COVID news 2/25/22
COVID news 2/25/22
Hi all,
I am happy to finally report that COVID cases and hospitalizations have decreased significantly across the U.S. since the Omicron peak. We are in a much better place than a few weeks ago. Today, the CDC announced that mask use is optional in the 70% of U.S. counties where the COVID hospitalization and case rates have decreased to low or medium risk. In Santa Clara county, the mask mandate is expected to be dropped next week for vaccinated people as new COVID cases and hospital numbers are decreasing. Across the U.S., people will still need to wear masks on public transit, in airports and airplanes and in hospitals for now.
There are several articles this week exploring how Long COVID can exhaust the body even after a mild initial infection. When people have Long COVID, despite normal appearing scans, they can have a reduced ability to extract oxygen from the lungs, small fiber neuropathy that affects the autonomic nervous system and cognitive issues related to microglia immune cells in the brain. In addition, in some cases of Long COVID, post COVID fatigue may be related to neural dysregulation of the motor cortex pathways in the brain and a reduction of force output in the skeletal muscles. Fortunately, a new study from Switzerland shows that vaccinating people after a COVID infection may reduce the risk of Long COVID by 40%. This makes sense for those who have Long COVID because of a reservoir of virus in the body (in the gut for example) but it probably won't help those people who have Long COVID symptoms because of autoantibodies.
California employers and employees should note a new law giving up to an additional 80 hours of paid sick leave to people who have COVID or have been exposed to COVID or whose children can't go to school or daycare because of an exposure or illness.
The pandemic isn't over yet, but I am hopeful that the next few months will be a lot better.
Have a good weekend,
Ruth Ann
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Ruth Ann Crystal MD
Kangarobe™: https://kangarobe.com/
Twitter: https://twitter.com/CatchTheBaby
Ukraine
2/25/22 NPR: How to help the people of Ukraine https://buff.ly/3BOn10t
Doctors Without Borders https://www.msf.org/
Voices of Children https://voices.org.ua/en/
International Red Cross https://buff.ly/3M6eJWg
UN Refugee Org https://buff.ly/3Hn3ipF
From the Polish government’s website: https://www.gov.pl/web/mswia-en/information-for-refugees-from-ukraine
COVID News:
World
U.S.
U.S. Cases:
Fully Vaccinated (2 doses): https://www.nytimes.com/interactive/2020/us/covid-19-vaccine-doses.html
U.S. Boosted (note max on chart is 30%)
2/25/22 NPR: CDC says masks are now optional in places where hospitals are not under strain https://buff.ly/3plmzld
Nearly 70% of the U.S. population lives in areas considered to be low or medium risk and residents there are advised they can go indoors without masks.
2/25/22 USA Today: Yes, masks are still required on planes and at airports despite new CDC mask guidelines https://buff.ly/3M2dB6e
The federal mask mandate covering planes, airports, trains and other public transportation is in effect until at least March 18.
2/25/22 CDC MMWR (Alaska 2022): Day 5 to Day 9 testing of SARS-CoV-2 on antigen tests https://buff.ly/3sky91W
With Omicron infection, 54% of people are still infectious on day 5 as seen by positive antigen tests.
2/25/22 MedRxiV (UK): Risk of Long Covid in people infected with SARS-CoV-2 after two doses of a COVID-19 vaccine: community-based, matched cohort study https://buff.ly/3sivi9Q
3,090 double-vaccinated participants
COVID-19 vaccination is associated with 41% reduced risk of Long Covid. Longer follow-up is needed.
At 12 weeks post infection, Long Covid symptoms were reported by
9.5% of double-vaccinated participants compared with
14.6% of unvaccinated participants.
2/24/22 Palo Alto Online: Santa Clara County could drop mask mandate soon https://buff.ly/3t95hsL
The county has reached the first two metrics and is on the cusp of meeting the third. Nearly 85% of all residents have completed their single- or two-shot vaccine series. The number of residents who have also received booster shots is on the rise, currently at 68%, Dr. Cody said.
NEW LAW: California 2022 COVID-19 Supplemental Paid Sick Leave Signed into Law February 9, 2022 – retroactive to January 1, 2022. https://buff.ly/3LUBJYm
All California employers, public or private, with 26 or more employees.
California requires employers to provide eligible employees with up to 80 hours of COVID-19 Supplemental Paid Sick Leave for a variety of COVID-19-related purposes, including family care.
The policy is effective Feb. 22, 2022 (retroactive to Jan. 1, 2022), and will expire on Sept. 30, 2022.
