Coronavirus Tidbits #227 1/8/23

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.

Reminder, Resilience: One Family's Story... is increasingly pertinent, as some of our politicians shift rightward. All proceeds go to Holocaust education.

Available here.

News 

Covid:

XBB.1 variant

At today's briefing, Maria Van Kerkhove, PhD, said XBB.1.5 has been detected in 29 countries so far and is the most transmissible subvariant detected so far. "We are concerned about its growth advantage," she said. So far, there are no data on severity or the clinical picture,

(also) while XBB.1.5 is equally as immune evasive as the two other XBB lineages -- which had a significant amount of antibody escape, according to a paper in Nature -- it has a higher affinity for ACE2, which explains its increased transmissibility.

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FDA warns it does not anticipate that the drug Evusheld will neutralize XBB.1.5

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US metrics all on the upswing

In CDC tracking of infections as of Jan 4, the 7-day average for new daily cases is 67,243, up 16.2% compared to the previous 7-day average. Over the same period, the 7-day average for new hospital admission rose 16.1%, and deaths increased 8.3%. Likewise, test positivity is increasing and is at 16%.

Also, the number of locations in the high–COVID-19 community transmission level increased by 10.6%. Overall, 49 of 52 jurisdictions were in the high- or medium-level community ranges, for which the CDC recommends measures such as wearing a high-quality mask or respirator in indoor public spaces and screening in high-risk settings.

Regarding wastewater surveillance, the CDC said about 80% of sites across the country are reporting moderate to high SARS-CoV-2 levels, with 58% recording their highest levels since December 2021.

https://www.cidrap.umn.edu/covid-19/us-covid-markers-rise-xbb15-keeps-fast-pace

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As more organs affected, outcomes worsen in kids with post-COVID syndrome

study of more than 4,100 US patients hospitalized with the post-COVID multisystem inflammatory syndrome in children (MIS-C) suggests that deaths, length of stay, adverse drug reactions, and the proportion of Black patients rose along with the number of organ systems involved.

MIS-C is a rare but serious COVID-19 complication characterized by an outsized inflammatory response arising roughly 1 month after infection, sometimes leading to cardiac conditions, the study authors noted. The study was published yesterday in JAMA Network Open....

https://www.cidrap.umn.edu/covid-19/more-organs-affected-outcomes-worsen-kids-post-covid-syndrome

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Persistent positive ANA tests 1 year after COVID-19 may predict long COVID symptoms

Consistently positive antinuclear antibody tests at 12 months following acute SARS-CoV-2 infection may predict long-term symptoms and inflammation, according to data published in the European Respiratory Journal.

https://www.healio.com/news/rheumatology/20230103/persistent-positive-ana-tests-1-year-after-covid19-may-predict-long-covid-symptoms

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Age-related macular degeneration a risk factor for COVID-19 infection, severe disease

Recent evidence has emerged to suggest that age-related macular degeneration (AMD) is a clinical risk factor for increased risk for infection and mortality. AMD has been reported to confer higher risk of severe complications of SARS-CoV-2 infection, including respiratory failure and death (25%), a risk which is higher than Type 2 diabetes (21%) and obesity (13%).

https://medicalxpress.com/news/2023-01-age-related-macular-degeneration-factor-covid-.html

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Does COVID change the body's response to other threats? Depends on your sex

...The answer, they found, depends on the individual's sex, according to a study published Jan. 4 in the journal Nature.

For the study, a team led by John Tsang, (who was at the National Institute of Allergy and Infectious Diseases (NIAID))  systematically analyzed immune responses of healthy people who had received the flu vaccine. From that data, they then compared the responses between those who had never been infected by SARS-CoV-2, the virus that causes COVID-19, and those who experienced mild cases but recovered.

To their surprise, they found that immune systems of men who had recovered from mild cases of COVID-19 responded more robustly to flu vaccines than women who had had mild cases or men and women who had never been infected.

In essence, the baseline immune statuses in men previously infected with SARS-CoV-2 was altered in ways that changed the response to an exposure different from SARS-CoV-2, the authors said.

https://medicalxpress.com/news/2023-01-covid-body-response-threats-sex.html

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Long COVID stemmed from mild cases of COVID-19 in most people, according to a new multicountry study

Even mild COVID-19 cases can have major and long-lasting effects on people's health. That is one of the key findings from our recent multicountry study on long COVID-19—or long COVID—recently published in the Journal of the American Medical Association.

https://medicalxpress.com/news/2023-01-covid-stemmed-mild-cases-covid-.html?

