Coronavirus Tidbits #182 3/6/22

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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’s New Mask Guidelines For Covid-19 Throw Vulnerable People Under The Bus

https://www.forbes.com/sites/judystone/2022/02/28/cdcs-new-mask-guidelines-for-covid-19-throw-vulnerable-people-under-the-bus/?sh=6395435c1573

News 

New National COVID-⁠19 Preparedness Plan 

The White House March 2, 2022 https://www.whitehouse.gov/covidplan/

The President’s National COVID-19 Preparedness Plan focuses on four key goals:

Protect Against and Treat Covid-19

Prepare for New Variants

Prevent Economic and Educational Shutdowns

Continue to Vaccinate the World

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Masking still ‘important layer of protection’ for children: AAP

In light of new masking recommendations from the CDC, the AAP has updated its own masking guidance but says that masking is still an “important layer of protection” for children.

The updates come less than a week after the CDC released new COVID-19 guidance indicating that most Americans live in areas where they can go maskless, and nearly a month after the Democratic governors of several states, including New Jersey and Delaware, said that they will soon lift COVID-19 mask mandates in K-12 schools, joining other states that have already eliminated such measures. The latter move was criticized at the time by the AAP, with the organization’s spokesperson saying it was “too early” to lift the mandates.

 AAP President Moira Szilagyi, MD, PhD, FAAP said in a statement that although the CDC’s new approach was “reasonable,” masking would still be needed for some children.

https://www.healio.com/news/primary-care/20220302/masking-still-important-layer-of-protection-for-children-aap

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SARS-CoV-2-infected individuals could have different variants hidden in different parts of the body

by Max Planck Society  MARCH 1, 2022

People suffering from COVID-19 could have several different SARS-CoV-2 variants hidden away from the immune system in different parts of the body, finds new research published in Nature Communications by an international research team. The study’s authors say that this may make complete clearance of the virus from the body of an infected person, by their own antibodies, or by therapeutic antibody treatments, much more difficult.

https://medicalxpress.com/news/2022-03-sars-cov-infected-individuals-variants-hidden-body.html

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Coronavirus infects penis, testicles and prostate in monkeys: Northwestern study

Multiple tissues of the male genital tract can be infected with SARS-CoV-2, reports a new Northwestern Medicine study in large animal models. The study, in SARS-CoV-2 infected-rhesus macaques, revealed the prostate, vasculature of testicles, penis and testicles were all infected with the virus.

The surprising discovery was made utilizing a PET scan specially designed to reveal sites of infection spreading over time in a whole-body scan. Scientists didn’t know what they would find, but they expected to see the virus in the lungs and high up in the nose near the brain because people were experiencing loss of taste and smell.

“But the signal that jumped out at us was the complete spread through the male genital tract,” said lead investigator Thomas Hope,

“These results indicate that the testicular pain, erectile dysfunction, hypogonadism, reduced sperm count and quality, and decreased fertility associated with SARS-CoV-2 infection are a direct consequence of infection of cells of the male reproductive tract and not indirect mechanisms such as fever and inflammation,” Hope said.

http://outbreaknewstoday.com/coronavirus-infects-penis-testicles-and-prostate-in-monkeys-northwestern-study-48932/

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Details:

Peripheral Neuropathy Evaluations of Patients With Prolonged Long COVID

Background and Objectives Recovery from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection appears exponential, leaving a tail of patients reporting various long COVID symptoms including unexplained fatigue/exertional intolerance and dysautonomic and sensory concerns. Indirect evidence links long COVID to incident polyneuropathy affecting the small-fiber (sensory/autonomic) axons.

Methods We analyzed cross-sectional and longitudinal data from patients with World Health Organization (WHO)-defined long COVID without prior neuropathy history or risks who were referred for peripheral neuropathy evaluations. We captured standardized symptoms, examinations, objective neurodiagnostic test results, and outcomes, tracking participants for 1.4 years on average.

