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.
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.
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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.
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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.”
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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.
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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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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.
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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....
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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.
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59 cases this year in Miami-Dade County; 525 locally acquired dengue cases have also been reported in Puerto Rico.
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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.
This study shows respirators lower risk of infection by 83%. Other masks are not as effective.
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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.
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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...
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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.
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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.
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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.
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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. https://t.co/cw5542VHLT
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 https://t.co/exMdGMxJy3 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 https://threadreaderapp.com/thread/1608970911277010948.html
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Anti-science kills: From Soviet embrace of pseudoscience to accelerated attacks on US biomedicine
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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.
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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.
A 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,
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Do those Catholics want to go there? The catholic church has the largest systemic child sexual abuse scandal in history. pic.twitter.com/M9eeDfidzv— Alejandra Caraballo (@Esqueer_) December 26, 2022
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Police - Kansas:
Buffalo police launch anti-looting unit amid deadly winter storm: 'You’re destroying your community'
What is more commonly known as ‘Carol of the Bells’ was originally a Ukrainian folk chant welcoming the New Year called ‘Shchedryk’. It was arranged by Ukrainian composer Mykola Leontovych in 1916. Here it is performed by Helena Androsova. (1/3) pic.twitter.com/Gc0KjcrHzY— Sandra Glab (@glabsandra) December 24, 2022
Feel good du jour:
Great idea! pic.twitter.com/udcL0nxbc3— Buitengebieden (@buitengebieden) December 26, 2022
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This holiday season I'm particularly in awe of my fiancée @rachaelgene — who *donated one of her kidneys* a few weeks ago! Thanks to her (and the organ she nicknamed "Kit") a three-year-old boy is now living dialysis-free for the first time in his entire life. pic.twitter.com/s4RVJcQPsr— David H. Montgomery (@dhmontgomery) December 23, 2022
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don't you ever sass me again pic.twitter.com/TWOO90KjuN— cats being weird little guys (@weirdlilguys) November 30, 2022
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Shrimp please pic.twitter.com/d8UUKzjWIJ— translated cats (@TranslatedCats) December 23, 2022
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he really said, i can do this all day long… 😂 pic.twitter.com/ZK7YNE1Gi8— The Woof World (@TheWoofWorld) December 25, 2022
THE HUNDRED NAMES OF LOVE Annie Lighthart
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: