Coronavirus Tidbits #191 5/8/22

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.

News 

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Important thread (see Drugs)

After ending treatment, if virus rebounds w a strong positive, it is the same virus It is actively replicating/causing test to go from Neg to Pos. It should be considered infectious.

? is also if people should take Paxlovid for 10 days.

Do NOT stop isolation at 5 days. Go for at least 5 more days after stopping Paxlovid and have a negative rapid test.

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Quite the thread--worth a read on how we are grossly underestimating impact of Covid by not measuring it.

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Secretary of State Blinken tested positive after dinner. Too dangerous to have our leaders at a likely superspreader event. They did have to test that day, but still unsafe. And why did they turn down the offer of a UV light system from Don Milton at UMD?

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Herpes Zoster Risk Increased by 15% Following COVID-19

Since the start of the COVID-19 pandemic, several case reports have been published describing Herpes Zoster (HZ) cases in COVID-19 patients.

As a SARS-CoV-2 coronavirus infection can result in T-cell immune dysfunction, it was hypothesized that this could trigger latent HZ reactivation.

A recent peer-reviewed study was the first large, retrospective cohort study designed to investigate the hypothesis that COVID-19 could increase the risk of HZ.

This study found that older adults diagnosed with COVID-19 have a 15% increased risk of developing HZ than those never diagnosed with COVID-19.

And the increased HZ risk was more pronounced (21%) following COVID-19 hospitalization.

These findings highlight the importance of getting and maintaining HZ immunization.

https://www.precisionvaccinations.com/herpes-zoster-risk-increased-15-following-covid-19

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Long Covid:

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Adenovirus:

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Diagnostics:

still an incredible, negligent last of testing.

Drugs and Vaccines:

Drug interactions w Paxlovid:

and if you are on a statin, you can stop it for the 5 days you take Paxlovid

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Rebound w Paxlovid

from Dr. Michael Mina:

When a drug is measured in a drug trial for its ability to limit virus replication in the body it isn't just the drug & virus interaction that is being measured Nope. The drug's ability to eliminate virus from the body is being measured **in context of the immune system**

This is critical bc if immunity is able to tackle some of the virus then even if there is a minimal amount of live virus left at the end of a 5 day treatment then when the treatment is stopped, those last remnants can be dealt with by the immune system

However, if the existing immunity (from vax or prior infection) is NOT good at limiting virus replication in the respiratory tract **as is the case with Omicron** Then when the drugs are stopped, if there remain some live virus, the leftover virus can start to grow quickly!

This is partly bc during the 5 day treatment, the immune system doesnt have to try so hard to find a good way to kill off the virus on it's own - the drug is doing the work for it! So, when you remove the drug, the 2 arms of the immune system may still be asleep at the wheel.

Combined 1) The immune system may be a bit asleep at the wheel (thanks to drugs doing the heavy lifting) 2) Plus we have a virus that v immune evasive even when immunity is at full steam --> any residual virus left after treatment is like a whole new high dose exposure

This is then further compounded by the fact that Omicron and the newer variants are VERY HIGHLY INFECTIOUS. They likely require only a rather low infectious dose (small amount of virus) to start replicating fast and furiously and get ahead of immunity.

w Omicron, these 3 issues are colliding in a way they didn't during trials - during Delta w Delta: 1) immunity still could take a back seat to the drug during 5 days of treatment, but 2) the virus was much less immune evasive & 3) less efficient at infection/replication

So even though Paxlovid works just as well to limit Omicron as it does Delta on a "drug to virus basis" in a petri dish... I believe Paxlovid in the trials was also benefitting from any lingering DELTA virus being eliminated better by IMMUNITY when some virus remained after

So... what to do about this? FIRST: We must study and measure the true incidence of rebound of the virus after treatment In trials, rebound was about 2% but was essentially the same regardless of whether ppl got Paxlovid or not SECOND: we should consider a 10 day course

Although a 5 day course was successful at eliminating the virus in the trials - that was with DELTA! It is likely that a 5 day course may not be sufficient for OMICRON bc the same level of immune system participation doesn't occur as effectively to clear Omicron (vs Delta).