Results Among 17 patients (mean age 43.3 years, 69% female, 94% Caucasian, and 19% Latino), 59% had ≥1 test interpretation confirming neuropathy. These included 63% (10/16) of skin biopsies, 17% (2/12) of electrodiagnostic tests and 50% (4/8) of autonomic function tests. One patient was diagnosed with critical illness axonal neuropathy and another with multifocal demyelinating neuropathy 3 weeks after mild COVID, and ≥10 received small-fiber neuropathy diagnoses. Longitudinal improvement averaged 52%, although none reported complete resolution. For treatment, 65% (11/17) received immunotherapies (corticosteroids and/or IV immunoglobulins).

Discussion Among evaluated patients with long COVID, prolonged, often disabling, small-fiber neuropathy after mild SARS-CoV-2 was most common, beginning within 1 month of COVID-19 onset. Various evidence suggested infection-triggered immune dysregulation as a common mechanism.

https://nn.neurology.org/content/9/3/e1146?utm_source=

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Diagnostics:

still an incredible, negligent lack of testing.

Study: At-home COVID-19 antigen tests detect omicron and delta variants similarly

At-home antigen tests performed similarly in detecting omicron and delta SARS-CoV-2 variants in comparison to polymerase chain reaction (PCR) tests and remain valuable tools to inform people of their infection status quickly,

https://medicalxpress.com/news/2022-03-at-home-covid-antigen-omicron-delta.html?

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No PCR, no problem: How COVID can be diagnosed with X-rays

It sounds simple, but to treat someone you suspect has COVID, you need to confirm they are actually infected with the coronavirus. In the UK, it is easy to take this for granted-we’ve had a reliable detection method for diagnosing infected patients widely available since early on in the pandemic. This allowed for people to be treated and cared for promptly, saving lives.

Algorithm had 98% accuracy

https://medicalxpress.com/news/2022-03-pcr-problem-covid-x-rays.html?

Drugs and Vaccines:

Rituximab May Render Certain COVID-19 Vaccines Less Effective

According to a recent study by researchers at Stanford Medicine, cancer patients who have been treated with rituximab, a widely used drug or similar drugs, respond poorly or not at all to subsequent COVID-19 mRNA vaccination.

In contrast, vaccination immediately before such treatments can generate a months-long, durable antibody response, found in the study published on Jan. 31, 2022, in Blood Cancer Discovery.

But the findings strongly suggest that people who are newly diagnosed with lymphoma should be offered the vaccine prior to beginning rituximab or similar drugs.

https://www.precisionvaccinations.com/2022/02/27/cancer-drug-may-render-certain-covid-19-vaccines-less-effective

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U.S. NIH Ranks COVID-19 Treatments

The purpose of this new NIH statement is to provide clinicians with guidance on the role of bebtelovimab a U.S. FDA Authorized monoclonal antibody treatment, as an additional option for this patient population.

For nonhospitalized patients with mild to moderate COVID-19 who are at high risk of progressing to severe disease, the Panel recommends using one of the following therapies, listed in order of preference:

  • Nirmatrelvir 300 mg with ritonavir 100 mg (Paxlovid) orally twice daily for five days, initiated as soon as possible and within five days of symptom onset in those aged ≥12 years and weighing ≥40 kg.
  • Sotrovimab 500 mg as a single intravenous infusion (IV), administered as soon as possible and within seven days of symptom onset in those aged ≥12 years and weighing ≥40 kg.
  • Remdesivir 200 mg IV on Day 1, followed by remdesivir 100 mg IV once daily on Days 2 and 3, initiated as soon as possible and within seven days of symptom onset in those aged ≥12 years and weighing ≥40 kg.
  • Bebtelovimab 175 mg as a single IV infusion, administered as soon as possible and within seven days of symptom onset in those aged ≥12 years and weighing ≥40 kg, ONLY if none of the preferred therapies are available, feasible to deliver, or clinically appropriate.
  • Molnupiravir 800 mg orally twice daily for five days, initiated as soon as possible and within five days of symptom onset in those aged ≥18 years, ONLY if none of the preferred therapies are available, feasible to deliver, or clinically appropriate.

