Coronavirus Tidbits #176 January 23, 2022

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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:

Even better–family is donating proceeds from the book and film to research on phages and antimicrobial resistance.

News 

Omicron news:

Israeli study shows 4th shot of COVID-19 vaccine NOT able to block Omicron

JERUSALEM, Jan 17 (Reuters) – A fourth shot of COVID-19 vaccine boosts antibodies to even higher levels than the third jab but it likely is not enough to prevent Omicron infections, according to a preliminary study in Israel.

The vaccines led to a increase in the number of antibodies “even a little bit higher than what we had after the third dose”, said Regev-Yochay, adding that the results were preliminary and not yet published.

Israel was the fastest country to roll out initial vaccinations a year ago and last month started offering a fourth shot, or a second booster, to the most vulnerable, high-risk groups. (Reporting by Ari Rabinovitch Editing by Mark Heinrich)

https://www.msn.com/en-us/news/world/israeli-study-shows-4th-shot-of-covid-19-vaccine-not-able-to-block-omicron/ar-AASRT8Q?ocid=msedgdhp&pc=U531

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Study identifies mutations specific to omicron variant

While the omicron variant continues to infect people around the world, researchers at the University of Missouri have identified the highly prevalent, specific mutations that are causing the omicron variant’s high rate of infection.

https://medicalxpress.com/news/2022-01-mutations-specific-omicron-variant.html?

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State employees/National Guard to work as substitute teachers to fight shortages

Omicron-related school disruptions have gotten to the point that Oklahoma and New Mexico will rely on state workers and the National Guard to act as substitute teachers.

https://www.npr.org/2022/01/19/1074109355/oklahoma-substitute-teachers-shortage-state-employees

https://www.reuters.com/business/healthcare-pharmaceuticals/new-mexico-asks-national-guard-teach-covid-shuts-schools-2022-01-20/

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Covid-19 is no longer the biggest issue facing hospitals. Staffing is

https://www.statnews.com/2022/01/19/covid-19-no-longer-biggest-issue-facing-hospitals-staffing-is/?

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As nations decide to live with the virus, some disease experts warn of surrendering too soon

The coronavirus isn’t going away, but that doesn’t mean resistance is futile, scientists say.

Washington Post By Joel Achenbach January 15, 2022

Nations around the planet are making a subtle but consequential pivot in their war against the coronavirus: Crushing the virus is no longer the strategy. Many countries are just hoping for a draw.

It’s a strategic retreat, signaled in overt and subtle ways from Washington to Madrid to Pretoria, South Africa, to Canberra, Australia. Notably, few countries today outside of China – which is still locking down cities – cling to a “zero-covid” strategy.

The phrase often heard now in the United States and many other nations is “live with the virus.” That new stance is applauded by some officials and scientists, and welcomed by people exhausted with the hardships and disruptions of this global health emergency entering its third year.

But there are also disease experts who fear the pendulum will swing too far the other way. They worry that many world leaders are gambling on a relatively benign outcome from this omicron variant surge, and sending messages that will lead people who are normally prudent to abandon the social distancing and mask-wearing known to limit the pathogen’s spread. Epidemiologists say the live-with-it strategy underestimates the dangers posed by omicron.

https://www.washingtonpost.com/health/2022/01/15/living-with-the-virus/?

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Other News:

Attention and memory deficits persist for months after recovery from mild COVID

Researchers from Oxford’s Department of Experimental Psychology and Nuffield Department of Clinical Neurosciences have shown that people who have had COVID but don’t complain of long COVID symptoms in daily life nevertheless can show degraded attention and memory for up to 6-9 months

https://medicalxpress.com/news/2022-01-attention-memory-deficits-persist-months.html?