If this turns out to be the case, and it turns out that 10 or 15% of people are experiencing rebound after 5 days of Paxlovid (I won't be surprised) We should expect there is actually quite a high risk of becoming infectious/sick after the 5 days treatment

It will be prudent for FDA to potentially move to making the treatment duration 10 days In this case, people should be free to exit isolation once negative on a rapid test - but, critically, they should continue taking the drugs all the way through Day 10.

For now, the best you can do if you become infected and take Paxlovid is: Consider having a few home rapid tests (doesn't matter what brand) and test on days 2, 3, 4 after paxlovid. This will let you know if you are rebouding and becoming infectious and at risk again

If you do, you MAY become symptomatic. If so, you may have to, unfortunately, treat it like a new infection Yes you may be infectious May even lose sense of smell or have respiratory issues Good thing is - treatments and Vax are still working Very very well for most ppl

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Pfizer’s Covid-19 Pill Failed Study Testing Its Preventive Use

Paxlovid, authorized to treat high-risk people early in infection, didn’t meaningfully reduce illness in exposed adults

The Covid-19 pill from Pfizer Inc. failed to prevent symptomatic infections in adults who had been exposed to the pandemic virus, a late-stage study found.

Pfizer said Friday that the drug, named Paxlovid, failed the study’s main objective of meaningfully reducing the risk of confirmed and symptomatic Covid-19 infections in adults who were exposed to the virus by someone in their household.

https://www.wsj.com/articles/pfizers-covid-19-pill-failed-study-testing-its-preventative-use-11651276069

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J&J COVID-19 Vaccine Access Limited by U.S. FDA

The U.S. Food and Drug Administration (FDA) today announced it had limited the authorized use of the Janssen COVID-19 Vaccine to individuals 18 years of age and older for whom other authorized or approved COVID-19 vaccines are not accessible or clinically appropriate and to adults who elect to receive the Janssen COVID-19 Vaccine because they would otherwise not receive an mRNA COVID-19 vaccine.

'After conducting an updated analysis, evaluation, and investigation of reported cases, the FDA determined that the risk of thrombosis with thrombocytopenia syndrome (TTS), a syndrome of rare and potentially life-threatening blood clots in combination with low levels of blood platelets with the onset of symptoms approximately one to two weeks following administration of the Janssen COVID-19 Vaccine, warrants limiting the authorized use of the vaccine,' stated the FDA.

The FDA has determined that the reporting rate of TTS is 3.23 per million doses of vaccine administered.

And the reporting rate of TTS deaths is 0.48 per million doses of vaccine administered.

As of today, the World Health Organization and the European Medicines Agency have not issued similar authorization changes.

https://www.precisionvaccinations.com/2022/05/05/jj-covid-19-vaccine-access-limited-us-fda

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COVID vaccine materials written at too-high reading level

--at more than a 10th-grade reading level. At least 25% of the US population currently has very low-level reading skills and is unable to comprehend a bus schedule or medication and cleaning-product labels, the authors said.

For the general population, a 7th-grade reading level is required for understanding educational material.

May 3 Vaccine study

https://www.cidrap.umn.edu/news-perspective/2022/05/news-scan-may-03-2022

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Devices/Masks:

Hidden benefit: Facemasks may reduce severity of COVID-19 and pressure on health systems, researchers find

McMaster University researchers who study the dynamics of infectious disease transmission have investigated the population-level consequences of a potentially significant––and unobvious––benefit of wearing masks.

For the study, the researchers developed a model to investigate COVID-19 "variolation"––an incidental but potentially beneficial form of immunization achieved by inhaling smaller doses of the virus than would be inhaled without a mask.

A form of variolation was deliberately used in the 18th century to control smallpox. It involved infecting a healthy individual with small doses of the live virus taken from a dried scab or pustule of a person infected with smallpox. Variolated individuals often experienced far less severe disease than those who were infected naturally, but nevertheless were immune to further infection.

