Coronavirus Tidbits #226 1/1/2023


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:

A fun post to end the year, reminding me of why I like infectious diseases so much as a specialty. So much weirdness and sleuthing!

What Do A Raccoon, Aquarium, And Walmart’s Aromatherapy Spray Have In Common?



"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.

~ ~ ~

@morganstephensa   Dec 29, 2022
 some important research. Latest in @Nature find replicating (meaning active) Covid-19 in brain and body tissue in 44 autopsy patients up to seven months out from acute infection. See thread for details and link.
Most Covid-19 replication happened in respiratory, cardiovascular, endocrine, ocular, and brain’s central nervous system, respectively. See table:
The takeaway? It’s another piece of research showing viral persistence of Covid-19. This time in the brain, which, until now, hasn’t been found *active* in tissue, but thought to be mediated from vascular/endothelial damage.
all 44 patients were from 2020/2021 and were unvaccinated.
Linked below is a piece on it via @medpagetoday  for layman’s terms and easier reading.
Original article in Nature:
~ ~ ~
5-year-old boy develops sudden onset of eye #tics, food restriction, separation anxiety, sleep disturbances, and enuresis several weeks after #COVID19 Case series describes pediatric patients with #neuropsychiatric symptoms following COVID-19. Study:
~ ~ ~

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.

~ ~ ~

@BNOFeed  Dec 30
Omicron subvariant XBB is quickly overtaking other variants in the U.S. and now accounts for 40% of new cases, more than double from last week - CDC
~ ~ ~
@EricTopol   Dec 30, 2022
All we know about the XBB.1.5 variant summarized here a week ago We’ve not seen such rapid growth of a variant since Omicron BA.1 a year ago. Total US XBB last week = 18% of cases. Northeast now ~75% XBB.1.5. Perhaps CDC and media will finally take note.
it appears that in New York State, XBB evolved further to XBB.1.5, with new mutations, which was aptly first noted by JP Weiland a couple of weeks ago, coincident with the beginning of a steep rise of hospitalizations there...
Of all the variants in the current mix, XBB.1.5 has the most growth advantage vs. BA.5
~ ~ ~
@AbraarKaran  Dec 31
"Together, our findings indicate that BQ and XBB subvariants present serious threats to current COVID-19 vaccines, render inactive all authorized antibodies, and may have gained dominance in the population because of their advantage in evading antibodies."
~ ~ ~
@EricTopol   Dec 30, 2022
New data for bivalent protection vs Covid hospitalization For age 65+, > 90% reduction and 2.5-fold lower than without bivalent booster (thru Nov) Reminder: some cross-reactive immunity of BA.5 bivalent vs XBB.1.5 variant
~ ~ ~
@luckytran   Dec 30, 2022
This is going under the radar, but looks like the CDC guidelines for masking are switching back to COVID-19 Community *TRANSMISSION* levels instead of "Community levels." That means the CDC now recommends universal masking for **71%** of counties in the US, instead of only 9%.
~ ~ ~

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.

~ ~ ~

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 MedicineXu’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.

~ ~ ~


(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.

~ ~ ~

@fitterhappierAJ  Dec 30
It looks like Covid suppresses innate immunity toward other viruses and Bacteria This doesn't bode well for the severity of other infections that aren't even covid Think of all the people saying "The worst cold of my life" Mild covid is harming the response to the common cold...


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.

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.

~ ~ ~

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....


@kallmemeg   Dec 29
When people ask, will the next COVID variant come from China? This is my answer A variant borne of high transmission in a naive population will not be immune evasive. It does not need to be. It will not succeed in a population with lots of immunity of different flavours.

~ ~ ~



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.

~ ~ ~

@landmanspeaking   Dec 28
2022 showed us—again—that public health works best when we let communities lead
~ ~ ~


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

~ ~ ~


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.


still an incredible, negligent lack of accurate testing...but better than nothing.

Good strategy:

@Globalbiosec  Dec 23:
Did my RAT just now and have advised guests coming for ] lunch they will need to do so too. All windows open, masks when not eating, air purifiers on. Providing RATs and masks at the door.

Drugs and Vaccines:

@EricTopol  Dec 29


@kprather88  12/23

This study shows respirators lower risk of infection by 83%. Other masks are not as effective.

~ ~ ~

@AltenbergLee  Dec 24
~ ~ ~
@CMClase   Dec 27
We curate info on all kinds of masks and the effects of mask wearing Here is our a new downloadable infographic/poster thanks to the amazing Shiblul Hasan #WearAMask #CovidIsNotOver

Epidemiology/Infection control:

~ ~ ~

@jonlevyBU   Dec 23
While we close our eyes and pretend the pandemic is over, MA reported the largest number of COVID deaths (96) last week since the winter Omicron wave, with ~ 3000 US deaths last week. These are preventable tragedies, each one an unnecessary bereavement just before the holidays.
~ ~ ~
@HughThunkIt   Dec 24
100 conferencees walk into a meal room: "Within 10 days . . . , 28% of respondents came down with COVID-19 (all but 2 cases were confirmed by antigen or polymerase chain reaction (PCR) tests), and a further 11% reported getting sick with something else."
~ ~ ~
@MicrobesInfect   Dec 28, 2022
Researchers discover that a kitchen sponge is a better incubator for diverse bacterial communities than a laboratory petri dish. But it's not just the trapped leftovers that cause the diversity to be so high; it's the structure of the sponge itself.
~ ~ ~
@OneHealthTrust   Dec 29, 2022
One of our most-shared posts of 2022 was on ways migrants face a heightened risk of antimicrobial resistance. Find out about how migrants face an increased burden of drug-resistant #superbugs. #AMR Read the blog here: More here:
~ ~ ~

Tips, general reading for public:






COVID Testing Company Missed Nearly All Positive Cases

Northshore Clinical Labs' PCR test was ultimately found to have missed 96% of positive COVID-19 cases on a university campus in Nevada last year, but early concerns raised by state epidemiologists went unheeded as the company aggressively pursued government customers, ProPublica reported.

~  ~ ~

I Fear for the Legal Determinants of Health - Lawrence Gostin

My last column in The Health Docket showed how the Court has weakened public health powers to combat the defining threats of our lifetimes -- COVID-19, climate change, and gun violence -- while unraveling deeply personal rights to abortion and LGBTQ+ freedoms...

They are set to further unravel health equity...

~ ~ ~

@BNOFeed   Dec 28, 2022
Nearly half of all passengers on 2 flights from China have tested positive for coronavirus, Italian officials say. All samples will be checked for possible new variants.
~ ~ ~

EU doesn't follow Italy with COVID checks on China arrivals

The European Union is assessing Beijing's rollback of its strict anti-infection controls but refrained Thursday from immediately following EU member Italy in requiring coronavirus tests for airline passengers coming from China.

~ ~ ~

Japan tests all China arrivals for COVID amid surging cases

Japan on Friday started requiring COVID-19 tests for all passengers arriving from China as an emergency measure against surging infections there and as Japan faces rising case numbers and record-level deaths at home.

~ ~ ~

China to stop publishing daily Covid figures: NHC

China will no longer publish daily figures for COVID-19 cases and deaths, the National Health Commission (NHC) said on Sunday, ending a practice that began in early 2020.

~ ~ ~

Psychology of Covid response - 

intriguing read from @RageSheen  Dec 26

~ ~ ~

Special disservice awards for making public health worse:

hosted by @neoliberalsnow in Peste Magazine:

1/7/22:  @DrTomFrieden: “18 months ago it was irresponsible and wrong to say: Covid is similar to the flu…Omicron is different. Now, that's basically correct.” @JuliaRaifman reminded him that day hospitalizations were at the highest of the entire pandemic:

1/7/22: Jay Bhattacharya (@DrJBhattacharya) called Omicron "a normal respiratory virus, not an unusual, extraordinary, or grave danger," in early January 2022 shortly before Omicron was killing more than 2,200 Americans per day (higher than Delta).

Long series, worth a read.  Special mentions:

He has no relevant expertise or knowledge. But still he wrote in the NYT things like Omicron is mild, which justified lifting mitigation efforts. His cruelty born out of hubris earns him the Snowzzie for Being Center of the Universe. He is David Leonhardt.  for how he has “obscured the ongoing toll of sickness, death and disability from the pandemic, erased the real impact on black and brown Americans.” Honoring him is Gregg Gonsalves @gregggonsalves.

