Coronavirus Tidbits #163 10/24/21

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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.

My latest posts:

Florida’s Private School –The “Brain School Centner Academy– With $25,000 Price Tag Promotes Anti-Vax Misinformation

https://www.forbes.com/sites/judystone/2021/10/20/floridas-centner-academy-promotes-anti-science-anti-vax-misinformation/?sh=7f1ac2975816

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Florida’s DeSantis Taps Controversial Surgeon General Ladapo As Covid Rates Soar

https://www.forbes.com/sites/judystone/2021/09/25/whats-going-on-in-florida-are-they-trying-to-bring-back-deadly-infections/?sh=6b26e96ead1b

News 

PSA:

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Co-Administering COVID-19 and Influenza Vaccines Found Safe and Effective

During today’s U.S. CDC’s Advisory Committee on Immunization Practices (ACIP) meeting, Ruvim Izikson, M.D., MPH, presented ‘Phase II safety and immunogenicity study of the coadministration of an influenza vaccine and high-dose flu shot.

This study is essential since the new COVID-19 vaccine primary series timing and strategy, and older adults are most likely eligible for COVID-19 boosters and their annual influenza vaccine during the same window of time.

This scheduling conflict creates the risk that many seniors get vaccinated only for one or the other; with the priority on the 3rd dose of COVID-19 vaccine, the annual flu shot is more likely the missed vaccination.

This study’s results are based on Sanofi Pasteur’s Fluzone® High-Dose Quadrivalent Influenza Vaccine (QIV-HD) and the third dose of SpikeVax COVID-19 vaccine (Moderna, mRNA-1273) on October 20, 2021.

This vaccine study assesses the safety and immunogenicity of Fluzone, 2021-2022 Formulation, and the third dose of SpikeVax (100µg), administered either concomitantly or singly in adults 65 yrs+, previously vaccinated with a 2-dose schedule of the SpikeVax vaccine.

The study’s results demonstrate that QIV-HD and SpikeVax vaccines can be administered safely together without evidence of immunogenicity interference.

In summary, this finding supports COVID-19 and influenza vaccine coadministration recommendations.

https://www.precisionvaccinations.com/2021/10/20/co-administering-covid-19-and-influenza-vaccines-found-safe-and-effective

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CDC advisory committee updates recommendations for pneumococcal, zoster vaccines

The CDC’s Advisory Committee on Immunization Practices made new recommendations Wednesday for adult pneumococcal and herpes zoster vaccination.

The committee voted 15-0 to recommend the 20-valent pneumococcal conjugate vaccine by itself or the 15-valent vaccine followed by the 23-valent vaccine for adults aged 65 years or older who have not received a pneumococcal conjugate vaccine before – or whose vaccination status is unknown – and people aged 19 to 64 years who have an underlying medical condition or other risk factors and who also have not received a pneumococcal vaccine.

It also voted 15-0 to recommend two doses of recombinant zoster vaccine given at least 4 weeks apart for people aged 19 years or older who are or will be immunodeficient or immunosuppressed due to disease or therapy.

Patients covered by the zoster vaccine recommendation include – but are not limited to -recipients of hematopoietic stem cell or solid organ transplants, patients with hematologic or solid tumor malignancies, people with HIV, or patients with primary immunodeficiencies or autoimmune and inflammatory conditions who are on immunosuppressive medications or therapies.

https://www.healio.com/news/infectious-disease/20211020/cdc-advisory-committee-updates-recommendations-for-pneumococcal-zoster-vaccines

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COVID super-immunity: one of the pandemic’s great puzzles

Nature Ewen Callaway 14 October 2021

People who have previously recovered from COVID-19 have a stronger immune response after being vaccinated than those who have never been infected. Scientists are trying to find out why.

https://www.nature.com/articles/d41586-021-02795-x

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Flu and heart disease: The surprising connection that should convince you to schedule your shot

Peer-Reviewed Publication

HOUSTON METHODIST

If you have heart disease or risk factors for heart disease, you already know about the increased risk of heart attack and stroke. But did you know that coming down with the flu can substantially increase the risk of a serious or even fatal cardiac event? Or that getting the influenza vaccine can substantially reduce that risk, even if you do wind up contracting the seasonal virus?

Probably not, if annual influenza vaccination rates are any indication, especially if you’re under the age of 65. According to a Houston Methodist review published in the Journal of the American Heart Association, Americans with heart disease continue to have low vaccination rates every year despite higher rates of death and complications from influenza.

The flu vaccination rate for American adults who are less than 65 years of age and have heart disease is less than 50%, compared to 80% in older adults with heart disease.

https://www.eurekalert.org/news-releases/931686

Diagnostics:

still an incredible, negligent last of testing.

Drugs and Vaccines:

***Comparison of vaccines from The Medical Letter***

Extensive charts – please see the link for safety and efficacy data!

https://secure.medicalletter.org/downloads/1621g_table.pdf

Note: Despite the copyright notice at bottom of pdf, in a message to me, Medical Letter generously said this chart and impt info could be shared.