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Diagnostics:

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Fraudulent ‘pop-up’ COVID testing centers are rampant. Here are 8 tips to help protect against phony clinics

Tricia Poreda recently walked inside a COVID-19 testing center on Chicago’s Northwest Side and was immediately appalled by the facility’s lack of basic health and safety protocols.

https://medicalxpress.com/news/2022-01-fraudulent-pop-up-covid-centers-rampant.html?

and

Minnesota’s attorney general is suing the Chicago-based company Center for Covid Control, which had 300 pop-up locations across the country, for allegedly falsifying and delivering inaccurate test results. (NBC News)

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Throat Swab on Rapid Testing Chokes in Omicron-Era Study

– Alternate methods of testing don’t hold up as well, pre-print finds

https://www.medpagetoday.com/infectiousdisease/covid19/96778?

Drugs and Vaccines:

Booster shots needed against omicron, CDC studies show

Three studies released Friday offered more evidence that COVID-19 vaccines are standing up to the omicron variant, at least among people who received booster shots.

https://medicalxpress.com/news/2022-01-booster-shots-omicron-cdc.html?

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COVID-19 vaccine booster provides good antibody protection against Omicron

A third ‘booster’ dose of COVID-19 vaccine successfully raises antibody levels that neutralize the Omicron variant, according to laboratory findings from the Francis Crick Institute and the National Institute for Health Research (NIHR) UCLH Biomedical Research Center, published  as a Research letter in The Lancet.

https://medicalxpress.com/news/2022-01-covid-vaccine-booster-good-antibody.html?

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Emerging protein-based COVID-19 vaccines could be game-changing

Current messenger RNA vaccines appear to offer at least some protection against new SARS-CoV-2 variants, including omicron, especially for people who have received boosters. But manufacturing costs and the need for ultra-cold refrigeration have limited availability of these vaccines in low-and middle-income countries. That’s where emerging protein-based COVID-19 vaccines-including two candidates developed at Boston Children’s Hospital-could change the game.

https://medicalxpress.com/news/2022-01-emerging-protein-based-covid-vaccines-game-changing.html?

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Low-cost drug Heparin effective and safe treatment for COVID-19

Heparin, a widely available and affordable drug, has found to limit lung damage when inhaled by COVID-19 patients.

https://medicalxpress.com/news/2022-01-low-cost-drug-heparin-effective-safe.html?

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Fewer breakthrough infections, lower hospitalization risk in Moderna vaccine recipients compared to Pfizer-BioNTech

A new study by researchers at the Case Western Reserve University School of Medicine finds those who received the Moderna COVID-19 mRNA vaccine are less likely to experience “breakthrough” COVID-19 cases, compared to recipients of the Pfizer-BioNTech mRNA vaccine.

the data showed 2.8 breakthrough cases in those vaccinated with Pfizer-BioNTech, compared to 1.6 cases per 1,000 people in November 2021. The 60-day hospitalization rate was 12.7% for Moderna recipients and 13.3% for Pfizer-BioNTech recipients.

No significant difference was observed in mortality rates between those who received the Moderna vaccine and Pfizer- BioNTech .

https://medicalxpress.com/news/2022-01-breakthrough-infections-hospitalization-moderna-vaccine.html?

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Monoclonal Antibodies

Due to the Omicron variant, updated NIH COVID guidelines recommend against two monoclonal antibody cocktails (bamlanivimab/etesevimab and casirivimab/imdevimab) for early treatment, and instead recommend sotrovimab or a 3-day course of remdesivir (Veklury) for such outpatients.

https://www.covid19treatmentguidelines.nih.gov/therapies/statement-on-therapies-for-high-risk-nonhospitalized-patients/?

