Coronavirus Tidbits #164 10/31/21

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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.

New post:

CDC Sleuths Find Source Of Deadly Melioidosis Outbreak Is A Room Spray Sold At Walmart

https://www.forbes.com/sites/judystone/2021/10/24/cdc-sleuths-find-source-of-deadly-melioidosis-outbreak-is-a-room-spray-sold-at-walmart/?sh=73014fc7e307

News 

FDA authorizes Pfizer vax for kids 5-11 yo

https://www.fda.gov/news-events/press-announcements/fda-authorizes-pfizer-biontech-covid-19-vaccine-emergency-use-children-5-through-11-years-age

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Merck to allow other nations to produce new COVID-19 antiviral

Merck and the United Nations-based Medicines Patent Pool (MPP) today announced a licensing deal that will allow pharmaceutical companies in other countries to make molnupiravir-an investigational antiviral to treat COVID-19-a step that would ease access in low- and middle-income countries.

First agreement of its kind for the pandemic

Results from promising clinical trials suggest that the drug, the first oral treatment of its kind for COVID-19, could be an important tool for cutting hospitalizations and deaths. Fearing a repeat of the inequitable global rollout of COVID-19 vaccine, global health experts have worried that molnupiravir would be inaccessible and expensive for lower-income countries.

Under the agreement terms, Merck (or MSD, of Kenilworth, New Jersey), Ridgeback Biotherapeutics, and Emory University will not receive sales royalties for molnupiravir as long as COVID-19 is considered a public health emergency of international concern by the World Health Organization (WHO).

https://www.cidrap.umn.edu/news-perspective/2021/10/merck-allow-other-nations-produce-new-covid-19-antiviral

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Rwanda and Senegal Will Host Africa’s First COVID-19 Vaccine Manufacturing Plants

The lack of vaccine production capacity in African countries has been the subject of much concern and hand-wringing in the wake of the COVID-19 pandemic. It has become a particularly hot topic because of the gravely unequal access to COVID-19 vaccines between developed and developing countries.

Africa has limited capacity for vaccines production. Only Tunisia, Senegal, Egypt, Ethiopia, and South Africa have varying capabilities to produce and fill or finish vaccines. The largest and most integrated facility is the Biovac Institute in Cape Town.

Recently Pfizer signed a letter of intent with the institute for 100 million doses per annum. The deal covers the importation of the drug substance in bulk, the filling of vials, and the distribution of the product in Africa and elsewhere.

Africa’s shortage of manufacturing capability contrasts strongly with developing countries such as India, which has extensive pharmaceutical production capability, and Brazil.

That’s why the recent announcement by German biotechnology company BioNTech that it will be building a vaccine manufacturing facility in Rwanda, to be followed by a second in Senegal, is seen as a game changer.

The BioNTech plan involves the construction in Germany of a containerised manufacturing unit that will then be installed in Rwanda, shortening the construction period for a vaccine facility by at least a year and lowering the risk of delays. Initially, the facility will be managed and operated by BioNTech staff. But the ownership and expertise will be transferred over time to local operations. At present, such expertise does not exist in Rwanda and, based on the experience of Biovac in South Africa, could take a decade to develop.

To make a vaccine you need intellectual property as well as know how. The deal between BioNTech and the two countries includes technology transfer – this will happen in the second phase of the contract – and a license agreement that covers intellectual property rights which will remain with the company.

https://globalbiodefense.com/2021/10/27/rwanda-and-senegal-will-host-africas-first-covid-19-vaccine-manufacturing-plants/

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Study finds the SARS-CoV-2 virus can infect the inner ear

Many COVID-19 patients have reported symptoms affecting the ears, including hearing loss and tinnitus. Dizziness and balance problems can also occur, suggesting that the SARS-CoV-2 virus may be able to infect the inner ear.

https://medicalxpress.com/news/2021-10-sars-cov-virus-infect-ear.html?

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Diagnostics:

What’s Driving the COVID Rapid Test Shortage?

– Demand from employers is surging, and so are prices

https://www.medpagetoday.com/special-reports/exclusives/95272?