She said an unvaccinated child is like a vaccinated grandma. Her advice led to recommendations against distancing and masking in schools, as she dismissed worker concerns. For this and more, she won a @PesteMagazine Disservice Award. She is @ProfEmilyOster   Award goes to Oster for the “individualist, ableist, anti-poor, anti-Black policies wrought by her ‘evidence-based parenting’ advocacy.” Honoring her is Adia Benton (@Ethnography911 )....Emily Oster, an economist, also infamously argued against AIDS drugs for people in Africa. Paul Farmer, who dedicated his life to helping provide the highest quality healthcare for the impoverished, explains why Oster’s cruel position makes zero sense:

Thread can be found at

~ ~ ~




@RBReich   Dec 30, 2022
Why don’t year-end summaries about the economy mention this year’s record high corporate profits, unprecedented levels of corporate concentration, highest-ever CEO pay, or record levels of corporate political contributions in a midterm election?
~ ~ ~

Hundreds of US hospitals sue patients or threaten their credit, investigation finds

Despite growing evidence of the harm caused by medical debt, hundreds of U.S. hospitals maintain policies to aggressively pursue patients for unpaid bills, using tactics such as lawsuits, selling patient accounts to debt buyers, and reporting patients to credit rating agencies, a KHN investigation shows.

~ ~ ~

@QasimRashid  Dec 27
.@SouthwestAir took $3.7B in federal aid from 2020-21. It’s CEO got a pay raise to a $9.1M package in 2022. Yet Southwest employees are working 16 hour shifts & threatened w/termination if they refuse overtime or call in sick. Socialism for the wealthy. Capitalism for workers.
@QasimRashid  Dec 29, 2022
As @SouthwestAir CEO Bob Jordan pretends to apologize—remember—SW got a $7B federal bailout, spent $5.6B of that on Stock Buybacks, gave their CEO a raise to $9.1M,& forced frontline workers to 16 hour shifts under threat of termination—while spending $0 updating their software
~ ~ ~
NEW: conservatives have a Millennials problem. In both UK & US, it’s not just that Millennials aren’t voting conservative because they’re young. Every previous generation grew more conservative with age, but Millennials are not playing ball.
In summary: • Parties on the right used to rely on people ageing into conservatism. Millennials are different, likely due to: • Coming of age during econ and home-ownership crises -> forming more left-wing views • Using culture war politics on the most educated generation ever
A great extension of my work here by @MortenStostad, who has added in data from more countries. Really interesting pattern: Anglophone countries all exhibit Millennial exceptionalism, but elsewhere in Europe Millennials are following the same path as the other generations
Jamie Raskin:
@hugolowell   Dec 28, 2022
New: Jan. 6 committee member Jamie Raskin says he’s been diagnosed with Diffuse Large B Cell Lymphoma, a serious, but curable form of cancer. Raskin says he expects to start chemo-immunotherapy at MedStar Georgetown University Hospital.
~ ~ ~
Greta Thunberg:
@Esqueer_   Dec 29, 2022
You can't make this up. Romanian authorities were urged last year to effectively prosecute human traffickers by GRETA, the Group of Experts Against Trafficking Human Beings.
~ ~ ~

Rising violence against HCWs:

Violence against healthcare workers appears to have worsened during the pandemic. During a 3-month stretch in 2022 in the U.S., 57 nurses were attacked each dayopens in a new tab or window on average -- that's two nurses every hour -- according to a Press Ganey analysisopens in a new tab or window of its National Database of Nursing Quality Indicators....

Emergency doctors also experienced increased violence. In 2022, two out of three reported being assaulted in the past year, according to an ACEP surveyopens in a new tab or window. At least two-thirds of those surveyed said the COVID-19 pandemic brought increased rates of violence and diminished levels of trust between patients and physicians or other ED staff...

In May, Sen. Tammy Baldwin (D-Wis.) re-introduced the Workplace Violence Prevention for Health Care and Social Service Workers Actopens in a new tab or window.

similar billopens in a new tab or window that was brought forward in the House by Rep. Joe Courtney (D-Conn.) had been approved by that chamber on April 16.

The bill, however, still has not passed the Senate.

A spokesperson for Baldwin told MedPage Today in an email that Republicans appear to be blocking it,

~ ~ ~


~ ~ ~

Domestic terrorism:

Two power substation facilities in Pierce County, Washington have been vandalized leaving thousands without power near Tacoma, Washington.

