Coronavirus Tidbits #235 March 5, 2023

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.

News 

@EricTopol   March 3

Heart attacks, strokes and other major adverse outcomes doubled

in people post-Covid at 1 year compared with matched uninfected controls #LongCovid, replicating previous reports

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@loscharlos   

Study: “#LongCovid is associated with reduced brain oxygen levels,

worse performance on cognitive tests Compared to those not infected.. showed a lack of increase in oxygen saturation in an area of the brain normally engaged during one of the tasks”
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COVID-related brain changes may lead to long-term fatigue

MRI revealed abnormal structural changes in the thalamus, the part of the brain responsible for relaying motor and sensory signals and regulating sleep and wakefulness. The changes have been correlated with physical fatigue severity, fatigue-related daily functional impairment, and daytime sleepiness, the authors noted.

The shape deformations and reduced volumes of the thalamus and other areas of the brain overlapped with the changes seen in the MS patients and were tied to impaired short-term memory.

https://www.cidrap.umn.edu/covid-19/covid-related-brain-changes-may-lead-long-term-fatigue

https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(23)00051-2/fulltext

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Interview w Ashish Jha on end of Public Health Emergency

worth a read, although I disagree w him on things like masking.

https://www.medpagetoday.com/opinion/faustfiles/103278?xid=nl_faust_2023-03-01&eun=g1184564d0r

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@EricTopol  March 4
It's surprising that the results with this oral antiviral RCT haven't received more attention, especially for potential of reducing #LongCovid in people with evidence of persistent virus nature.com/articles/d4158
[There are also concerns resistance will develop rapidly]
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Avian Flu:

@alexandraphelan   Mar 2
China has reported a case of H5N1, as well as a current H5N6 case, and two H9N2s from late last year.
The Hong Kong Avian Influenza Report where these cases are detailed is really excellent (via @ProMED_mail)
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Polio:

New cases in Israel

@KrutikaKuppalli   Mar 3
#Israel reported a case of #polio in an #unvaccinated 8 year old. Now 3 children in contact with the case have tested positive. Polio can cause disability, paralysis and death. Missed #vaccines due to delays & hesitancy are a public health threat.

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Jeremy Farrar, WHO Chief Scientist (via Kai Kupferschmidt):

Humanity remains "incredibly vulnerable", if we ignore the legal and illegal wildlife trade, land use change, climate change etc.
H5N1 is a good example of the risks he says: “Influenza remains one of the greatest threats to humanity. I personally think the biggest risks in influenza are nonhuman influenza, to which none of us have got any immunity. I think that is the biggest risk. So H5N1 fits into that."
And if H5N1 started spreading in humans, we would not have vaccines ready, Farrar points out. "Would we get there in 100 days? Well, we might, but we might well not. And with current global travel that would pass around the world very quickly."
How likely is this? "I think it's low but I can't quantify it. It's big enough for me to worry about it. And it's big enough for me to say I think we should push forward with the preparation of having countermeasures in place. We cannot leave the world as vulnerable as that."  (2/28)
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Drug shortages:

BCG, used to treat bladder cancer, is unavailable.

Now, dire shortages of Albuterol, an inhaler used for asthma.

Diagnostics:

still an incredible, negligent last of testing.

Drugs and Vaccines:

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@Dysautonomia   Mar 1

Researchers from the University of Adelaide report improvement in a #LongCOVID #POTS patient after treatment with plasmapheresis, which removes antibodies from the blood. The article is behind a paywall, but here’s the link for anyone interested: amjmed.com/article/S0002-

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A thread on Sildenafil for Long Covid:

https://threadreaderapp.com/thread/1591421633226592257.html

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'COVID rebound' is common, even in untreated patients

"COVID rebound," in which evidence of the illness disappears and then returns days or weeks later, is surprisingly common—whether or not patients are given the antiviral Paxlovid.

medicalxpress.com/news/2023-03-c

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FDA Panel Backs Pfizer's RSV Vaccine for Older Adults

with certain misgivings, both about efficacy and 2 cases of Guillain Barre...Because currently, no vaccines exist to protect against RSV infection. According to data from the CDC, an estimated 177,000 older adults in the U.S. were hospitalized due to RSV infections in 2017 alone, and 14,000 died.

https://www.medpagetoday.com/infectiousdisease/vaccines/103317?

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@LizSzabo   Mar 1
2 large randomized trials showed a single dose of an antibiotic (doxycycline) within 72 hours of exposure reduced STIs by 60%.

Devices:

Viewpoint: COVID-19 and Airborne Transmission: Science Rejected, Lives Lost. Can Society Do Better?