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Here’s how hard it can be to get Pfizer’s new COVID pill nirmatrelvir-ritonavir (Paxlovid) for eligible patients.

https://www.nytimes.com/2022/01/19/business/covid-pill-treatment-pfizer.html

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Opinion: Pharmacies shouldn’t be the only place to get Paxlovid, the new Covid pill

Several states have decided to distribute the Covid-fighting drug Paxlovid to retail pharmacies rather than hospitals. That’s a mistake.

https://statnews.us11.list-manage.com/track/click?u=f8609630ae206654824f897b6&id=019751ec97&e=f4c6ea30a0

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Starbucks (needlessly) nixes vaccine mandate after Supreme Court ruling

https://apnews.com/article/coronavirus-pandemic-us-supreme-court-health-business-d5fa7213edbd7926fd19bc0a5f2c45ca

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1 million French get 1st vaccine shot ahead of new virus law

France’s government spokesman said Thursday that more than 1 million adults got their first COVID-19 vaccine shot over the past month, after the government announced a plan to exclude unvaccinated people from all restaurants, sports arenas and other venues.

https://medicalxpress.com/news/2022-01-million-french-1st-vaccine-shot.html?

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Italian doctors, dentists not fully vaccinated are suspended

Some 1,900 Italian doctors and dentists have been suspended from the country’s professional association because they haven’t complied with a law requiring them to be fully vaccinated against COVID-19, including having a booster shot.

https://medicalxpress.com/news/2022-01-italian-doctors-dentists-fully-vaccinated.html?

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Vaccination, Religion, and Science: An Astonishing 300-Year-Old Story

– It’s time for a history lesson in the roots of vaccine advocacy and resistance

https://www.medpagetoday.com/opinion/revolutionandrevelation/96743?

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CDC Says Natural Immunity Outperformed Vaccines Against Delta Strain

Natural immunity from prior infection granted stronger levels of protection against the Delta variant of COVID-19 than vaccination alone, the Centers for Disease Control and Prevention (CDC) said in a study released Wednesday.

Before Delta became dominant, individuals who had natural immunity were experiencing higher case rates than individuals who were only vaccinated, the study found, but after Delta took hold, those with natural immunity caught COVID-19 less frequently than those who were only vaccinated.

The most protection against infection and hospitalization was in those who had both been vaccinated and survived an earlier bout with the virus.

The agency cautioned that the data in question only measured results against the Delta variant and that Omicron may present new challenges that alter the calculus of natural immunity versus vaccination.

https://www.msn.com/en-us/health/medical/cdc-says-natural-immunity-outperformed-vaccines-against-delta-strain/ar-AASWPCZ?ocid=msedgdhp&pc=U531

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WHO says no evidence healthy children, adolescents need COVID-19 boosters

Jan 18 (Reuters) – There is no evidence at present that healthy children and adolescents need booster doses of COVID-19 vaccine, the World Health Organization’s chief scientist Soumya Swaminathan said on Tuesday.

Speaking at a news briefing, she said that while there seems to be some waning of vaccine immunity over time against the rapidly spreading Omicron variant of the coronavirus, more research needs to be done to ascertain who needs booster doses.

“There is no evidence right now that healthy children or healthy adolescents need boosters. No evidence at all,” she said.

Israel has begun offering boosters to children as young as 12, and the U.S. States Food and Drug Administration earlier this month authorized the use of a third dose of the Pfizer (PFE.N) and BioNTech COVID-19 vaccine for children aged 12 to 15.

Last week Germany became the latest country to recommend that all children between ages of 12 and 17 receive a COVID-19 booster shot. Hungary has also done so.

https://www.reuters.com/business/healthcare-pharmaceuticals/who-says-no-evidence-healthy-children-adolecents-need-covid-19-boosters-2022-01-18/?

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Persistent T cell response to omicron after infection and vaccination

by Karolinska Institutet JANUARY 19, 2022

The omicron variant can partly evade the antibody response provided by vaccination or infection with previous variants of SARS-CoV-2. However, T cells still recognize omicron, scientists at Karolinska Institutet in Sweden report in a study published in the journal Nature Medicine.

Omicron has rapidly become the dominant variant of the SARS-CoV-2 virus. New data indicate that omicron is not only more infectious than previous variants, it can also infect people with previous immunity by evading what are known as neutralizing antibodies.

