Coronavirus Tidbits #185 3/27/22

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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.

News 

Better Collection, Better Data

The US Centers for Disease Control and Prevention is working to improve how it collects and analyzes data, Politico reports. It adds that in a letter to CDC employees, Director Rochelle Walensky urged them to help with the “success of the Data Modernization Initiative”

The agency, Politico notes, suffered from data gaps that hindered its response to the COVID-19 pandemic. The CDC relies on state and local health departments to collect and provide it with lab and hospital records, but as Politico points out, local health departments are typically underfunded and many have not updated their data collection methods – some, it says, rely on labs to fax their results. . .

https://www.genomeweb.com/scan/better-collection-better-data?

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Experts worry about how US will see next COVID surge coming

As coronavirus infections rise in some parts of the world, experts are watching for a potential new COVID-19 surge in the U.S.-and wondering how long it will take to detect.

Despite disease monitoring improvements over the last two years, they say, some recent developments don’t bode well:

-As more people take rapid COVID-19 tests at home, fewer people are getting the gold-standard tests that the government relies on for case counts.

-The CDC will soon use fewer labs to look for new variants.

-Health officials are increasingly focusing on hospital admissions, which rise only after a surge has arrived.

-A wastewater surveillance program remains a patchwork that cannot yet be counted on for the data needed to understand coming surges.

-White House officials say the government is running out of funds for vaccines, treatments and testing. . .

https://medicalxpress.com/news/2022-03-experts-covid-surge.html

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White House diverges from CDC, focuses on aerosol COVID spread

3/23/ the White House published a blog post titled “Let’s Clear the Air on COVID,”…the first time the White House has formally acknowledged that aerosol transmission has been the primary driver of the COVID-19 pandemic. In doing so, it has turned away from the language used by the CDC…

If aerosol transmission is the dominant way the virus is spread, cloth and surgical masks are inefficient face coverings, and layered mitigation strategies must focus on optimal respiratory protection such as N95 respirators and on ventilation and air quality.

“This gives prominence to the importance of clean air,” said Michaels. “It parallels clean water and outdoor air quality. We expect clean water, and we demand pollution be eliminated to make outdoor air clean. Now people will demand clean indoor air quality.”

Michaels explained that the White House’s embrace of aerosol transmission shifts the paradigm of COVID-19 from an infectious disease model to an industrial hygiene approach. ” Last week the United States released ventilation standards for schools and businesses, as part of the nation’s new plan to move into the next phase of pandemic management.

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Not enough funds for 4th US doses of vaccine

Without Congress passing a $15 billion COVID funding package, White House officials said the federal government would not have enough funds to buy fourth COVID-19 booster doses for every American who wanted one.

While officials told the Washington Post that the Biden administration has the funds to purchase boosters for adults ages 65 and older and initial vaccine series for children 5 and younger-if approved-they currently cannot buy fourth booster doses for the general population.

https://www.cidrap.umn.edu/news-perspective/2022/03/asian-hot-spots-battle-omicron-us-eyes-supply-4th-vaccine-doses

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Some PASC Patients May Experience Long-Lasting Airway Disease – Even if They Only Had Mild COVID-19

Patients in this study with post-acute sequelae of COVID-19 (PASC), or ‘Long Covid’, experienced small airway disease independent of initial infection severity. The long-term consequences are unknown.

Disease of the small airways in the lungs is a potential long-lasting effect of COVID-19, according to a new study published in the journal Radiology. The study found that small airways disease occurred independently of initial infection severity. The long-term consequences are unknown.

“There is some disease happening in the small airways independent of the severity of COVID-19,” said study senior author Alejandro P. Comellas, M.D., professor of internal medicine and faculty in the Division of Pulmonary and Critical Care Medicine at the Carver College of Medicine, University of Iowa in Iowa City. “We need to investigate further to see whether it is transient or more permanent.”

Early reports indicate that more than 50% of adult survivors of SARS-CoV-2 infection experience post-acute sequelae of COVID-19 (PASC), more commonly known as “long COVID.” Respiratory symptoms, including cough and dyspnea, are reported by nearly 30% of patients with long COVID, including those who experienced mild infection.

The study grew out of observations from University of Iowa clinicians that many patients with initial SARS-CoV-2 infection who were either hospitalized or treated in the ambulatory setting later showed signs of chronic lung disease such as shortness of breath and other respiratory symptoms.

https://globalbiodefense.com/2022/03/22/some-pasc-patients-may-experience-long-lasting-airway-disease-even-if-they-only-had-mild-covid-19/

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Diagnostics:

still an incredible, negligent last of testing.

Drugs and Vaccines:

Evushield: Vulnerable Americans are desperate to find this Covid-19 drug. Thousands of boxes are sitting around unused

In the State of the Union address this month, President Joe Biden said that “if you’re immunocompromised or have some other vulnerability, we have treatments. … We’re leaving no one behind or ignoring anyone’s needs as we move forward.”

But a CNN investigation raises questions about the way federal and state governments have distributed Evusheld and why, more than three months into the rollout, many immune-compromised people are still having trouble getting it.

CNN’s investigation found that as the Omicron variant ripped through the United States, infecting and killing Americans, including some who might have been saved with timely access to Evusheld, thousands of boxes of the drug have been sitting on pharmacy shelves.

CNN also found that the government distributed Evusheld, a drug that was developed by AstraZeneca with the support of the US government, to unlikely places such as a spa that offers Botox and another location that does eyelash extensions.

Then, last week, the US Department of Health and Human Services removed at least dozens of locations that have Evusheld from an online locator, which means millions of immune compromised patients and their doctors can no longer find them.

A leading researcher on Covid-19 and the immune-compromised emphasized that Evusheld, a monoclonal antibody, is the only prevention available for immune-compromised people – transplant patients and some cancer patients, for example, or people who take certain medications for rheumatoid arthritis and other conditions – who had a weak response to the Covid-19 vaccines.

https://www.cnn.com/2022/03/24/health/evusheld-unused/index.html

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Moderna seeks approval for COVID-19 vaccine in young children

After months of stops and starts, Moderna announced today it seeks emergency use authorization from the Food and Drug Administration (FDA) of a two-dose primary series of its COVID-19 vaccine for children ages 6 months to 6 years.

The company said positive interim analysis of a phase 2/3 study showed a robust neutralizing antibody response and a favorable safety profile.

37% to 44% protection against Omicron

The trial used two doses of the company’s mRNA vaccine on children at one-fourth the dose of the adult primary vaccine series. No deaths, myocarditis, pericarditis, or multisystem inflammatory syndrome in children (MIS-C) were reported in more than 6,000 pediatric study participants.

The vaccine, however, was not as successful at preventing illnesses in young children as it was in previous trials of adults and adolescents. Conducted during the Omicron variant surge, Moderna’s trial showed a 43.7% vaccine efficacy in children 6 months to 2 years and 37.5% in the 2- to 5-year age-group.

According to the New York Times, Pfizer and BioNTech are expected to release trial results of their vaccine in children 5 years and under next month; the pediatric vaccinations series will consist of three shots given at one-tenth the strength of the standard vaccine.

https://www.cidrap.umn.edu/news-perspective/2022/03/moderna-seeks-approval-covid-19-vaccine-young-children

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Australia to give fourth COVID-19 jab to over 65s

Australia is offering a fourth dose of COVID-19 vaccines to over 65s from next month, federal health authorities announced Friday, as a new Omicron strain races through the population.

[Note: added protection hasn’t been great nor long-lasting]

https://medicalxpress.com/news/2022-03-australia-fourth-covid-jab-65s.html?

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Aspirin may improve three-month survival for patients critically ill with COVID-19

Antiplatelet drugs such as aspirin have little effect on the need for life support in COVID-19, but they may improve survival in the following months. (REMAP-CAP trial)

https://medicalxpress.com/news/2022-03-aspirin-three-month-survival-patients-critically.html?

Devices:

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New type of ultraviolet light makes indoor air as safe as outdoors

A new type of ultraviolet light that is safe for people took less than five minutes to reduce the level of indoor airborne microbes by more than 98%, a joint study by scientists at Columbia University Vagelos College of Physicians and Surgeons and in the U.K. has found. Even as microbes continued to be sprayed into the room, the level remained very low as long as the lights were on.

https://medicalxpress.com/news/2022-03-ultraviolet-indoor-air-safe-outdoors.html?

