Coronavirus Tidbits #208 8/28/22

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 post:

This was a fun post and interview:

Medieval Friars Were Riddled With Parasites, Say Archaeologists

https://www.medscape.com/viewarticle/979596

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Election volunteer opportunities:

NOPE Neighbors: https://www.nopeneighbors.org/volunteer

Power the Vote https://www.powerthevote.org//. I'm a fellow volunteer.
Are you interested in voter protection research? Battleground states including Arizona, Michigan and Texas need help. Volunteers would work with the voter protection program directly on research tasks. Examples include: (i) calling elections offices to get information about certain election plans, so that programs know where and when to send volunteers; (ii) calling elections offices to follow up on public records requests for needed information (such as data on ballot rejections); and (iii) reviewing elections websites to ensure information is accurate and up to date. This volunteer commitment is variable and flexible, but will require an ability to make calls during election offices' business hours. Volunteers will need to be comfortable inputting information into basic spreadsheets.
**If you are interested in joining a research team, please email volunteer@powerthevote.org.** We will be in touch with more detailed information as soon as we can.

If you like calling and talking to voters, Power the Vote is assembling weekly volunteer opportunities. These are remote opportunities that you can do from home! Click on this link to find out more: https://docs.google.com/document/d/1v3IQa3qeJMuLaa2MW0ObAoXltpLUyoKu0L7xhd-98zE/edit

News 

Great news:

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WHO: COVID deaths for 2022 pass 1 million worldwide

At a World Health Organization (WHO) briefing today, Director-General Tedros Adhanom Ghebreyesus, PhD, said COVID-19 deaths for 2022 alone passed 1 million this week, as he pressed countries to do more to vaccinate all healthcare workers, older people, and others at highest risk. Since the pandemic began in early 2020, 6,472,848 deaths have been reported, according to the Johns Hopkins online dashboard.

Tedros said countries in Africa with the lowest rates are making progress with vaccine coverage, and many countries are making good strides in targeting high-priority groups. He said, however, that one third of the world is still unvaccinated, including two thirds of health workers and three quarters of older adults in low-income countries...

Germany tightened its COVID measures ahead of fall and winter, including wearing N95 respirators for long-distance travel by plane, train, or bus, according to the Associated Press (AP).

Aug 25 Tedros speech
Johns Hopkins online 
dashboard
Aug 25 AP 
story

https://www.cidrap.umn.edu/news-perspective/2022/08/covid-19-scan-aug-25-2022

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Nirmatrelvir [Paxlovid] Use and Severe Covid-19 Outcomes during the Omicron Surge (nejm)

A total of 109,254 patients met the eligibility criteria, of whom 3902 (4%) received nirmatrelvir during the study period. Among patients 65 years of age or older, the rate of hospitalization due to Covid-19 was 14.7 cases per 100,000 person-days among treated patients as compared with 58.9 cases per 100,000 person-days among untreated patients.

No evidence of benefit was found in younger adults.

https://www.nejm.org/doi/full/10.1056/NEJMoa2204919?utm_source=

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Study: Incubation times of SARS-CoV-2 variants fell over time

As the dominant circulating strain of SARS-CoV-2 evolved from Alpha to Omicron, the incubation period from infection to symptoms or first positive COVID-19 test result gradually decreased, from 5 to 3.4 days, according to a systematic review and meta-analysis published today in JAMA Network Open.

The incubation period is the time from exposure to a pathogen like a virus to the time of first symptoms of the disease that the pathogen causes.

https://www.cidrap.umn.edu/news-perspective/2022/08/study-incubation-times-sars-cov-2-variants-fell-over-time

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New type 2 diabetes diagnoses in youth climbed 77% amid COVID

New diagnoses of type 2 diabetes in US youth rose 77% during the first year of the COVID-19 pandemic over the previous 2 years, according to a new multicenter study published in the Journal of Pediatrics.

A team led by Johns Hopkins Children's Center researchers retrospectively reviewed the records of 3,113 COVID-19 patients 8 to 21 years at 24 US hospitals who had a new type 2 diabetes diagnosis and a body-mass index (BMI) in the 85th percentile (overweight or obese) from March 2018 to February 2021.

https://www.cidrap.umn.edu/news-perspective/2022/08/new-type-2-diabetes-diagnoses-youth-climbed-77-amid-covid-19

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Could tiny blood clots cause long COVID’s puzzling symptoms?

Scientists debate evidence for a micro-clot hypothesis that has some people pursuing potentially risky treatments.