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NIAID Director Anthony Fauci, MD, recommends people just stick with their original vaccine if available. (Reuters)

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Half doses, third doses, kids’ doses: Covid vaccine delivery goes next-level difficult

The only certainty is that this administration of vaccines will be rife with errors.

https://www.statnews.com/2021/10/21/half-doses-third-doses-kids-doses-covid-vaccine-delivery-goes-next-level-difficult/?

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Antibody treatment for MIS-C works by depleting inflammatory immune cells

NIH-funded study explains how intravenous immune globulin helps children with rare COVID condition

Intravenous immune globulin (IVIG)-a common treatment for multisystem inflammatory syndrome in children (MIS-C)-likely works by depleting immune cells called neutrophils, according to a recent study funded by the National Institutes of Health (NIH). MIS-C is a rare condition that usually affects school-age children who initially had only mild COVID-19 symptoms or no symptoms at all. The researchers also found that IVIG works in a similar manner for treating Kawasaki disease, another rare inflammatory condition that affects children and shares symptoms with MIS-C. The findings are published in the Journal of Clinical Investigation.

MIS-C is marked by severe inflammation of two or more parts of the body, including the heart, lungs, kidneys, brain, skin, eyes and gastrointestinal organs.

https://www.eurekalert.org/news-releases/931592

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Interferon does not improve outcomes for hospitalized adults with COVID-19

A clinical trial has found that treatment with the immunomodulator interferon beta-1a plus the antiviral remdesivir was not superior to treatment with remdesivir alone in hospitalized adults with COVID-19 pneumonia. In addition, in a subgroup of patients who required high-flow oxygen, investigators found that interferon beta-1a was associated with more adverse events and worse outcomes. These findings were published today in the journal The Lancet Respiratory Medicine.

https://www.eurekalert.org/news-releases/931731

https://www.medpagetoday.com/infectiousdisease/covid19/95113?

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In briefing documents submitted ahead of an FDA advisory committee meeting, Pfizer said its lower-dose COVID-19 vaccine showed 90.7% efficacy (95% CI 67.7-98.3) against symptomatic infection for kids ages 5 to 11.

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Politics is derailing a crucial debate over the immunity you get from recovering from Covid-19

Some who’ve had Covid-19 are suing over mandates. But there’s still no consensus on the strength or durability of natural immunity.

https://www.statnews.com/2021/10/19/politics-is-derailing-a-crucial-debate-over-the-immunity-you-get-from-recovering-from-covid-19/?

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Devices:

COMMENTARY: What can masks do? Part 1: The science behind COVID-19 protection

CIDRAP

  • Explaining the differences between cloth face coverings (or cloth masks), surgical masks, and respirators in the context of infectious aerosol inhalation.
  • Delving into the science of respiratory protection.
  • Discussing the role of masks and respirators in the hierarchy of controls for disease prevention.

https://www.cidrap.umn.edu/news-perspective/2021/10/commentary-what-can-masks-do-part-1-science-behind-covid-19-protection

Part 2, will dig deeper by:

  • Detailing how the quality of evidence to inform mask policies could be improved via well-conducted studies.
  • Laying out-using several recent publications as examples-how to assess studies about masks, underscoring the importance of waiting for the peer review process conducted by subject matter experts before drawing conclusions.

https://www.cidrap.umn.edu/news-perspective/2021/10/commentary-what-can-masks-do-part-2-what-makes-good-mask-study-and-why-most

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Epidemiology/Infection control:

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Delta outbreak in Delhi shows immunity evasion, high transmission

CIDRAP

Delhi’s COVID-19 outbreak this past spring-the city’s fourth since the pandemic began-showed the Delta variant’s high transmissibility and higher ability to infect the previously infected, researchers say in a study published yesterday in Science. . .

Among 91 people who had COVID-19 before the Delta outbreak, 27.5% had increased levels of antibodies, indicating reinfection. Also, regarding breakthrough infections, a single center showed that of 24 cases, Delta was seven times more likely to be the cause.

“The concept of herd immunity is critical in ending outbreaks, but the situation in Delhi shows that infection with previous coronavirus variants will be insufficient for reaching herd immunity against Delta,” said co-author Ravi Gupta, PhD, MPH, BMBCh, in a University of Cambridge press release. “The only way of ending or preventing outbreaks of Delta is either by infection with this variant or by using vaccine boosters that raise antibody levels high enough to overcome Delta’s ability to evade neutralisation.”
Oct 14 Science study
Oct 14 University of Cambridge 
press release

https://www.cidrap.umn.edu/news-perspective/2021/10/covid-19-scan-oct-15-2021

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Asymptomatic COVID-19 Adult Outpatients identified as Significant Viable SARS-CoV-2 Shedders

Differential kinetics of RNA loads and infectious viral levels in the upper respiratory tract between asymptomatic and symptomatic SARS-CoV-2 infected adult outpatients remain unclear limiting recommendations that may guide clinical management, infection control measures and occupational health decisions. In the present investigation, 496 (2.8%) of 17,911 French adult outpatients were positive for an upper respiratory tract SARS-CoV-2 RNA detection by a quantitative RT-PCR assay, of which 180 (36.3%) were COVID-19 asymptomatic. Of these adult asymptomatic viral shedders, 75% had mean to high RNA viral loads (Ct values < 30) which median value was significantly higher than that observed in symptomatic subjects (P = 0.029), and 50.6% were positive by cell culture assays of their upper respiratory tract specimens. Our findings indicate that COVID-19 asymptomatic adult outpatients are significant viable SARS-CoV-2 shedders in their upper respiratory tract playing a major potential role as SARS-CoV-2 transmitters in various epidemiological transmission chains, promoting COVID-19 resurgence in populations.

https://www.nature.com/articles/s41598-021-00142-8

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COVID reinfections likely within one or two years, models propose

Estimates based on viral evolution forecast a 50% risk 17 months after a first infection without measures such as masking and vaccination.

Nature  Lynne Peeples

People who have been infected with SARS-CoV-2 can expect to become reinfected within one or two years, unless they take precautions such as getting vaccinated and wearing masks. That’s the prediction of modelling based on the genetic relationships between SARS-CoV-2 and other coronaviruses1.

The findings also warn that people could be reinfected in just a few months if they are not vaccinated. “Immunity is relatively short-lived,” says study co-author Jeffrey Townsend, a bioinformatician at the Yale School of Public Health in New Haven, Connecticut. “You should still get vaccinated even if you got infected.”

Further data over the coming months, and years, will be necessary to know precisely how long natural immunity lasts. “But we don’t want to wait for that. And we don’t have to,” says Townsend.

https://www.nature.com/articles/d41586-021-02825-8

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What to Know About the New Delta Sublineage

– CDC acknowledges AY.4.2 is stateside after quick spread in the U.K.

10-15% more transmissible than Delta

https://www.medpagetoday.com/special-reports/exclusives/95166?

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Tips, general reading for public:

StayAtHome

Wash your hands.

Rinse and repeat.

Politics:

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Montana Officials Threaten Docs for Not Providing Ivermectin, Hospital Says

https://www.medpagetoday.com/special-reports/exclusives/95186? 

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Where are laws to prevent price-gouging?

Arthritis Drug Price Spiked 50-Fold

The cost of a 30-count box of indomethacin (Indocin), an anti-inflammatory rectal suppository for arthritis, surged from $198 in 2008 to more than $10,000 by October 1 of this year, according to Axios. That’s an increase of more than 50-fold.

“Indocin is another example of how nothing prevents some drug companies from hiking prices at will and selling them within a broken supply chain,” Axios stated.

Indocin has changed ownership several times over the years, most recently being acquired by Assertio in May 2020. Assertio raised the price twice, first to about $6,000 at the start of 2021, then to $10,350 earlier this month.

Last week, MedPage Today reported on a recent documentary about Martin Shkreli, which notes that the price of toxoplasmosis drug pyrimethamine (Daraprim) remains at $750 per pill, after Shkreli’s company infamously hiked its price from $13.50. The film ends with a reminder that there “remains no national pharmaceutical price gouging or drug price transparency law in the United States.”

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Public Health in Crisis

American public health agencies are “in crisis” and ill-prepared to face another pandemic, according to a national analysis by the New York Times.

Dozens of public heath workers have left their positions, and local and state health departments lack the funds they need to handle even their core functions, let alone another catastrophe.

Over the past 19 months, more than 500 top health officials have left their jobs; more than 100 new laws have been enacted limiting health department powers; and numerous new government leaders have been voted into positions after promising to “rein in” public health departments.

https://www.nytimes.com/2021/10/18/us/coronavirus-public-health.html?

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Since July 1, when the Delta wave started VT has had 50% more cases than PR And today, PR has one of the lowest infections rates in America Here’s data from @CovidActNow . Puerto Rico has one of the lowest infection rate in the US (way lower than most states)

Ah you say, but its Puerto Rico – and they are tiny Actually, no They are about 5 times bigger than VT And PR has more people than 21 states So how have they done it? Its not their immense wealth – PR is actually quite poor compared to much of the US

Best I can tell, they’ve done this largely by not tying vaccines to politics They pay less attention to mainland politics All their political parties actively support vaccinations And generally, political identify & vaccinations are not intermixed

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Feel good du jour:

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Comic relief:

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Toddlers everywhere:

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Perspective/Poem

full thread at https://t.co/iGHvrD4V0s?amp=1

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Bits of beauty:

Raymondskill Falls, Delaware Water Gap

 

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