Coronavirus Tidbits #276, January 7, 2024

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.

It's hard getting settled back into work. Our trip to Costa Rica was a dream of mine; more and better pics are now posted at bugdoc.smugmug.com/Travel/Costa-Rica-1/

Given what is going on with the Supremes and in the world, it's clearly more important than ever that we work to defeat the GOP and protect democracy. There are so many ways you can help, from GOTV, to supporting various grassroot efforts, to phone banking, etc. Strongly suggest checking out NOPE Neighbors for direction and opportunities. https://nopeneighbors.org/ I've done a lot of work with/through them. Highly recommend.

News 

Covid-19 levels in wastewater, a leading measure of viral transmission, are very high nationally

– higher than they were at this time last year in every region, CDC data shows. Weekly emergency department visits rose 12%, and hospitalizations jumped about 17% in the most recent week.

flu-like activity is high or very high in two-thirds of the United States, including California, New York City and Washington,

Just 19% of adults and 8% of children have gotten the latest Covid-19 vaccine, and 17% of adults 60 and older have gotten the new RSV vaccine,

https://www.cnn.com/2024/01/01/health/virus-season-rising-levels-flu-covid-rsv/index.html

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Mike Hoerger: we are now unequivocally in the 2nd largest #surge of the U.S. #pandemic with 4% (1 in 25 people) actively infectious as of Dec 30. In some counties, over 1 in 10 people are infectious.

The regional #wastewater graph shows 7.25% (1 in 14 people) actively infectious with #Covid in the Northeast as of Dec 30.

Biobot regional graph, last 6 months, highest peak in the Northeast

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New COVID vaccine induces good antibody response to mutated viral variants

...the updated COVID-19 vaccine gives a 10-fold increase in antibodies against not only XBB but also newer and more mutated strains, such as BA.2.86--the new vaccine also provides cross-protection against the new variants.

https://medicalxpress.com/news/2023-12-covid-vaccine-good-antibody-response.html?

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@EricTopol
Beyond avoiding Covid infections altogether, the next best way to prevent LongCovid is through vaccinations, reduced ~70% by recent reports and a meta-analysis of 24 studies (Figure) scientificamerican.com/article/vaccin
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Experimental drug that alters gut microbiome shows promise for long COVID relief

A randomized controlled trial in Hong Kong finds that the synbiotic drug SIM01 relieves multiple symptoms of long COVID, or post-acute COVID-19 syndrome (PACS).

https://medicalxpress.com/news/2023-12-experimental-drug-gut-microbiome-covid.html?

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Muscle abnormalities worsen after post-exertional malaise in long COVID

We find a skeletal muscle alterations in patients with #longcovid, which worsen with exercise.

we confirmed the lower exercise capacity in patients with #longcovid, which can partly be explained by changes in skeletal muscle structure and function 2/n

We next wanted to find out if skeletal muscle abnormalities contribute to the feeling of muscle pain, and fatigue one day after an exercise test on a bike. We found that in some #longcovid patients there was extensive muscle damage, but also signs of repair

Skeletal muscle mitochondrial function and metabolism were altered in patients with #longcovid, and this worsened after induction of post-exertional malaise (PEM). Intense exercise is not good for patients with long COVID!

Blocking of capillaries by amyloid-containing deposits (or microclots) could reduced exercise capacity. We found these deposits in muscle tissue, but surprisingly not inside capillaries. They were located in between fibers, were higher in patients, and went up after exercise

We tested whether viral persistence contribute, and screened muscle biopsies for the N-protein. We saw equal amounts in patients and healthy controls (who recovered after COVID). No viral particles were inside cells, so we assume remnants and not active viral particles

This study contributed to our understanding of muscle pain, fatigue and weakness in patients, and provides a biological substrate for the disease. It doesn’t directly point to the cause of the disease, but highlights that exercise can worsen symptoms in patients

To reduce the skeletal muscle abnormalities (reduction in mitochondrial function, muscle damage and more microclots), we can only recommend to avoid strenuous exercise for now. Every patient likely has a different threshold for induction of post-exertional malaise.

--Rob Wüst  @RobWust

https://www.nature.com/articles/s41467-023-44432-3

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Some hospitals reinstating mask requirements amid rise in COVID

As COVID-19 and other respiratory infections rise across the country, some major health systems are bringing back mask requirements to stop the spread of infections.

This week, Mass General Brigham, the largest health system in Massachusetts, said it will require masking for health care staff who interact directly with patients in clinical care locations starting Jan. 2.

Patients and visitors will be “strongly encouraged” to wear a facility-issued mask. Masks will not be required for staff in hallways and common areas.

[JS: How does this make sense? Covid is airborne. So not masking in hallways, nurses stations, waiting rooms, etc., makes ZERO sense...Pity they are setting standards for the rest of the country. Also, using surgical masks, and not N95s.

And their policy is still that HCWs can refuse to mask, even if a vulnerable patient requests it]

The health system in a statement said its policy is based on the percentage of patients presenting to emergency departments or outpatient clinics with symptoms of respiratory illness.

Once this figure exceeded 2.85 percent for two consecutive weeks, the masking requirement took effect. It will end once the level falls below 2.85 percent for a week.

https://thehill.com/policy/healthcare/4380733-hospitals-reinstating-mask-requirements-rise-covid/

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Pets and Covid

Canadian government recommends that if you have Covid symptoms and want to be around your pet, you should use an N95. The recommendations say to only use a surgical mask if N95s aren’t available.

https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/prevention-risks/animals-covid-19.html

Diagnostics:

Ongoing brain injury caused by COVID-19 may not always be detected by routine tests

A new study details that markers of brain injury are present in the blood many months after COVID-19 infection, despite inflammation blood tests being normal. The full paper, "Para-infectious brain injury in COVID-19 persists at follow-up despite attenuated cytokine and autoantibody responses," is available in Nature Communications

https://medicalxpress.com/news/2023-12-ongoing-brain-injury-covid-routine.html?

Drugs and Vaccines:

Paxlovid does not reduce the risk of long Covid for vaccinated, non-hospitalized people

getting Covid for the 1st time. Another finding: "a higher proportion of individuals with acute symptoms rebound and test-positivity than previously reported." onlinelibrary.wiley.com/doi/10.1002/jm
Paxlovid treatment for acute COVID-19 has been shown to be effective for high-risk unvaccinated individuals.
Also, rebound occurred in 26% of those who took Paxlovid
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Less than a third of high-risk COVID outpatients prescribed antivirals

In total, 31.9% of patients were prescribed a COVID-19 antiviral, the most common of which was Paxlovid (87.6%), followed by molnupiravir (11.9%) and remdesivir (0.5%). The vast majority of patients were given their prescription on either the day they tested positive (30.3%) or the day after (56.3%).

The prescribing rate rose slightly over time, from 28.0% in 2022 to 34.6% in 2023.

https://www.cidrap.umn.edu/covid-19/less-third-high-risk-covid-outpatients-prescribed-antivirals-study-finds

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Paul Offit Debunks Florida Surgeon General's Anti-Vax Warning

https://www.medpagetoday.com/infectiousdisease/covid19vaccine/108145?

[JS: Florida's Ladapo has a bunch of crazy ideas. Please do not take anything he says seriously]

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Pfizer:

Devices:

@vipintukur

Infrared thermometers for fever screening during COVID-19: Largely futile!

An extensive non-contact infrared thermometers (NCITs) screenings failed to detect fever among 736 HCWs, serology identified 229 HCWs with prior COVID-19 exposure, underscoring the futility of NCIT. 1/
 In this study cohort of 736 HCWs, 44,836 NCIT screenings revealed no fever cases. The serological analysis identified prior COVID-19 exposure in 229 HCWs. Additionally, 68 symptomatic HCWs tested COVID-19 positive through RT-PCR,
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NYC DOH does it right:
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Measles Outbreak: Canada
An infant arrives at Children’s Hospital of Philadelphia with a fever. Two days later, while hospitalized, develops a rash. It’s measles. An unvaccinated family is fffin the next room. The child and parent get sick. How a cluster starts —>'ghttps://archive.ph/flVHo/again?url= f

Epidemiology/Infection control:

Duration of exposure to individuals with COVID-19 contact increases the risk of infection more so than proximity.

Short exposures demonstrated a linear growth in the probability of reported transmission at a rate of 1.1% per hour.

"Digital measurement of SARS-CoV-2 transmission risk from 7 million contacts," published in Nature

https://medicalxpress.com/news/2023-12-tracking-sars-cov-app-insights-proximity.html?

Nature (2023). DOI: 10.1038/s41586-023-06952-2

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Many US nursing home residents have not been vaccinated for flu, COVID-19, or RSV for 2023–24

Many nursing home residents and adults have not been vaccinated for influenza, COVID-19, or respiratory syncytial virus (RSV) for the 2023 to 2024 season, according to research published in the Dec. 22 issue of the U.S. Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report

https://medicalxpress.com/news/2023-12-nursing-home-residents-vaccinated-flu.html?