Nature Cassandra Willyard 24 August 2022

Researchers are baffled by long COVID: hundreds of studies have tried to unpick its mechanism, without much success. Now some scientists, and an increasing number of people with the condition, have been lining up behind the as-yet-unproven hypothesis that tiny, persistent clots might be constricting blood flow to vital organs, resulting in the bizarre constellation of symptoms that people experience.

Proponents of the idea (#teamclots, as they sometimes refer to themselves on Twitter) include Etheresia Pretorius, a physiologist at Stellenbosch University in South Africa, and Douglas Kell, a systems biologist at the University of Liverpool, UK, who led the first team to visualize micro-clots in the blood of people with long COVID. They say that the evidence implicating micro-clots is undeniable, and they want trials of the kinds of anticoagulant treatment that Hawthorne is considering. Pretorius penned the Guardian article that caught Hawthorne’s attention.

But many haematologists and COVID-19 researchers worry that enthusiasm for the clot hypothesis has outpaced the data. They want to see larger studies and stronger causal evidence. And they are concerned about people seeking out unproven, potentially risky treatments.

https://www.nature.com/articles/d41586-022-02286-7

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Regular physical activity tied to lower risk of COVID, poor outcomes

At least 150 minutes (2.5 hours) of moderate physical activity—or 75 minutes (1.2 hours) of vigorous exercise—weekly was linked to a lower risk of COVID-19 infection, hospitalization, severe illness, and death during periods dominated by the Beta and Delta variants, according to a systematic review and meta-analysis published yesterday in the British Journal of Sports Medicine.

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Up to 4 million Americans out of work with long COVID

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Monkeypox:

Trials for monkeypox antiviral, fractional vaccine dosing launch

The NIAID will start a clinical trial of tecovirimat in September in collaboration with the AIDS Clinical Trials Group. Plans are to enroll more than 500 patients.

The agency is also collaborating with the National Institute for Biomedical Research to initiate a clinical trial of tecovirimat in adults and children with monkeypox in the Democratic Republic of the Congo. This trial was planned before the current outbreak, the NIAID said.

In the United Kingdom, the National Institute for Health and Care Research (NIHR) announced a separate clinical trial of tecovirimat, called PLATINUM (for placebo-controlled randomized trial of tecovirimat in non-hospitalised monkeypox patients).

Study shows Tpoxx well tolerated

In related news, today JAMA published a research letter on the compassionate use of tecovirimat in 25 monkeypox-confirmed patients seen at University of California-Davis this summer.

the Centers for Disease Control and Prevention (CDC) released demographic information on patients who have received Tpoxx in the United States. The median age of patients is 37 years, 98.9% are men, and Whites (40%) are the largest ethnic group to have received it.

Overall, however, Blacks and Hispanics make up about 65% of US monkeypox cases. The CDC also published new data from a behavioral survey to stop the spread of the virus. It shows that 48% of men who have sex with men say they are reducing their number of sexual partners, 50% are reducing the number of one-time sexual encounters, and 49% are reducing sex with partners met at sex clubs or on dating apps. Results were based on an online survey.

All participants were men, with a median age of 40.7 years. Nine had HIV, 1 had a smallpox vaccine more than 25 years earlier, and 4 had received one dose of Jynneos after symptom onset.

Oral tecovirimat was well tolerated by all patients with monkeypox infection, with minimal side effects, the authors said. Ten patients had complete resolution of lesions by day 7 of therapy, while 23 (92%) had resolution of lesions and pain by day 21.

"No control group was included, limiting conclusions of antiviral efficacy pertaining to duration of symptoms or severity," the authors cautioned,

In total, the nation has 15,433 monkeypox cases, the most of any country in the world.

https://www.cidrap.umn.edu/news-perspective/2022/08/trials-monkeypox-antiviral-fractional-vaccine-dosing-launch

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Polio:

Spate of polio outbreaks worldwide puts scientists on alert

Cases of paralysis in the United States and Israel suggest vaccine-derived poliovirus has infected many people.

Nature Heidi Ledford 22 August 2022

The discovery of poliovirus in New York state, London and Jerusalem this year has taken many by surprise — but public-health researchers fighting to eradicate the disease say it was only a matter of time.

“No country in the world is immune to the effects of polio,” says Zulfiqar Bhutta, a global-health researcher at the Aga Khan University in Karachi, Pakistan. “It’s all interconnected.”

