Coronavirus Tidbits #184 3/20/22

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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 Posts:

Aerosolized Hydrogen Peroxide Can Significantly Reduce C. difficile Infections

https://www.medscape.com/viewarticle/970559

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Politicians Overrule Board of Health’s Medical Officer

https://www.medscape.com/viewarticle/970093

 

News 

China, Hong Kong cases climb

In global COVID news, China today reported 4,130 new cases today, 1,742 listed as asymptomatic, with the more transmissible Omicron variant pushing cases to 2-year highs. More than half of today’s new cases were from Jilin province, one of the handful of locations that are under lockdown.

At a briefing today, Chinese officials emphasized that the country must learn Hong Kong’s painful lesson about deaths in vulnerable people by ensuring that older people are vaccinated, according to Reuters. Currently, only 19.7% of Chinese seniors have been boosted, and only 50.7% are fully vaccinated. [and this is w less-effective Sinovac]

Meanwhile, Hong Kong today reported 20,082 new cases, along with 206 more deaths.

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Here’s what COVID case incr in Europe and Asia mean for the US

BA.2 variant has roughly doubled each week for the last month, What’s not yet known is if BA.2 causes severe illness

[and in Africa, only about 15% of the region’s adult population is fully vaccinated, well behind other parts of the world]

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‘Is it worth it?’: New report lays bare harassment of public health officials during the pandemic

 There’s a mountain of evidence showing the devastating toll of the pandemic on health workers. Now, new research lays bare the brutal impact on their counterparts in public health.

To capture the experience of public health officials during the pandemic, researchers scoured data from a national survey of local health department workers and combed through media reports of attacks. They turned up nearly 1,500 different instances of harassment against public health workers between March 2020 and January 2021, and also found at least 222 public health officials left their jobs during that time frame.

The survey results were troubling: Health officials said they were personally attacked, villainized, and their experiences often marginalized. Their work was, at best, underappreciated, and, at worst, blamed for broader problems. Of those who said they’d experienced harassment, 24% reported facing backlash on social media; 6% said they had received personally targeted messages; 6% said they received threats to their own safety or their family’s; and 2% said their personal information was publicly shared online, a type of attack known as doxxing.

https://www.statnews.com/2022/03/17/public-health-harassment-covid19-pandemic/?

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Feds (finally) unveil ventilation standards

In other federal developments, the Biden Administration unveiled new standards for ventilation of schools and businesses. The guidance from the Environmental Protection Agency (EPA), the first to address air filtration in these settings, is part the nation’s new COVID-19 plan.

In releasing the new guidance today, the EPA issued a “Clean Air in Buildings Challenge,” which focuses on creating a clean indoor air action plan, optimizing fresh-air ventilation, enhancing air filtration and cleaning, and conducting community engagement.

https://www.cidrap.umn.edu/news-perspective/2022/03/covid-19-cases-soar-asian-hot-spots-us-gets-new-covid-czar

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Single-dose Peginterferon Significantly Reduced COVID-19 Hospitalization or ER Risk

California-based Eiger BioPharmaceuticals, Inc. today announced that Peginterferon Lambda was found to significantly reduce the risk of COVID-19-related hospitalizations or emergency room visits greater than six hours by 50% and death by 60% in the Phase 3 TOGETHER study.

Lambda is a late-stage, first-in-class, type III interferon that stimulates immune responses critical to innate defenses with a mechanism of action potentially agnostic to variants of the SARS-CoV-2 coronavirus and resistance concerns with other treatments.

The final analyses evaluated data from 1,936 patients, with 84% of patients receiving at least a single dose of any COVID-19 vaccine.

“These data demonstrate that a single subcutaneous injection of Lambda has the potential to be a convenient, ‘one and done’ treatment to reduce the severity of COVID-19, reducing hospitalizations and death, even in a vaccinated population,” said Eiger President and CEO, David Cory, in a related press release issued on March 17, 2022.

https://www.precisionvaccinations.com/2022/03/17/single-dose-peginterferon-significantly-reduced-covid-19-hospitalization-or-er-risk

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70% of COVID survivors in UK study had impaired memory, focus

An online UK study finds that about 70% of 181 adult COVID survivors had memory and concentration problems several months after infection, 75% reported persistent symptoms so severe that they couldn’t work, and 50% said that medical professionals didn’t take their symptoms seriously.