Drugs and Vaccines:

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Antidepressant Fluvoxamine cuts COVID-19 hospital cases 30% to 65%

The inexpensive antidepressant fluvoxamine reduced the need for a long emergency department (ED) observation or a hospital stay among high-risk, symptomatic COVID-19 outpatients treated within 7 days of symptom onset as much as 30% to 65%, finds a Brazilian platform clinical trial yesterday in The Lancet Global Health.

https://www.cidrap.umn.edu/news-perspective/2021/10/antidepressant-cuts-covid-19-hospital-cases-30-65

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Mix-and-match COVID vaccines ace the effectiveness test

Combining two different COVID-19 vaccines provides protection on par with that of mRNA vaccines – including protection against the Delta variant.

Nature Ewen Callaway 21 October 2021

Study after study has shown that people who receive two different COVID-19 vaccines generate potent immune responses, with side effects no worse than those caused by standard regimens.

But now, for the first time, researchers have shown that such ‘mix and match’ regimens are highly effective at preventing COVID-19 – roughly matching or even exceeding the performance of mRNA vaccines.

The studies sprang out of a natural experiment that began in March, when a number of countries partially or completely halted the use of the vaccine developed by the University of Oxford and the pharmaceutical company AstraZeneca in Cambridge, UK, because of extremely rare but serious side effects. This meant that some people who’d already received one dose of this vaccine then had a different vaccine as their second jab. Sester’s team and several others demonstrated that these mix-and-match combinations were safe and led to a strong immune response1,2,3.

Now, three teams have provided the first measurements of the effectiveness of mix-and-match regimens. The studies looked at various populations at various times – including during the rise of the hyper-infectious Delta variant – but they all agree that mix-and-match, or heterologous, vaccination is highly protective.

https://www.nature.com/articles/d41586-021-02853-4

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Two vaccine doses boost antibody levels in the airways after COVID

Antibodies in the airways quickly wane after SARS-CoV-2 infection, but vaccination results in a strong increase in antibody levels, especially after two doses, according to a new study from Karolinska Institutet in Sweden published in the journal JCI Insight. The results suggest that having a second dose of vaccine also after recovering from COVID-19 may be important for protecting against re-infection and to prevent transmission.

https://www.eurekalert.org/news-releases/932135

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Lack of clarity in government messaging could lead to low public compliance if restrictions are reintroduced

As health leaders call on the UK Government to implement COVID-19 contingency plans, a leading COVID-19 behavioral expert from Swansea University has warned that clear messaging from the UK and devolved governments will be essential to ensure high public compliance if additional measures are introduced.

***Note: This lack of clarity is also a huge problem in the US and will get worse when the CDC changes the definition of “fully vaccinated.”

https://medicalxpress.com/news/2021-10-lack-clarity-messaging-compliance-restrictions.html?

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Tens of millions of J&J COVID-19 shots sit at Baltimore factory.

They’ve been collecting dust in a Baltimore plant for months, waiting for the go-ahead to be shipped out, after Emergent manufacturing problems. https://www.reuters.com/business/healthcare-pharmaceuticals/exclusive-tens-millions-jj-covid-19-shots-sit-baltimore-factory-sources-2021-10-28/

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Molnupiravir

Devices:

Epidemiology/Infection control:

How much less likely are you to spread covid-19 if you’re vaccinated?

People who are fully vaccinated against covid-19 are far less likely to infect others, despite the arrival of the delta variant, several studies show. The findings refute the idea, which has become common in some circles, that vaccines no longer do much to prevent the spread of the coronavirus.

“They absolutely do reduce transmission,” says Christopher Byron Brooke at the University of Illinois at Urbana-Champaign. “Vaccinated people do transmit the virus in some cases, but the data are super crystal-clear that the risk of transmission for a vaccinated individual is much, much lower than for an unvaccinated individual.”

A recent study found that vaccinated people infected with the delta variant are 63 per cent less likely to infect people who are unvaccinated.

This is only slightly lower than with the alpha variant, says Brechje de Gier at the Center for Epidemiology and Surveillance of Infectious Diseases in the Netherlands, who led the study. Her team had previously found that vaccinated people infected with alpha were 73 per cent less likely to infect unvaccinated people.

What is important to realise, de Gier says, is that the full effect of vaccines on reducing transmission is even higher than 63 per cent, because most vaccinated people don’t become infected in the first place.

https://www.newscientist.com/article/2294250-how-much-less-likely-are-you-to-spread-covid-19-if-youre-vaccinated/

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A Resurgent Covid-19 Means Another Tough Winter Could Be Coming

…With winter coming in the Northern Hemisphere, the pandemic isn’t going anywhere, belying hopes that vaccines would provide a speedy path out of the crisis. And while the shots have proven to be effective in reducing severe illness and death, they don’t always stop infection or transmission and their potency diminishes over time, making the picture in some ways more complicated than it was a year ago.

“The expected colder temperatures, the waning vaccine efficacy and the gaps in the immunization coverage make it difficult to predict the epidemic’s evolution,” said Arnaud Fontanet, an epidemiologist at Institut Pasteur who advises the French government. “The next three to six weeks will be key.”

No two countries are the same, but some things are clear: those that vaccinated early, like Israel, the U.S. and the U.K., are first in line to experience the shots’ waning effectiveness. Those that keep additional public-health guardrails in place — whether they be masks, immunity passports or limits on gatherings — appear to do better. And those whose citizens have refused vaccines fare the worst of all.

https://www.bloomberg.com/news/articles/2021-10-23/a-resurgent-covid-19-means-another-tough-winter-could-be-coming

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3 takeaways from the emergence of the ‘Delta Plus’ coronavirus variant AY.4.2 

https://www.statnews.com/2021/10/27/3-takeaways-from-the-emergence-of-the-delta-plus-coronavirus-variant/? ~ ~ ~

COVID-19 vaccines lower risk of infection with Delta variant, but infection can still be passed on in household settings

People who have received two vaccine doses against COVID-19 have a lower, but still appreciable, risk of becoming infected with the delta variant compared with unvaccinated people. Vaccinated people clear the infection more quickly, but the peak viral load among vaccinated people is similar to that seen in unvaccinated people, which may explain why they can still readily pass on the virus in household settings, according to a study published in The Lancet Infectious Diseases.

https://medicalxpress.com/news/2021-10-covid-vaccines-infection-delta-variant.html?

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Tips, general reading for public:

StayAtHome

Wash your hands.

Rinse and repeat.

Politics:

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Florida:

Florida is suing the Biden administration over the vaccine mandate for federal contractors, with Gov. Ron DeSantis (R) alleging the administration lacks such authority. (AP)

In other Florida news, the U.S. Department of Education filed a cease and desist complaint to Florida’s education department after it took funding from school districts issuing mask mandates. (The Hill)

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Feel good du jour:

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Do check out the link–the photos are pretty darn funny!

Comic relief:

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Perspective/Poem

We’re not talking about those little burp cloths fastened with diaper pins here. Modern systems require waterproof covers in different sizes, plus the inserts (cloth or disposable). A diaper service costs even more. Here’s more on how they work: (3/)

https://t.co/qoS1BUXjy9?amp=1

Perhaps the bigger issue is that it’s illegal in a lot of laundromats and apt laundry facilities to wash your old diapers. These moms rarely had their own W/D, and some didn’t even have access to clean water. Plus, public laundromats can cost $5-6 a load — not affordable. (4/)

Plus, most daycare facilities only accept disposable — a deal breaker for moms who work. One survey found the majority of parents who use cloth were married with a $50,000-$70,000 annual household income. Nearly half were stay-at-home parents.(5/) https://t.co/G5Cu7fJOGO?amp=1

Like all moms, the mothers in Randles research want to provide a safe and hygienic option for their babies’ diapers — that’s awfully hard without an easy way to wash them. (6/)

Environmental impact is a mixed bag. A 2008 study by the U.K. Environmental Agency found that “the environmental impacts of using shaped reusable nappies can be higher or lower than using disposables, depending on how they are laundered.” More here: https://stanfordmag.org/contents/don-t-pooh-pooh-my-diaper-choice-essential-answer… (7/)

To sum up, as Jennifer Randles told me, “The same conditions that would prevent moms from being able to readily afford disposable diapers are the same conditions that keep them from being able to use cloth.” (FIN)

 

Bits of beauty:

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