Coronavirus Tidbits #187 4/10/22

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:

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On the Receiving End of Care

https://www.medscape.com/viewarticle/971420

News 

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Why the WHO took two years to say COVID is airborne

Early in the pandemic, the World Health Organization stated that SARS-CoV-2 was not transmitted through the air. That mistake and the prolonged process of correcting it sowed confusion and raises questions about what will happen in the next pandemic.

As 2021 drew to a close, the highly contagious Omicron variant of the pandemic virus was racing around the globe, forcing governments to take drastic actions once again. The Netherlands ordered most businesses to close on 19 December, Ireland set curfews and many countries imposed travel bans in the hope of taming the tsunami of COVID-19 cases filling hospitals. Amid the wave of desperate news around the year-end holidays, one group of researchers hailed a development that had seemed as though it might never arrive. On 23 December, the World Health Organization (WHO) uttered the one word it had previously seemed incapable of applying to the virus SARS-CoV-2: ‘airborne’.

On its website, a page titled ‘Coronavirus disease (COVID-19): How is it transmitted?’ was quietly edited to state that a person can be infected “when infectious particles that pass through the air are inhaled at short range”, a process otherwise known as “short-range aerosol or short-range airborne transmission”. The website says that transmission can occur through “long-range airborne transmission” in poorly ventilated or crowded indoor settings “because aerosols can remain suspended in the air or travel farther than conversational distance”.

https://www.nature.com/articles/d41586-022-00925-7

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How COVID-19 triggers massive inflammation

A study led by researchers at Boston Children's Hospital explains for the first time why COVID-19 causes severe inflammation in some people, leading to acute respiratory distress and multi-organ damage. Surprisingly, the study also finds that antibodies that people develop when they contract COVID-19 can sometimes lead to more inflammation, while antibodies generated by mRNA COVID-19 vaccines seem not to.

https://medicalxpress.com/news/2022-04-covid-triggers-massive-inflammation.html?

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COVID-19 cases rise in eastern US cities

In US developments, COVID-19 cases have doubled in Washington, DC, and risen about 60% in New York City since the last week of March, the New York Times reported today, a sign the BA.2 subvariant is causing increased virus activity.

Connecticut, Massachusetts, New York, and New Jersey have seen COVID-19 cases jump more than 40% over the latest 14-day period, the New York Times reports.

Other states, including Delaware, Florida, Illinois, New Hampshire, and Wisconsin, have all seen greater than 10% increases in daily case counts, as well.

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Shanghai lockdown snarls world's busiest port and China supply chains

Shanghai's grinding coronavirus lockdown is slowly clogging China's supply chains, as delays hit the world's busiest container port where staff are tangled in a morass of Covid controls.

Beijing has refused to tack away from its strict zero-Covid strategy that has protected its public health system through the pandemic but at a mounting economic cost.

https://medicalxpress.com/news/2022-04-shanghai-lockdown-snarls-world-busiest.html

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Study sheds light on death spike in Hong Kong COVID-19 surge

The recent Omicron variant surge in Hong Kong came with a mortality rate among the world's highest yet in the pandemic, a troubling development in a region known for its strong pandemic measures, and today researchers from the United States, Hong Kong, and China who dug into the data suggest that vaccination lapses in older people played a major role.

The team published its findings today in Morbidity and Mortality Weekly Report (MMWR).

Vaccine gap in oldest Hong Kongers

Hong Kong's surge began in early January with a cluster of Omicron infections in a quarantine hotel. Its fifth wave peaked on Mar 4, along with a mortality rate of 37.7 per million population that was among the highest in the world during the pandemic.

Among the deaths, 96% occurred in people ages 60 and older, and of those 70% were unvaccinated. "The high overall mortality rate during the ongoing 2022 Hong Kong Omicron COVID-19 outbreak is being driven by deaths among unvaccinated persons aged ≥60 years," the team wrote.

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A way to prevent loss of smell and taste from COVID

Loss of smell and taste—a hallmark symptom of COVID-19—was not on the minds of a group of Yale School of Medicine researchers when they embarked on a study of Camostat in the spring of 2020.

https://medicalxpress.com/news/2022-04-loss-covid-.html?

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People wrongly believe their friends will protect them from COVID

People may feel less vulnerable and take fewer safety precautions about COVID-19 when they are with, or even just think about, their friends instead of acquaintances or strangers, according to research published by the American Psychological Association.

https://medicalxpress.com/news/2022-04-people-wrongly-friends-covid-.html?

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Simulation-design tools map a ventilation system to reduce COVID-19 infection risks

Advanced computing expertise is being used to help ensure that hospice patients are better protected from COVID-19 following a pioneering study led by The University of Manchester.

https://medicalxpress.com/news/2022-04-simulation-design-tools-ventilation-covid-infection.html?

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COVID and diabetes, colliding in a public health train wreck

After older people and nursing home residents, perhaps no group has been harder hit by the pandemic than people with diabetes. Recent studies suggest that 30-40% of all coronavirus deaths in the United States have occurred among people with diabetes, a sobering figure that has been subsumed by other grim data from a public health disaster that is on track to claim 1 million American lives sometime this month.

People with diabetes are especially vulnerable to severe illness from COVID, partly because diabetes impairs the immune system but also because those with the disease often struggle with high blood pressure, obesity and other underlying medical conditions that can seriously worsen a coronavirus infection.

“It’s hard to overstate just how devastating the pandemic has been for Americans with diabetes,” said Dr Giuseppina Imperatore, who oversees diabetes prevention and treatment at the Centres for Disease Control and Prevention.

Diabetes patients hospitalized with COVID spend more time in the ICU, are more likely to be intubated and are less likely to survive, according to several studies, one of which found that 20% of hospitalized coronavirus patients with diabetes died within a month of admission. Though researchers are still trying to understand the dynamics between the two diseases, most agree on one thing: Uncontrolled diabetes impairs the immune system and decreases a patient’s ability to withstand a coronavirus infection.

https://theworldnews.net/bd-news/covid-and-diabetes-colliding-in-a-public-health-train-wreck

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Gridiron club dinner:

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I'll have more on this thread next week. Infuriating:

 

Diagnostics:

COVID-19 test-to-stay strategies safe, effective for students

A study today in Pediatrics suggests a test-to-stay (TTS) strategy, as opposed to quarantine, was a safe and effective tool for Massachusetts public schools for the 2021-22 school year, as it was associated with both limited COVID-19 transmission and increased in-person learning days for students.

The TTS program required all students exposed to a COVID-19 case in the classroom to use a rapid antigen test for 7 days following the last exposure date. If the test was negative, students could remain in school. The program was opt-in, and for students who chose not to participate, an exposure resulted in at-home quarantine for at least 7 days following any in-school close contact if the student was not fully vaccinated.

Apr 8 Pediatrics study and commentary

https://www.cidrap.umn.edu/news-perspective/2022/04/covid-19-scan-apr-08-2022

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Drugs and Vaccines:

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Wachter's whole thread is worth a read: https://threadreaderapp.com/thread/1512170975911051275.html

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Fourth COVID vaccine dose (modestly) boosts protection against infection, severity

A study in Israel during the Omicron variant surge finds that rates of COVID-19 infection and severe illness were lower after a fourth dose of the Pfizer/BioNTech vaccine than after three doses, and while protection against infection waned quickly after 4 weeks, protection against severe disease was still strong at 6 weeks.

The study, published yesterday in the New England Journal of Medicine (NEJM), involved data from 1,252,331 people aged 60 years and older, who became eligible for a fourth COVID-19 shot in Israel on Jan 2, 2022. The study period ran from Jan 10 to Feb 18 for severe illness and to Mar 2 for infection.

"These analyses provided evidence for the effectiveness of a fourth vaccine dose against severe illness caused by the omicron variant, as compared with a third dose administered more than 4 months earlier," the researchers wrote. "For confirmed infection, a fourth dose appeared to provide only short-term protection and a modest absolute benefit."
Apr 5 NEJM study

https://www.cidrap.umn.edu/news-perspective/2022/04/covid-19-scan-apr-06-2022

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Pulse oximeters did not change outcomes for patients in COVID-19 monitoring program

Using a pulse oximeter to measure oxygen levels is no better than just regularly asking patients with COVID-19 if they are short of breath, according to new research at the Perelman School of Medicine of the University of Pennsylvania. Pulse oximeters have often been applied because of concerns that patients might not notice their blood oxygen levels sliding dangerously. But people in Penn Medicine's COVID Watch program—which uses automated text messages to keep tabs on patients recovering at home—had the same outcomes whether they used oxygen-measuring devices or not. Findings from this work were published in the New England Journal of Medicine.

https://medicalxpress.com/news/2022-04-pulse-oximeters-outcomes-patients-covid-.html?

