COVID news & more 12/30/23

We are presently in what appears to be the second largest COVID wave of the entire pandemic. There are several reasons for this.

1. JN.1 is a descendant of BA.2.86 (Pirola) which has more than 40 new mutations making it very different from the variants to which we have immunity.

2. No one seems to care any more about COVID. People feel that they already have had COVID infections and that they are protected by previous vaccinations against COVID, so most people are not worrying about COVID this year. 

The media and governments have not been warning people that it can be dangerous to get multiple COVID infections, but it really can. Data from Dr. Al-Aly in the U.S. and recent data from Canada both show that each additional COVID infection increases the risk of getting Long COVID. My family member has Long COVID and I can tell you that you don’t want to get it. Long COVID can be disabling and absolutely miserable.

Plus, each COVID infection can also increase your risk of chronic diseases like diabetes, heart attacks and other cardiovascular diseases, strokes and other chronic conditions.

3. You need the updated XBB.1.5 vaccine to be better protected against JN.1. A new study this week from Kaiser Permanente of Southern California and Pfizer shows that prior vaccinations do nothing to protect you against hospitalization with JN.1; only the updated XBB.1.5 vaccine does. The new vaccine protects about 60% against outpatient visits, Emergency department visits, and hospitalizations for the COVID infections from the latest variants. 

4. It is the winter and it is holiday time so many people will be getting together indoors together without masks and without extra ventilation. Indoor contact without masks increases the risk of getting COVID, especially with a transmissible variant like JN.1.

So, there are many reasons for us to see a large wave of COVID infections now. As of December 25th, Michael Hoerger’s modeling using wastewater SARS-CoV-2 virus levels shows that there are now 1,655,000 new COVID cases each day and that between 81,000 and 330,000 people every day will end up getting Long COVID from these infections. Some of those people will become completely disabled and will not be able to work again. Their family members may have to reduce their work hours to take care of them. These factors can take a toll on a country’s economy, in addition to causing personal misery. By January 10th, there may be close to 2 million new cases of COVID each day in the United States. 

Overall, JN.1 represents 44% of infections currently in the United States. In the most recent week, test positivity increased to 12.7%, Emergency Department visits for COVID infections are up 12%, COVID hospitalizations are up 16.7% and deaths have increased by 10%. But, the stress on Emergency Departments and hospitals is not only from COVID infections, as influenza and RSV infections are still high too. In Italy, this is putting a large strain on hospitals. 

The CDC reports that nationally, wastewater monitoring of SARS-CoV-2 is now “VERY HIGH” with the highest wastewater viral levels shifting from the northeast to the midwest. Currently, at least every 1 in 29 people in the U.S. is infected with COVID now as seen by wastewater virus levels. In the UK, cases are measured by testing people on a population level and this shows that in England, 1 in 24 people is currently infected and in London, 1 in 17 people have a COVID infection now. It is really important to wear an N95 or KN95 mask now when indoors with others.  

This week, the County of Los Angeles warned its residents to protect themselves against an increase of COVID infections and hospitalizations. San Jose, California is seeing its 3rd highest wave of infection during the entire SARS-CoV-2 pandemic as seen by current wastewater levels. Clinical professor emeritus John Swartzberg warned that “On top of that, acute illness isn’t the only thing to worry about. For some people, the lingering effects of an infection can be debilitating. “Be sure to throw into your calculus the issue of long-COVID,” he said."

Antiviral medication Paxlovid (Nirmatrelvir/Ritonavir) can reduce hospitalizations for acute COVID infections and it can reduce the risk of getting Long COVID by about 24%. Unfortunately, few eligible Americans are taking Paxlovid when they get a COVID infection. Only 25% of all eligible adults and about 30% of adults age 65 and over have filled prescriptions for Paxlovid when infected. "There are a number of factors that may contribute to low antiviral uptake among those [infected] including low awareness of antivirals, healthcare disparities, and barriers to healthcare and prescription access." In New York City, a recent study showed that 44% of adults did not know that antiviral treatments existed. Eligible adults who test positive for COVID-19 or for the flu can get a prescription for an antiviral medication (Paxlovid for COVID, Tamiflu for Influenza) for free with the NIH-funded program called “Test to Treat”. See test2treat.org for more information about this free service. 