~ ~ ~

@MollyMcKew  Dec 26
It’s funny because for years everyone has been worried about cyber attacks on the very not-hardened power grid and now militia bros just be like “but I can shoot it?”

~ ~ ~

Police - Kansas:

@_Eric_Reinhart  Dec 27
Doctors, nurses: please don’t be cops. “Police raided a terminally ill Kansas man’s hospital room because he allegedly used a weed vape and THC paste to ease the symptoms of the cancer that will kill him within weeks... [he] is set to appear in court"
~ ~ ~
@ajplus  Dec 27
Thousands in Jackson, MS, lost access to running water after a winter storm burst pipes. Residents said they couldn't flush toilets or take showers. The EPA began investigating Jackson's water system this year after the 83% Black city went without clean water for over a month
~ ~ ~
New Mexico:
@Alexander_Tin   Dec 30, 2022
A team from @ASPRgov's National Disaster Medical System is deploying to New Mexico, @HHSGov says "to help support the hospital due to the surge in pediatric patients. The team is expected to begin seeing patients on Monday."
~ ~ ~
New York, Santos:
@danielsgoldman  Dec 26, 2022
Time to add a third potential federal crime: campaign finance fraud. In 2021, Santos incorporated the Devolder Org in FL, which has no known assets. In 2022, he reports income of $750k, all from Devolder. He then gives $700k to his campaign. Where did that money come from?
~ ~ ~
To lose your mother on 9/11 may be regarded as a misfortune; to lose her again on 12/23 looks like carelessness.
Santos had tweeted 9/11 claimed my mother's life on July 12
and Dec 23 marks 5 years...

Buffalo police launch anti-looting unit amid deadly winter storm: 'You’re destroying your community'

@KeeangaYamahtta Dec 28
They don’t have a “feed the hungry” unit or a “heat the cold” unit, or a “house the homeless” unit, but of course they have an “anti-looting” unit. Property is always priority.
~ ~ ~


@NoahGrayCNN  Dec 24
~ ~ ~
@brexit_sham   Dec 24
The government's next fleet of armoured ministerial cars will be German built Audi A8s because supply chain issues hampered by Brexit mean no British manufacturer is able to meet its requirements.
~ ~ ~
@academic_la  Dec 26 
~ ~ ~
@visegrad24  Dec 25
Russia is warning that it could invade Moldova Russian Deputy Foreign Minister Mikhail Galuzin stated on Christmas Eve that Moldova should be reminded of “the sad experience of Ukraine” He warned Moldova not to sell or buy weapons from NATO countries Time to free Transnistria?
~ ~ ~
It was intended to be sung a capella by a four-voiced choir. In 1921, the Ukrainian National Chorus sang the song in the US, to a sold-out audience at Carnegie Hall. Later, Peter J. Wilhousky rearranged the melody for orchestra and wrote the new lyrics in English.
The song is a story of a swallow flying into a household to sing about wealth that will come in spring time. Now more poignant than ever, I hope it carries hope that the war in Ukraine is nearing its end. Слава Україні
~ ~ ~
@timkmak   Dec 25
It's also Hanukkah. Russian attacks on Ukraine's energy infrastructure have left millions w/o power, which gives new meaning to the Jewish 'Festival of Lights.' We took a look at how they're celebrating the holiday in Odesa for All Things Considered:
~ ~ ~

Feel good du jour:

~ ~ ~

~ ~ ~

“No one’s coming to the rescue,” the state health officer said. No one, that is, but Mississippi Delta residents themselves. Great @IsabelleTaft profile of a remarkable woman--Wyconda Thomas--navigating a messed-up system.
~ ~ ~
@chicagotribune   Dec 25
Sandra Brown, against huge odds, earned a bachelor’s and a master’s degree and started a Ph.D. program while she was locked up in the Illinois Department of Corrections.





The children have gone to bed.

We are so tired we could fold ourselves neatly

behind our eyes and sleep mid-word, sleep standing

warm among the creatures in the barn, lean together and sleep, forgetting each other completely in the

velvet, the forgiveness of sleep.

Then the one small cry:

one strike of the match-head of sound:

one child's voice:

and the hundred names of love are lit as we rise and walk down the hall.

One hundred nights we wake like this

wake out of our nowhere

to kneel by small beds in darkness.

One hundred flowers open in our hands,

a name for love written in each one.

Bits of beauty:


Coqui frog in Puerto Rico

Share this post: