Benefits and Safety of Nasal Saline Irrigations in a Pandemic—Washing COVID-19 Away

Good Summary: SARS-CoV-2 is a highly virulent respiratory virus with significant presence in the nasal and nasopharyngeal mucosa. Hypertonic nasal saline, which facilitates mucociliary clearance, likely decreases viral burden through physical removal. Other additives, such as povidone-iodine [Betadine], may aid in eliminating viral particles within the nasal cavity and nasopharynx prior to active infection. Given available evidence, saline irrigations with or without indicated additives may be safe to use in the presence of COVID-19. This is critical to communicate for patients who already use these therapies for rhinosinusitis management. Importantly, the lavage fluid, rinse bottle, and surrounding surfaces may become contaminated and serve as a source of infection in the future. Thus, patients should practice good hand hygiene and decontaminate the surrounding surfaces (eg, sink, counters) and plastic rinse bottle to prevent subsequent infection. Given the safety profile of these therapies, HS nasal irrigations should be encouraged for patients and health care workers especially. For our patients with chronic rhinosinusitis, continued use of steroid irrigations should be encouraged. Emerging research is expected to shed further light on saline irrigation’s protective and therapeutic effect on COVID-19.

(J. Harris: We previously looked at 0.5% Betadine nose solutions, mixed at home, which is said to work well. I’ll probably review the subject soon

Fully vaccinated people can skip Covid quarantines, CDC says


1. Germany’s Merkel Warns Coronavirus Variants Could ‘Destroy’ Gains Against Pandemic (NPR) German Chancellor Angela Merkel defended her government’s decision to extend a COVID-19 lockdown into March, as she issued a stark warning that new strains of the coronavirus “may destroy any success” already achieved in keeping the pandemic in check. Merkel told lawmakers that the agreement between the federal government and state leaders to extend a nationwide lockdown until March 7, with an option to gradually reopen schools, day care centers and hairdressers earlier, was a prudent measure.

2. COVID-19 Immune Signatures Reveal Stable Antiviral T Cell Function Despite Declining Humoral Responses (Cell) The role of SARS-CoV-2-specific T cell immunity, its relationship to antibodies, and pre-existing immunity against endemic coronaviruses (huCoV), which has been hypothesized to be protective, were investigated in 82 healthy donors (HDs), 204 recovered (RCs), and 92 active COVID-19 patients (ACs). ACs had high amounts of anti-SARS-CoV-2 nucleocapsid and spike IgG but lymphopenia and overall reduced antiviral T cell responses due to the inflammatory milieu, expression of inhibitory molecules (PD-1, Tim-3) as well as effector caspase-3, -7, and -8 activity in T cells. SARS-CoV-2-specific T cell immunity conferred by polyfunctional, mainly interferon-γ-secreting CD4+ T cells remained stable throughout convalescence, whereas humoral responses declined.  

(J. Harris: We will foll

3. Immunogenicity and Safety of Reduced-Dose Intradermal vs Intramuscular Influenza Vaccines: A Systematic Review and Meta-analysis (JAMA) In this systematic review and meta-analysis including 30 studies with a total of 177 780 participants, the seroconversion rates of low doses of intradermal influenza vaccine vs the 15-µg intramuscular dose for each of the H1N1, H3N2, and B strains were not statistically significantly different. Seroprotection rates for the 9-µg and 15-µg intradermal doses were not statistically significantly different from the 15-µg intramuscular dose, except for the 15-µg intradermal dose for the H1N1 strain, which was significantly higher.

(J. Harris: A lower dose of the FLU vaccines produced adequate antibodies to the infection. The point here is that even after all these years, vaccine work for ubiquitous pathogens persists.)

Resurgence of COVID-19 in Manaus, Brazil, despite high seroprevalence

(J. Harris: Uh oh? Why the recurrence. Good readable article with discussions concerning reinfection, ? lack of herd immunity development, and mutated Covid.)

The new SARS-CoV-2 lineages may drive a resurgence of cases in the places where they circulate if they have increased transmissibility compared with pre-existing circulating lineages and if they are associated with antigenic escape. For this reason, the genetic, immunological, clinical, and epidemiological characteristics of these SARS-CoV-2 variants need to be quickly investigated. Conversely, if resurgence in Manaus is due to waning of protective immunity, then similar resurgence scenarios should be expected in other locations. Sustained serological and genomic surveillance in Manaus and elsewhere is a priority, with simultaneous monitoring for SARS-CoV-2 reinfections and implementation of non-pharmaceutical interventions. Determining the efficacy of existing COVID-19 vaccines against variants in the P.1 lineage and other lineages with potential immune escape variants is also crucial. Genotyping viruses from COVID-19 patients who were not protected by vaccination in clinical trials would help us to understand if there are lineage-specific frequencies underlying reinfection. The protocols and findings of such studies should be coordinated and rapidly shared wherever such variants emerge and spread.

Extraordinary Patient Offers Surprising Clues To Origins Of Coronavirus Variants

(J. Harris: An immunocompromised patient provides a recycling and   mutation site, over and over and over.)


(J. Harris: Interesting read, full of confusing conditional  situations and explanations. Without computers, it would take years to get all this data localized and almost understandable–they are using a Dutch system. To me, it looks as if the Russian Vaccine works pretty well and has had few side effects so far. This was published in Lancet, a British medical journal which is well respected.)

“…Our interim analysis of the randomized, controlled, phase 3 trial of Gam-COVID-Vac in Russia has shown high efficacy, immunogenicity, and a good tolerability profile in participants aged 18 years or older… The vaccine was well tolerated,..Although the study was not designed to assess the efficacy of a single-dose regimen, our early starting point allows us to observe a possible partial protective effect of a single dose…Our interim analysis of this phase 3 trial of Gam-COVID-Vac has shown promising results( 91·6% … efficacious against COVID-19 (from day 21 after first dose, the day of receiving second dose).) …Our results also showed that the vaccine was 100%  efficacious against severe COVID-19, although this was a secondary outcome so the results are preliminary….In parallel with implementation of multiple clinical trials (in Russia, Belarus, United Arab Emirates, and India), the vaccine has already been released in Russia for use by the public, largely in at-risk populations, medical workers, and teachers, and as of Jan 23, 2021, more than 2 million doses of Gam-COVID-Vac have already been administered to the public…We are conducting

 research to investigate a single-dose regimen of the vaccine…” 


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