://t.co/N9dZ1SoDsY
— WHRYale (@WHRYale) July 6, 2021
Tips, general reading for public:
StayAtHome
Wash your hands.
Rinse and repeat.
Politics:
What happens when the first teacher is arrested for teaching about Jim Crow in a memory laws state?
He missed a few #COVID19 charlatans, but this is a good start. https://t.co/8or4gMP8E9
— David Gorski, MD, PhD (@gorskon) July 9, 2021
Recent rulings may embolden hospital employees to speak publicly about safety issues
A recent ruling could mean hospitals will need to revise policies barring workers from talking to the news media and posting on social media.
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if you don't stop everything and sing the national anthem next to the stack of mountain dew the terrorists win
— jordan (@JordanUhl) July 4, 2021
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https://twitter.com/Amy_Siskind/status/1412069247459729418?s=20
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Ohio allows doctors to deny LGBTQ health care on moral grounds. https://t.co/7HpxoRXTL4
— Rolling Stone (@RollingStone) July 7, 2021
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Trump reported making more than $1.6 billion while president
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this is honestly stunning pic.twitter.com/3SF9AmNjN6
— sam deutsch (@samdman95) July 6, 2021
Feel good du jour:
Two women chatted in a bathroom. They soon realized they were each a match for the other’s husband, who needed a k… https://t.co/8t3L0OPbAt
— Judy Stone (@DrJudyStone) July 10, 2021
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For years, this doctor has showed up after strangers’ weddings and — with permission — brought flowers back to her… https://t.co/RngkVJK5yq
— Judy Stone (@DrJudyStone) July 10, 2021
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Mathematics, physics, beauty.
— Cliff Pickover (@pickover) July 3, 2021
All the bearings are moving in a straight line. https://t.co/EFaQsyjW3h pic.twitter.com/Z8otKCf1I9
Comic relief:
You do realize this is their pep rally as they prepare to slaughter us. https://t.co/2P5ZJIFRqO
— Larry Lynam (@scopedbylarry) July 5, 2021
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https://twitter.com/OdedRechavi/status/1413723059157143552?s=20
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https://twitter.com/Boston_Grandpa/status/1412857010480111622?s=20
Perspective/Poem
A hospital janitor who's paid so little he can't afford rent worked extra hard in the pandemic and won employee of the month. He was awarded a $6 coupon to the hospital cafeteria.
— Dan Price (@DanPriceSeattle) July 8, 2021
The hospital CEO got a 13% raise and now makes $30 millionhttps://t.co/6mWfSMUkoQ
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https://twitter.com/colinmcfarlane/status/1413401047046017025?s=20
Bits of beauty:

