Coronavirus Tidbits #159 9/26/21

Quick links

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.

What’s Going On In Florida? Are They Trying To Bring Back Deadly Infections?

State Government Penalizes Vaccinated by Rationing Regeneron Antibody Treatment…

to preserve supplies for those who are unwilling to get vaccinated and remain most vulnerable

 

News 

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Diagnostics:

still an incredible, negligent last of testing.

Drugs and Vaccines:

This (below) is a good perspective on why there was a discrepancy between what the ACIP recommended and what Dr. Walensky/CDC decided about boosters–which was to extend them to people at occupational risk. I believe that was the correct decision to make.

https://twitter.com/denise_dewald/status/1441232015576080387?s=20

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26. Even with highly effective boosters, if there’s a lot of #Covid in the community & a lot of introduction into nursing homes by unvaccinated staff, boosters won’t stop cases in nursing homes, #ACIP is told. Higher vax rates among staff would have a greater impact.

29. Among people who got a 3rd dose of mRNA, side effects were comparable to dose 2, but were reported at slightly lower rates.

The rates of side effects after dose 3 were lower than after dose 2. There was more lymphadenopathy – swollen lymph nodes.

36. FDA’s Doran Fink says the agency’s position on boosting with a different vaccine (ie Pfizer after Moderna) is that there are no data to inform that decision. He said he needs to check with FDA leadership on legal questions related to using a Pfizer boost after another vax

40. Analysis of data suggests that receipt of an mRNA vaccine is not associated with a higher risk of having a miscarriage. (aka Spontaneous abortion)

43. Despite the evident risks associated with contracting Covid during pregnancy and the evident safety of the vaccines for pregnant people, the rate of vaccine uptake among pregnant people is only about 30%.

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I Got Moderna. Can I Boost With Pfizer?

https://www.medpagetoday.com/special-reports/exclusives/94678 More at

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Key nursing home staff lag in COVID-19 vaccination, study shows

Sixty percent of staff and 81.4% of residents, on average, from more than 14,900 nursing homes were fully vaccinated. Mean vaccination rates were lowest among CNAs (49.2%) and registered and licensed practical nurses (61.0%), while therapists, physicians, and independent practitioners had 70.9% and 77.3% coverage, respectively.

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How is vaccine-induced immunity holding up?

“Things wane,” says Nicole Doria-Rose, an immunologist at the US National Institute of Allergy and Infectious Diseases in Bethesda, Maryland. But not all things wane equally.

‘Neutralizing’ antibodies that can intercept viruses before they infiltrate cells might not have much staying power. Levels of these molecules typically shoot up after vaccination, then quickly taper off months later. “That’s how vaccines work,” Doria-Rose says.

But cellular immune responses are longer lasting – and as Jennifer Gommerman, an immunologist at the University of Toronto in Canada, explains: “Cellular immunity is what’s going to protect you from disease.” Memory B cells, which can rapidly deploy more antibodies in the event of re-exposure to the virus, tend to stick around, and so do T cells, which can attack already-infected cells. Both provide an added measure of protection should SARS-CoV-2 sneak past the body’s first line of defence.

“So, you have this reserve,” says John Wherry, an immunologist at the University of Pennsylvania Perelman School of Medicine in Philadelphia, who led the study. “Circulating antibodies may be declining, but your immune system is capable of jumping into action once again.”

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J&J booster 94% effective against severe COVID, company says

Today, Johnson & Johnson (J&J) announced that a second dose of its COVID-19 vaccine given 2 months after the first raises its effectiveness against moderate to severe disease to 94% in the United States. The booster was also well tolerated, generating side effects similar to those observed after the first dose.

In a press release, the company said that its phase 3 US clinical trial data showed that a booster dose given at 56 days conferred 94% protection against moderate to severe disease in nearly 30,000 adult participants. The confidence interval (CI), however, was wide, at 58% to 100%, leaving doubt as to the precision of the finding.

J&J also said that antibody levels quadrupled when a booster dose was administered at 56 days, while they jumped 12-fold when the booster was given at 6 months. Median follow-up was 36 days. The data have not been peer-reviewed, but the company said it would submit them for publication soon.

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Llama antibodies have ‘significant potential’ as potent COVID-19 treatment

A unique type of tiny antibody produced by llamas could provide a new frontline treatment against COVID-19 that can be taken by patients as a simple nasal spray.

Devices:

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Experts Clash Over Masking Kids in Schools During House Hearing

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Is my cloth mask good enough to face the delta variant?

In recent months, some European airlines have banned the use of cloth face coverings to control the spread of the coronavirus during air travel, instead favoring surgical masks-sometimes referred to as medical or disposable-and N95 respirators.