Serious disease seems, however, to be relatively uncommon in people who have been vaccinated or infected, suggesting that other components of the immune system are still able to recognize omicron. A new study by researchers at Karolinska Institutet now shows that so-called memory T cells formed following previous infection or mRNA vaccination also respond to the omicron variant.

“Along with viral factors, such as a lower level of viral replication in the lower airways, and other immune components, these results give us a clearer picture that may explain why the protection against severe omicron disease remains good in previously mRNA-vaccinated individuals,” says principal investigator Marcus Buggert at Karolinska Institutet’s Center for Infectious Medicine.

https://medicalxpress.com/news/2022-01-persistent-cell-response-omicron-infection.html

Devices and Masks:

N95, bandana, or something in between: Which masks are the most popular?

cloth , scarves, bandanas, and gaiters remain the masks of choice for 64%

surgical masks 38%

higher-quality respirators such as the N95 21%

from COVID States Project, a collaborative research effort by Northeastern, Harvard, Northwestern, and Rutgers

https://medicalxpress.com/news/2022-01-n95-bandana-masks-popular.html

Epidemiology/Infection control:

Where are you most likely to catch COVID?

crowded movie theater w poor vent, mostly unmasked audience => 14% risk of inf

If people are talking throughout => risk of infection when unmasked jump to 54%.

If the crowd is masked, the risk of infection drops to 5.3% w/o talking, 24% with talking.

Gym: well-ventilated: working out for even a short amount of time => a 17% chance of infection if masks aren’t in use.

Gym: poorly ventilated: There’s a 67% chance.

https://medicalxpress.com/news/2022-01-covid-highlights-high.html?

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COVID-19 cases and hospitalizations surge among children

It’s a tough time to be a parent. And it has been for nearly two years. Schools are threatening to close again (or already have) due to high COVID-19 volume. And pediatric case rates and hospitalizations are soaring-particularly among children under 5, who are too young to be vaccinated.

For the week ending January 13, over 981,000 child COVID-19 cases were reported, a 69% increase over the week before and nearly four times higher than last winter’s peak, according to the American Academy of Pediatrics.

https://medicalxpress.com/news/2022-01-covid-cases-hospitalizations-surge-children.html?

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EXPLAINER: What does it mean for COVID-19 to be endemic?

Some European countries such as Spain are making tentative plans for when they might start treating COVID-19 as an “endemic” disease, but the World Health Organization and other officials have warned that the world is nowhere close to declaring the pandemic over. A look at what endemic means and the implications for the future.

https://medicalxpress.com/news/2022-01-covid-endemic.html?

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One in five Americans have been infected with COVID-19, according to statistics

 according to statistics from Johns Hopkins University..

California leads the country in COVID cases per state, with greater than 6.9 million cases diagnosed. Texas is next with 5.5 million cases and Florida is third with just greater than 5 million cases.

https://www.whio.com/news/trending/one-five-americans-have-been-infected-with-covid-19-according-statistics/JML45B4QMVD7VPJWOKY2QB7OM4/

Tips, general reading for public:

Tatiana Prowell (@tmprowell) and others have tips for newly infected and/or exposed, below. See also https://cleanaircrew.org/someone-in-my-home-has-covid-how-do-we-isolate-safely/

1/ The first thing to say is that if someone has #COVID19 symptoms (#Omicron most common: nasal congestion/runny nose, scratchy sore throat, fever, & aches), you have to assume they have it. You may not have a test (urgent cares are still open & do) or they may still be neg.

2/ You, as the person exposed to the one with symptoms, have to assume that you both do & don’t have #Omicron too. Wait, what?  I mean: assume you could infect others now & take care to avoid exposing them, BUT don’t assume it’s too late for you to avoid getting it.

3/ Especially in households with #vaccinated (& #boosted) family members, I have seen people manage to limit #Omicron to the first person who was infected. This #CovidVariant is incredibly contagious, but It CAN be done. Don’t give up on the idea!