Long COVID

An interesting retrospective case series came out this week showing that both myalgic encephalomyelitis/ chronic fatigue syndrome (ME/CFS) and Long COVID are characterized by dysfunctional CD8 T-cells that do not make enough IFNγ and TNFα. The study looked at 12 ME/CFS and 8 Long COVID patients, compared to 10 healthy controls (HC). Authors suggest that CD8 T-cell dysfunction (low IFNγ and TNFα production) could be used as a biomarker for ME/CFS and Long COVID and could be used to track success of a therapy. This study had a conflict of interest in that they also treated the ME/CFS and Long COVID patients with a nebulized drug called Inspiritol which is made by two of the authors. The Inspiritol nebulizer treatments reversed the CD8 T cell dysfunction and significantly improved IFNγ and TNFα production. Inspiritol is a nebulized solution containing glutathione and methylcobalamin, N-acetylcysteine, a plant extract containing 1,8-cineole and β-caryophyllene. It is not yet FDA approved, but this small study looks promising.

Fig. 1. Dysfunction of CD8 T cells in Long COVID & ME/CFS patients compared to HC. (stim = stimulation with PMA (Phorbol-12-myristate-13-acetate))

An article in Scientific American discusses vagus nerve stimulators and how they may help some Long COVID symptoms. The vagus nerve is part of the autonomic nervous system that controls the function of internal organs. It controls body functions that are automatic and are done unconsciously such as breathing and digestion. A study from July 2023 showed that in post-mortem specimens from people who had a COVID infection, the vagus nerve was infected by SARS-CoV-2 and this was associated with a strong inflammatory response in neurons, endothelial cells lining the blood vessels and in Schwann cells. Stimulating the vagus nerve with a small electric device can trigger the parasympathetic nervous system to slow down heart rate and calm the body.

The RECOVER Initiative will be sponsoring 5 Long COVID clinical trials. The first 2 trials are currently recruiting people with Long COVID. I discussed RECOVER-VITAL last week. This study will compare giving the antiviral Paxlovid to people with Long COVID for either 25 days, 15 days or 0 days (placebo). The RECOVER-NEURO study will compare BrainHQ (an online brain training program) to PASC-CoRE (online virtual staff to help people with Long COVID plan goals, learn skills for focus and manage mental tiredness). The study will also look at transcranial direct current stimulation (tDCS) which is a noninvasive form of brain stimulation.

Three additional clinical trials from RECOVER that are not recruiting yet will look at sleep interventions, the autonomic nervous system with a focus initially on postural orthostatic tachycardia syndrome (POTS), and a study on exercise intolerance and fatigue in people with Long COVID.

Regarding exercise intolerance in people with Long COVID, Yale reports that they studied exercise intolerance the invasive cardiopulmonary exercise test (iCPET) where pressure sensing catheters are placed in the pulmonary artery and the radial artery of the wrist while Long COVID patients exercised. The authors found “that despite the fact that the heart was pumping oxygenated blood that the lungs were providing adequate amounts of oxygen for, the extraction of oxygen by the body’s tissues was compromised in patients who had symptoms of exercise intolerance after COVID.” They concluded that it is not deconditioning or a lack of physical exercise that causes Long COVID exercise intolerance, but rather it is an abnormality of oxygen extraction by the tissues in the body. The majority of PASC patients in this study (75%) exhibited a primary peripheral limitation to exercise with a low peak systemic oxygen extraction (pEO2) during iCPET in conjunction with supranormal cardiac output. Some Long COVID patients showed a distinct type of Heart Failure with Preserved Ejection Fraction (HFpEF) which was unexpected.

This reminded me of two other studies on exercise intolerance in Long COVID. A study from Italy showed that exercise tolerance in PASC (Long COVID) is mainly peripheral in the skeletal muscles and not caused by central causes in the respiratory or cardiac systems. The peripheral skeletal muscles had “lower fractional oxygen extraction and impaired muscle oxidative capacity, substantial reductions in biomarkers of mitochondrial function and content, and overall reduced mitochondrial sensitivity to [ADP].”

A small study from Germany shows that Long COVID exercise intolerance is associated with fewer capillaries, thicker capillary basement membranes and increased numbers of CD169+ macrophages in the skeletal muscles of people with Long COVID. These changes in the microvasculature of muscles could lead to poor oxygen extraction which could cause exercise intolerance, fatigue and post-exertional malaise. Other skeletal muscle abnormalities in Long COVID including amyloid deposits, an increase in glycolytic fibers and lower mitochondrial respiration have been reported by Rob Wust’s lab as well.