The Panel favors ritonavir-boosted nirmatrelvir, sotrovimab, or remdesivir as the preferred therapies for these patients, primarily based on a 79% to 88% reduction in hospitalization or death in treated patients, as well as on the agents’ in vitro activities against the Omicron VOC.

The Panel’s recommendation on bebtelovimab is primarily based on laboratory data showing its potent activity against the Omicron VOC, its BA.1 and BA.2 subvariants, other VOCs, and on limited clinical trial data.

https://www.precisionvaccinations.com/us-nih-ranks-covid-19-treatments

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Pfizer shots protect kids from severe COVID even in omicron

by Lauran Neergaard  MARCH 1, 2022

Pfizer’s COVID-19 vaccine gave children 5 and older strong protection against hospitalization and death even during the omicron surge that hit youngsters especially hard, U.S. health officials reported Tuesday.

New data from the Centers for Disease Control and Prevention come a day after a study of New York children suggested the vaccine may not be as effective in 5- to 11-year-olds as in older kids-especially at blocking milder infections. That data raised the question of whether kid-sized doses given to those under 12 might be too low.

But the CDC said data from multiple other states suggests the issue isn’t children’s ages or dose size-it’s omicron. Vaccination generally is less effective against the hugely contagious omicron variant than earlier versions of the coronavirus-and vaccinations for 5- to 11-year-olds began just weeks before omicron began circulating.

“As a parent of a very young child, I think I would do everything to keep them out of the emergency department in the middle of the night,” said CDC epidemiologist Ruth Link-Gelles. “What we see from the data that we have is that the vaccine continues to provide good protection against more severe outcomes.”

Pediatricians say the back-and-forth results may seem confusing but that parents need to understand the shots are still the best way to prevent serious illness.

https://medicalxpress.com/news/2022-03-pfizer-shots-kids-severe-covid.html

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Third vaccine dose boosts Omicron protection, with some waning

Two doses of the AstraZeneca/Oxford, Pfizer/BioNTech, or Moderna COVID-19 vaccine offered limited protection against symptomatic infection with the SARS-CoV-2 Omicron variant, and although a third dose with any of the three vaccines boosted effectiveness substantially, it waned a bit over time.

These findings, from a study by UK Health Security Agency researchers, were published yesterday in the New England Journal of Medicine.

https://www.cidrap.umn.edu/news-perspective/2022/03/third-vaccine-dose-boosts-omicron-protection-some-waning

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Disparities in COVID-19 Vaccination Coverage Between Urban and Rural Counties – US December 14, 2020-January 31, 2022

What is added by this report?

COVID-19 vaccination coverage with the first dose of the primary vaccination series was lower in rural (58.5%) than in urban counties (75.4%); disparities have increased more than twofold since April 2021. Receipt of booster or additional doses was similarly low in both rural and urban counties.

https://www.cdc.gov/mmwr/volumes/71/wr/mm7109a2.htm?

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Moderna sued for allegedly infringing patents tied to COVID-19 vaccine

Biopharma Dive

  • Two biotech companies on Monday sued Moderna in U.S. federal court over claims the COVID-19 vaccine maker infringed on six patents they hold that describe technology important to the delivery of messenger RNA shots into the body.
  • The 51-page lawsuit, filed by Arbutus Biopharma and partner Genevant Sciences in the U.S. District Court for the District of Delaware, alleges that Moderna used their technology in its coronavirus vaccine and repeatedly refused to “engage meaningfully” in licensing negotiations.
  • In a statement emailed to BioPharma Dive, Moderna denied Arbutus and Genevant’s allegations and said it would defend itself in court. The company added that its vaccine is the product of years of mRNA research and development, including the creation of proprietary delivery technology different than Arbutus and Genevant’s.

https://www.biopharmadive.com/news/moderna-arbutus-roivant-lawsuit-patents-lnp-vaccine/619502/?

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Plant-based COVID-19 vaccine approved in Canada

Medicago and GlaxoSmithKline (GSK) have gained approval for Covifenz, the companies’ plant-based COVID-19 vaccine, from Health Canada.

