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.
What’s Causing A Sudden Outbreak Of Hepatitis In Kids In Europe And The US?
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Experts Decry CDC's Long Pause on Tropical Disease Testing
The CDC stopped testing for parasites last September without telling anyone, later saying it was to "make improvements." Testing for some can't readily be done elsewhere--especially hurting poor people of color and immigrants, most likely to be infected. #Chagas #leishmania
COVID-19 pneumonia increases dementia risk
A new study from the from the University of Missouri School of Medicine and MU Health Care shows patients hospitalized with COVID-19 pneumonia have a higher risk of developing dementia than those with other types of pneumonia.
A team of MU researchers pulled Cerner Real World Data from 1.4 billion medical encounters prior to July 31, 2021. They selected patients hospitalized with pneumonia for more than 24 hours. Among 10,403 patients with COVID-19 pneumonia, 312 (3%) developed new onset dementia after recovering, compared to 263 (2.5%) of the 10,403 patients with other types of pneumonia diagnosed with dementia.
“The risk of new onset dementia was more common in COVID-19 pneumonia patients over the age of 70 in our study,” said lead researcher Adnan I. Qureshi, MD, a professor of clinical neurology at the MU School of Medicine. “The type of dementia seen in survivors of COVID-19 infection mainly affects memory, ability to perform everyday tasks and self-regulation. Language and awareness of time and location remained relatively preserved.”
The median time interval between infection and dementia diagnosis was 182 days for COVID-19 patients. The study only included new onset dementia associated with hospital admission during a short follow-up period. Qureshi said further study over longer periods of time would provide a more complete picture and may help to determine the underlying reasons why COVID-19 pneumonia might increase dementia risk.
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Long-term lung abnormalities common 1 year after COVID-19 pneumonia
Long-term CT abnormalities were common up to 1 year after COVID-19 pneumonia in a study published in Radiology.
Researchers performed a secondary analysis of CovILD, a prospective, multicenter, observational cohort study, conducted from April to August 2020. The study evaluated pulmonary abnormalities on chest CT at 2, 3 and 6 months and 1 year after COVID-19 symptoms in 142 adults who had mild to severe COVID-19. Researchers graded pulmonary CT findings for each lung lobe and assessed associations between demographic and clinical factors with CT abnormalities at 1 year. The study was conducted in Austria.
Overall, 91 participants from the CovILD study (mean age, 59 years; 38% women) had 1-year follow-up CT data and were included in the secondary analysis.
“More than half of the hospitalized participants still have permanent lung changes 1 year after COVID-19,” Schwabl told Healio.
Among the 54% of participants with CT abnormalities 1 year later, 34% had subtle subpleural reticulation, ground-glass opacities or both and 20% had extensive ground-glass opacities, reticulations, bronchial dilation and/or microcystic changes in the lung.
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Global data reveal half may have long COVID 4 months on
Worldwide, 49% of COVID-19 survivors reported persistent symptoms 4 months after diagnosis, estimates a meta-analysis of 31 studies published late last week in The Journal of Infectious Diseases.
University of Michigan researchers, who conducted a systematic review on Jul 5, 2021, also found the prevalence of long COVID at 1 month at 37%, while it was 25% at 2 months and 32% at 3 months. Fifty studies were identified in the review, and 41 were included in a quantitative synthesis, and 31 reporting overall prevalence were meta-analyzed.
The 50 studies included a total of 1,680,003 COVID-19 patients, including those who were hospitalized (67,161 patients from 22 studies), nonhospitalized (4,165 from 5 studies), and any COVID-19 patients, regardless of hospitalization status (1,608,677 from 23 studies).
Impact on health, workforce 'enormous'
Estimated global prevalence of long COVID was 43% (95% confidence interval [CI], 39% to 46%), although estimates ranged from 9% to 81%, which the study authors said may be attributable to differences in sex, region, study population, and follow-up.
Long COVID prevalence among hospitalized patients was 54% (95% CI, 44% to 63%), while it was 34% (95% CI, 25% to 46%) for outpatients.
Regionally, estimated pooled prevalence of lingering COVID-19 symptoms was 51% (95% CI, 37% to 65%) in Asia, 44% (95% CI, 32% to 56%) in Europe, 31% (95% CI, 21% to 43%) in North America, and 31% (95% CI, 22% to 43%) in the United States.