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A 3D printed vaccine patch offers vaccination without a shot

Scientists at Stanford University and the University of North Carolina at Chapel Hill have created a 3D-printed vaccine patch that provides greater protection than a typical vaccine shot.

 

Epidemiology/Infection control:

Israel’s struggles to contain COVID-19 may be a warning for other nations

Israel, among the first countries to launch coronavirus vaccinations and the first to roll out booster shots on a large scale, is offering a disturbing glimpse of what could be in store for other rich nations if they begin to give boosters this fall. Israel launched its pioneering booster campaign in late July, prompted by a surge in cases reflecting the extreme contagiousness of the Delta variant, the loosening of restrictions, and an apparent waning of protection from vaccines given in early winter. But cases have risen even higher since, suggesting boosters are far from a panacea when children and others remain unvaccinated.

Since 30 July, Israel has given a third shot of messenger RNA vaccine to more than 3 million people, including a majority of those 40 and older. Yet Israel is “stuck in a status quo of 1000 or 900 new cases per million per day,” says Ran Balicer, chief innovation officer at Clalit Health Services, Israel’s largest health maintenance organization, “which is a very bad status quo to be stuck at.”

Public health experts differ about exactly why a country of 9.3 million that is vaccinating so aggressively still has one of the highest rates of reported infections per capita in the world, more than twice that of the United States.

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Pediatric COVID-19 case surge continues across US

Today, the American Academy of Pediatrics (AAP) released its latest numbers on how many American children are being infected with COVID-19 and said nearly 226,000 child COVID-19 cases were reported from Sep 9 to 16, the third highest number of child cases in a week since the pandemic began.

Children represented 25.7% of the weekly reported cases.

“After declining in early summer, child cases have increased exponentially, with over 925,000 cases in the past 4 weeks,” the AAP said. In total, roughly 5.5 million US children have been infected with COVID-19 since the pandemic began.

Though severe illness is very rare, the AAP warned, “There is an urgent need to collect more data on longer-term impacts of the pandemic on children, including ways the virus may harm the long-term physical health of infected children, as well as its emotional and mental health effects.”

Yesterday, the United States reported 201,648 new COVID-19 cases and 2,302 deaths, according to the Johns Hopkins COVID-19 tracker. In total, the United States has confirmed 42,341,134 COVID-19 cases, including 677,261 deaths.

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COVID Vaccines No Match for a Delta Prison Outbreak

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Leader of WHO’s new pandemic hub: improve data flow to extinguish outbreaks

Former Nigeria CDC leader Chikwe Ihekweazu talks with Nature about the COVID crisis, and strengthening global response to future public-health emergencies.

Nature Amy Maxmen 21 September 2021

Chikwe Ihekweazu will be the first director of the WHO’s new Hub for Pandemic and Epidemic Intelligence.

When epidemiologist Chikwe Ihekweazu posted a blog in 2010 warning that his home country of Nigeria would “pay the price the hard way” if a pandemic struck, he never imagined that the government would not only ask for his advice, but also his leadership. In 2016, he was tasked with leading the nascent Nigeria Centre for Disease Control (NCDC), where he would increase the agency’s staff numbers and laboratory capacity, and navigate the country through waves of infectious disease outbreaks.

These accomplishments – including his guidance during the COVID-19 pandemic – caught the attention of the World Health Organization (WHO), which announced earlier this month that Ihekweazu would lead its new Hub for Pandemic and Epidemic Intelligence in Berlin. Details about the hub, which will initially be funded by the German government, are scant, but the WHO has cast it as an initiative to better gather data on infectious diseases from around the world and assess them so that authorities can make rapid, informed decisions in public-health emergencies.

Tips, general reading for public:

StayAtHome

Wash your hands.

Rinse and repeat.

Politics:

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All of the lies also have a tangible effect. A CNN poll last week, for instance, found that 78% of Republicans do not believe that Biden won last November and is therefore not the legitimate president.

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‘Vigilante treatments’: Anti-vaccine groups push people to leave ICUs

As the anti-vaccine movement escalates its rhetoric, doctors warn that they’re dealing with the fallout: “They’re starting to target people, the messengers – nurses and doctors.”…

“We were making headway, and now we’re just losing really, really badly. There’s something that’s happening on the internet, and it’s dramatically increasing steam.”

Those concerns echo various local reports about growing threats and violence directed toward medical professionals. In Branson, Missouri, a medical center recently introduced panic buttons on employee badges because of a spike in assaults. Violence and threats against medical professionals have recently been reported in MassachusettsTexasGeorgia and Idaho.

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Feel good du jour:

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Comic relief:

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https://twitter.com/buitengebieden_/status/1440011586287046663?s=20

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Perspective/Poem

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Bits of beauty:

 

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