Medicago’s tech takes the idea of traditional vaccine manufacturing – based on using eggs to produce viruses – and instead uses living plants as the bioreactor that produces a protein particle that mimics the target virus.

Covifenz represents the first COVID-19 vaccine using plant-based vaccine; as well as being Medicago’s first approved vaccine and the first authorized COVID-19 vaccine developed by a Canadian-based company.

75% efficacy vs. Delta

https://www.biopharma-reporter.com/Article/2022/02/28/Plant-based-COVID-19-vaccine-approved-in-Canada?

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Study: COVID vaccine effectiveness declines after 6 months without boosters

A study released in The Lancet Respiratory Medicine by Providence, one of the largest health systems in the United States, confirms the overall effectiveness of vaccines in preventing severe infection resulting in hospitalization from COVID-19, but also shows a substantial decline in protection after six months. Completed by a team of clinicians and scientists in the Providence Research Network, the study examined data from nearly 50,000 hospital admissions between April and November of 2021, finding that vaccines were 94% effective at preventing hospitalization 50-100 days after receiving the shot but fell to 80.4% 200-250 days later, with even more rapid declines after 250 days.

https://medicalxpress.com/news/2022-02-covid-vaccine-effectiveness-declines-months.html?

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Booster critical as COVID-19 vaccine-induced antibodies wane in 6 months, don’t protect against Omicron

A new study using serum from human blood samples suggests neutralizing antibody levels produced by two-dose mRNA vaccines against the original and early variants of the SARS-CoV-2 virus wane substantially over time, and offer essentially no protection against the Omicron variant.

https://medicalxpress.com/news/2022-03-booster-critical-covid-vaccine-induced-antibodies.html?

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Russia’s Sputnik V vaccine, Pfizer, and Moderna induce better than natural immunity from mild COVID

Researchers from Skoltech, two Russian Academy of Sciences institutes, and U.S. biotech companies VirIntel and Argentys Informatics have investigated the effect of coronavirus immunization with three popular vaccines: Moderna, Pfizer, and the Russian Sputnik V. The team found that complete vaccination-that is, getting both shots-on average resulted in a similar and sufficiently high immune response regardless of which of the three vaccines was used. The effect was also comparable to that after recovering from a severe or moderate, but not mild, COVID-19 infection. The findings are reported in a study released as a preprint on medRxiv

https://medicalxpress.com/news/2022-03-russia-sputnik-vaccine-pfizer-moderna.html?

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WHO recommends Merck’s COVID pill, Molnupiravir, for non-severe, at-risk patients

The World Health Organization on Wednesday recommended an anti-COVID pill be taken by sufferers who have mild symptoms but are at high risk of hospitalization, such as older people or the unvaccinated.

https://medicalxpress.com/news/2022-03-merck-covid-pill-non-severe-at-risk.html?

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Devices:

ECMO therapy cuts Covid-19 patients’ chance of dying by half, if they can get it

For extremely sick patients, an advanced form of life support called extracorporeal membrane oxygenation, or ECMO, cuts the risk of dying from Covid-19 by half, according to a new study by researchers at Vanderbilt University.

But at the height of the pandemic, many patients couldn’t get the treatment because there weren’t enough beds, machines or skilled staff to care for them, the study found.

Nearly 90% of patients who met Vanderbilt’s stringent criteria to receive ECMO, but couldn’t get in for care, died.

“I think this is very powerful to me, because, you know, for the first time, we were actually seeing what is happening to these patients, when they don’t receive this therapy,” said lead study researcher Whitney Gannon, director of quality and education for the adult ECMO program at Vanderbilt.

