Coronavirus Tidbits #226 1/1/2023

Covid:

"There are currently more than 66,045 cases reported in the United States per day, with test positivity of 12%. When test positivity is above 5%, transmission is considered uncontrolled. There are more than 473 deaths per day, and hospitalizations have increased 22% over the last two weeks.

Since many are using home tests that are not reported through public health or are not testing at all, the official case counts underestimate the actual prevalence of COVID-19.

https://www.nebraskamed.com/COVID/what-covid-19-variants-are-going-around

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US sees jump in XBB subvariant as COVID cases track higher

In its latest SARS-CoV-2 variant update, posted just before Christmas Eve, the Centers for Disease Control and Prevention (CDC) reported a sharp jump in XBB levels, along with a stall in the growth of BQ.1 subvariants.

XBB already dominant in the northeast

The nation's COVID-19 cases saw a modest jump just after Thanksgiving but leveled off as Christmas approached. Now, cases appear to be on the rise again. The 7-day average for new daily cases is 73,121, up about 10% compared to the week before, according to Washington Post tracking. Over the same period, daily deaths were up 4%, and new daily COVID hospitalizations were down 4%.

The CDC's variant projections for the week ending Dec 24 suggest that the Omicron XBB variant, a recombinant of two BA.2 viruses, now makes up 18.3% of sequenced samples, up sharply from the week before. Much of the rise appears to be from two northeastern regions where XBB is now the dominant subtype. XBB has fueled outbreaks in parts of Asia, including Singapore.

At the national level, BQ.1 and BQ.1.1, descendants of BA.5, made up about 63% of sequenced samples, down a bit from 69% the week before.

Regarding XBB, experts are watching a subvariant called XBB.1.5 that was detected in New York and has a mutation that has been linked to immune escape. Scientists suspect that XBB.1.5 has a growth advantage over BQ.1.1.

In a Substack blog post analyzing the latest genetic findings from virologists, Eric Topol, MD, founder and director of the Scripps Research Translational Institute, said New York is a bellwether for what's happening with XBB.1.5, and he said it's concerning that its rise in dominance is coming with a marked rise in hospitalizations, especially in New York's senior population.

Topol said that multiple factors could be fueling the rise in hospitalizations, including waning immunity and more frequent indoor gatherings. "So we don't know for sure how much of this is being driven by XBB.1.5, but it doesn't look favorable," he wrote. He added that only time will tell how patterns play out in neighboring states.

https://cidrap.umn.edu/covid-19/us-sees-jump-xbb-subvariant-covid-cases-track-higher

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Loss of Smell During Long COVID Sniffed Out

From the beginning of the COVID-19 pandemic, profound changes in the sense of smell— including total smell loss—have been a notable (and perplexing) symptom of the infection. Although the changes in smell are often transient, many patients with COVID-19 have long-term olfactory dysfunction. Up until now, it has been unclear how SARS-CoV-2 infection causes persistent smell loss in a subset of patients.

Now, a new study reveals that the reason some people fail to recover their sense of smell after COVID-19 is linked to an ongoing immune assault on olfactory nerve cells and an associated decline in the number of those cells. The study involved analysis of olfactory epithelial samples collected from 24 biopsies, including from nine patients with objectively quantified long-term smell loss after COVID-19.

The study provides important insight into a vexing problem that has plagued millions who have not fully recovered their sense of smell after COVID-19. Although focused on the smell loss, the finding also sheds light on the possible underlying causes of other long COVID-19 symptoms—including generalized fatigue, shortness of breath, and brain fog—that might be triggered by similar biological mechanisms.

This work is published in Science Translational Medicine, in the paper, “Persistent post–COVID-19 smell loss is associated with immune cell infiltration and altered gene expression in olfactory epithelium.”

https://www.genengnews.com/virology/coronavirus/loss-of-smell-during-long-covid-sniffed-out/

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New antiviral VV116

a derivative of Gilead’s remdesivir, the first antiviral authorized for Covid-19 in May

In an 822-patient clinical trial published Wednesday in the New England Journal of Medicine, Xu’s antiviral, VV116, appeared just as effective as Paxlovid at easing patient’s symptoms. Newly diagnosed patients who took VV116 recovered after a median of 4 days, compared with 5 days for Paxlovid, though experts caution that the study was not large enough to say one was better than the other....

While the FDA has previously approved antivirals, such as the flu drugs Xofluza and Tamiflu, that are shown to alleviate symptoms faster than alternatives, the primary endpoint of U.S. trials of antivirals to treat Covid has been their effectiveness in preventing hospitalization or death. .

(Pfizer data)  showing high-risk unvaccinated patients who took Paxlovid recovered faster than patients on placebo. But the company acknowledged this year that vaccinated, standard-risk patients who received Paxlovid didn’t recover significantly faster than placebo in a separate trial. 

https://www.statnews.com/2022/12/28/chinese-developed-alternative-to-paxlovid/?

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(She has many more refs)

5/ Overall, studies show that #SARSCoV2 infection of the brain -- even in mild #COVID19 disease -- can lead to inflammation that, in turn, spawns disorders that mimic #Parkinsons #Alzheimers & general dementia, including short & long term memory losses.

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China:

The CDC announced Dec 28, a COVID-19 testing requirement for passengers arriving from China, Hong Kong, and Macau to slow the spread of the virus in the US. However, the added screening will not begin until Jan 5.

Japan's health ministry today reported a record daily high for COVID deaths, with 415 fatalities reported, according to Reuters. The country is also approaching record daily highs for new cases, with 216,219 reported today.

https://cidrap.umn.edu/covid-19/cdc-tightens-covid-measures-passengers-china

Counter arguments: Some say, too little, too late. Others that it will just increase hate crimes and xenophobia. And others, that it seems useless to single out China when most of the US is going around unmasked, many unvaxxed, and taking too few precautions.

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China's COVID-19 surge raises odds of new coronavirus mutant

Could the COVID-19 surge in China unleash a new coronavirus mutant on the world?

Every new infection offers a chance for the coronavirus to mutate, and the virus is spreading rapidly in China. The country of 1.4 billion has largely abandoned its "zero COVID" policy. Though overall reported vaccination rates are high, booster levels are lower, especially among older people. Domestic vaccines have proven less effective against serious infection than Western-made messenger RNA versions. Many were given more than a year ago, meaning immunity has waned.

The result? Fertile ground for the virus to change.

"When we've seen big waves of infection, it's often followed by new variants being generated," Ray said....

Experts said a partially immune population like China's puts particular pressure on the virus to change. Ray compared the virus to a boxer that "learns to evade the skills that you have and adapt to get around those."

One big unknown is whether a new variant will cause more severe disease. Experts say there's no inherent biological reason the virus has to become milder over time.

"Much of the mildness we've experienced over the past six to 12 months in many parts of the world has been due to accumulated immunity either through vaccination or infection, not because the virus has changed" in severity, Ray said....

https://medicalxpress.com/news/2022-12-china-covid-surge-odds-coronavirus.html?

vs.

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Other:

Monkeypox:

For the first time since August, the World Health Organization (WHO) updated its mpox guidance, recommending that known case contacts avoid sexual contact with others for 21 days, whether symptomatic or not, given that transmission may occur before symptom onset.

If mpox is suspected in a clinical or hospital setting, the WHO said providers should wear personal protective equipment (PPE) and investigate patients in well-ventilated rooms.

https://cidrap.umn.edu/mpox/whos-new-mpox-guidance-all-contacts-should-avoid-sex-21-days

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Dengue:

59 cases this year in Miami-Dade County; 525 locally acquired dengue cases have also been reported in Puerto Rico.

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Cholera:

Since the notification of the first two confirmed cases of Vibrio cholerae O1 in the greater Port-au-Prince area on 2 October 2022, to 23 December 2022, the Haitian Ministère de la Santé Publique et de la Population reported a total of 19,378 suspected cases in 10 departments of the country, including 1,427 confirmed cases, 16,581 hospitalized suspected cases, and 355 registered deaths.

http://outbreaknewstoday.com/haiti-confirmed-cholera-cases-top-1400/