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Pfizer's $5 Billion Bill for Covid Pills to Take Big Bite from New Pandemic Funds

(Bloomberg) -- The Biden administration is on the hook to pay Pfizer Inc. nearly $5 billion for pills it’s already ordered to treat Covid-19, meaning as much as half of a scaled-back pandemic funding bill the Senate is debating is already spoken for, according to officials familiar with the matter.

Senators announced a deal Monday to provide $10 billion in new Covid funding, far less than the White House has requested. The true purchasing power of the package will be even less because of commitments the government’s already made, the officials said.

https://www.bloombergquint.com/politics/pfizer-s-5-billion-bill-for-u-s-takes-big-bite-from-covid-aid

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Devices:

replying: Go Deep, I'll Look for You @MattSchultz13
I had a mask on & walked into a jammed post office. A guy was leaving, approaching the doors as I entered. He looked at me & muttered loudly “Fucking sheep,” & I hollered back “Nobody wants to hear about your hobbies.” The entire PO exploded in laughter. A few folks clapped.

Epidemiology/Infection control:

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PE:

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Long Covid

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Studies find long COVID symptoms, including joint pain, at 1 year

Two new studies detail long COVID symptoms, with one from France showing that 85% of patients who had symptoms 2 months after illness onset still had them at 1 year and some symptoms worsened, and one from China revealing that 12% of patients reported rheumatic symptoms at 1-year follow-up.

In the first study, researchers in Paris analyzed data from 968 adult COVID-19 participants in an ongoing prospective cohort study in France, including their responses to the online Long COVID Symptom Tool questionnaire about daily occurrence of 53 symptoms from December 2020 to October 2021. The data were published today in Nature Communications.

Of patients with symptoms 2 months after symptom onset, 85% still had them at 1 year. The prevalence of 27 symptoms such as a loss of taste or smell declined over time, while 18 symptoms (eg, shortness of breath) remained stable, and 8 (eg, abnormal sensations due to nerve damage) increased.

Symptoms had a greater effect on patients' lives starting at 6 months. "Our results are of importance to understand the natural history of post COVID-19 disease," the researchers concluded.
Apr 5 Nat Commun 
study

The second study, conducted by researchers in Harbin and Beijing, involved face-to-face interviews of 1,296 COVID-19 survivors 1 year after they were released from the hospital from Jan 7 to May 29, 2020. The findings were published yesterday in Open Forum Infectious Diseases.

Of the 1,296 patients, 12.3% still reported rheumatic symptoms at 1 year. The most common symptoms involved joints in the knee (38%), hand (25%), and shoulder (19%). The symptoms were independent of illness severity and corticosteroid therapy during the initial illness. Older age (odds ratio [OR], 1.22) and female sex (OR, 1.58) were risk factors for these symptoms.

"Our investigation showed a considerable proportion of rheumatic symptoms following COVID-19 in discharged patients, which highlights the need for continuing attention," the study authors wrote.
Apr 4 Open Forum Infect Dis study

https://www.cidrap.umn.edu/news-perspective/2022/04/covid-19-scan-apr-05-2022

Tips, general reading for public:

Ventilate

Wear a mask

Test before leaving quarantine

Politics:

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GOP:

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preserve war crimes

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NATO

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MTG

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Hawley

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Fox

TuckyRose:

TFG:

Medicare/insurance

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Voting:

Abortion:

Trans:

DeSantis/Florida:

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ERA:

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Ukraine:

Feel good du jour:

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Perspective/Poem

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https://twitter.com/Goodable/status/1511876537427333125?s=20&t=YviQ2msdppxhi2dq4c3-RQ

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Bits of beauty:

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