4/ If you have N95/KN95/KF94 masks, get in them immediately. If you have only 1, put the sick person in it for source control. If you have >1 but not enough for all put the sick one & the highest risk (older, #immunocompromised) people in them. Then get outside, & leave door open.

5/ Fresh air is a friend & shared air is an enemy. The more you can ventilate your , now & until this is over, the better. You want the concentration of #omicron in air as low as possible. This decreases odds of infection & may make you less sick if you do get infected.

6/ Plan to bundle up if you’re in a  climate, because you’re going to need to leave doors & windows open enough for air exchange, esp for next 5d or so, & a cross draft. If you have a fresh HVAC filter, change it. If a hardware place is open, get a MERV13 HVAC filter. (Amazon has too.)

7/ Run the fan on your thermostat on high. Filter that #Omicron ! If you need supplies of any kind, please do curbside pickup or same-day delivery or drive-thru. No one exposed should be indoors in public, & def not the one with symptoms, to prevent further spread.

8/ If you don’t have any N95/KN95/KN94 masks, please see if a nearby friend or neighbor has unused ones you can have & order them replacements. The nonprofit @projectn95  (http://projectn95.org) is a great place to get them. Your backup plan for right now is a surgical mask.

9/ A surgical mask (ASTM level 3, 3-ply is best) has good filtration but usually not good fit. There are often gaps. Knot ear loops where they join the mask & then tuck to improve the mask fit. Here’s a short video demo: https://youtu.be/GzTAZDsNBe0. Put a cloth mask over the surg mask.

10/ Now it’s time to create the space where the infected person or people will isolate for 10d to let #Omicron run its course. This prior  of mine covers what is helpful to have in there & other things to consider.

11/ This whole scenario assumes that things are going ok with the person who has #Omicron. How do you know if they are ok? As I mentioned before, if you have a pulse oximeter (O2 sat monitor)-the thing drs put on your fingertip to measure O2-use it. See guide in .

12/ If you don’t have a pulse oximeter, many pharmacies carry them. They are over the counter. Ask the pharmacist if you don’t see them. You can order them online from many places too. Get one highly rated by many people. They need not be expensive. $15 gets a very good one.

13/ Some of your devices (smart watches, fitness trackers) can detect heart rate (60-100 normal for adults) & less reliably O2 levels. If you have them & they read low O2 levels, def do call a dr or seek care. Video calls are helpful to check on the sick as well.

14/ If the person w/ #Omicron is high-risk (especially #immunocompromised, organ or bone marrow transplant, active #cancer#pregnant#diabetes, older, etc), they should contact a dr even if they seem ok. There are outpatient treatments that sig risk of being hospitalized.

15/ These include monoclonal antibodies (some brands no longer work vs #Omicron, but 1 called sotrovimab remains effective). It is given IV as a single dose. There are also two types of pills taken for 5d at home. All are in short supply at the moment. https://google.com/amp/s/abcnews.go.com/amp/Health/omicron-treatments-monoclonal-antibodies-work-variant/story%3fid=81893922….

16/ All of these things to treat outpatients w/ #Omicron, the monoclonal antibody sotrovimab, as well as the pills (Paxlovid: https://google.com/amp/s/www.nytimes.com/2021/12/22/health/pfizer-covid-pill-fda-paxlovid.amp.html…) & (molnupiravir: https://google.com/amp/s/www.nytimes.com/2021/12/23/health/covid-pill-merck.amp.html…) are new, so they are being reserved for higher-risk folks while supply increases. [Paxlovid is better imho] 17/ If you are not the sick person, but one of the exposed, & you can walk-up/drive-up (NOT indoors & ONLY in a !) to #GetVaccinated, do it. If age 16+ & 6+ mos post dose 2 of vaccine (or 2+ post J&J), go #GetBoosted now! The booster protects w/in a wk! 19/ If you are high-risk #immunocompromised or #immunosuppressed, we know that #vaccineswork less well in many of you. While you should still #GetVaccinated & #GetBoostedan injection (Evusheld) can decrease your risk of #COVID19. It’s given every 6 mos. ~ ~ ~ Also #Remdesivir might be available as an outpatient for high-risk- (1.6%) in the remdesivir group and 21 of 252 (8.3%) hosp or death in placebo https://www.nejm.org/doi/full/10.1056/NEJMoa2116846 I suggest contacting the local health department +/- hospital to see where any of these drugs might be available. There are very limited supplies.