The virus found in these regions is derived from an oral polio vaccine used in some countries. So far, only two cases of polio-related paralysis have been reported, in Jerusalem in February and New York in June1; the New York infection was the first such US case in nearly a decade. But wastewater samples in all three areas suggest that the virus is circulating more widely.

Polio causes irreversible paralysis in less than one in 200 of the susceptible people it infects, so the cases of paralysis suggest that many other people there have been infected, says Walter Orenstein, who studies infectious diseases at Emory University in Atlanta, Georgia. “Cases like that are just the tip of the iceberg,” he says. “It’s very concerning.”

Nature talked to researchers about the scale of the outbreak, and what can be done to stop it.

Why are these outbreaks happening?

Wild poliovirus circulates in only two countries — Afghanistan and Pakistan — where this year nine cases had been reported by June.

But vaccine-derived poliovirus appears periodically elsewhere, particularly in Africa and Asia. These cases come from a widely used oral vaccine that contains live, weakened virus that sometimes mutates to a dangerous form capable of infecting the nervous system.

https://www.nature.com/articles/d41586-022-02233-6

 

Diagnostics:

still an incredible, negligent last of testing.

Drugs and Vaccines:

Covid:

Moderna files for emergency use of BA.4/BA.5 Omicron booster

Moderna yesterday announced that it has submitted an application to the Food and Drug Administration (FDA) for emergency use of its bivalent (two-strain) COVID booster vaccine that targets the BA.4/BA.5 Omicron subvariants, following a similar move this week from Pfizer and BioNTech.

The company said a phase 2/3 trial of the BA.4/BA.5 targeted booster is already under way and that it has rapidly scaled up manufacturing to be ready, if authorized, to deliver doses in September.

https://www.cidrap.umn.edu/news-perspective/2022/08/moderna-files-emergency-use-ba4ba5-omicron-booster

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Life-saving COVID-19 treatments didn't make it to US patients, study finds

Paxlovid and Molnupiravir, two leading COVID-19 antiviral medications, are life-saving drugs that have been shown to reduce deaths, in Paxlovid's case, by a factor of 10 in the most severe cases.

Distribution was inequitable. Researchers also report significant socioeconomic and gender disparities in who received treatment, with roughly 16% of those surveyed who received treatment for their infections reporting that they earn more than $100,000, compared to just 7% of those who reported earning $25,000 or less, the data shows. Adults over 65—considered high risk for severe COVID-19 illness—had higher treatment rates than other age groups at roughly 20%, which the authors note is still low.

https://medicalxpress.com/news/2022-08-life-saving-covid-treatments-didnt-patients.html?

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Monkeypox:

Can a smallpox drug treat monkeypox? Here’s what scientists know

Tecovirimat, a little-known antiviral, shows promise against monkeypox. But human data and supplies of the drug are limited.

Nature Max Kozlov 25 August 2022

As supplies of vaccines against monkeypox remain constrained and the number of people contracting the disease continues to mount, physicians and researchers are looking to the drug tecovirimat for relief. In animals infected with monkeypox, the antiviral has been shown to lower the amount of virus in their bodies and reduce the number of fluid-filled ‘pox’ lesions forming on their skin.

Efficacy data in humans, however, are much more limited, making some researchers and regulatory agencies hesitant about authorizing tecovirimat’s widespread use. But people with monkeypox — in particular those with severe disease, which can cause extreme pain, scarring and, in rare cases, death — are pleading for access to the drug.

Clinical trials of the drug are starting up now, but results are still months away. Nature spoke to infectious-disease specialists to understand how tecovirimat works, and what data are still needed to assess whether it is effective against monkeypox in humans.

https://www.nature.com/articles/d41586-022-02245-2

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Devices:

Simple rubber band fix improves surgical mask seal to N95 levels, study shows

Throughout the COVID-19 pandemic and when maximum protection is needed against air-born infections, the N95 respirator has remained the gold standard of personal protective equipment. However, it is also much more difficult to produce and obtain than a standard surgical mask.

Fig 1. Demonstration of the assembly of the modified mask.