Worldwide, estimated prevalence of long COVID was 37% (95% CI, 26% to 49%) 1 month after diagnosis, 25% (95% CI, 15% to 38%) at 2 months, 32% (95% CI, 14% to 57%) at 3 months, and 49% (95% CI, 40% to 59%) at 4 months. The most common symptoms were fatigue (23%), followed by memory problems (14%), shortness of breath (13%), sleep problems (11%), and joint pain (10%).
Overall, the meta-analysis showed that a higher percentage of women reported long COVID symptoms than men (49% vs 37%, respectively) and that preexisting asthma was a predisposing factor for lingering symptoms. Risk factors identified in the studies that weren't meta-analyzed included severe initial illness, older age, and underlying conditions such as obesity and hypothyroidism.
Findings from the study show that the prevalence of long COVID is substantial, the health effects of infection seem to be prolonged, and the condition could stress the healthcare system, the researchers said.
"We recommend continued attention be focused on identifying patients at-risk of developing post COVID-19 condition and on quantifying duration of symptoms. With an estimated 200 million individuals affected, post COVID-19 condition's impact on population health and the labor force is enormous," they concluded.
"It is imperative that those affected are provided proper health, social, and economic protections."
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At CDC's urging, Justice Department appeals judge’s decision to drop mask mandate
The Justice Department has appealed a federal judge’s decision that struck down the mask mandate on public transportation, the Washington Post reports, after CDC recommended the move. “It is CDC’s continuing assessment that at this time an order requiring masking in the indoor transportation corridor remains necessary for the public health,” the agency said late yesterday. “CDC believes this is a lawful order, well within CDC’s legal authority to protect public health.” The ruling in question was made on Monday by U.S. District Judge Kathryn Kimball Mizelle in Florida, who concluded that the mandate exceeded CDC’s statutory authority. Her decision blindsided the Biden administration and set off changes mid-flight on some airlines. The Justice Department on Tuesday had said that it would wait for CDC’s recommendation on whether to proceed with an appeal, which could tee up a battle at the Supreme Court.
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Woman, 31, catches Covid twice within three weeks in Spain https://t.co/XYmH6J7RLi— Judy Stone (@DrJudyStone) April 21, 2022
still an incredible, negligent last of testing.
Drugs and Vaccines:
CDC advisers air frustration over booster policy
Experts who advise the CDC met yesterday to discuss a thorny issue: Covid vaccine boosters, specifically the new policy to allow people 50 and older and people who are immunocompromised to get a second booster. By the end of the meeting — during which members of the Advisory Committee on Immunization Practices expressed frustration with the lack of clarity about the goal of the U.S. booster policy — it wasn’t entirely clear why people are being offered a second booster at this time. Data presented by CDC experts suggested the protection that immune-competent people have received from their primary series and first booster is holding up and the expected benefits from the fourth shots are modest at best. ACIP member Beth Bell raised concerns about “booster fatigue” and said offering another dose now could undercut confidence in vaccines that are working well at protecting people from severe Covid. The policy to offer the fourth doses was made without consulting ACIP.
I can’t believe what I just heard on @MSNBC. @kavitapmd just stated a test for N95 mask seal is spray perfume and if you smell it, the seal is not good. Nooooooo! You smell the gaseous vapor…molecules that masks can’t block. Aerosols w/ virus are MUCH larger. Terrible seal test.— Kimberly Prather, Ph.D. (@kprather88) April 23, 2022
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Day to day in lower risk situations, the Powecom KN95 with ear loops is my go-to. With an increasingly contagious virus, wearing a comfy good fitting mask is more important than ever. Surgical masks without a brace are no longer enough. (2/2)— Kimberly Prather, Ph.D. (@kprather88) April 23, 2022
Coronavirus found in human feces up to 7 months after infection
COVID-19 is mainly known as a respiratory ailment, but a new study suggests the coronavirus can infect your intestinal tract for weeks and months after you've cleared the bug from your lungs.
In the study about 1 out of 7 COVID patients continued to shed the virus' genetic remnants in their feces at least four months after their initial diagnosis, long after they've stopped shedding the virus from their respiratory tract, researchers found.