The international group of scientists who successfully lobbied the World Health Organization to recognize the airborne transmission of COVID-19 have published four key steps needed to avoid similar critical mistakes in the future.

https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciad068/7034152?login=false

Epidemiology/Infection control:

Study shows COVID-19 rates were likely forty-times higher than CDC estimates

About 17% of study participants reported being infected with SARS-CoV-2 during the Omicron BA.4/BA.5 dominant period. This equates to 44 million cases, which is much higher than the 1.8 million cases estimated by the U.S. Centers for Disease Control and Prevention (CDC) during that period.

When the prevalence of SARS-CoV-2 infections was analyzed according to sociodemographic factors, adults between the ages of 18 and 24 had a higher incidence of infections, as did non-Hispanic Black and Hispanic adults. The prevalence of infections also varied according to income and education levels, with groups with lower income and lower education having a higher incidence of SARS-CoV-2 infections.

Approximately 21.5% of the patients who had SARS-CoV-2 infection four weeks before the survey reported experiencing long COVID symptoms. This estimate was higher than the 18.9% estimate for long COVID incidence reported by the Household Pulse Survey.

https://www.news-medical.net/news/20230227/Study-shows-COVID-19-rates-were-likely-forty-times-higher-than-CDC-estimates-during-BA4BA5-dominant-period-in-the-US.aspx

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Massive surge in hospitalizations of babies and young kids due to COVID recorded in 2nd year of pandemic

"In the second year of the pandemic, hospitalizations due to COVID-19 skyrocketed more than 600 per cent among children aged 0-4 compared to the previous year, according to new data from the Canadian Institute for Health Information (CIHI)."

#CDNHealth #CdnHealthcare

ctvnews.ca/health/massive-surg

Tips, general reading for public:

Ventilate.

Mask.

Vax.

Politics:

Covid:

@JReinerMD   Feb 25
Today is the 1 year anniversary of the sudden greenwashing of the CDC COVID map, effectively ending widespread mask use in the US. Since that time, 160k Americans have died of COVID.
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@JenniferLerner1  March 4
The Bad News: CA, OR, and WA all decided to drop their mask requirements in healthcare settings, effective Apr. 3. The Good News: they gave us a month to fight back.
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@ApricotTreeCaf1  March 4
So we had about 80 K customers come through the doors over the last year being mask less for a couple of hours. And yet, none of our staff has ever been infected at work. Wish public health and political leaders would take our approach and scale it across the country.
#Hepa filters  #Ventilation
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UK Covid:
@jessicaelgot
Matt Hancock admits in this message to Simon Case that he helped cover up rising cases in key areas during Eat Out to Help Out. Strikes me as potentially the biggest revelation yet…
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@1goodtern   March 4
Under 5s admitted to hospital with Covid in England:
Most recent 365 days: 10714
Previous 365 days: 7758
Previous 365 days: 2587    THE PANDEMIC IS NOT OVER FOR BABIES.

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Abortion/Reproduction:

Walgreens is bending to the will of Republican Christo-fascists & agreeing not to send mifepristone to Kansas & West Virginia.

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@evan_greer
“One of the most concrete things Senate democrats can do to protect reproductive rights is get off their butts and get Gigi Sohn confirmed,”  Read this from Gizmodo:

Texas Is Trying to Scrub Abortion From Its Internet

Last week, Texas introduced a bill that would make it illegal for internet service providers to let users access information about how to get abortion pills. The bill, called the Women and Child Safety Act, would also criminalize creating, editing, or hosting a website that helps people seek abortions.

If the bill passes, internet service providers (ISPs) will be forced to block websites “operated by or on behalf of an abortion provider or abortion fund.” ISPs would also have to filter any website that helps people who “provide or aid or abet elective abortions” in almost any way, including raising money.

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@NoLieWithBTC   Mar 3
New: South Carolina Republicans have introduced a bill that would allow women to be executed if they have an abortion. The bill is also vague enough to potentially include miscarriages.
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Book bans:

@ACLUIndiana   Feb 28
The Indiana Senate just passed SB 12, a book banning bill opening school librarians and teachers up to felony prosecution for having material a parent finds objectionable. SB 12 would have a chilling effect on free speech in schools. The bill now heads to the House.
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Environment:

Revealed: the US is averaging one chemical accident every two days

https://www.theguardian.com/us-news/2023/feb/25/revealed-us-chemical-accidents-one-every-two-days-average?CMP=Share_iOSApp_Other

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@SDonziger   Mar 3
Ohio police link environmental hero @ErinBrockovich to "terrorism" because she is organizing residents in East Palestine to challenge the rail company that poisoned their town. Outrageous. Those who challenge polluters are now terrorists?
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Contaminated soil from the site around the East Palestine train wreck in OH is being sent to a nearby incinerator with a history of clean air violations, raising fears that chemicals being removed from the ground will be redistributed across the region.
[It's also being shipped to Texas and Michigan]
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Fox/Rupert Murdoch:

@SawyerHackett   Feb 27
Rupert Murdoch admitted at least two bombshells under oath:
1) that he—the chairman of a news org—provided debate strategy and info about Biden ads to Jared Kushner
2) that multiple Fox hosts knowingly endorsed false narratives about a stolen election
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Guns:

@teamtrace   March 3
West Virginia passed a law this week allowing concealed weapons on public college campuses.
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Jon Stewart:
State Sen. Nathan Dahm (R-OK) has penned several bills loosening gun restrictions, including the nation’s first anti-red flag law. He thinks these bills protect the Second Amendment – and that they make us safer. We think it's probably one or the other. Watch clip:
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LGBT:
@ethnobot
Girl Scout sells out entire cookie inventory after drag queens and other gay bar patrons rush her stand: ‘Everyone was so friendly and kind’
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@LizSzabo   Mar 1
New state bills restrict transgender health care — for adults
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Tennessee gives trans youth 1 year to detransition. The state also banned drag performances

These cry bullies love to talk about the constitution. KK

The 14th Amendment

No State shall make or enforce any law which shall abridge the privileges or immunities of citizens of the United States; nor shall any State deprive any person of life, liberty, or property, without due process of law; nor deny to any person within its jurisdiction the equal protection of the law

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(See Florida bill that could cause parents to lose their kids, below)
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@pwhickey   March 3   [Interesting strategy re military being endangered by being assigned to Florida, Texas, etc.]
Dear @SecDef & @DoD_DHA, @MilitaryHealth can no longer sit on the sidelines hoping this storm passes us. Our collective silence about how we will protect the 1000s of military families and their care teams ASSIGNED to states putting these laws to vote breaches our duty to them
twitter.com/equalityfl/sta
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GOP and TFG:
@namwella1961   Feb 26
We don’t have massive federal debt because of Social Security. We have massive federal debt because the rich don't pay their fair share of taxes.
House Republicans decided making people work until they're 70 made more sense. #ProudBlue #GOPClownShowContinues #TaxTheRich
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@girlsreallyrule   Mar 2
The DoJ said Thursday that Trump can be sued by police officers over the violence at the Capitol on Jan. 6 and does not have absolute immunity from civil lawsuits, filed by police officers and members of Congress, which seek to hold him liable for damages. nbcnews.com/politics/donal
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BBC News - AOC under investigation for Met Gala dress reading "Tax The Rich" bbc.co.uk/news/world-us-
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California:
@NohaAboelataMD   March 3
Welp, there it is. No more mask requirements in healthcare settings in California after April 3rd. Time to talk with County and hospital leadership.
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Florida:

Florida Republicans Hope to Enshrine a Right to Religious Discrimination

A Florida defamation bill shrouds a right for conservative Christians to pursue their anti-social civic agenda under the guise of a free speech protection.

https://newrepublic.com/maz/article/170862/florida-defamation-law-religious-discrimination

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@NoLieWithBTC   Feb 28
A Republican in Florida just introduced a bill that would ban the Democratic Party from existing in the state. Registered Democrats in Florida would be notified that their party has been “canceled” and they’re now no-party voters.
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@dburbach   Mar 3
For the five member Disney district board, Desantis chose this "tap water makes you gay" and "gays caused Rome to fall" evangelical minister, as well as the woman who leads the Moms For Liberty book-banning organization.
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@equalityfl   March 3
A bill has been filed in the FL Senate to criminalize parents & health care providers providing gender affirming care to trans youth. It would allow the government to seize control of kids if their parents might seek the care that is supported by all major medical orgs.
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Iowa:

@MorePerfectUS   Feb 7
A new Iowa bill would roll back child labor laws, allowing 14 to 17-year-olds to work in mining, meatpacking, demolition, operating guillotine shears, and other dangerous jobs. Under the business-backed bill, employers wouldn't be civilly liable if kids are injured or killed.
The new Iowa bill would also completely lift a ban on 14 and 15-year-olds working in freezers and meat coolers, and allow kids as young as 14 1/2 to drive themselves to work. Other dangerous jobs would be allowed with exemptions.
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Mississippi:

Mississippi residents might get back the ability to enact public policy through statewide ballot initiatives, but people would be banned from using the process to change abortion laws.

https://medicalxpress.com/news/2023-03-mississippi-renew-abortion.html?

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@GanucheauAdam   Mar 2
First Lady Elee Reeves wrote and is touring a children’s book, “Fred the Turtle.” Gov. Tate Reeves’ office quietly gave $10,000 in federal Head Start funds to a new nonprofit, which paid for printing thousands of copies. 
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New York:

@luckytran
@Gothamist   Feb 28
NYPD Chief of Department Jeffrey Maddrey says that businesses should require customers to briefly remove their masks "as a condition of entry" because too many people are allegedly using masks as a way to get away with robbery.
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@luckytran   March 4
For 3 consecutive years, COVID-19 has been the top cause of death in the line of duty for police officers. But the NYPD wants to criminalize wearing a mask anyway.
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South Carolina:

@cscnme   Feb 21
There is a proposed bill in South Carolina to charge newcomers a "moving in fee" of $250 before they can get their new IDs. IDs are required to vote in South Carolina.
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Russia:
@KyivIndependent   Feb 28
Putin signs law suspending major nuclear treaty with US. Russian dictator Vladimir Putin signed a law officially suspending Russia’s participation in the New START treaty on Feb. 28.

 

Feel good du jour:

During the Civil War, an enslaved African-American taught himself to read, commandeered a ship, rescued the enslaved crew, then sailed them all to freedom. Then, he came back, bought his former master’s home and was elected to Congress.

Robert Smalls was born in Charleston, South Carolina. He grew up working on the docks, and because of his knowledge of boats, the Confederate army forced him to steer a steamship.

The night before his planned escape, Smalls asked the captain if he could bring his family on board. He told them it was just for a visit. The white captain agreed — as long as they left before curfew.

That night, Smalls hatched his plan. Not only was he going to escape, but he was going to deliver the boat to Union forces. It meant escaping, avoiding detection, sailing through the Confederate harbor, and convincing Union forces he was on their side.

That night, other enslaved crew members had their families hide on a nearby ship. When the white crew had gone ashore, Smalls put on the captain’s uniform, lifted anchor, picked up the other families, and set sail — right through enemy waters!

Smalls made it through all five confederate harbors. Because it was dark and Smalls was wearing the captain’s uniform, no one suspected a thing. When he approached the Union fleet, he replaced the confederate flag with a white bed sheet, hoping they wouldn’t fire.

Miraculously, despite the thick fog, the Union Navy was able to see the white flag. Smalls surrendered the ship along with the weapons, ammunition, confederate maps, and the captain’s code book. He had just handed the Union army a goldmine.

After gaining his freedom, Smalls was awarded prize money for delivering the steamship to Union Forces. He continued to serve in the Union Navy until the end of the war.

By the end of the war, Smalls had taught himself to read and write. And thanks to his prize money, he went back and bought his former master’s house. Then, he bought another building and turned it into a school for African-American children.

After escaping from the south, rescuing several families, and becoming a war hero, Smalls decided it was time to break another barrier. He ran for US Congress and won - not just once but five times, representing South Carolina in the House of Representatives.

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Comic relief:

Hilarious thread by Dr. Elinne Becket on Twitter, begins with this, then many suggestions and photos:

@bielleogy   March 1

Read in entirety here: https://threadreaderapp.com/thread/1630806917085032450.html

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https://twitter.com/buitengebieden/status/1632026904990498817?s=20

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https://twitter.com/buitengebieden/status/1631043295836028931?s=20

 

Perspective/Poem

See this thread from Daniel Ellsberg, announcing that he has inoperable pancreatic cancer:
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@Boghuma   Feb 27
Continued epidemics of most infectious dz are a choice. What gets funding + attention is a factor of who is most impacted by the burden of disease.
1700 African children died today from Malaria,
funding a vaccine that can reduce deaths by 50% should not be subject to debate.
The RTS,S #Malaria Vaccine was Approved by WHO in 2021. Unfortunately there are still not enough doses to go meet the demand. ~
There is an estimated 25million children born each year in areas with moderate to high malaria transmission, meaning we need 100 million doses of RTS,S each year (assuming 4 dose regimen).
It is unlikely that we can meet even one quarter of this yearly demand for the next 5 years.
WHO Has had to develop a framework for the supply of the limited available doses ~ Now, compare this to the oversupply of COVID19 Vaccines;
and Remember that Malaria Killed ~1700 kids today
and will kill another ~1700 tomorrow, and every day after that

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   Feb 28

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Bits of beauty:

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