In the ongoing COVID and Cognition study, published as two papers today in Frontiers in Aging Neuroscience, a team led by University of Cambridge researchers report on the baseline characteristics and cognitive test performance of 181 long COVID patients and 185 never-infected peers.

https://www.cidrap.umn.edu/news-perspective/2022/03/70-covid-survivors-uk-study-had-impaired-memory-focus

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Diagnostics:

Place Your Order for Free At-Home COVID-19 Tests

Residential households in the U.S. are eligible for #2 orders of #4 free at-home tests on USPS.com. Here’s what you need to know about your order:

  • Limit of #2 orders per residential address
  • Each order includes #4 individual rapid antigen COVID-19 tests
  • Orders will ship free as tests are received from manufacturers

U.S. households can place a total of #2 separate orders for free, at-home COVID-19 rapid tests (#4 tests per order). If an order was previously placed for your address, you can place a second order now.

https://special.usps.com/testkits

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COVID-19 Wastewater Surveillance Shows Sixty-Two Active Sites

The U.S. CDC’s Wastewater Surveillance dashboard of COVID-19 indicated on March 14, 2022, there were very few testing sites identifying active SARS-CoV-2 virus samples.

However, 62 (15%) sites have a 1,000% or greater increase in viral RNA detected in the past 15-day period.

Highlighted states on this map include, but are not limited to, Florida and Ohio.

This weekly information represents all wastewater data submitted directly to CDC’s National Wastewater Surveillance System’s DECIPHER platform, subject to suppression criteria.

Separately, these systems also reported activity:

  • CDC’s Nowcast system estimates more recent proportions of circulating variants.
  • The nationwide blood donor seroprevalence survey.
  • Commercial laboratories nationwide COVID-19 Infection-Induced Antibody Seroprevalence.

https://www.precisionvaccinations.com/2022/03/15/covid-19-wastewater-surveillance-shows-sixty-two-active-sites

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Drugs and Vaccines:

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Israeli study points to modest 4-dose vaccine protection against Omicron

Four-dose efficacy of mRNA vaccines against symptomatic Omicron COVID-19 infection is modest, according to a research letter yesterday in the New England Journal of Medicine that described a small study in Israel.

Of 1,050 eligible Israeli healthcare workers, 154 received a fourth dose of Pfizer and 120 received a fourth dose of Moderna. The researchers selected two age-matched controls from the remaining eligible participants for each person vaccinated.

The fourth dose produced a robust immune response and caused no concerning adverse events. Overall, 25.0% of the volunteers in the control group were infected with Omicron, compared with 18.3% in the Pfizer group and 20.7% in the Moderna group.

The researchers reported vaccine efficacy of 30% for Pfizer and 11% for Moderna for any SAR-CoV-2 infection, but neither vaccine achieved statistical significance for this measure. Vaccine protection against symptomatic COVID-19 was 43% for Pfizer and 31% for Moderna. Omicron accounted for 100% of circulating SARS-CoV-2 in Israel at the time of the study.

The authors note, “Our cohort was too small to allow for accurate determination of vaccine efficacy. However, within the wide confidence intervals of our estimates, vaccine efficacy against symptomatic disease was 65% at most.”

They conclude, “A fourth vaccination of healthy young health care workers may have only marginal benefits. Older and vulnerable populations were not assessed.” Also, they did not assess a fourth dose against severe COVID-19.
Mar 16 N Engl J Med study

https://www.cidrap.umn.edu/news-perspective/2022/03/covid-19-scan-mar-17-2022

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Why early COVID treatments like Paxlovid are going unused 

https://www.npr.org/sections/health-shots/2022/03/18/1087380770/lifesaving-covid-drugs-are-sitting-unused-on-pharmacy-shelves-hhs-data-shows

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Vaccine effectiveness wanes after three months among care home residents

Vaccination-acquired immunity against COVID-19 wanes substantially after three months among elderly care home residents, suggesting that regular booster jabs may be needed for this group,

https://medicalxpress.com/news/2022-03-vaccine-effectiveness-wanes-months-home.html?

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Key antiviral treatment for COVID-19–Paxlovid–still effective despite resistance fears

https://medicalxpress.com/news/2022-03-key-antiviral-treatment-covid-effective.html?

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Molnupiravir Heavily Used, Despite Concerns

Merck’s COVID antiviral molnupiravir is being heavily used despite concerns and a preference for Pfizer’s nirmatrelvir/ritonavir (Paxlovid), according to the Wall Street Journal.

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One-Dose J&J COVID Vaccine Quietly Effective Throughout Delta Surge

– Real-world claims data finds often-maligned vaccine showed little waning over 6 months

https://www.medpagetoday.com/infectiousdisease/covid19vaccine/97722?

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Devices and Masks:

for a person doing all of the activities above (or similar), we’d need to keep SARS-CoV-2 under 50 cases per 100,000 people weekly, if one-way N95 masking in those public settings were to be safe enough that the 4-month risk of infection would be under 1% for an immune-compromised person in whom vaccines offer no protection.

That figure is striking-almost uncanny-because it falls right at the upper limit of the CDC’s old “moderate transmission” category, which was the agency’s previously stated threshold (from July 2021) for advising universal indoor masking regardless of vaccination status. It’s also the exact proposal that Dr. Gregg Gonsalves had proposed to me a couple weeks ago! For the United States, it would mean around 25,000 new cases per day (I already baked in the assumption that we miss 2 out of 3 infections).