Politics:

A top Florida health official was placed on leave after encouraging his colleagues to get vaccinated against COVID-19. (Washington Post)

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Arizona says it “will not be intimidated” by Biden on anti-mask school policies

Arizona floated legal action against the Biden administration for threatening to withhold COVID-19 relief funds over the state’s anti-mask school policies.

https://www.axios.com/arizona-biden-administration-yellen-covid-aid-c235c74b-6916-4ea7-97fe-a41d36a6ad81.html

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Virginia

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Supremes:

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Voting

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Election

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U.K. – pregnant people are non-patient facing from 28/40. As a surgical trainee I had a year of maternity leave with each of my children, and the option to reduce my hours after returning to work.

In GER, paid maternal leave starts 6 weeks before her due date, she isn’t allowed to work with infectious patients during her pregnancy (she might stop earlier), she has up to 1 yr of paid parental leave.

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One of the most important things to remember about the rise of the Third Reich. pic.twitter.com/6oKaj60P6R

— Kristine Schachinger (@schachin) January 16, 2022

Feel good du jour:

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When I was 4, I wrote a letter to the Entomology department at UCB. “My name is Rebecca and I have a bug collection. I read about yours and it is bigger than mine is. Can I see it? Also, I have a question. Do walking sticks have knees? Sincerely, Rebecca”

I have no memory of doing this, but a professor wrote back! Not only did he take the time to reply, he invited me to come to UCB & see “a really big bug collection”. Following a lot of begging, my mom made time to drive to Berkeley, despite mild alarm at this whole situation.

Apparently I told her that we’d exchanged letters so he didn’t count as a stranger and therefore it was safe. And we went, and I had the greatest day of my young life. I remember snippets. Him laughing because I lost my mind at the foot-long walking sticks.

Him asking me what bug I wanted to meet alive, and being delighted when I said Luna moth, because (this was a secret) moths are better than butterflies.

He let me hold a live scorpion. As my mom tells it, he commented that they made good pets until she shot him an absolute death glare over my head, at which point he clarified “but only in museums and zoos”. I also met a tarantula, a hissing cockroach, and live walking sticks.

He explained how “knees” work in insects, then said he had to go, to teach his class on bugs. And I demanded to know where you could take an ENTIRE CLASS about bugs. He explained what college was. I asked if anybody was allowed to go, and he said yes.

Apparently, I promptly declared that I would go to college, and get a PhD, so I could work somewhere like that. He shook my hand and told me it was a pleasure to meet another biologist.

I have no idea who this amazing person was. But on days like today when I’m working on outreach that brings animals into classrooms, now with a doctorate in biology, I wish I could tell him thank you. Collections, when shared, are warehouses of wonder.

And somewhere in a drawer at UC Berkeley there’s a foot-long walking stick partially responsible for my college education. If anybody knows who this amazing tour guide may have been, let me know! Otherwise, do outreach and answer the weird questions!

She did permit me to get a pet walking stick, not knowing they were parthenogenic. Eight generations later, I had hundreds and a love of genetics. I think we share the good fortune of parents who nurtured our curiosity. And trilobites are adorable creatures!

Comic relief:

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https://twitter.com/buitengebieden_/status/1483495020896395265?s=20

Perspective/Poem

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Bits of beauty:

 

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