Coronavirus Tidbits #275, Dec 31, 2023

December 29, 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.

Happy New Year to all! After years of writing Tidbits weekly (or more often),  I actually found that I missed doing it. Having had a wonderful bucket list trip, I'm back at it.

Apologies that this is an unusually long edition--a lot has happened.

You can savor it over the next few days...

News 

Covid hospitalizations up 10.4% and deaths up 3.4% this past week.

JN.1 variant now behind nearly half of US COVID cases

JN.1 is similar to BA.2.86 (Pirola) but has an additional mutation (L455S) in the spike protein. The speed at which the JN.1 variant has spread this month suggests it may spread more easily and be better at evading people's immune systems than other circulating variants, according to a recent CDC report.

existing vaccines, tests, and treatments still work well against JN.1

https://medicalxpress.com/news/2023-12-jn1-variant-covid-cases.html

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Vaccination rates are low in US:

the CDC reported that 7.6% of children and 18.5% of adults have been vaccinated.

The percent of the population reporting receipt of a flu vaccine is about 43%

The percentage of adults 60+ reported receiving an RSV vaccine is 17%.

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Study finds similar brain effects after severe COVID, other critical illnesses

A study involving hospitalized adults today in JAMA Network Open finds that severe COVID-19 negatively affects brain health, but no more so than pneumonia, heart attack, or other critical illnesses.

https://www.cidrap.umn.edu/covid-19/study-finds-similar-brain-effects-after-severe-covid-other-critical-illnesses

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More on neuro changes. Scary read

CDC website, Nov 2023: "evidence strongly suggests that even asymptomatic SARS-CoV-2 patients might have neuropathologic changes in their brains, which could develop into severe neurologic disorders later in life." 1/x wwwnc.cdc.gov/eid/article/29

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Europe Wasted $4.3 Billion Worth of COVID-19 Vaccines

POLITICO reported today at least 215 million COVID-19 vaccines purchased by European Union (EU) countries have been recently discarded at an estimated cost of $4.3 billion.

https://www.precisionvaccinations.com/2023/12/18/europe-wasted-43-billion-worth-covid-19-vaccines

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(Huge waste for PPE as well)

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Almost a third of COVID survivors report symptoms 2 years post-infection

A meta-analysis of 12 studies shows that 30% of COVID-19 survivors have persistent symptoms 2 years after infection, the most common of which are fatigue, cognitive problems, and pain.

For the study, published yesterday in the Journal of Infection,

The sample included 7,912 hospitalized and non-hospitalized COVID-19 survivors; the average age was 59.5 years, and 50.7% were women. Up to 54% of patients had at least one underlying medical condition, with high blood pressure (34.0%) and obesity (22.4%) the most common. Long-COVID symptoms were evaluated at an average follow-up of 723 days.

The most common post-COVID symptoms 2 years post-infection were fatigue (28.0%), cognitive impairment (27.6%), and pain (8.4%). Psychologic problems such as anxiety (13.4%), depression (18.0%), and disturbed sleep (20.9%) were also prevalent.

The most common respiratory and general symptoms were fatigue (28.0%), runny nose (8.2%), and shortness of breath (5.7%). Prevalent neurologic and cognitive symptoms were dizziness and vertigo (6.7%) and impaired sense of smell (5.3%) and taste (4.9%).

https://www.cidrap.umn.edu/covid-19/almost-third-covid-survivors-report-symptoms-2-years-post-infection

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COVID study: 40% of children still infectious after symptom resolution

A study today of viral shedding dynamics in 101 children who had COVID-19 during the Omicron surge in Toronto shows that 40% were still infectious on the day after their symptoms resolved.

Moreover, rapid antigen tests (RATs) were often negative early in the course of illness, and thus cannot be relied on to exclude infection, they authors say. The study is published in Clinical Infectious Diseases.

https://www.cidrap.umn.edu/covid-19/covid-study-40-children-still-infectious-after-symptom-resolution

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Public health officials detail threats, changed landscape post-pandemic

which led to up to 30% to step down, retire, or leave the field, according to a recent study in Public Health in Practice.

https://www.cidrap.umn.edu/covid-19/public-health-officials-detail-threats-changed-landscape-post-pandemic

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COVID-19 Exposure in Womb May Impair Child Development, Brazilian Researchers Reveal