Regarding the brain, a group from the UK found that markers of brain injury, particularly neuroglial injury, can be seen in patients who had COVID infection both in the acute setting and months later. This "study shows that markers of brain injury are present in the blood months after COVID-19, and particularly in those who have had a COVID-19-induced brain complication (e.g. inflammation, or stroke), despite resolution of the inflammatory response in the blood. This suggests the possibility of ongoing inflammation and injury inside the brain itself which may not be detected by blood tests for inflammation,” said Professor Michael. Although blood levels of serum inflammatory proteins (cytokines) and antibodies had normalized, brain (neuroglial) injury proteins were still elevated in some cases.

Looking at healthcare utilization, the OpenSAFELY study in the UK found that "Long COVID increases healthcare utilization and costs. Public health policies should allocate more resources towards preventing, treating, and supporting individuals with long COVID." People with Long COVID cost the NHS two-thirds more than people without Long COVID with more visits to the General Practitioner, more prescription costs, as well as more emergency room and hospital visits. Preventing Long COVID could reduce healthcare costs.

An article from Australia entitled “Long COVID will take your health, your wealth — then it will come for your marriage” looked at what Dr. David Putrino calls “the looming social impact of long COVID. He said, "I'm talking about the workforce being diminished, the fact that people can't think the way they used to think — we're losing intellectual capital, we're losing physical capital, we're losing social capital." "There's this shared fantasy that Long COVID is someone else's problem, and I just think we need people to understand that it's [Long COVID is] everyone's problem." 

In non-COVID news, high blood pressure in pregnancy can affect heart structure and function years later. When private equity firms buy hospitals, serious medical errors increased. The FDA warns that fake Ozempic shots are being sold and they can be dangerous. The president of Mexico introduced a new centralized 'super pharmacy' to supply medicines to the entire country. CNN has a 2023 Good News generator where I learned about Eldera, an online platform that uses an AI algorithm to help baby boomers find kids who need a mentor.

Have a great holiday weekend and Happy New Year!

Ruth Ann Crystal MD

COVID news:

US Variant tracker: https://covid.cdc.gov/covid-data-tracker/#variant-proportions

Variants in locations around the globe: https://outbreak.info/

CDC COVID data tracker: https://covid.cdc.gov/covid-data-tracker/index.html#datatracker-home

CDC COVID Hospitalizations (blue) and Emergency Room (orange) visits tracker: https://covid.cdc.gov/covid-data-tracker/index.html#trends_weeklyhospitaladmissions_7dayeddiagnosed_00

Weekly ED visits for respiratory illnesses, by age and disease: https://www.cdc.gov/ncird/surveillance/respiratory-illnesses/index.html

US SARS-CoV-2 Wastewater Monitoring:

CDC COVID wastewater reporting: https://www.cdc.gov/nwss/rv/COVID19-nationaltrend.html

CDC wastewater map: https://www.cdc.gov/nwss/rv/COVID19-currentlevels.html

Biobot: https://biobot.io/data/

Wastewater SCAN: https://data.wastewaterscan.org/

  California statewide view https://buff.ly/3YObiul

Sewer Coronavirus Alert Network (SCAN) project by Stanford University: 

Santa Clara County wastewater: https://covid19.sccgov.org/dashboard-wastewater

County of Los Angeles press release 12/28/23: Continued Increases In COVID-19 Transmission, Hospitalizations Indicate Need for Common-Sense Protections Against Infection https://buff.ly/3NIut4i

CDC Respiratory vaccination trends: https://www.cdc.gov/respiratory-viruses/data-research/dashboard/vaccination-trends-adults.html

JP Weiland: https://twitter.com/JPWeiland

Michael Hoerger modeling:  http://pmc19.com/data/

https://twitter.com/michael_hoerger

Variants 

JN.1 

12/28/23 Mercury News: New Year’s risk? San Jose experiencing 3rd highest COVID wave right now, wastewater shows https://buff.ly/48g16yv

• “On top of that, acute illness isn’t the only thing to worry about, Swartzberg said. For some people, the lingering effects of an infection can be debilitating.

• “Be sure to throw into your calculus the issue of long-COVID,” he said.

• John Swartzberg, a clinical professor emeritus of infectious diseases and vaccinology at UC Berkeley’s School of Public Health. 

World- Hospitals inundated with COVID and Flu hospitalizations in Italy.

Vaccines

12/28/23 MedRxiV (Kaiser Permanente So Cal and Pfizer): BNT162b2 XBB1.5-adapted Vaccine and COVID-19 Hospital Admissions and Ambulatory Visits in US Adults https://buff.ly/47dCcyd

• 4232 COVID cases and 19,775 controls at Kaiser Permanente in Southern California

• Those who received the XBB.1.5 updated Pfizer vaccine had:

  • 63% reduction of hospitalization

  • 58% reduction of Emergency department visits

  • 58% reduction of outpatient visits for COVID infection

• (1) XBB1.5-adapted vaccines provided significant additional protection against a range of COVID-19 outcomes and 

• (2) older versions of COVID-19 vaccines offered little, if any, additional protection, including against hospital admission, regardless of the number or type of prior doses received.

12/22/23 PNAS: Infectious virus shedding duration reflects secretory IgA antibody response latency after SARS-CoV-2 infection https://buff.ly/3RZtBuw

• Anti-spike secretory IgA in the mucosa of the nose, mouth, throat and lungs is very important to reduce viral shedding which, in turn, reduces transmission of the virus to other people.

Antiviral treatments

12/27/23 CIDRAP: COVID antiviral (Paxlovid and Molnupiravir) uptake low among eligible Americans https://buff.ly/3NKcASR

• COVID infections in 2021 to 2022 in vaccinated adults.

• Over time, prescriptions for antiviral Paxlovid increased to only 25% of eligible adults and about 30% in adults over age 65.

• "There are a number of factors that may contribute to low antiviral uptake among those including low awareness of antivirals, healthcare disparities, and barriers to healthcare and prescription access," said the authors.

• "A population-representative study in NYC found that 44% of adults were unaware of antivirals." 

Long COVID

12/27/23 Brain, Behavior and Immunity- Health: Identification of CD8 T-cell dysfunction associated with symptoms in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and Long COVID and treatment with a nebulized antioxidant/anti-pathogen agent in a retrospective case series https://buff.ly/48gXlsI

• 12 ME/CFS and 8 Long COVID patients, compared to 10 healthy controls (HC).

• Highlights:

  • Both Long COVID and ME/CFS are characterized by dysfunctional CD8 T-cells that are unable to make enough IFNγ and TNFα.

  • In a small Long COVID and ME/CFS case series, patients' immune deficiency and health improve during treatment period with a neubilzed antioxidant, anti-pathogen and immune-modulatory pharmacological agent.

  • This work provides evidence of a useful biomarker, CD8 T-cell dysfunction reminiscent of T cell exhaustion, that may assist diagnosis and have utility for tracking disease outcome during therapy, including response to a potential new treatment.

• Inspiritol:This nebulized agent consists of five ingredients previously reported individually to relieve oxidative stress, attenuate NF-κB signaling, and/or to act directly to inhibit pathogens, including viruses. 

• Inspiritol, is a proprietary nebulized, sterile isotonic pH-balanced liquid suspension with 

  • two endogenously produced compounds (glutathione and methylcobalamin); 

  • one repurposed prescription drug that is a pro-drug to an endogenously produced amino acid (N-acetylcysteine); 

  • one plant extract monoterpene cyclic ether (1,8-cineole) and 

  • one natural bicyclic sesquiterpene (β-caryophyllene), 

  • in a proprietary liquid carrier. 

  • These five compounds are present in low concentrations (i.e., total of 8.1% (w/w)) in a 90.9% (w/w) saline solution with a DMF-listed emulsifier.

  • nebulized treatment was 5.0 mL TID, taken morning, afternoon and evening. 

Fig. 1. Dysfunction of CD8 T cells in Long COVID & ME/CFS patients compared to HC.

Fig. 4. ME/CFS (ME 1) (B) and Long COVID (LC 1) (C) patients show reversal of CD8 T cell dysfunction as evidenced by significantly improved IFNγ and TNFα production following PMA stimulation (stim) in ICS assay.

12/28/23 Sci Am: Zapping the Vagus Nerve Could Relieve Some Long COVID Symptoms https://buff.ly/48eDdre

• Vagus nerve stimulators

7/2023 Acta Neuropath: Vagus nerve inflammation contributes to dysautonomia in COVID-19 https://buff.ly/48glpfk.

postmortem vagus nerves from COVID-19 patients and controls, and detected SARS-CoV-2 RNA together with inflammatory cell infiltration composed primarily of monocytes. Furthermore, we performed RNA sequencing which revealed a strong inflammatory response of neurons, endothelial cells, and Schwann cells which correlated with SARS-CoV-2 RNA load. 

7/31/23 NIH launches Long COVID clinical trials through RECOVER Initiative, opening enrollment https://buff.ly/3TD6lUF

2 are active studies that are recruiting people with Long COVID: RECOVER-VITAL and RECOVER-NEURO

RECOVER-VITAL: https://trials.recovercovid.org/vital

RECOVER-NEURO: https://trials.recovercovid.org/neuro

• BrainHQ is an interactive online brain training program.