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Epidemiology/Infection control:

https://twitter.com/risahoshinoMD/status/1507130912525496326?s=20&t=q5hJ4DooIndPTWHEO4Qq3Q

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Lots of Covid in UK, Europe, China, Hong Kong…

Dr. Deepti Gurdasani  @dgurdasani1 3/25 This is nuts. 3.5 million people positive with SARS-CoV-2 in the last week in England. 1 in 16 people. In Scotland this is 1 in 11. We’re at the level of the infections at the previous omicron peak in England & have exceeded it in Scotland & Wales. ~ ~ ~

Different variants produce varied long COVID symptoms, study suggests

Pre-Delta variant data to be presented next month at the European Congress of Clinical Microbiology & Infectious Diseases (ECCMID) meeting in Portugal suggest that different variants of COVID-19 may produce different symptoms in people who develop long COVID.

The research is based on outcomes seen in 428 COVID-19 case-patients at the University of Florence and Careggi University Hospital in Italy. The patients were seen from June 2020 to July 2021, when the Alpha variant was the dominant strain and before the Delta and Omicron variants rose to prominence.

Seventy-six percent of the patients reported at least one persistent symptom of COVID-19 during follow-up, including shortness of breath (37%) and chronic fatigue (36%) followed by sleep problems (16%), vision problems (13%), and brain fog (13%).

Compared to men, women were twice as likely to develop long COVID, and patients on immunosuppressive drugs were six times more likely.

The authors also found a change in long COVID symptoms when comparing patients who had Alpha variant to those infected with the original, wild-type strain. Myalgia, insomnia, brain fog and anxiety and depression significantly increased with the Alpha strain, while anosmia (loss of smell), dysgeusia (difficulty in swallowing), and impaired hearing were less common.

“This is the first time they [symptoms] have been linked to different COVID-19 variants,” said Michele Spinicci, MD, the lead researcher of the study, in an ECCMID press release. “Future research should focus on the potential impacts of variants of concern and vaccination status on ongoing symptoms.”
Mar 24 ECCMID press release

https://www.cidrap.umn.edu/news-perspective/2022/03/covid-19-scan-mar-25-2022

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Caught COVID? Here’s what you should and shouldn’t do when self-isolation isn’t mandatory

We are all tired of COVID. But even though the news has moved on to other concerning geopolitical issues, it is a fact that COVID is still very much with us. Vaccines have certainly helped drive down its worst effects, but the disease is here to stay…

[Hint–Still Protect others!]

https://medicalxpress.com/news/2022-03-caught-covid-shouldnt-self-isolation-isnt.html?

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Tips, general reading for public:

Covid isn’t over. Protect yourself.

Politics:

Not too early to begin volunteering to help w the upcoming elections–text or phone banking, registering voters, etc. Let me know if you need direction.

Covid:

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Ginny/Clarence Thomas/ Supremes

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https://twitter.com/JoyAnnReid/status/1506383347219587076?s=20&t=Dy02_jZ01ZVsKe1_lV54rQ

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GOP:

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Race:

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Voting:

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Guns:

Ukraine:

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Nestle (among other companies) still doing business in Russia

Jeffrey Sonnenfeld at Yale has an extensive list, divided into convenient categories:

His list of companies that have dug in include: Acer, Astra Zeneca,  Cloudfare, Huawei, International Paper, Koch, Lenovo

https://som.yale.edu/story/2022/over-400-companies-have-withdrawn-russia-some-remain

Feel good du jour:

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Comic relief:

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https://twitter.com/buitengebieden_/status/1506687892747341824?s=20&t=ZTL6GWHPeOpsM9-p2sk27A

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https://twitter.com/buitengebieden_/status/1507691088466882562?s=20&t=ZTL6GWHPeOpsM9-p2sk27A

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https://twitter.com/buitengebieden_/status/1505518012459270146?s=20&t=ZTL6GWHPeOpsM9-p2sk27A

Perspective/Poem

https://twitter.com/buitengebieden_/status/1505672805727318022?s=20&t=ZTL6GWHPeOpsM9-p2sk27A

Bits of beauty:

 

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