This could explain why some COVID patients develop GI symptoms like abdominal pain, nausea, vomiting and diarrhea, said senior researcher Dr. Ami Bhatt, an associate professor of medicine and genetics at Stanford University.
"We found that people who had cleared their respiratory infection—meaning they were no longer testing positive for SARS-CoV-2 in their respiratory tract—were continuing to shed SARS-CoV-2 RNA in their feces," Bhatt said. "And those people in particular had a high incidence of GI symptoms."
A long-term infection of the gut also might contribute to long COVID symptoms in some people, Bhatt and her colleagues theorized.
"Long COVID could be the consequence of ongoing immune reaction to SARS-CoV-2, but it also could be that we have people who have persistent infections that are hiding out in niches other than the respiratory tract, like the GI tract," Bhatt said.
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I've written about how South Korea controlled the pandemic.— Vincent Rajkumar (@VincentRK) April 21, 2022
But nothing captures the dramatic difference like cumulative deaths over 2 years. It's a painful watch. pic.twitter.com/Gu4IxBSBiI
Tips, general reading for public:
I’ll get to these choices later (if this is TL;DR, skip to 15/25). But to understand them, you need to appreciate my own risk, risk tolerance, & synthesis of the evidence – since as rules melt away, choices will be increasingly personal, often without clear “right” answers.(2/25)— Bob Wachter (@Bob_Wachter) April 17, 2022
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1. Wear a good fitting mask. See previous tweets. (1/)
3. Realize shared indoor spaces with no people can still have airborne virus (bathrooms, break rooms). (3/)— Kimberly Prather, Ph.D. (@kprather88) April 23, 2022
4. Realize #COVIDisAirborne and wear the best masks. Filter indoor air.(4/)
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If @CDCDirector @AshishKJha46 lived in a crowded apartment building & traveled only by public transportation, their perspective on masking & other #Covid19 prevention efforts might be different.— Myra Batchelder - Still masking! (@myrabatchelder) April 18, 2022
If you live in your own house & have a car you're experiencing a different pandemic.
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This isn’t just about planes. This means a 4 year old kid with cancer who’s parents have no vehicle might be forced to sit next to a floridly sick / coughing covid patient with no mask on a bus, while going to get chemo.— Jerome Adams (@JeromeAdamsMD) April 18, 2022
But tell me about the great ventilation systems on those… https://t.co/hpnggcW0ai
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Nothing screams “freedom” like preventing residents from traveling to obtain services unavailable locally. https://t.co/lxfhNXn7En— Miranda Yaver, PhD (@mirandayaver) April 22, 2022
True: In Irving, TX (just outside Dallas) the school board is debating whether to fire a teacher who put rainbow stickers on her classroom door. A lawyer for the district said "(The stickers) may be endangering students." The teacher has already been suspended for the stickers.— Kurt Eichenwald (@kurteichenwald) April 21, 2022
Washington Post: Mark Meadows was simultaneously registered to vote in three states https://t.co/Td6Hgj4IxC— andrew kaczynski (@KFILE) April 22, 2022
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Breaking news: Prosecutors are dropping all criminal charges against Pamela Moses, the Memphis woman sentenced to six years in prison for trying to register to vote. She was granted a new trial in February, but prosecutors said today they won't pursue it. https://t.co/zG6nvuzC7K— Sam Levine (@srl) April 22, 2022
Wow — House GOP Leader Kevin McCarthy told Republican colleagues after Jan. 6 that he would say to Trump “it would be my recommendation you should resign” per audio of the call obtained by @jmartNYT and @alexburnsNYT, despite McCarthy’s denial tonight.— Hugo Lowell (@hugolowell) April 22, 2022
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Mike Lee wasn't mentioned a single time on CNN's State of the Union, Fox News Sunday, NBC's Meet the Press, ABC's This Week, or CBS's Face the Nation. Not one mention of new revelations about a senator scheming w/the Trump admin to end democracy on any of the major Sunday shows.— Aaron Rupar (@atrupar) April 17, 2022
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Anybody else still curious who planted the pipe bombs, disabled Mike Pence’s key card, removed the panic button in Ayanna Presley’s office, and shared the locations of non-reinforced Capitol windows?— Andrea Junker (@Strandjunker) April 23, 2022
In response to the more than 1,500 books challenged to be removed from libraries in the last year, the New York Public Library launched an effort to make some banned books available for everyone — for free. https://t.co/Jix9pXfVuB— NPR (@NPR) April 15, 2022