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Why some are worried about XBB.1 (pathophysiology):

@yunlong_cao  Dec 27:
1) XBB.1.5 is equally immune evasive as XBB.1, but 2) XBB.1.5 has a much higher hACE2 binding affinity....
However, the S486P mutation greatly enhanced hACE2 binding,
The fact that XBB.1.5 showed a much superior growth advantage than XBB.1 suggests that hACE2 binding affinity does play a heavy role in SARS-CoV-2 spreading. XBB.1 truly suffered from low-hACE2 binding, despite XBB.1’s highest immune evasion capability. 4/
Another important observation is that XBB.1.5's hACE2 binding affinity is almost comparable to that of BA.2.75, which may enable XBB.1.5 to gain more mutations, similar to what BA.2.75 had. It's just XBB.1.5 haven't felt much immune pressure yet. 5/
Detailed information for the experiments described here can be found in the newly uploaded preprint: biorxiv.org/content/10.110
{SARS-CoV-2 gets into your cells when its spike protein binds to hACE2 proteins on your cells. Antibodies sticking to spike can hinder this binding. Stronger binding means fewer virions are needed to get a successful cell invasion, which increases the reproduction within the body.)
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@WesElyMD   
1/ Our cell’s genes are rewired in MILD COVID    Stunning data in

White Cells (monocytes) switch gene expression from an established innate immune profile to a pro-clotting signature in COVID.   We’re immunocompromised. 

Let’s unpack this…   go.nature.com/3GeDygW
2/ These data explain how the COVID virus places our bodies at risk for macro (large) blood clots in acute dz (which we see often), brain disease due to down-stream micro-clotting, and possibly later cardiovascular dz.
Look how different gene expression was (color difference) in COVID vs. HC (healthy control) pts   What’s it mean?
Our innate immunity is being re-wired by COVID
Monocytes of COVID pts display abnormal markers of inflammation & clotting that drives us to immuno-thrombosis & vascular platelet+cell aggregates.   Very scary stuff if you want a body & brain to get blood, food & oxygen normally.
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Other:

Polio:

Canada detects poliovirus in wastewater samples

Testing to see if they are genetically related to VDPV2 samples from New York.

https://www.cidrap.umn.edu/polio/canada-detects-poliovirus-wastewater-samples

Three African countries also reported more polio - Algeria, Central African Republic, and Democratic Republic of the Congo.

https://www.cidrap.umn.edu/polio/three-african-nations-report-more-vaccine-derived-polio-cases

 

wastewater testing for poliovirus is required to determine if there is a community health risk.

As of December 30, 2022, an updated sequencing analysis by the CDC confirmed the presence of poliovirus in a total of 99 positive samples of concern, with 92 samples genetically linked to the Rockland County resident.

https://www.precisionvaccinations.com/2022/12/30/new-yorks-poliovirus-detections-total-99

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ASRA advocates for all patients undergoing procedures with anesthesia to be screened for cannabis use.

The American Society of Regional Anesthesia and Pain Medicine (ASRA Pain Medicine) has released new guidelines surrounding cannabis use in relation to surgery,

The guidelines come as cannabis use has risen in the United States over the last few decades, with several states relaxing criminal penalties and legalizing medicinal and recreational use. ASRA is concerned that cannabis could interact with anesthesia, and the guidelines also note that regular cannabis use may worsen pain and nausea after surgery and increase the need for opioids. Currently, about 10% of U.S. adults use cannabis monthly, according to the U.S. Substance Abuse and Mental Health Services Administration.

https://healthexec.com/topics/patient-care/care-delivery/industry-group-pushes-cannabis-screenings-surgery

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Publisher’s Platform: Is it past time for a warning label on sprouts?

... # of “Sproutbreaks” for years: “We document at least 55 sprout-associated outbreaks occurring worldwide affecting a total of 15,233 people since 1988. A comprehensive table of sprout-related outbreaks can be found here.

Is it past time for a warning label for sprouts?