Gannon said when the Delta surge was at its worst in the South, she would get 10 to 15 calls a day for patients who needed ECMO. At maximum capacity, Vanderbilt had space for seven EMCO patients at a time, so many of these patients were turned away.

https://www.cnn.com/2022/02/25/health/ecmo-cuts-covid-19-death-risk/index.html

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More info at https://threadreaderapp.com/thread/1498350093811990532.html

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Epidemiology/Infection control:

Had Omicron? You’re unlikely to catch its rising variant BA.2

Infection with the first widely circulating version of Omicron protects against the emerging BA.2 subvariant – as does vaccination.

https://www.nature.com/articles/d41586-022-00558-w

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New research suggests a causal link between blood group and severe COVID-19

A new study has analyzed over 3000 proteins to identify which are causally linked to the development of severe COVID-19. This is the first study to assess such a large number of proteins for their connection to COVID-19. The findings provide insight into potential new targets for approaches to treat and prevent severe COVID-19.

https://medicalxpress.com/news/2022-03-causal-link-blood-group-severe.html?

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Wuhan market was epicentre of pandemic’s start, studies suggest

Report authors say that the coronavirus SARS-CoV-2 jumped from animals sold at the market into people twice in late 2019 – but some scientists want more definitive evidence.

Nature Amy Maxmen 27 February 2022

Scientists have released three studies that reveal intriguing new clues about how the COVID-19 pandemic started. Two of the reports trace the outbreak back to a massive market that sold live animals, among other goods, in Wuhan, China1,2, and a third suggests that the coronavirus SARS-CoV-2 spilled over from animals – possibly those sold at the market – into humans at least twice in November or December 20193. All three are preprints, and so have not been published in a peer-reviewed journal.

These analyses add weight to original suspicions that the pandemic began at the Huanan Seafood Wholesale Market, which many of the people who were infected earliest with SARS-CoV-2 had visited. The preprints contain genetic analyses of coronavirus samples collected from the market and from people infected in December 2019 and January 2020, as well as geolocation analyses connecting these samples to a section of the market where live animals were sold. Taken together, these different lines of evidence point towards the market as the source of the outbreak – much like animal markets were ground zero for the severe acute respiratory syndrome (SARS) epidemic of 2002-2004 – says Kristian Andersen, a virologist at the Scripps Research Institute in La Jolla, California, and an author on two of the reports. “This is extremely strong evidence,” he says.

Still, none of the studies contain definitive evidence about what type of animal might have harbored the virus before it spread to humans. Andersen speculates that the culprits could be raccoon dogs, a squat dog-like mammal used for food and for their fur in China. One of the studies he coauthored2 suggests that raccoon dogs were sold in a section of the market where several positive samples were collected. And reports4 show that the animals are capable of harboring other types of coronaviruses.

Some virologists say that the new evidence pointing to the Huanan market doesn’t rule out an alternative hypothesis. Namely, they say that the market could have just been the location of a massive amplifying event, in which an infected person spread the virus to many other people, rather than the place of the original spillover.

“Analysis-wise, this is excellent work, but it remains open to interpretation,” says Vincent Munster, a virologist at the Rocky Mountain Laboratories, a division of the National Institutes of Health, in Hamilton, Montana. He says searching for SARS-CoV-2 and antibodies against it in blood samples collected from animals sold at the market, and from people who sold animals at the market, could provide more definitive evidence of COVID-19’s origins. The number of positive samples from the market suggests an animal source, Munster says. But he is frustrated that more thorough investigations haven’t already been conducted: “We are talking about a pandemic that has upended the lives of so many people.”

https://www.nature.com/articles/d41586-022-00584-8

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Long Covid: Consider, too, that, according to a study in JAMA, about 10 per cent of health workers – a group with high COVID-19 infection rates – now have long COVID. More at:

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Tips, general reading for public:

#CovidIsAirborne Improve ventilation everywhere.

Politics:

Grassley and Manchin did, too.

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Voter suppression:

GOP:

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Kentucky:

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Texas:

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Florida:

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Other:

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Feel Good du jour:

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https://twitter.com/buitengebieden_/status/1499519430044393479?s=20&t=XPOITEhjp4OzllL9NhRUSg

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Comic relief:

https://twitter.com/buitengebieden_/status/1499264938749140996?s=20&t=XPOITEhjp4OzllL9NhRUSg

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Perspective/Poem

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Bits of beauty:

 

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