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Shelved under Z, for "Zealotry."— John Schwartz (@jswatz) April 17, 2022
“You’re taking away people’s freedom to read books and that’s not right,” said a fired librarian. “Your intellectual freedom, your mind, is one of the only things you ever truly own." https://t.co/dXj40BqXxf
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The judge is a Trump appointee who was rated unqualified when nominated & had never tried a case. She clerked for Justice Thomas. Elections matter in more ways than one. This injunction will have nationwide effect-at least until the 11th Cir (hopefully) reverses. https://t.co/hKuuc44isg— Joyce Alene (@JoyceWhiteVance) April 18, 2022
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Biden administration needs to fight this decision, even if is was gearing up to make the same call in a couple of weeks. Accepting a precedent that says that @CDCgov or other agencies don't have the authority to enact mandates during a public health emergency is enormously scary.— Bob Wachter (@Bob_Wachter) April 18, 2022
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Senator Lana Theis accused me by name of grooming and sexualizing children in an attempt to marginalize me for standing up against her marginalizing the LGBTQ community...in a fundraising email, for herself.— Mallory McMorrow (@MalloryMcMorrow) April 19, 2022
Hate wins when people like me stand by and let it happen. I won't. pic.twitter.com/jL5GU42bTv
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Beautifully done:https://t.co/i6NrfSlnZx— Rachel Maddow MSNBC (@maddow) April 18, 2022
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The most important issue to Republicans is destroying Disney because the company won’t discriminate against gay people.— Chris Murphy (@ChrisMurphyCT) April 21, 2022
Just chew on that for a minute. https://t.co/yPSqB4Pjws
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Guns became the leading cause of death among children and teens in 2020, killing more people ages 1 to 19 in the U.S. than vehicle crashes, drugs overdoses or cancer. https://t.co/NV9RSj8oco— NBC News (@NBCNews) April 23, 2022
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On both-sidism:— Adam Davidson (@adamdavidson) April 23, 2022
In 2016, an NPR reporter asked me for advice covering the economic plans of Trump and Clinton.
I said there is nothing to compare. Hillary has a very comprehensive plan. Trump has none. Just slogans.
He said: I can't say that. I need something balanced.
Millions of Americans are food insecure…meanwhile the Governor of Texas is forcing $250 million worth of produce go to waste so he and the GOP can blame President Biden for inflation.— Smite⚡️ (@7Veritas4) April 16, 2022
It’s political terrorism.
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Nance: The more I saw of the war going on, the more I thought I’m done talking… So about a month ago I joined the international legion here in Ukraine… pic.twitter.com/zviTHUm2a0— Acyn (@Acyn) April 18, 2022
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‼️ The #DeSantisDebtBomb means that residents of Orange and Osceola counties will pay an average of $2,200 more per household in local property taxes every year. https://t.co/3dkQw7L1rChttps://t.co/7iQv4BfXCS— The Daily Edge (@TheDailyEdge) April 22, 2022
The #TN House passed a bill to make homelessness a FELONY last night. So much hate and blatant hypocrisy. So little compassion, empathy and love. We are better than this, friends.— John Ray Clemmons (@JRClemmons) April 19, 2022
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Ukraine has registered the shipwreck of Russia’s Moskva vessel as “underwater cultural heritage” — in a move described as “trolling” Moscow rather than having a basis in international law.https://t.co/89lvzFrJGb— POLITICOEurope (@POLITICOEurope) April 22, 2022
Feel good du jour:
In many coffee houses in Kyiv:— Olga Rudenko (@olya_rudenko) April 21, 2022
Pink post-its are beverages and desserts that visitors have paid for as a treat for military or territorial defense members, who can come and claim any of them for free.
It’s people’s way to thank their defenders. pic.twitter.com/a8CaGVa3H4
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This is Moko. Her mom was part fox and her dad was actually a powdered donut. An extremely rare mix. 13/10 pic.twitter.com/gjUEG2zMDU— WeRateDogs® (@dog_rates) April 19, 2022
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This is Loulou and Coco. They just became new parents. It's a lot to handle so far. 13/10 for all pic.twitter.com/cStVlAPl0v— WeRateDogs® (@dog_rates) April 20, 2022
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