Perhaps the labeling could mirror the requirements now found on unpasteurized juices?

https://www.foodsafetynews.com/2023/01/publishers-platform-is-it-past-time-for-a-warning-label-on-sprouts/

Diagnostics:

still an incredible, negligent last of testing.

Drugs and Vaccines:

Timely booster vaccination reduces omicron breakthrough infections and COVID-19 severity

Researchers at the AIDS Institute, Department of Microbiology, School of Clinical Medicine, and the State Key Laboratory of Emerging Infectious Diseases, LKS Faculty of Medicine of The University of Hong Kong (HKUMed) reveals that the timely third vaccination of either CoronaVac or BNT162b2 is critical to induce activated virus-specific memory B cells and omicron cross-reactive T cell responses, leading to significantly reduced frequencies of breakthrough infection and disease severity.

https://medicalxpress.com/news/2023-01-booster-vaccination-omicron-breakthrough-infections.html?

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Vaccine and prior SARS-CoV-2 infection confer long-lasting protection against omicron BA.5

A new study led by Luís Graça, ... and published today in the scientific journal Lancet Infectious Diseases, shows that the protection conferred by hybrid immunity against the SARS-CoV-2 subvariant omicron BA.5, obtained by the infection of vaccinated people, lasts for at least eight months after the first infection.

https://medicalxpress.com/news/2023-01-vaccine-prior-sars-cov-infection-confer.html?

Devices:

Epidemiology/Infection control:

Shocking #s of Covid cases:

In week ending Dec 28: # of ppl w current Covid (not in congregate settings)

England 1 in 20                          Wales 1 in 18

N. Ireland 1 in 16                       Scotland 1 in 25

ow.ly/EiEv50MjQqG

 

About 1 in every 38 people in Canada are currently infected. Link:

Tips, general reading for public:

Ventilate.

Mask.

Vax.

Politics:

Covid:

Screening passengers from China:

The Infectious Diseases Society of America isn't sold on the governments new plan to require pre-flight COVID-19 testingopens in a new tab or window for travelers from China, saying this policy will have "limited impact on transmission" and could "fuel anti-Asian bias and xenophobia."

[Besides, the latest XBB.1 strain that is so transmissible apparently originated in NYC. But monitoring wastewater from flights makes some sense to detect new variants more efficiently

https://medicalxpress.com/news/2023-01-wastewater-flights-china-covid.html?]

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@KashPrime   Jan 3
This is amazing, France is going to require clean air in classrooms, aiming at CO2 levels of 800 ppm. Other countries should quickly follow suit. Aside from limiting Covid, just the benefits of lowering common respiratory viruses makes this worth it alone, as any parent knows. twitter.com/nousaerons/sta
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@maryjirmanus   Jan 3
California just adopted a new permanent OSHA regulation for COVID and airborne pandemic prevention and workplace safety. We need a Federal Standard OSHA like this one. Time to fight for it. details here: dir.ca.gov/dosh/coronavir
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GOP:

Thanks to President Biden and Democrats the price of insulin is capped at $35 per month for seniors. But never forget that every Republican voted against lowering the cost of insulin. They simply don’t care about improving lives.

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@rachel_roubein   Jan 2
The House GOP's rules package keeps the Select Subcommittee on Covid, but alters its focus to include investigating the origins of the virus, the implementation of vaccine mandates, gain-of-function research, etc. Link to the text:
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@hugolowell   Jan 2
New: House GOP rules package has provision to take control of records obtained by previous Congress and sent to Archives — which is why Jan. 6 committee released its underlying evidence via GPO, amid fears that Republicans might meddle with the docs.
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@NoLieWithBTC   Jan 4
Steve Scalise (R), a potential replacement for Kevin McCarthy, previously spoke to a summit of white supremacists and neo-Nazis. Scalise described himself as “David Duke without the baggage.”
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@BeschlossDC   Jan 3
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@gwupoe   Jan 5
On the eve of the 2 year anniversary of the January 6th riot, we’ve done a massive update on our database of individuals arrested related to crimes that day. As of today, 940 people have been arrested. Our site has more than 25,000 pages of court records
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On the Speaker McCarthy Shitshow:
@mcuban   Jan 5
Is there a better commercial for Rank Choice Voting than what is going on with the Speaker's vote in the House ? The current system, from primary to generals to speaker voting, empowers the extremes to the expense of constituants. Time to change
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Santos flashes Proud Boys/White Power symbol, captured by Reuters'  

