Coronavirus Tidbits #277, January 14, 2024


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.

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My latest:

Doctors Aren’t Prescribing Paxlovid Often Enough. Here’s Why

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Check out Field Team 6: MISSION:
Register Democrats.
Save the World.

I've just started text banking with them--they've automated much of it! Looking forward to exploring them further. They claim: Every $0.70 you donate helps us register one Democratic voter in a swing state. Compare that to the Obama re-elect campaign, who spent $150/voter.

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May be an image of text that says 'TLC: TREA TMENTS FOR LONG COVID SURVEY If you are a Long COVID patient, please consider participating in the CURE ID TLC survey. Your experience may help inform future research, identify promising treatments, or treatments that are ineffective or harmful.'

#FDA and #CURE-ID's #LongCovid treatment survey has launched!
There are many treatment surveys, but this one is special - the data will be used as evidence to help inform which drugs to study in clinical trials!
Please share!
They need several thousand case reports to create enough data.
Anyone in the world can submit cases.
Please send to every #LongCovid patient and clinician you know.
There are two links to submit reports:
For #LongCovid patients:


If you watch/share 1 thing today, make it this:

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COVID-19 survivors at higher risk for digestive diseases, study suggests

Adult COVID-19 survivors are at higher risk for digestive diseases, including gastrointestinal (GI) dysfunction, peptic ulcers, gastroesophageal reflux disease (GERD), gallbladder disease, nonalcoholic liver disease, and pancreatic disease—even among patients with mild infections, according to a study published yesterday in BMC Medicine.

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Nearly two thirds of Korean SARS-Cov-2 cohort had long COVID at 2 years

Two years after COVID-19 infection, 62.0% of a South Korean cohort still had symptoms such as fatigue, memory loss, and depression, finds a study published today in Scientific Reports.

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Covid can make you lose your hearing

Paul Simon unlikely to perform live again due to sudden hearing loss | he recently survived a severe bout of COVID-19, which has been linked to sudden irreversible hearing loss in some patients. May 2023

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Brain aging:

Covid can cause a reduction in grey matter and “ongoing brain damage” leading to cognitive decline the equivalent of 20 years ageing, new research with huge implications has just revealed”

Scores are compared to 2,927 matched normative community volunteers.

Cognitive deficits were associated with elevated brain injury biomarkers and reduced grey matter volume. The half-lives of the brain injury markers mean that this is objective evidence of *ongoing* brain injury one year after COVID-19. 4/n

Deficits were correlated with symptoms of depression and the anterior cingulate cortex volume, which has functional roles in connecting cognition, attention, and emotion 5/n

The severity of the initial infection, infection early in the pandemic, post-acute psychiatric symptoms and a history of encephalopathy were associated with greatest deficits. Importantly this means our findings don't generalised to COVID-19 today or mild respiratory disease 6/n

Treatment with corticosteroids during the acute phase appeared *protective* against post-acute cognitive deficits 7/n

There is growing biochemical evidence that neurological complications in COVID-19, including cognitive impairment, are immune-mediated which is corroborated here by clinical demonstration of the protective effect of acute treatment with corticosteroids 9/n

--thread by Greta Karen Wood  @gkwood3

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Benefit of eyeglasses in preventing infection

A total of 19,166 participants responded to the questionnaire, with 13,681 (71.3%, CI 70.7-72.0) reporting they wore eyeglasses. Multivariable logistic regression model showed a 15% lower odds of infection for those who reported using eyeglasses always for general use (odds ratio [OR] 0.85, 95% 0.77-0.95, P = 0.002) compared to those who never wore eyeglasses. The protective effect was reduced for those who said wearing eyeglasses interfered with mask-wearing and was absent for contact lens wearers.



@CDCgov estimates so far this season 14M people have been sick with flu, 150,000 hospitalized & 9,400 have died from flu. CDC is also estimating this season could see quite a bit of severe illness. (Pro tip: Vax is well matched this yr.)

RSV shown to infect nerve cells, cause inflammation and damage

Respiratory syncytial virus (RSV), a common infection in children and senior adults, can also infect nerve cells and trigger inflammation leading to nerve damage, according to a new Tulane University study.

RSV can cause mild symptoms such as coughing, sneezing and fever or lead to more severe conditions such as pneumonia or bronchiolitis. But since the disease was first discovered in 1956, it has been thought to only infect the respiratory tract.

This study, published in The Journal of Infectious Diseases, is the first to prove that RSV can penetrate nerve cells. It may provide the clearest link between RSV and reported neurological symptoms in children.


A new study showed that, during the Omicron era, viral load peaked (i.e., had low values in the graph below) on days 3-4. This is very different than the beginning of the pandemic when it peaked at the start of symptoms. (They also looked at the flu, which peaked on days 1-2.)

Why does this matter? You may not reliably test positive on a rapid antigen test until the third, fourth, or even fifth day of symptoms. This raises questions on how best to use tests, too, like with Paxlovid (which needs to be given within 5 days of symptoms) and isolation.

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Michael Mina:

COVID tests take longer to turn positive after symptoms start But nothing changed w test ability to detect new virus What changed is we have existing immunity —> makes symptoms start v fast after exposure before the virus grows up

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What are the recommendations for testing?

take a second Rapid Antigen Test (RAT) test 48 hours later. ...and another on Day 4...or get a PCR test.

Drugs and Vaccines:

Universal vaccine for Coronavirus? 

What if scientists had developed a universal coronavirus vaccine in the years prior to 2020 so that it was available at the start of the COVID-19 pandemic? A universal coronavirus vaccine targets parts of the virus that are common to either many or all coronaviruses, thereby offering some degree of protection against a range of strains.

"COVID-19 was the third major and serious coronavirus epidemic or pandemic following SARS in 2002 and MERS in 2012, thus, we should anticipate a fourth coronavirus outbreak within the next decade or so," says Peter J. Hotez, MD, Ph.D. "A universal vaccine is cost-effective and cost-saving and a priority for advancement."

The travesty of not funding Corbevax...

Note:  Texas Children’s Hospital and Baylor College of Medicine developed CORBEVAX, a protein sub-unit COVID-19 Vaccine, which is used in India.

Dubbed “The World’s COVID-19 Vaccine”, it uses a traditional recombinant protein-based technology that will enable its production at large scales making it widely accessible to inoculate the global population. The initial construct and production process of the vaccine antigen was developed at Texas Children’s Hospital CVD, led by co-directors Drs. Maria Elena Bottazzi and Peter Hotez.

Their vaccine is patent free, open science, with no proprietary technology.

The vaccine formula can be licensed by a vaccine producer in any low- or middle-income nation, which would then take ownership of it, produce it, name it and work with the government to get it to the people, Hotez said.

In 2020, the Houston team’s work was passed over for funding by Operation Warp Speed, Operation Warp Speed spent more than $12 billion in federal tax dollars to develop and distribute the vaccines launched by Pfizer, Moderna and Johnson & Johnson. The Corbevax formula is also not new — but unlike the mRNA shots, its recombinant protein technology has been in widespread use globally for decades.


Epidemiology/Infection control:

Transmission takes hours

New info: Transmission increased linearly by 1% chance per hour. Most transmission resulted from exposures lasting one hour to several days. Households accounted for 6% of contacts but 40% of transmissions.

Figure from Ferretti et al., 2023.. Nature. Source here.

Why does this matter? Transmission = time x proximity. This may help your risk calculations. Quick passersby at a grocery store are far less risky than staying in a house with someone infected.

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Tips, general reading for public:





Covid:  Masking:

US healthcare is so broken. It's the second-biggest COVID wave so far, and patients have to call individual hospitals to beg them to reinstate masks. Meanwhile, the Spanish government simply overruled right-wing anti-maskers and made masks required in all hospitals nationwide.
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California OSHA is nuts!
Cal-OSHA's new COVID isolation policy as of yesterday is utterly preposterous: "For COVID-19 cases with no symptoms, there is no infectious period for the purpose of isolation or exclusion." 60% of transmission is asymptomatic by this 2021 study:
CAL OSHA's new definitions
• “Infectious period” for the purpose of cases the Cal/OSHA COVID-19 Prevention Non-Emergency Standards, is now defined as: ○ For COVID-19 cases with symptoms, it is a minimum of 24 hours from the day of symptom onset:  COVID-19 cases may return if 24 hours have passed with no fever, without the use of fever-reducing medications, AND  Their symptoms are mild and improving. ○ For COVID-19 cases with no symptoms, there is no infectious period for the purpose of isolation or exclusion. If symptoms develop, the criteria above will apply.
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SCOTUS will hear Johnson v Grants Pass, a case about if homeless people can be punished for using things like pillow and blankets when sleeping outside if there are no safe shelters. This is the biggest SCOTUS case about homelessness in decades.

the Johnson v. Grants Pass case says that "unless everybody has access to shelter that meets their needs, they cannot be arrested, ticketed, or otherwise punished for sleeping outside."

whether officials can jail or fine homeless people for sleeping outside.