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Epidemiology/Infection control:

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Hospitalization of infants, children aged 0 to 4 up during Omicron

(HealthDay)-U.S. infants and children aged 0 to 4 years were hospitalized at a much higher rate during Omicron variant predominance than during delta variant predominance, according to research published in the March 15 early-release issue of the U.S. Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report.

https://medicalxpress.com/news/2022-03-hospitalization-infants-children-aged-omicron.html?

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COVID’s Death Toll 3 Times Worse Than Official Counts

– In U.S. alone, excess deaths were 300,000 higher than those attributed to virus

https://www.medpagetoday.com/infectiousdisease/covid19/97610?

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More data show omicron’s toll on youngest children

Surveillance data continue to show that COVID-19 hospitalizations among young children increased fivefold during the omicron wave of SARS-CoV-2 compared with the peak of the delta wave, researchers reported in MMWR.

According to the COVID-NET Surveillance Network, from Dec. 19 to Feb. 19, weekly COVID-19-associated hospitalization rates per 100,000 infants and children aged 0 to 4 years peaked at 14.5 during the week ending Jan. 8 – about five times the rate during the delta wave from June 27 to Dec. 18.

 Additionally, monthly ICU admission rates were approximately 3.5 times as high during the omicron peak in January (10.6 per 100,00 infants) as during the delta peak in September (3 per 100,000), although hospitalization rates among infants and children aged 0 to 4 years did decrease by Feb. 19.

similar report was published in MMWR last month. In the new report, the researchers noted that the proportion of patients who also tested positive for respiratory syncytial virus was higher during delta wave than the omicron wave.

https://www.healio.com/news/primary-care/20220316/more-data-show-omicrons-toll-on-youngest-children

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After accounting for lag between infection & death, *1 in 20* cases in Hong Kong currently ends in death. To put that into context, HK’s case fatality rate (NB different to infection fatality rate) is currently higher than England’s pre-vaccine peak. Two years into the pandemic.

Hong Kong’s total death toll has risen almost vertically in the last two weeks, shooting past not only its Asia-Pacific peers, but now European countries including Norway and Finland. And that line will keep rising. it’s extraordinary the extent to which it is an outlier in terms of the lethality of this wave. So what’s driving this? Vaccines. Or more specifically: the elderly vaccination rate. When Omicron hit, *more than two-thirds of people aged 80+ in Hong Kong were still unvaccinated*, compared to a couple of percent in New Zealand and Singapore. This was a year after vaccines became available. Exacerbating this is that most of Hong Kong’s elderly vaccinees had China’s non-mRNA Sinovac shot, which is less effective than Pfizer etc at blocking infection.

Tips, general reading for public:

Politics:

Covid:

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Today, the federal government is rationing monoclonal antibody treatments, reducing state allocations by 30% to stretch supplies as long as possible. By early April there will be no funds to reimburse physicians and others who provide COVID tests and treatments for uninsured patients. By May there will be no funds to purchase Evusheld to prevent or treat COVID in the immunocompromised. By June, funding for the purchase of COVID tests will run out, reducing availability of tests for the fall. If the FDA authorizes a fourth dose of the COVID vaccine for Americans over 65, there will be no money to purchase those vaccines for Americans. Without funding, USAID will have to stop efforts to distribute and administer vaccines in under vaccinated countries, the very countries that are most likely to spawn a new variant. And maybe most importantly, without funds surveillance for new variants, research and purchase of new oral antiviral drugs, and research into next generation COVID vaccines will be halted or dramatically slowed.

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GOP:

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Abortion:

Florida:

Alabama:

Anderson later inspired a state senator and the state superintendent to work for the passage of a new law (enacted in 1953) to repeal the prohibition. She retired in 1982 after teaching in Greensboro public schools for 34 years.

In addition to teaching, Anderson was an advocate. She inspired the city of Greensboro to provide accommodations for mobility before being required by law to do so. She also served on the AL Governor’s Committee on Employment of the Handicapped in 1977.

Anderson died in 1998 at the age of 72. In 2011, She was inducted into the Alabama Women’s Hall of Fame.

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Arizona:

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Georgia: MTG:

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North Carolina/Cawthorn/Mark Meadows, and more!

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Minnesota

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Kansas:

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Texas:

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Missouri:

Idaho:

Ukraine/Russia:

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Feel good du jour:

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https://twitter.com/buitengebieden_/status/1503606559984730112?s=20&t=DhxzyFBMhAvH4wr-SpkdEg

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Comic relief:

https://twitter.com/buitengebieden_/status/1504951806115336193?s=20&t=DhxzyFBMhAvH4wr-SpkdEg

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https://twitter.com/buitengebieden_/status/1504556949962174468?s=20&t=DhxzyFBMhAvH4wr-SpkdEg

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https://twitter.com/buitengebieden_/status/1504122359019712522?s=20&t=DhxzyFBMhAvH4wr-SpkdEg

Perspective/Poem

Bits of beauty:

 


 

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