In a groundbreaking study from Brazil, published in the International Journal of Infectious Diseases, scientists have uncovered alarming evidence that babies exposed to COVID-19 while in the womb face a heightened risk of developmental impairments. This prospective cohort study, led by Carolina A.D. Santos and a team of experts, closely monitored 127 children for a year, comparing those exposed to SARS-CoV-2 during pregnancy with a control group of unexposed babies.
Key Findings: -Increased Risk of Delays: The study found that 20.3% of children exposed to COVID-19 in utero experienced neurodevelopmental delays within their first year, compared to only 5.9% in the control group. -Motor and Social Skills Affected: The most significant delays were observed in fine motor skills and personal-social interactions. -Cranial Abnormalities: Notably, 10% of exposed infants also displayed abnormal results in cranial sonography, a type of brain scan.
@drseanmullen
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@luckytran
Researchers estimate that the economic cost of Long COVID in the US is $3.7 trillion, which is comparable to the cost of the Great Recession. It is reckless for governments to ignore preventing and treating COVID and Long COVID. Source: hks.harvard.edu/centers/mrcbg/
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“In this status quo, people are expected to ignore the threat of infection, pay through the nose if they get sick & face stigma and ridicule if they become disabled. Journalism can & should repudiate that bargain.” Must read @edyong209 oped on Long Covid - FREE gift link

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Other:

Over 35,000 Zika Cases Confirmed in the Americas

The mosquito-borne virus circulates in 89 countries worldwide although 89%, or more than 33,000 of the cases were in Brazil. No vaccine is available yet, in the effort to prevent congenital abnormalities.

https://www.precisionvaccinations.com/2023/12/27/over-35000-zika-cases-confirmed-americas

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The Ebola survivors who are still infectious – 10 years after the world’s biggest outbreak

A decade after the virus ravaged West Africa, the threat of its return looms in an unlikely source: the testicles of men who survived.

https://www.telegraph.co.uk/global-health/science-and-disease/ebola-outbreak-west-africa-10-year-anniversary/

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“Parrot fever is surging in Sweden,

with 12 people infected this month alone, amid concerns that the outbreak could escalate. The flu-like disease – spread by wild birds including parakeets, can lead to severe pneumonia & meningitis in humans.” telegraph.co.uk/global-health/ via @LauraMiers

Diagnostics:

Here’s how to get FREE telehealth, treatment and *multiplexed molecular tests* for FLU + COVID this winter

The NIH funded FREE Home Test-to-Treat Program (test2treat.org) has expanded to include: 1) COVID + FLU Multiplex Molecular Home Tests 2) Telehealth and Treatment Options for both COVID & Flu Enroll at test2treat.org Read about it in

@TIME

here time.com/6341128/free-f

Drugs and Vaccines:

@EricTopol

New data for the "updated" (XBB.1.5) booster ~60% protection from hospitalization and ED visits vs JN.1 and recent circulating variants medrxiv.org/cgi/content/sh

@KPSCalResearch

But vaccination w/ prior versions (& waned immunity) offered no protection vs hospitalization

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@dr_kkjetelina
Ooof. Covid-19 vaccine rates in UK vs. US
Long-term care residents: 78% vs. 17%
65+ years old: 68% vs. 31%

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(My fellowship research was on secretory immunity, working to develop an oral vaccine for influenza. I remain a big enthusiast of nasal/mucosal approaches).

Devices:

Epidemiology/Infection control:

Today on Christmas, 3.5% of the U.S. population (1 in 29) is actively infectious with #COVID & rising toward a Jan 10 peak. COVID transmission is higher than during 94.7% of the pandemic. There's a 50% chance of a COVID exposure if interacting with 20 people today.

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The risk of COVID transmission from 7 million contacts, as assessed by the @NHS digital app "the cumulative duration of exposure to infected individuals is a key predictor of transmission" nature.com/articles/s4158

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Risks of Covid vs Flu

Details on @zalaly’s latest study of Covid vs Flu

… Risk of Death: People with COVID-19 had a 51% higher risk of dying compared to those with seasonal influenza. This means for every 100 people with COVID-19, about 9 more died compared to those with the flu. Health Outcomes: COVID-19 was riskier for a wider range of health problems. About 68% of the specific health issues they looked at were more likely with COVID-19, compared to only about 6% with the flu. Impact on Different Organ Systems: COVID-19 generally had a higher risk of causing problems in various organ systems, except for the lungs. The flu had a higher risk of causing lung-related issues. Overall Health Impact: Measured in something called DALYs (Disability-Adjusted Life Years, a measure of overall disease burden), people with COVID-19 had a higher burden of health loss compared to those with the flu. Hospital Readmissions and Intensive Care: People with COVID-19 were more likely to be readmitted to the hospital and needed intensive care more often than those with the flu. Long-term Effects: Both COVID-19 and the flu caused more health problems after the initial illness phase. However, except for lung problems, COVID-19 had a more significant long-term impact on health. thelancet.com/journals/lanin

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"COVID-19 in Workplace Settings: Lessons Learned for Occupational Medicine in the UK."

...In spite of good prior research and statute, the necessary resources to protect workers’ health were seriously lacking when the pandemic struck. Weak public health guidance, which did not recognise dominant airborne transmission, was applied to workplaces, leaving workers and others unprotected, especially in respect to Respiratory Protective Equipment (RPE).

https://mattioli1885journals.com/index.php/lamedicinadellavoro/article/view/15461

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Long Covid:

@lisa_iannattone  Dec 8
StatCan just dropped a bombshell report on LC. This is the most important figure. It highlights that the risk of long term symptoms is cumulative, it increases with increasing number of infections. By 3+ infections, 38% report long term symptoms — that’s 1 in every 2.6 people
https://www150.statcan.gc.ca/n1/pub/75-006-x/2023001/article/00015-eng.htm
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Masks:

In November 2022, our pediatric hospital replaced the requirement for universal masking of all healthcare personnel and visitors in all clinical buildings with a requirement for masking only during patient encounters. Following this change, we observed an immediate, substantial, and sustained increase in healthcare-associated respiratory viral infections.
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As Covid cases are rapidly increasing multiple hospitals are bringing back masking, at least in some areas. Boston is lagging...
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MassGeneralBrigham will require staff to wear masks when interacting with patients. But their requirements don't include lobbies or patients and visitors, nor nurses stations or the like.
Also. they still allow HCWs to refuse to mask even when a patient requests them to.
@PlaguePoems  Nov 29, 2023
Just in time for the holiday season the CDC has given us an early gift: in the form of a wastewater dashboard, so while the CDC is far too restrained is far too polite to state that we’re in deep shit their wastewater dashboard makes that clear with less profanity.

Tips, general reading for public:

Vax

Mask

Ventilate

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I'm hearing more about docs/NPs refusing to give Paxlovid.
Know:
Free telemedicine visits are available for those who want antivirals like Paxlovid at
https://test2treat.org
and
Amazon Clinic, COVID-19 treatment - Online visit $35
https://clinic.amazon.com/COVID-19-treatment/dp/B0BL1Z6VXB
Also in one study, Metformin reduced the risk of Long Covid significantly.  "metformin reduced long COVID incidence by about 41%, with an absolute reduction of 4·1%, compared with placebo."
The metformin dose was titrated over 6 days: 500 mg on day 1, 500 mg twice daily on days 2–5, then 500 mg in the morning and 1000 mg in the evening up to day 14.
https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(23)00299-2/fulltext
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With this current surge in Covid, please:
Be sure you are vaccinated.

Wear a protective mask (not a surgical mask) of at least an N95 if you are with others in close contact.
Use HEPA filters or Corsi-Rosenthal boxes
Open windows a little.
Avoid eating inside with others--if you feel you can't, mask when not eating, open windows, and use filters.

 

Politics:

This hit home with my recent trip to Costa Rica.

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Covid:

I saw someone say the CDC Director is recommending wearing a mask again and was in disbelief, but went to look up the video and... ...the CDC Director recommended wearing a mask! 
@Sblahov 12/7

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Abortion/Texas:

Judge allows Texas woman to abort fetus with lethal abnormality texastribune.org/2023/12/07/tex via @TexasTribune

Within hours of a state judge's order Thursday clearing the way for Kate Cox to have an abortion, Texas Attorney General Ken Paxton sent a letter to The Methodist Hospital in Houston threatening felony charges against the hospital. dallasobserver.com/news/kate-cox-

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GOP:

@RightWingWatch Dec 6
Mike Johnson told a gathering of Christian nationalists last night that weeks before he became House Speaker, "the Lord told me very clearly" to prepare to become a "Moses" who will lead the nation through a "Red Sea moment." bit.ly/3Ni4oZH
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@TimothyDSnyder   Dec 20
"A group of Russian nationals were able to donate to newly elected House Speaker Mike Johnson's campaign in 2018 by funneling the money through a U.S. company." – Ewan Palmer, Newsweek
Johnson was an ardent supporter of funding for Ukraine last year. Then, "He berated Biden for delays and said it was 'a threat to liberty around the world' not to get them the weapons they need." https://www.youtube.com/watch?v=HhOnEhJ6clk&t=3s Now? Not so much...
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LGBTQ:
Texas is demanding the records of a Seattle hospital regarding health care for trans youth. OAG Ken Paxton is using the power of the state to threaten out of state hospitals with criminal prosecution.
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Racism/White supremicism:

Trump New Hampshire rally 2023: Immigrants will “poison the blood” of our country.
Hitler Nuremberg rally 1932: The Jews will "poison the blood of our country.
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@JuddLegum  Dec 4

1. A PAC with close ties to the @TexasGOP  met with white supremacist Nick Fuentes for hours. To tamp down the controversy, a member of the @TexasGOP exec committee introduced a resolution banning associations with Nazi sympathizers and Holocaust deniers. IT WAS VOTED DOWN

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Missouri's Francis Howell School Board voted to eliminate Black History and Black literature.

https://www.stltoday.com/news/local/education/francis-howell-school-board-votes-to-remove-black-history-literature-classes/article_ffd0d192-a049-11ee-9b41-eb47ef9cd237.html

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Voting rights:

Michigan Law Is First to Automatically Register People to Vote As They Leave Prison

The legislature passed a bill that will also expand automatic voter registration in other ways, including applying it at Medicaid offices, and likely add many new Michiganders to voter rolls.

https://boltsmag.org/michigan-automatic-voter-registration-prison/

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Israel/Gaza:

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Ukraine:

@TimothyDSnyder

Help me protect life in Ukraine. Last year, many of you joined me in a

@U24_gov_ua (https://u24.gov.ua/) project to fund an anti-drone system. I very much hope you will join me in a new fundraiser to spread the drone-detection system throughout the country. Please help.
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Another worthy for Ukraine is Razom, https://www.razomforukraine.org/donate/
It's also a 501 C-3 if that matters to you.

Feel good du jour:

Using AI, MIT researchers identify a new class of antibiotic candidates

The new compounds can kill methicillin-resistant Staphylococcus aureus (MRSA) which causes 10,000 deaths per year in the US. Blog post from MIT:

In a study appearing today in Nature,,,

“The insight here was that we could see what was being learned by the models to make their predictions that certain molecules would make for good antibiotics.

https://news.mit.edu/2023/using-ai-mit-researchers-identify-antibiotic-candidates-1220

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Saul Dreier, 98-year-old founder of the Holocaust Survivor Band, plays at the

@WhiteHouse (and more).

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@Rainmaker1973  Dec 29
Croatia is known for its stunning beaches and crystal-clear waters, but it’s not just the scenery that makes it a popular tourist destination. Croatia is also one of the few countries in the world that has dog lifeguards.
Furry friends are patrolling the beaches of Croatia all summer long, helping to keep swimmers safe. These specially trained dogs are experts at water rescue, and they can even tow multiple swimmers to safety at once.
Dog lifeguards are typically large breeds of dogs, such as Newfoundlands, Golden Retrievers, and Labrador Retrievers. They are known for their strong swimming skills, their calm demeanor, and their gentle nature.
To become a dog lifeguard, dogs must undergo rigorous training. They learn how to swim in all types of water conditions, how to rescue swimmers in distress, and how to work with human lifeguards.
Image Image

Comic relief:

https://twitter.com/buitengebieden/status/1739206217199661122?s=20

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https://twitter.com/Yoda4ever/status/1739615803304235081?s=20

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https://twitter.com/buitengebieden/status/1739393830405738758?s=20

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https://twitter.com/buitengebieden/status/1739315816632558009?s=20

Perspective/Poem

"...despite being hit on the head w/the evidence for why, those we expect to lead & protect us have done next to nothing towards that end" "Without leadership, it’s so much more difficult to keep ourselves safe in an interconnected, busy & often densely packed world"   @MackayIM
From his excellent article/explainer, What is "Immunity Debt"?
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@luckytran  Dec 16
The CDC is warning that hospitals may have to ration care because of the winter virus surge. But it’s extraordinary to me that hospitals continue to refuse to require and provide N95 masks to prevent staff from getting sick (as well as to protect patients).
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Image

Bits of beauty:

Aracaris at Maquenque Lodge, Costa Rica

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