Coronavirus Tidbits #254, July 16, 2023

Covid:

To optimize performance of SARSCoV2 rapid tests, if negative

If Asymptomatic—repeat 3 times at 48 hr intervals

If Symptomatic —repeat 2 times at 48 hr intervals

From a prospective study, largest to date, paired rapid tests and PCR https://acpjournals.org/doi/10.7326/M23-0385…

Gene linked to #LongCovid found in analysis of thousands of patients

https://www.nature.com/articles/d41586-023-02269-2

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Long Covid:

From a new preprint of a 2-year, prospective follow-up cohort of unvaccinated individuals with Covid in Spain "Recovery is extremely rare [from #LongCovid] during the first 2 years [full = 7.6%], posing a major challenge to healthcare systems." https://papers.ssrn.com/sol3/papers.cfm?abstract_id=4505315

Those hospitalized with COVID, esp in the early pandemic, seem more likely to have forms of #LongCovid that are *not* the neurological form. The neuro form seems to last longer (& often overlaps with ME/CFS & dysautonomia, lifelong conditions). https://twitter.com/ahandvanish/status/1599538152435163137…

Other factors that correlated with INCREASED likelihood to recover from #LongCovid include: -being male -having cardiovascular comorbidities -lost appetite in acute phase -had smell/taste alterations (this is often its own subtype that can come with no other symptoms)

The risk factors for NOT recovering from #LongCovid were those with these issues in the acute phase: -muscle pain -impaired attention -dyspnea -tachycardia

The acute COVID symptoms that were more likely to signify #LongCovid included dysphonia, tinnitus, visual alterations, insomnia, neurocognitive complaints, sensory alterations, mucosal dryness, tachycardia, dizziness, abdominal pain, and others:

Of the 7.6% who did recover from #LongCovid, the median time to recovery was 11.4 months.

thread from Hannah Davis.

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On transmission, a rant and cautionary tale:

Dr Bob Wachter, a prominent UCSF doc, has a long Twitter thread on his having gotten Covid. He took a hot shower because he was sweaty and uncomfortable, and he passed out, waking up in a pool of blood. Besides lacerations, he had a small subdural hematoma (bleeding surrounding the brain) and a C-spine fracture.

"By the way, I have no idea where I got Covid. Yes, I’ve been on clinical service but haven’t had any Covid patients. And I wear a KN95 in clinical areas. Outside of patient care, I have taken my mask off for meetings in non-crowded rooms…" and dined with others...

My rant relates to the "no idea where I got Covid." Certainly he knows that asymptomatic people can spread infection. That's why we need to improve ventilation and environmental monitoring and encourage masking.

It's also a warning of some of the things that can go wrong. He could have easily been paralyzed from that fall. He may have lingering post-concussion symptoms on top of Covid. Be careful and wear masks. Cheap insurance!

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In-N-Out Burger is banning employees from masking w/o a doctor's note

see their policy here: https://mailchi.mp/innout/mask-policy-update-for-az-co-nv-tx-ut-associates

Please call them at 1-800-786-1000 and tell them how obscene this is. I did (and hope to write about them as soon as I get more of a response. I have to hear their side of it).

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Other: 

H5N1/bird flu

increasingly being found in mammals, too prompting concern about spread to people.

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Zika:

While not in the news, is still a big problem in Latin America, and now endemic.. Pregnant women are cautioned to avoid Costa Rica and Puerto Rico.

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Rickettsia

Rickettisa Bacterium Orientia, associated with #scrubtyphus disease, found in NC chiggers https://medicalxpress.com/news/2023-07-bacterium-disease-nc-chiggers.html

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Measles:

London measles warning: Outbreak could hit tens of thousands https://buff.ly/3NRWNjV