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Tips, general reading for public:

Vax

Mask

Ventilate

Politics:

@chantz_y
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23andMe was hacked with the profile data of Ashkenazi Jews specifically targeted in the breach. According to emails sent to customers today from 23andMe, the data that was hacked included: ancestry, Family Tree, display name, relationship labels, self-reported location (city/zip code), and birth year.
The date of the 23andMe cyber attack predates the October 7 massacre in Israel.
The data breach affected HALF of 23andMe customers -- 6.9 Million users. 23andMe has moved to transfer the growing number of lawsuits to California. The lawsuits reveal that the following list of information was exposed in the hack: -Names -Email addresses -Dates of birth -Gender -Profile photos -Geographic locations -DNA Relatives information -Family Tree information engadget.com/23andme-hack-n
    @MarinaMedvin
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Wisconsin protects mail-in ballots:
Wisconsin court rules that that any witness address information on the ballot certificate that’s enough to identify a location where they can be reached is sufficient.
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TFG/GOP
New documents show Donald received up to $7.8 million dollars from foreign governments when he was in the White House. Here are the details and the breakdown: -China made the largest payments to Donald’s businesses during his tenure, spending more than $5.5 million at Trump Tower in New York and two of Donald’s hotels in Washington and Las Vegas. Millions of dollars came directly from China’s Embassy in the U.S and a state-owned Chinese bank accused by the DOJ of helping North Korea evade sanctions. - Donald also received over $2 million from corrupt and authoritarian governments including Saudi Arabia and Qatar - MaryLTrump
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Trump regarding SCOTUS: “All I want is fair. I fought really hard to get 3 very, very good people in. They're great people, very smart people. And I just hope they're going to be fair because you know, the other side plays the ref.” He is daring Barrett, Gorsuch and Kavanaugh to uphold the Colorado decision to remove him from the ballot. Trump is telling them to choose him over the Constitution....
And then...Brett Kavanaugh, the US supreme court justice, will “step up” for Donald Trump and help defeat attempts to remove the former president from the ballots in Colorado and Maine for inciting an insurrection, a Trump lawyer said.
“I think it should be a slam dunk in the supreme court,” Alina Habba told Fox News on Thursday night. “I have faith in them. “You know, people like Kavanaugh, who the president fought for, who the president went through hell to get into place, he’ll step up.
Texas/immigrants:
@JuddLegum

1. Something that should be getting a lot more attention:

@GovAbbott is flying hundreds of migrants out of Texas and dropping them off in the Chicago suburbs in January Some have no coats and are wearing flip flips It is a gross violation of human rights
Abbott says that he is transporting migrants to "sanctuary cities" as punishment for the cities' permissive policies But this isn't a matter of enforcing immigration law Nearly all the migrants being used as pawns by Abbott are in the US LEGALLY
One approach to deterring migrants is ignoring human rights and making the ordeal as traumatic as possible. That appears to be Abbott's strategy. But it is not the law.
The Refugee Act of 1980, which passed Congress unanimously, gives migrants inside the U.S. the right to claim asylum based on "a well-founded fear of persecution on account of race, religion, nationality, membership in a particular social group, or political opinion."
The Refugee Act of 1980 was enacted "in part to make amends for the country’s shameful refusal to accept Jewish refugees during the Holocaust." How will history look back at our treatment of migrants today?...

Feel good du jour:

Massimo: @Rainmaker1973 
This is Mr. Pickles, a critically endangered species of tortoise at the Houston Zoo, who finally became a father at the age of 90 earlier this year. He and his partner, Mrs. Pickles, welcomed three tortoise hatchlings: Dill, Gherkin and Jalapeño. Radiated tortoises are a critically endangered species, and Mr. Pickles is considered the most genetically valuable radiated tortoise in the Association of Zoos and Aquariums' Species Survival Plan. They are native to Madagascar and are known for their beautiful shells, which are adorned with a unique starburst pattern. Unfortunately, their numbers in the wild have been declining due to habitat loss and poaching. The species is also threatened by the illegal pet trade, as radiated tortoises are often captured and sold as exotic pets.
Image
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Comic relief:

https://twitter.com/buitengebieden/status/1741715887995175237?s=20

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Perspective/Poem

Bits of beauty:

 

Manuel Antonio, Costa Rica; view from La Mariposa Hotel.

 

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