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@SaltzmanJason   Jan 6
House of Representatives members make 174k a year. With 435 members, each day this cost taxpayers 207,369.86 to do their job for the American public. So far, this Speaker of House fiasco has cost American Taxpayers $829,279.45.
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Antisemitism:
@BillyCorben   Jan 3
Antisemitic words projected onto Downtown Orlando building on New Year’s Eve is just the latest example of the recent explosion in statewide incidents of antisemitism #BecauseFlorida: clickorlando.com/news/local/202
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@YoniFreedhoff   Jan 6
The @OCDSB off to a great we’re listening and we care about antisemitism start in 2023 in their back to school email where they write about International Holocaust Remembrance Day without mentioning Jews
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Greed:
@DanPriceSeattle   Jan 4
UnitedHealthcare Pay Scale Data entry $30,000 Customer Service $35,000 Senior Customer Service $40,000 Registered Nurse $73,000 Nurse Manager $80,000 Vice President $218,000 CEO $18.4 million Previous CEO $142 million
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@linakhanFTC   Jan 5
1. One in five US workers is bound by a noncompete clause, which restricts them from freely switching jobs, lowering wages and undermining fair competition. Today @FTC proposed a rule to prohibit firms from imposing noncompete clauses on their workers. ftc.gov/news-events/ne
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@RBReich   Jan 5
$12 billion. That’s the estimated cost of expanding the Child Tax Credit to 19 million children in the lowest-income families in America. $858 billion dollars. That's the estimated cost of the latest defense bill. Can you guess which one Congress claims it can't afford to fund?
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LGBTQ:
@BrodyLevesque   Jan 5
GLAAD, the world’s largest lesbian, gay, bisexual, transgender, and queer (LGBTQ) media advocacy organization, is responding to the New York Times’ recent announcement of their hiring of anti-LGBTQ attorney & writer David French as a columnist.
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Police:
NYPD help Proud Boys commit fare evasion & then tell journalists to go back and pay for the fare. Everyone should see this video.
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@ScottHech   Jan 2
As a public defender, I represented hundreds of Black men & women accused of doing this. Most couldn’t afford $2.75 subway fare. Difference between eating/not. Arrested, caged, forced to plea to crime of “theft of services.” But when you’re white & proud: twitter.com/lipbrenna/
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@SamTLevin   Jan 6
Killings by US police reached a record high in 2022. Data reveals: •1 in 3 victims was fleeing •majority were routine encounters turned deadly, incl traffic stops, mental health calls, no crime alleged •major surge in killings by sheriff depts
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Racism:
@notcapnamerica   Jan 2
.@Lowes actually called back their driver from a delivery because the customer complained saying they didn’t want a Black man delivering their item.
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Priorities:

@hautdesert  Jan 1
Good news: this is actually the lowest that ratio's been in several years. In some of the Obama years it was near 3:1.
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Abortion/Reproductive care:

The South Carolina Supreme Court struck down the state's 6-week abortion ban, deeming it unconstitutional. (CNBC)   “our state constitutional right to privacy extends to a woman’s decision to have an abortion”

Meanwhile, the Idaho Supreme Court upheld multiple state laws that amount to a near total-ban on the procedure. (Politico)

And over in Minnesota, a bill to codify abortion rights just passed the House health panel. (CBS Minnesota)