• PASC-CoRE (PASC Cognitive Recovery) uses online virtual staff to help plan goals, learn skills for focus and manage mental tiredness.

• Transcranial direct current stimulation (tDCS) is a safe, noninvasive form of brain stimulation.

From the NIH: “Additional trials, based on the below platform protocols still under review, will launch in the coming months: https://buff.ly/3TD6lUF

RECOVER-SLEEP will test interventions for changes in sleep patterns or ability to sleep after having COVID-19. A trial for hypersomnia, or excessive daytime sleepiness, will test two wakefulness-promoting drugs compared to a placebo control. A second trial for sleep disturbances, such as problems falling or staying asleep, will test other interventions designed to improve sleep quality to learn if these interventions may help regulate sleep patterns in adults with long COVID.

RECOVER-AUTONOMIC will examine interventions to help treat symptoms associated with problems in the autonomic nervous system, which controls a range of bodily functions including heart rate, breathing and digestive system activity. 

The initial trial will focus on postural orthostatic tachycardia syndrome (POTS), a disorder with a number of symptoms including irregular heartbeat, dizziness and fatigue, and will have multiple study arms. The first arm will evaluate a treatment used for immune diseases versus placebo. The second arm will evaluate a drug currently used to treat chronic heart failure in people with an elevated heart rate versus placebo. Participants within each arm will then be randomized to receive either more intensive coordinated care that does not involve additional medication, or usual care.

A fifth platform protocol, focusing on exercise intolerance and fatigue, is under development with input from the patient community and scientific experts.

12/19/23 Yale news: Study helps explain post-COVID (Long COVID) exercise intolerance https://t.co/NGGqOtUdCd

• cardiopulmonary exercise test

• Invasive cardiopulmonary exercise test (iCPET) was performed on all patients using pressure sensing catheters inserted in the pulmonary artery and the radial artery of the wrist while the patients exercised. 

• 55 patients were evaluated for post-COVID exercise intolerance, including 41 who showed no evidence of heart or lung limitations after initial tests. They then underwent iCPET.

• “We found that despite the fact that the heart was pumping oxygenated blood that the lungs were providing adequate amounts of oxygen for, the extraction of oxygen by the body’s tissues was compromised in patients who had symptoms of exercise intolerance after COVID,”

• “Our findings contradict that hypothesis [that symptoms were a result of deconditioning or a lack of physical activity], and instead support the idea that there is a clear physiologic abnormality underpinning the symptoms experienced by our patients,” said Kahn. 

12/2023 EJR Open Research: Differential Cardiopulmonary Hemodynamic Phenotypes in PASC Related Exercise Intolerance https://buff.ly/3TN3x7c

• 55 patients with PASC (Long COVID)

• Supine right heart catheterization (RHC) and invasive CPET (iCPET) during exercise with pulmonary arterial (PA) and radial arterial catheters in place were performed on all participants.

• Conclusions: 

  • The majority of PASC patients in this study (75%) exhibited a primary peripheral limitation to exercise with an impaired peak systemic oxygen extraction (pEO2) during iCPET in conjunction with supranormal cardiac output (CO).

  • Some PASC patients had a distinct type of Heart Failure with Preserved Ejection Fraction (HFpEF).

12/8/23 Acta Neuropathologica Communications: Post-COVID exercise intolerance (Long COVID, ME/CFS type) is associated with capillary alterations and immune dysregulations in skeletal muscles https://buff.ly/3teNk00

• Skeletal muscle biopsies obtained from 11 patients suffering from enduring fatigue and post-exertional malaise after an infection with SARS-CoV-2 vs. historical controls.

• The skeletal muscles of patients with post-COVID exertion intolerance had:

  • fewer capillaries

  • thicker capillary basement membranes

  • increased numbers of CD169+ macrophages.

  • No SARS-CoV-2 RNA was detected in muscle biopsies.

• Complement system related proteins were more abundant in the serum of patients with PCS, matching observations on the transcriptomic level in the muscle tissue.

• We hypothesize that the initial viral infection may have caused immune-mediated structural changes of the microvasculature, potentially explaining the exercise-dependent fatigue and muscle pain. 

9/7/23 Journal of Applied Physiology: Structural and functional impairments of skeletal muscle in patients with post-acute sequelae of SARS-CoV-2 infection (PASC, Long COVID) https://buff.ly/3sQUJSq

• “In conclusion, present findings indicate that the main limitation to exercise tolerance in post-acute sequelae of SARS-CoV-2 (PASC, Long COVID) syndrome can be mainly “peripheral”. 

• The origin of such peripheral limitation to exercise is indicated by impairment in skeletal muscle function underlined by in-vivo lower fractional O2 extraction and impaired muscle oxidative capacity, substantial reductions in biomarkers of mitochondrial function and content, and overall reduced mitochondrial sensitivity to [ADP].”

12/22/23 Eurekalert Press Release: Ongoing brain injury caused by COVID-19 may not always be detected by routine tests https://buff.ly/3GWDNxV

• “Our study shows that markers of brain injury are present in the blood months after COVID-19, and particularly in those who have had a COVID-19-induced brain complication (e.g. inflammation, or stroke), despite resolution of the inflammatory response in the blood. This suggests the possibility of ongoing inflammation and injury inside the brain itself which may not be detected by blood tests for inflammation,” Professor Michael says.

12/22/23 Nature: Para-infectious brain injury in COVID-19 persists at follow-up despite attenuated cytokine and autoantibody responses https://buff.ly/48ylvP3

• "Neurological complications of COVID-19 are associated with evidence of neuroglial injury in both acute and late disease and these correlate with dysregulated innate and adaptive immune responses acutely."

12/24/23 MedRxiV (UK): Healthcare utilisation in people with long COVID: an OpenSAFELY cohort study https://buff.ly/47kJznA

• "Long COVID increases healthcare utilisation and costs. Public health policies should allocate more resources towards preventing, treating, and supporting individuals with long COVID."

• People with Long COVID cost the NHS 67% more than people without Long COVID and included more visits to the General Practitioner, more prescription costs, more emergency room and hospital visits.

12/26/23 Australia ABC: Long COVID will take your health, your wealth — then it will come for your marriage https://buff.ly/3txdgUI

• For David Putrino, the "one thing" he wishes people would understand sooner rather than later is the "looming social impact" of long COVID. "I'm talking about the workforce being diminished, the fact that people can't think the way they used to think — we're losing intellectual capital, we're losing physical capital, we're losing social capital," he says.

• "I don't know how to be more clear about how much of an existential threat this is, but it doesn't seem to be getting through — we still seem to be in this denial phase of 'othering' the illness," Dr Putrino says. "There's this shared fantasy that long COVID is someone else's problem, and I just think we need people to understand that it's everyone's problem." 

12/23/23  Michael Hoerger tweet: “As COVID transmission spikes, you may have opportunities to raise awareness about Long COVID.

These are a few of the most popular videos I've shared that people found useful. A family member or friend might find one of them relatable too.”

Videos:

Dr. Rae Duncan on Endothelial dysfunction in COVID:

https://twitter.com/drclairetaylor/status/1595244354133803011

5/2023 Shark Tank episode: Man explains flat sales because he is taking care of his wife who is very disabled with Long COVID:

https://twitter.com/michael_hoerger/status/1654697865615163394

UCSF Grand Rounds Long COVID experts still wearing their masks:

https://twitter.com/michael_hoerger/status/1736640106511901074

At 1:01:15 on the YouTube video

Dr Claire Taylor: Why we can’t “learn to live with COVID”

Other news:

12/22/23 AP: FDA says fake Ozempic shots are being sold through some legitimate sources https://buff.ly/3RXB51n

12/26/23 NY Times: Serious Medical Errors Rose After Private Equity Firms Bought Hospitals https://buff.ly/47jMvRf

12/28/23 HealthDay: Heart Effects of High Blood Pressure in Pregnancy Could Linger https://buff.ly/3S0ElJq

• "This study confirms the results of others and demonstrates that women who experience a hypertensive disorder during their pregnancy are more likely to have lasting changes in the structure and function of their hearts than women who have normal blood pressure during their pregnancy," study co-author Dr. Natalie Bellow.

12/29/23 AP: Mexican president inaugurates centralized 'super pharmacy' to supply medicines to all of Mexico https://buff.ly/4aPDjHA

10/23/23 CNN: How AI is helping Baby Boomers find kids who need a mentor https://buff.ly/3s1S7Bk

• Mentors across the United States are matched with mentees by Eldera, an online platform that uses an AI algorithm to pair adults who are at least 60 with young people ages 5-18 for regular video chats.

CNN 2023 Good News generator: https://edition.cnn.com/interactive/2023/12/specials/good-news-generator-dg-cec/