Photographs of the simple modification demonstrating an individual properly donning the modified mask. (A) Modified mask components consist of a standard ASTM Level 1 surgical mask and two 8” rubber bands. (B) While wearing an ASTM Level 1 surgical mask which has been adjusted to fit along the bridge of the nose, apply one 8” rubber band along the crown of the head and place the front of the rubber band under the nose. (C) Take another 8” rubber band and apply it perpendicularly under the first rubber band so that two loops are formed above and below the first rubber band. (D) Shift the first rubber band so that it is over the bridge of the nose and fold the second rubber band in half on itself along the first rubber band on the horizontal axis. € Place the second rubber band along the cheeks and under the chin. Adjust both rubber bands as needed to achieve a full seal as shown in this anterior view of the final construct. (F) Lateral view of the final construct.

https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0272834

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https://twitter.com/TheAngryEpi/status/1562460043303276544?s=20&t=hnc29ZfYvuUsn1fqx0BpaQ

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Epidemiology/Infection control:

Covid:

Important info for the Back-to-School crowd:

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Life expectancy fell amid COVID, especially for Hispanic and Black males

In 2020, amid the COVID-19 pandemic, life expectancy in the United States fell by 4.5 and 3.6 years for Hispanic and Black males, respectively, while declining 1.5 years for their White counterparts, finds a study published yesterday in PNAS.

Aug 23 PNAS study

https://www.cidrap.umn.edu/news-perspective/2022/08/news-scan-aug-24-2022

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Polio:

Tips, general reading for public:

Ventilate.

Mask.

Vax.

Politics:

Covid: 

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https://twitter.com/amandalhu/status/1561517055588777984/photo/1

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Denialism in UK:

Student loans:

https://twitter.com/schwarz/status/1562521561118429187?s=20&t=2-zb5SthryZy8aHgjYKauQ

this is a screenshot from "Vietnam and Other American Fantasies" by H. Bruce Franklin. Freeman was quoted in an article in the San Francisco Chronicle on October 30, 1970, p. 13. You can find it via the Chronicle archives.

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There's a whole series of tweets from the White House rebutting these ppl:

incl: Congressman Mike Kelly had $987,237 in PPP loans forgiven.

Congressman Matt Gaetz had $482,321 in PPP loans forgiven.

Dr. Oz also was forgiven of his PPP loan to the tune of $365,745

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[or the benefits of burying Ivana there]

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Espionage/TFG

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https://twitter.com/RexChapman/status/1562207363620392960?s=20&t=2-zb5SthryZy8aHgjYKauQ

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https://twitter.com/duty2warn/status/1561884725681192960?s=20&t=hnc29ZfYvuUsn1fqx0BpaQ

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Elections:

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Books:

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Busing migrants to NYC fr Texas:

It’s clear the migrants did not give their consent in any real way to be sent here. As many as 40% have family or close relations in other parts of the country who could provide them accommodation, but the migrants were not given the option of going to those places. 3/

Not only is the State of Texas not coordinating with NYC, they have made [bus company employees] sign NDAs to ensure we get no advance warning of bus arrivals. 4/

Regardless of these obstacles, NYC is showing up strong to receive the arriving migrants. This morning there were scores of City staff and volunteers running a receiving operation at the bus terminal. Providing medical care, essential supplies, coordination social services. 5/....

has proven to be cynical and heartless in his treatment of the asylum seekers. I am proud that NYC is responding with compassion, as we always have, to people seeking refuge here. This is the true America way. 8/

Deleting texts:
Kochs, Leo, Seid, SCOTUS:
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CNN:
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Twitter:
Elon Musk:
Police:
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Disparities:
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Hobby Lobby:

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Abortion:

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https://twitter.com/duty2warn/status/1562642676373020672?s=20&t=hnc29ZfYvuUsn1fqx0BpaQ

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Antisemitism:

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LGBTQ:

https://twitter.com/PolarPrem/status/1561392046811881473?s=20&t=2-zb5SthryZy8aHgjYKauQ

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Climate Change/Ecology:

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remarkable story cont at https://t.co/HzOGSjSfgi

Leana Wen:

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Peds Academy pushes back at Leana attributing her child's slow speech development to masks:

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Arizona:

California:

California Gov. Gavin Newsom (D) turned down a bill [really, vetoed] that would have allowed supervised drug injection sites in three large cities, though San Francisco may proceed with the plan anyhow. (Politico) [Clearly signaling political/presidential aspirations]

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Colorado:

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Florida:

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Georgia:

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Minnesota:

Missouri:

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North Carolina:

Oklahoma:

Oregon

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Pennsylvania:

Feel good du jour:

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https://twitter.com/nehakprasad9/status/1561844792857853953?s=20&t=hnc29ZfYvuUsn1fqx0BpaQ

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Comic relief:

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https://twitter.com/buitengebieden/status/1562535440304918528?s=20&t=hnc29ZfYvuUsn1fqx0BpaQ

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Perspective/Poem

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Bits of beauty:

 

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