Coronavirus Tidbits #253, July 9, 2023

July 8, 2023 /

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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 

Covid:

#Novids:

Updated seroprevalence estimates show nearly 1 in 4 people in the US hadn't had a covid infection, including 44% of those >65yo, by the end of 2022. In California by the end of 2022, 30% hadn't had covid, including 50% of those >65.

This nationwide study looked at antibodies in the blood. From Jan 2022 it was conducted as a longitudinal study of ~143,000 blood donors, with quarterly seroprevalence estimates. The study has now ended. We're now relying on wastewater, hospitalization, ER and death. Not ideal.

https://covid.cdc.gov/covid-data-tracker/#nationwide-blood-donor-seroprevalence-2022

@CHRomatowski  July 5
But it’s possible to have had Covid w/negative serology; rates of non-seroconversion & seroreversion could account for these stats. This matters: the false belief neg serology means no Covid is wrongly excluding patients from Long Cov research & care nature.com/articles/s4157
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Digital Contact Tracing:

app prevented around one million infections and saved more than 9,600 lives in England and Wales between September 2020 and September 2021. And it achieved this even though, on average over the year, only around 25% of the population was using it.

https://www.nature.com/articles/d41586-023-02130-6  commentary

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Study links overuse of antibiotics with severe COVID-19 side effects

Frequent and diverse use of antibiotics may be associated with developing more severe outcomes after a COVID-19 infection, including death, a study led by University of Manchester scientists has shown.

https://medicalxpress.com/news/2023-07-links-overuse-antibiotics-severe-covid-.html?

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Rare link between coronavirus vaccines and Long Covid–like illness starts to gain acceptance

Studies probe unusual cases of neurologic complications, blood pressure swings, and other side effects

Science Jul 3

COVID-19 vaccines have saved millions of lives, and the world is gearing up for a new round of boosters. But like all vaccines, those targeting the coronavirus can cause side effects in some people, including rare cases of abnormal blood clotting and heart inflammation. Another apparent complication, a debilitating suite of symptoms that resembles Long Covid, has been more elusive, its link to vaccination unclear and its diagnostic features ill-defined. But in recent months, what some call Long Vax has gained wider acceptance among doctors and scientists, and some are now working to better understand and treat its symptoms.

“You see one or two patients and you wonder if it’s a coincidence,” says Anne Louise Oaklander, a neurologist and researcher at Harvard Medical School. “But by the time you’ve seen 10, 20,” she continues, trailing off. “Where there’s smoke, there’s fire.”

Cases seem very rare—far less common than Long Covid after infection. Symptoms can include persistent headaches, severe fatigue, and abnormal heart rate and blood pressure. They appear hours, days, or weeks after vaccination and are difficult to study. But researchers and clinicians are increasingly finding some alignment with known medical conditions. One is small fiber neuropathy, a condition Oaklander studies, in which nerve damage can cause tingling or electric shock–like sensations, burning pain, and blood circulation problems. The second is a more nebulous syndrome, with symptoms sometimes triggered by small fiber neuropathy, called postural orthostatic tachycardia syndrome (POTS). It can involve muscle weakness, swings in heart rate and blood pressure, fatigue, and brain fog.

https://www.science.org/content/article/rare-link-between-coronavirus-vaccines-and-long-covid-illness-starts-gain-acceptance

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Public health funding:

@amymaxmen   Jul 7
CDC is cutting the budget for childhood vaccination & STI control. -Measles vaccine rates are decreasing in kids -Gonorrhea & chlamydia are up, and syphilis is surging -We JUST experienced what happens when public health is short-changed @KFFHealthNews kffhealthnews.org/news/article/c
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Take-home Covid

Employers cannot be held liable when workers contract COVID-19 on the job and spread it to their household members, California's Supreme Court has ruled
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Spinal cord injuries can suppress immune function.

This explains why patients with spinal cord injury are prone to infections, & may lead to insight into #LongCovid. medpagetoday.com/neurology/gene via @ahandvanish

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POTS and Long Covid

(79%) of those with Post-acute sequelae of Covid-19 (PASC) or #LongCovid met the internationally established criteria for Postural Orthostatic Tachycardia Syndrome #POTS.” “Notably, majority of participants with #LongCovid in this study reported mild acute COVID-19 infection and the lag in the onset of autonomic symptoms by at least two weeks from acute infection lends further support to COVID-19 as a trigger for Dysautonomia.”

https://www.contagionlive.com/view/majority-of-patients-with-long-covid-meet-criteria-for-pots

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Other:

Air France plane flew back and forth across the Atlantic for multiple flights with bloody diarrhea on the floor. Passenger discovered it from "manure" smell, after having put his cat carrier in it. "I didn’t expect to find more blood than I’ve seen in Beirut on an @airfrance plane.” He'd "picked up the (cat) carrier, slung it on his back as a backpack" and went to their families. Outrageous sloppiness w bloody diarrhea, endangering Habib Battah and potentially thousands.  h/t  @emilyesfraser

https://www.cnn.com/travel/airline-passenger-air-france-blood/index.html

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CDC raises risk slightly for recent H5N1 avian flu viruses

The Centers for Disease Control and Prevention (CDC) this week published a new risk assessment for the H5N1 avian flu viruses that continues to circulate in wild birds and poultry, using a sample from a 2022 outbreak at a Spanish mink farm. Though the virus scored higher on some risk measures, the overall threat is moderate and similar to the earlier version of the virus.

Scientists said human infections remain rare and the likelihood of human-to-human transmission remains low.

Risk similar for both viruses

The CDC conducted the assessment using the Influenza Risk Assessment Tool (IRAT), which has a goal of answering two questions, one on emergence and the other on public health impact. Health officials use IRAT to gauge the pandemic potential of flu viruses and to guide preparedness measures.

details of that assessment tool are in the Cidrap article:

The agency said previously recommended candidate vaccine viruses against H5 are expected to be effective against the H5N1 viruses circulating in birds and poultry, and most viruses remain susceptible to antiviral medications.

https://www.cidrap.umn.edu/avian-influenza-bird-flu/cdc-raises-risk-slightly-recent-h5n1-avian-flu-viruses

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Drug resistant organisms:

prior hospitalization in Ukraine to be a critical risk factor for colonization with MDR organisms.

https://www.cidrap.umn.edu/antimicrobial-stewardship/case-report-ukrainian-soldier-riddled-extensively-drug-resistant-bacteria

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Monkeypox

#mpox cases low but increasing in our European region. @WHO_Europe @ECDC_EU report 30 new cases reported in the past 4 weeks

monkeypoxreport.ecdc.europa.eu

Progress towards elimination is at risk if we turn away from it.

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West Nile Virus:

Massachusetts reports its first finding of the season of West Nile virus-positive mosquitoes; good time to start thinking about applying DEET-containing repellant outdoors. 10 states have already reported human cases in 2023.

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Tuberculosis

@onisillos   Jul 7
#Tuberculosis on the rise for first time in decades after COVID-19 interrupted public health interventions and increased inequality theconversation.com/tuberculosis-o via @ConversationUS
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Pertussis:

@MarcusBlimi Jul 7
We knew this was happening but now it’s confirmed:
Orthodox providers warning about major pertussis outbreak in frum communities. Two frum kids died, age 2 and an infant. Both unvaccinated.
Give DTaP to your babies, and give Tdap to your pregnant women. [and grandparents]
The reason this wasn’t reported is very depressing and reflects concerted efforts by families to keep these cases and deaths off the grid. It is heartbreaking that people are losing loved ones but also are being warned by AV leadership to not seek care or not to report cases.

Diagnostics:

still an incredible, negligent last of testing.

Drugs:

Paxlovid tied to 30% lower risk of severe COVID in patients with chronic conditions

Paxlovid was linked to a 30% lower risk of all-cause emergency department (ED) visits, hospitalization, and death among vaccinated, nonhospitalized COVID-19 patients with serious chronic conditions but didn't appear to benefit those with only asthma or chronic obstructive pulmonary disease (COPD) or no serious underlying conditions, concludes a Harvard University–led study.

For the observational study, published today in Clinical Infectious Diseases, researchers assessed outcomes among two groups of 2,547 COVID-19 patients aged 18 to 50 years.

Participants had been vaccinated from December 2021 to July 2022, and the search was conducted in September. One group received Paxlovid (nirmatrelvir plus ritonavir), while the matched control group didn't.

https://www.cidrap.umn.edu/covid-19/paxlovid-tied-30-lower-risk-severe-covid-patients-chronic-conditions

Devices, Masks, and Ventilation:

On masks, smoke, ventilation:

Linsey Marr: "a main difference between an N95 and a KN95 is that the  N95 has straps that go around the back of your head and you're able to get a tighter fit with those. So I think on average, an N95 is going to do a little better than a KN95. But you can, if you're careful with a KN95, I think you still can get a good fit and a good seal to your face. One way you can test that is if you're wearing the KN 95, kind of cup your hands around the edges and hold it down while you're breathing through it and see if there's any difference when you do that and press it to your face versus when you don't. If you notice a difference, that means it's not well sealed to your face and you should try a different type of mask.

another thing regarding the mask is that if you've got wildfire smoke [or other smells] indoors you can detect that, but the mask is still protecting you.

The mask is still protecting you, whether you're indoors or outdoors from any type of particle in the air. It's filtering out at least 95% of it and reducing your exposure, whether it's viruses or cigarette or, or wildfire smoke or, or cooking smoke or anything in the air.

On one vs 2-way masking:

masks work in both directions. They filter out particles coming into the mask that you would breathe in. They also filter out particles that you might exhale. And so let's say that we have a hundred particles in the air that you might take in from the, from the air around you, if you're not wearing a mask, and if you have a mask that's 90% efficient and it fits well, then that's going to block 90 of those particles and you'll only breathe in 10 of them. So that's, that's a good reduction. Now, if we're talking about these particles being respiratory particles that came from someone else who might be infected, if they're wearing a mask, instead of those a hundred particles all being there, they're wearing a mask, it reduces what they emit by 90%. So now there's only 10 particles in the air, and, if I'm wearing a mask instead of breathing in all 10. If the mask removes 90% of those, it removes nine. Now I'm down to breathing in only one. So we've gone from a situation with one-way masking, where I'm breathing in 10 out of the 100 to two-way masking where I'm breathing in one out of the 100 particles. And so you get, you can see you get this, this multiplicative effect with two-way masking.

On air exchanges:

I would go beyond five air changes per hour in those types of situations (schools, restaurants, meeting spaces). Let's hit the hospital grade, you know, 12 air changes per hour or better, and let's add high quality filtration to that air

https://erictopol.substack.com/p/linsey-marr-air-qualitya-major-issue

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Thread on air quality and smoke/wildfires by Jeff Gilchrist: https://threadreaderapp.com/thread/1675174138741178371.html

Epidemiology/Infection control:

Almost one in five respondents (18%) UK Docs reported that they were now unable to work due to their post-acute Covid ill-health

  • Less than one in three (31%) doctors said they were working full-time, compared to more than half (57%) before the onset of their illness;
  • 54% of respondents acquired Covid-19 during the first wave of the pandemic in 2020, and 77% of these believed that they contracted Covid -19 in the workplace;
  • A small minority of doctors had access to respiratory protective equipment (RPE) around the time that they contracted Covid-19, with only 11% having access to an FFP2 respirator and 16% an FFP3 respirator;

https://www.bma.org.uk/bma-media-centre/first-major-survey-of-doctors-with-long-covid-reveals-debilitating-impact-on-health-life-and-work-and-wider-implications-for-workforce-and-health-services

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one in 20 K-12 educators believe they have long COVID.

Another 14 percent think or know they previously had it but eventually recovered.

https://www.edweek.org/teaching-learning/the-pandemic-has-faded-from-view-but-many-educators-still-have-long-covid/2023/06

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COVID variants exploited air travel for swift spread

go.nature.com/44vHap9

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Tips, general reading for public:

Ventilate.

Mask.

Vax.

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Warning re "Threads" app:

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Info on heat related illnesses:

https://www.medpagetoday.com/special-reports/features/105391?

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Educating field workers to listen to their bodies can help save lives as the climate grows warmer

https://www.washingtonpost.com/climate-solutions/2023/07/05/farmworker-deadly-heat/

 

Politics:

Covid

The Texas Supreme Court ruled Friday that Gov. Greg Abbott had the legal authority to forbid local officials from enacting their own mask mandates during a public health emergency. bit.ly/3JGJJgd

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Abortion/Reproduction:

Cops illegally sharing license plate reader data with out-of-state law enforcement agencies that could use it to prosecute someone for seeking an abortion, according to records seen by The Sacramento Bee

"The Sacramento County Sheriff’s Office isn’t the only one sharing that data; in May, EFF released a report showing that 71 law enforcement agencies in 22 California counties — including Sacramento County — were sharing such data,"

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Adults in #Arizona can now obtain contraceptive medications over the counter at a pharmacy

https://medicalxpress.com/news/2023-07-arizona-governor-contraceptive-medications-counter.html?

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Child Labor:

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Climate/Environment:

@dwallacewells
“Homeowners insurance is becoming more expensive nationwide, with the average premium jumping 11% this year to $1,700. Florida residents pay much more: $6,000 a year on average, doubling over the past three years.”  https://t.co/HuuKE6vKWc
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@lisa_iannattone  June 30
Yes the smoke smells like plastic. And the reason is horrifying: “The VOC’s from the wildfire smoke interact with UV radiation to create benzene and formaldehyde compounds in the atmosphere. These are toxic air pollutants – and they happen to smell like burning plastic.”
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GOP/TFG:
Trump campaign advisor Susie Wiles who saw classified map works for a China lobbying firm:
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A commentary by  @jrpsaki
 of how the GOP is pitting Muslim Americans against the trans community. They are also trying to pit African Americans against Asian Americans. They divide.
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LGBT:
@kylegriffin1 Jul 2
Pete Buttigieg on the homophobic DeSantis video to CNN: "I'm going to leave aside the strangeness of trying to prove your manhood by putting up a video that splices images of you in between oiled-up, shirtless bodybuilders."
"And just get to the bigger issue that is on my mind whenever I see this stuff in the policy space, which is, again: Who are you trying to help? Who are you trying to make better off? And what public policy problems do you get up in the morning thinking about how to solve?"
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Scotus:

@Davidlaz  
If I understand correctly, a Christian woman invented a hypothetical scenario in which she felt threatened by imaginary gay people, and the Supreme Court not only agreed to hear the case but ruled that her bigotry is acceptable.
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@TristanSnell
Lorie Smith has never created a wedding website. And the man she said asked her for a wedding website? He’s a web designer.
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Man cited in Supreme Court LGBTQ rights case says he was never involved

The man says he has been married to a woman for 15 years and never asked for services from a Christian website designer

https://www.washingtonpost.com/politics/2023/07/01/supreme-court-colorado-website/

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Debt relief/student loans:
Biden, "These Republican officials just couldn't bear the thought of providing relief for working class middle Americans." Biden then blasted Republicans for taking PPP loans and supporting PPP, "You can't help a student but you can help a millionaire and have debt forgiven?"
$760 billion in PPP loans were forgiven. That’s $360 billion more than this Administration’s student debt relief program. And, several Republican members of Congress who opposed student debt relief benefited from those PPP loans.
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Colorado:
@WhiteHouse
87,500 of Representative Boebert’s constituents would have been eligible for this Administration’s one-time student debt relief plan.
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Delaware:
Delaware House approves bill allowing business entities to vote in town’s municipal elections
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Florida:
Florida is now requiring hospitals to ask patients about their immigration status. Responses aren't supposed to "matter"—for care provision or reports to authorities—but this is absolutely going to have a chilling effect on health care access.
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@jftaveira1993
@NormEisen/ @RWPUSA: "Some of #DeSantis' conduct, as well as that of his minions, is disturbingly reminiscent of the tactics of the various autocrats from whom #Florida constituents and their families have fled." salon.com/2023/07/01/ron
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DeSantis’ pastor claims gay people should be “put to death” by wrongfully citing the Biblical laws
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Shoot the pool boy if you must, but do NOT mess with #Florida's iguanas. 9 months in prison. Shooting the pool boy would have been "stand your ground."
sun-sentinel.com/2023/06/30/sho
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Idaho:
@jricole   
Not so Pro-Life? As US Maternal Mortality Rates Surge, Idaho Abolishes Panel Investigating Deaths in Pregnancy
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Iowa:
@hannahdreier
A major child labor rollback goes into effect in Iowa this weekend. 14 year-olds are now allowed to work in meat coolers, 15 year-olds can join assembly lines and 16 year-olds can serve alcohol. In a few weeks, similar rollbacks take effect in Arkansas. who13.com/news/new-iowa-
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Louisiana:
Louisiana Gov. Jon Bel Edwards (D) vetoed three bills targeting the LGBTQ community on Friday.
HB 648 would have banned gender-affirming care for minors — barring puberty-blockers, hormone treatment and surgeries. In a 6-page veto message sent to state House Speaker Clay Schexnayder, Edwards argued that the bill is part of a “targeted assault on children.”
HB 466 — would prevent teachers from discussing gender identity and sexual orientation in public school classrooms. In his veto message, Edwards said the bill places “vulnerable children” on the “front lines of a vicious culture war.”
HB 81 — that would require public school teachers to use the pronouns and names that the students had at birth.
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New York:
@tribelaw
It looks like member of “Exonerated Five” Yusuf Salaam will represent Harlem in NYC City Council! He was 15 when wrongly convicted in 1989. Served 7 yrs in prison before exoneration in 2022. Trump nonetheless called for his execution and has never apologized.
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North Carolina:
North Carolina lieutenant governor Mark Robinson tells Moms for Liberty "it's time" to start reading Hitler quotes
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Tennessee:
@TheTNHoller
Per @briOKC Oklahoma’s far-right schools Superintendent Ryan Williams just told a county GOP meeting he doesn’t want kids taught the Tulsa Race Massacre happened “because of the color of people’s skin”
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Texas:
Texans die from heat exhaustion after governor bans water breaks — At least 9 inmates, including 2 men in their 30s, died in Texas prisons that lack air conditioning. At least 4 workers have died after collapsing while laboring in triple-digit heat texasobserver.org/texans-die-fro
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@NoLieWithBTC   Jul 6
Wow. Virginia Governor Glenn Youngkin just secretly removed suicide prevention resources for LGBTQ youth from a state website. He did so after facing a backlash from MAGA influencers telling him to remove the resources. : washingtonpost.com/dc-md-va/2023/

Feel good du jour:

https://twitter.com/Gabriele_Corno/status/1675069395238830081?s=20

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His bank card was declined. A stranger stepped up, and now they’re ‘friends for life.’

https://www.washingtonpost.com/lifestyle/2023/03/03/jason-boudreaux-kevin-jones-grocery-bill/

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She saved a man’s life. Six years later, she saved his daughter’s life. #GiftOfLife #transplants

https://www.washingtonpost.com/lifestyle/2023/07/05/kidney-donor-paramedic-hadfield-jones/

Comic relief:

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Perspective/Poem

"We always feel younger than we are. I carry inside myself my earlier faces, as a tree contains its rings. The sum of them is me. The mirror sees only my latest face, while I know all my previous ones." — Tomas Transtromer

Bits of beauty:

 

 

 

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