Early in the COVID-19 pandemic, it was suggested that people who were infected while masked might experience mild illness and could be considered "variolated".

The new mathematical model allows researchers to estimate the potential impact of this effect on the population as a whole.

https://medicalxpress.com/news/2022-05-hidden-benefit-facemasks-severity-covid-.html

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Epidemiology/Infection control:

International study finds nearly 13% of COVID-19 hospitalized patients had serious neurologic symptoms

Boston University School of Medicine (BUSM) studied 16,225 patients from 179 hospitals in 24 countries as part of the Society for Critical Care Medicine's Viral Infection and Respiratory Illness University Study.

The researchers found nearly 13 percent

 of patients admitted for COVID-19 in the first year of the pandemic developed serious neurologic manifestations. Specifically, 1,656 (10.2 percent) had encephalopathy (any diffuse disease of the brain that alters brain function or structure) at admission, 331 (2.0 percent) had a stroke, 243 (1.5 percent) had a seizure, and 73 (0.5 percent) had meningitis or encephalitis at admission or during hospitalization.

Additionally, they discovered all serious neurologic manifestations were associated with increased disease severity, greater need for ICU interventions, longer length of stay, ventilator use and higher mortality.

Black patients had an increased frequency of stroke, seizure and encephalopathy when compared with white patients.

https://www.eurekalert.org/news-releases/951655

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Severe COVID-19 may cause 10-point IQ drop, 20-year brain aging

Cognitive impairment from severe COVID-19 is equivalent to losing 10 IQ points or 20 years of aging, and any recovery is slow at best, suggests a small study published late last week in eClinicalMedicine.

A team led by Imperial College London and University of Cambridge researchers tested 46 COVID-19 patients admitted to a single hospital 6 to 10 months earlier, from Mar 10 to Jul 31, 2020, and matched controls. Sixteen of the COVID-19 patients (34.8%) had required mechanical ventilation.

Participants underwent computerized cognitive assessment at an average follow-up of 6 months after their initial infection.

The tasks most affected by COVID-19 dealt with higher cognition and processing speed, which was qualitatively different from those of normal aging and dementia but comparable to those of advancing from the age of 50 to the age of 70. The patients' deficits began to lessen over time since infection, but the trend didn't achieve statistical significance.

In a University of Cambridge press release, senior author David Menon, PhD, said, "Cognitive impairment is common to a wide range of neurological disorders, including dementia, and even routine ageing, but the patterns we saw—the cognitive 'fingerprint' of COVID-19—was distinct from all of these. It is very possible that some of these individuals will never fully recover."
Apr 28 EClinicalMedicine study
May 3 University of Cambridge press release

https://www.cidrap.umn.edu/news-perspective/2022/05/news-scan-may-03-2022

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Tips, general reading for public:

Ventilate.

Mask.

Vax.

Politics:

Covid:

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Add to this, below, that Test-to-treat also requires people to go to a drug store (while ill) and mingle with many other (likely unmasked) people. Incredibly stupid.

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Abortion/Supremes:

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https://twitter.com/alidreith/status/1521489352370573315?s=20&t=gtjTg8VQiD246a9rFxtYbQ

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Message to SCOTUS and GOP:

Contraception:

Musk:

https://twitter.com/DearAuntCrabby/status/1520491716461142018?s=20&t=gtjTg8VQiD246a9rFxtYbQ

Amazon:

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Starbucks:

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GOP:

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Want to get more depressed about election shenanigans? Read this thread on the expired consent decree and voter intimidation. Start here:

Florida:

https://twitter.com/AaronParnas/status/1520590955660943362?s=20&t=gtjTg8VQiD246a9rFxtYbQ

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Texas:

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TN:

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Russia/Ukraine:

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Feel good du jour:

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Comic relief:

Perspective/Poem

Bits of beauty:

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