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Abortion training

"By allowing physician residents to come to California, where there are more opportunities for abortion training, and by allowing them to be reimbursed for this work, we're sending a message that abortion care is health care and an essential part of physician training,"
The question of how to provide complete OB-GYN training promises to become more urgent as the effects of abortion bans on  become clear: 18 states restrict or ban abortion to the point of effectively stripping 20% of OB-GYN medical residents of the opportunity to get abortion training,
The restrictions in some cases aim to reach beyond state borders, prohibiting residents from training out of state.
a Kansas law that requires repayment of state medical school scholarships—with 15% interest—if residents perform abortions or work in clinics that perform them, except in cases of rape, incest, or a medical emergency.
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Book bans:
A Florida school district has removed MerriamWebster's Dictionary for Students from library shelves, saying it may violate a law championed by Ron DeSantis
No, this is not a parody.
Escambia County School District, located in the Florida panhandle, has removed 3 dictionaries, 2 thesauruses, 8 encyclopedias, and 2800 other books saying they may violate HB 1069,   --- Judd LeGum
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Iowa grants gun permits to the blind
(old article, still impressive)
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Medicaid/Free lunches
NH:House Deputy Speaker Steven Smith, R-Charlestown, casts deciding vote, 189-188, to kill bill making low-income families automatically eligible for free and reduced lunch if they are on Medicaid (HB 601). #nhpolitics
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Gov. Greg Abbott’s effort to bus migrants to cities run by Democrats has already cost the state of Texas more than $100 million, a CBS News investigation found. A woman who worked on the inside is speaking out about why she will no longer participate.
Can you imagine if this money had been spent on Texas' school system? Its hospitals? Or its broken power grid? -- @RBReich
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Republicans have introduced legislation to eliminate vote-by-mail in Florida as we know it for nearly everyone, with narrow exceptions like for people with disabilities and folks living overseas. - SB 1572

Feel good du jour:

How opioid overdoses in public restrooms led an electrician to invent ‘safe bathrooms’
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Rangers discovered a one-year-old hippo, whom they have named Owen, alone and dehydrated near Kenya's Indian Ocean coast after he became separated from his herd in 2004. They took him to a wildlife sanctuary in Mombasa, where he soon found a male tortoise with the same dark grey coloring as adult hippos. The tortoise initially hissed at Owen, warning him to stay away, but according to park officials the pair have since become inseparable. The Aldabran tortoise, called Mzee, or "Old Man" in Swahili, now eats and sleeps beside Owen. Rangers say they could not have placed Owen with another herd of hippos as he would have been killed by an adult male. The park's tourism manager, Pauline Kimoto, told reporters: "Since Owen arrived on 27 December, the tortoise behaves like a mother to him. The hippo follows the tortoise around and licks his face."
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"I graduated High School this week.
When my dad said he had a present for me I thought I was getting some cheesy graduation card.
But what I received was something truly priceless.
Following the ceremony he handed me a bag with a copy of "Oh The Places You'll Go" by Doctor Seuss inside.
At first I just smiled and said that it meant a lot and that I loved that book.
But then he told me, 'No, open it up.'
On the first page I see a short paragraph written by none other than my kindergarten teacher. I start tearing up but I'm still confused.
He tells me, 'Every year, for the past 13 years, since the day you started kindergarten I've gotten every teacher, coach and principal to write a little something about you inside this book.'
"My early teachers mention my "pigtails and giggles" while my high school teachers mention my "wit and sharp thinking." But they all mention my humor and love for life.
It is astounding to receive something this moving, touching nostalgic and thoughtful."


Bits of beauty:

Sloth at Toucan Rescue Center

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