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@mjs_DC   Dec 30
OBGYNs in Louisiana are refusing to see patients before 12 weeks of pregnancy because miscarriages are very common during that period and doctors afraid of being investigated and prosecuted for abortion if a patient miscarries.
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@DrJenLincoln   Jan 3
Self-managed abortion w/ misoprostol up to 13wks:
1. 800 mcg of miso under your tongue, wait 30 min, then swallow.
2. Wait 3 hrs. 3. Repeat step 1 with another 800 mcg.
4. Wait 3 hrs. 5. Repeat step 1 with another 800 mcg. (total= 2400mcg miso)
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Guns:
@bshelburne   Jan 2
A man walks into a Publix wearing body armor, carrying six loaded weapons- 4 handguns, a semiautomatic rifle & a 12-gauge shotgun. And that’s A-OK? We are so lost.
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Homelessness:
@thetimeisnowTB
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@BrentToderian   Jan 2
“In Finland, the # of homeless people has fallen sharply. Those affected receive a small apartment & counselling with no preconditions. 4 out of 5 people affected make their way back into a stable life. And all this is CHEAPER than accepting homelessness.”
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Alabama:
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Florida:
DeSantis announced $1000 bonus checks for first responders but didn't mention the $$$ comes from Biden's American Rescue Plan.
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@ChristieZizo   Jan 6
Gov. DeSantis announced that he appointed 6 conservatives to New College of Florida's Board of Trustees, including conservative activist Christopher Rufo, and a professor from Hillsdale College. This is a deliberate move to remake a liberal arts college.
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Georgia:
Sen. Ossoff's bipartisan bill to help veterans afford mental health care is now law-- remove copays act
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Mississippi:
@ashtonpittman   Jan 5
NEW: Jackson public school students are back to learning virtually on the first day of the new semester because more than half of the district's 54 schools still lack running water weeks after the latest water failures. @KayodeCrown reports:
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Missouri:
@JoshuaPHilll  Jan 1
In Missouri the new year started with it becoming a crime to sleep on state-owned land. That means streets, parks and beneath bridges and overpasses. You‘ll be fined $750 and face 15 days in jail. In other words poverty is criminalized in Missouri.
Local governments must enforce ban or risk losing state funds for homeless services

United Nations report concludes that the persistence of extreme poverty in US is political choice made by people in power and calls on govs to address the underlying problems facing the underclass rather than "punishing and imprisoning the poor."

https://www.dw.com/en/un-report-slams-us-for-criminalizing-poverty-as-destitution-grows/a-44053385?

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New York:
Brazilian authorities are reopening the criminal case against George Santos, who committed fraud in Brazil.
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North Carolina:
North Carolina needs to explain why they charged Lanisha Bratcher and not Mark Meadows for voting fraud--she faces 2 felony charges for mistakenly voting while on probation. He faces no charges.
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Ohio:

@jake_zuckerman   
BREAKING: Gov. Mike DeWine signs legislation that -Legally redefines natural gas, a fossil fuel, as "green energy" -Expands oil and gas drilling in state parks
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@Victorshi2020   Jan 6
Ohio Governor Mike Dewine just signed a massive voter suppression law that would enact stricter ID laws, slash the period of early voting, and restrict voting drop boxes.
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UK:
@rowlsmanthorpe  Jan 4
Huge story by @HSJnews. NHS England "has shelved priorities on long covid" and will no longer attempt to meet targets for the condition I have confirmed independently. A source tells me long covid is being "deprioritised" by the NHS
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Ukraine:
@IuliiaMendel   Jan 1
Department for infants of the Kherson Regional Children's Hospital. The hospital where my mother works. A few minutes before the New Year, russians started shelling it. Nurses saved the children, no one was injured. Almost all other buildings are damaged. Russian army is sick.

Feel good du jour:

https://www.archdaily.com/992550/okra-receives-the-european-urban-public-space-award-2022

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@fasc1nate   Dec 31, 2022
In the 1880s, the Harvard Observatory director was frustrated with his staff, and would say "My Scottish maid could do better!" So, he hired his Scottish maid. Williamina Fleming, who discovered tens of thousands of stars and more.
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Stephen and Ayesha Curry
plan to install 150 libraries in Oakland to help raise literacy rates for Black and Latina
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Base editing: Revolutionary therapy clears girl's incurable cancer
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Quote from Damar Hamlin on why he stayed home to play at Pitt.
Gives you a sense for what kind of person he is:
"I had a little brother that was 2 yo at the time. I wanted him to just grow up with a role model in his life and to give him someone to be able to model himself after."
“I’m extremely close to my family. My mom, she was sixteen when she had me and I just try to think about when I was sixteen years old and I just couldn’t imagine having a little boy,”
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Comic relief:

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https://www.dailymotion.com/video/x8ansc5

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https://twitter.com/buitengebieden/status/1611804579204849664?s=20&t=DiDlRwUy-oZ6AkfWCeDFqA

Perspective/Poem

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https://twitter.com/eainsaunt/status/1609950693426868224?s=20&t=DiDlRwUy-oZ6AkfWCeDFqA

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Bits of beauty:

 

 

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