2/24/22 AP: Oregon's COVID emergency declaration to be lifted in April 1st https://buff.ly/3BMfrU5
Oregon’s mask requirement for indoor public places and schools will be lifted on March 19.
2/24/22 AP: Florida's new coronavirus guidance: 'Buck the CDC' https://buff.ly/3BWmnxV
Florida Gov. DeSantis and state Surgeon General Joseph Ladapo announced new recommendations that discourage mask-wearing and push physicians to use off-label medications to treat the virus.
2/24/22 CDC: Some people should wait longer for 2nd COVID shot https://buff.ly/3t1a1k9
Research suggests that 12- to 64-year-olds, and especially males ages 12 to 39, benefit from spacing vaccine doses 8 weeks apart.
The original, 3 to 4 week interval is still recommended for people with weakened immune systems; people 65 and older; and anyone who needs fast protection due to risk of severe disease.
2/24/22 Nature Immunology: Fighting the SARS-CoV-2 pandemic requires a global approach to understanding the Heterogeneity of vaccine responses https://buff.ly/3HnHA4N
Comprehensive article on host genetic and environmental factors including age, biological sex, diet, geographical location, microbiome composition and metabolites that converge to influence innate and adaptive immune responses to vaccines.
Microbiome and metabolite compositions definitively shape host immune responses during vaccination. Mucosal immunity is affected by microbial dysbiosis and gut barrier integrity loss.
2/24/22 Reuters: Iceland to lift all COVID-19 restrictions on Friday https://buff.ly/3LUt6Nq
"As many people as possible need to be infected with the virus as the vaccines are not enough, even though they provide good protection against serious illness." Iceland's Ministry of Health
2/24/22 PNAS: The major genetic risk factor for severe COVID-19 is associated with protection against HIV https://buff.ly/3sgu4f6
The Neanderthal-derived chromosome 3 locus increases risk of severe Covid may decrease risk of HIV infection.
The risk-associated DNA segment modulates the expression of several chemokine receptors, among them CCR5, a coreceptor for HIV which is down-regulated in carriers of the COVID-19 risk haplotype.
2/24/22 Business Insider: Target stores no longer require employees and customers to wear masks as daily COVID-19 case numbers fall in the US https://buff.ly/3vgrLdN
Walmart lifted its mask requirement for vaccinated employees last week.
2/24/22 Journal of General Internal Medicine: Symptoms After COVID-19 Vaccination in Patients with Post-Acute Sequelae of SARS-CoV-2 https://buff.ly/36sQy44
n = 1596 patients with Long COVID in Geneva, Switzerland
Overall, 40% improvement of symptoms of Long Covid after 2-dose vaccination.
2/23/22 Nature: Will a rising Omicron variant scramble antibody treatments? https://buff.ly/3pcz0zD
BA.2 is resistant to Sotrovimab in vitro, but Vir says research suggests that Sotrovimab “retains neutralizing activity” against BA.2.
Regardless of Sotrovimab’s abilities, Bebtelovimab is active against both BA.1 and BA.2.
2/23/22 MedRxiV (Denmark): Omicron BA.1 infection followed by BA.2 reinfection is rare https://buff.ly/3JRhj0I
Reinfections with BA.2 after BA.1 infection were rare and caused mild disease mostly in young unvaccinated individuals.
2/23/22 NY Times: When People Take Pandemic Precautions, Gorillas Breathe Easier https://buff.ly/3t1l4K6
Closing the Volcanoes park in Rwanda to humans and then requiring humans to wear masks when it reopened has protected the mountain gorillas from Covid.
2/23/22 NY Times: How Long Covid Exhausts the Body https://buff.ly/3hcjSOA
Long Covid is often not explainable using conventional lab tests.
10 to 30% of people infected may develop Long COVID symptoms
A patient with autoantibodies might benefit from immunosuppressive medication, while a patient with remnants of the Covid virus should receive antivirals.
Despite having apparently normal hearts and lungs, they have a reduced ability to extract oxygen from blood vessels.
Small fiber neuropathy seen in skin biopsies is caused by chronic inflammation of nerve fibers that help control circulation. This is associated with dysautonomia, a malfunction of automatic functions like heart rate, breathing and digestion.
Microscopic blood clots.
Possible mitochondrial damage related to increased cytokines.
Cognitive impairments may be from the over-activation of immune cells called microglia in a way that appears similar to the process that can contribute to cognitive problems in aging and some neurodegenerative diseases.
2/23/22 MedRxiV (Newcastle): Neural Dysregulation in Post-Covid Fatigue (pCF) https://buff.ly/3t3JN0h
In comparison to age and gender matched volunteers without fatigue, 37 people with fatigue from Long COVID after mild infection show
underactivity in specific cortical circuits (motor cortex in brain),
dysregulation of autonomic nervous system function
myopathic change in skeletal muscles.
During prolonged maximal contraction, we found pCF subjects had an increased level of peripheral fatigue which suggests that pCF produces metabolic changes in muscle fibres leading to reduced force output after prolonged activity.
2/23/22 LA Times Op-Ed by Eric Topol MD: The pandemic isn't over. Omicron won't be the last coronavirus variant to haunt us. https://buff.ly/3h0SlzB
The virus can evolve and mutate in immunocompromised people (>7 million in the U.S. alone) and in animal hosts.
We rank 67th in the world for being “fully vaccinated” (2 doses) and 54th for the booster shot that preserves a high level of protection against hospitalizations and deaths.
So far, it does not look like BA.2 poses a threat as a major new variant.
The good news is that we’re probably moving to a relatively quiescent phase, with low numbers of cases and limited severe disease, representing containment of the virus. That is not the same as the pandemic being over and we need to be vigilant.
2/23/22 JAMA: Risk of Second Allergic Reaction to SARS-CoV-2 Vaccines: A Systematic Review and Meta-analysis https://buff.ly/3semqSk
There was a low incidence (0.16%) of immediate severe allergic reactions associated with receiving a second dose of SARS-CoV-2 mRNA vaccine among individuals who had an immediate allergic reaction to their first dose.
2/23/22 BioRxiV (Japan): Virological characteristics of SARS-CoV-2 BA.2 variant https://buff.ly/35lqM12
These in vitro and in animal studies show that BA.2 is more pathogenic than BA.1 in hamsters (but this hasn't been shown in humans.)
2/21/22 BBC: UK Covid boosters: Who is being offered a fourth dose? https://buff.ly/3h1ZcZq
A second booster will be offered 6 months after the previous jab to:
adults aged 75+
residents in care homes
people aged 12+ who are immunosuppressed
2/21/22 BBC: Covid: England ending isolation laws and mass free testing https://buff.ly/3p7Btvs
All Covid restrictions will end in England on Thursday 24 Feb. and free mass testing will stop from 1 April in the "Living with COVID" plan.
2/21/22 AP: Surgeon General Vivek Murthy announced Friday that he and his young family have COVID-19 despite their best efforts to avoid infection by getting vaccinated and taking other precautions. https://buff.ly/3IaoIHY
2/21/22 Guardian: Why one-shot after a Covid-19 infection should suffice to be considered fully-vaxxed | Eric Topol https://buff.ly/3p8ppKf
2/21/22 AP: Estimated 73% of US now immune to Omicron: Is that enough? https://buff.ly/3h12j3M
We don’t know how long immunity will last. It is best to be vaccinated and boosted.
There is variability in immunity to Omicron across the U.S.
2/21/22 BMJ: Oral famotidine versus placebo in non-hospitalised patients with COVID-19: a randomised, double-blind, data-intense, phase 2 clinical trial https://buff.ly/3GJ9KXF
Symptomatic unvaccinated adult outpatients with confirmed COVID-19 between January 2021 and April 2021.
80 mg famotidine (n=28) or placebo (n=27) orally three times a day for 14 days.
50% reduction of overall baseline symptom scores:
8.2 days for famotidine
11.4 days for placebo.
Time to symptom resolution was not statistically improved (p=0.4).
2/18/22 From the COVID Data Tracker https://buff.ly/3o9MsUP
Reduction of hospitalization for all age groups for 2 doses plus booster as compared to unvaccinated people.
2/20/22 FT Covid-19 vaccine tracker: the global race to vaccinate https://buff.ly/35beuZ2
Only 63.9% of Americans have received 2 doses of vaccine and only 28% have received the booster.
2/20/22 WSJ: As Omicron Surged, Non-Covid-19 Patients Contracted Virus in Hospitals in Higher Numbers https://buff.ly/3gUwUA7
Increased nosocomial COVID infections coincided with the CDC telling healthcare workers to isolate for only 5 days after testing positive for COVID. Also, Omicron is much more transmissible.
Look at the Denmark curve which is an outlier compared to other countries
2/19/22 Raven the Science Maven’s tweet thread on how she is disabled from Long COVID and has to use a walker now.
