CORONAVIRUS INFO PROVIDED BY DR. JIM HARRIS – 04/30/2021

HELLO: REMEMBER  SATURDAY VOTE FOR MISD SCHOOL

Association of Maternal SARS-CoV-2 Infection in Pregnancy With Neonatal Outcomes

“Conclusions and Relevance  In a nationwide cohort of infants in Sweden, maternal SARS-CoV-2 infection in pregnancy was significantly associated with small increases in some neonatal morbidities. Given the small numbers of events for many of the outcomes and the large number of statistical comparisons, the findings should be interpreted as exploratory.”

FROM The Lancet:

Hospital admissions due to COVID-19 in Scotland after one dose of vaccine

“….The analysis includes 1 331 993 individuals vaccinated between Dec 8, 2020, and Feb 22, 2021. The authors constructed this comprehensive cohort by linking vaccination, primary care, laboratory testing, hospital admission, and mortality datasets covering 5·4 million people in Scotland…Focusing on 28–34 days after a single dose, the authors report an estimated vaccine effect of 91% (95% CI 85–94) for COVID-19 hospital admissions for BNT162b2 [Pfizer}, and an estimated 88% (75–94) vaccine effect during the same period for ChAdOx1[AstraZeneca].

J. Harris: This is reassuring information and other data showed pretty good prevention starting about a week after receiving the first injection. I must say I feel a little braver after having the second jab, too. 

FASCINATING LETTER TO THE NYT EDITOR under “What You’re Doing”

“I’ve read this bit every day for the past year. Now I read about people happily resuming pre-Covid activities, like meeting up with friends and family, socializing, or getting excited to attend concerts and dine out. I can’t at all relate. Pandemic isolation and introspection have been my sanctuary and bliss. After 47 years of feeling uncomfortable in my own skin and making lame excuses for missing social and work networking events, 2020 permitted me to lean into my true introvert. I felt braver and more creative than ever in my remote work. I relished the relief of masks, of not being judged for my appearance, of getting a break from scrutiny about not smiling enough. I loved attending Zoom programs hosted by public libraries and nonprofits nationwide. I mourn the loss of all of this. I dread having to feign sociability again to be accepted in life and at work, acting my way through re-acclimating to the majority’s version of normal.”

— Tara Chhabra, Saratoga Springs, N.Y.

(J. Harris: Unpleasant people in the grocery store might still think and say hateful things like “Old fat men shouldn’t wear shorts and T-shirts when out and about,” but masks do provide a comfortable “so what” anonymity.)

FROM HOPKINS CITATIONS:

1. RESEARCH

Airport Traveler Testing Program for SARS-CoV-2 — Alaska, June–November 2020 SARS-CoV-2 testing on arrival in Alaska airports identified 951 SARS-CoV-2 infections, or one per 406 arriving travelers, and might have contributed to Alaska’s low incidence during the summer by reducing opportunities for community transmission at travelers’ destination locations. Posttravel self-quarantine and testing programs might reduce travel-associated SARS-CoV-2 transmission and importation, even without enforcement. Traveler education and community and industry partnerships might help ensure success. (CDC MMWR, 4/23/2021)

2. RESEARCH

COVID-19 Outbreak Associated with a SARS-CoV-2 R.1 Lineage Variant in a Skilled Nursing Facility After Vaccination Program — Kentucky, March 2021 In a COVID-19 outbreak at a Kentucky SNF involving a newly introduced variant to the region, unvaccinated residents and health care personnel (HCP) had 3.0 and 4.1 times the risk of infection as did vaccinated residents and HCP. Vaccine was 86.5% protective against symptomatic illness among residents and 87.1% protective among HCP. (CDC MMWR, 4/21/2021)

J. Harris: It is dangerous and careless and illogical not to prevent Covid with the good vaccines that we have. Fortunately, scientists had been working on the various types of vaccines for similar viruses for many years before this Covid Pandemic, so the vaccine response was fairly quick — thank God.

AND FINALLY: HAVE A GOOD LAUGH AND A PLEASANT WEEKEND

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CORONAVIRUS INFO PROVIDED BY DR. JIM HARRIS – 04/29/2021

HELLO, ETBU VACCINE CLINIC 10-4 TODAY. FREE. PFIZER. SHORT WAIT. NO APPOINTMENT NECESSARY. HELP SOMEONE ELSE GET VACCINATED?

Track Coronavirus Cases

“Harrison County is at a high risk level for Covid-19 infections. The average number of new cases in Harrison County reached five yesterday, a 3 percent increase from the day before. Since January of last year, at least 1 in 14 people who live in Harrison County have been infected, and at least 1 in 628 have died.”

What to Do If You Received the J&J/Janssen COVID-19 Vaccine

After a temporary pause, CDC and the U.S. Food and Drug Administration (FDA) recommend use of Johnson & Johnson’s Janssen (J&J/Janssen) COVID-19 Vaccine resume in the United States. A review of all available data at this time shows that the J&J/Janssen COVID-19 Vaccine’s known and potential benefits outweigh its known and potential risks. However, women under 50 years old should be aware of the rare but increased risk of the adverse event called thrombosis with thrombocytopenia syndrome (TTS), and that there are other COVID-19 vaccine options available for which this risk has not been seen. CDC and FDA will continue to monitor the safety of all COVID-19 vaccines. 

HOPKINS CITED:

1. The Anti-Vaccine Influencers Who Are Merely Asking Questions (The Atlantic) Life can go back to normal in the United States only if millions more Americans get vaccinated against COVID-19. The problem is that today’s communication environment is perfectly engineered to discourage that. Wild claims go viral, and partisans exploit any scientific uncertainty for political advantage.

Hopkins Recent Citations:

1. Pfizer CEO Says Antiviral Pill To Treat Covid Could Be Ready By The End Of The Year (Forbes) A pill that can be ingested orally at home to combat Covid-19 when illness is first detected could be available to the public by the end of 2021, Pfizer CEO Albert Bourla told CNBC on Tuesday, noting that the antiviral treatment is expected to be effective against variants of the virus.

2. An Unexpected Pandemic Side Effect In Peru: A Comeback For TB (NPR) Tuberculosis kills around 1.5 million people a year, making it a top priority for public health organizations. The United Nations aims to end the epidemic of tuberculosis by 2030, but COVID-related disruptions to TB treatments may push that goal out of reach — and end up propagating strains that are resistant to treatment, which also tend to be the deadliest.

Genomic Epidemiology of SARS-CoV-2 Infection During the Initial Pandemic Wave and Association With Disease Severity

Question  Are SARS-CoV-2 variants, virus clades, or clade groups associated with disease severity and patient outcomes?

Findings  In this cross-sectional study of 302 SARS-CoV-2 isolates, 6 different Global Initiative on Sharing All Influenza Data clades circulated in the community followed by a rapid reduction in clade diversity. Several variants, including 23403A>G (D614G), were significantly associated with lower hospitalization rates and increased patient survival.Meaning  These findings suggest that SARS-CoV-2 clade assignment is an important factor that may aid in estimating patient outcomes.

Can You Have Alcohol After the Covid Vaccine?

“…One thing that is clear from studies is that heavy alcohol consumption impairs the immune response and increases your susceptibility to bacterial and viral infections. It prevents immune cells from traveling to sites of infection and carrying out their duties, like destroying viruses, bacteria and infected cells; makes it easier for pathogens to invade your cells, and causes a host of other problems.” 

(J. Harris: …and they use tiny little jiggers to measure the hooch.)

LAST BUT NOT LEASED:

Depression is merely anger without enthusiasm.

I drive way too fast to worry about cholesterol

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PFIZER VACCINE AVAILABLE TODAY AND TOMORROW AT ETBU:

FROM NYT COVID TRACKER:

HOPKINS CITED:

1. Higher Stroke Risk Linked to Asymptomatic COVID-19 in Younger Men (CIDRAP) Men under 50 recovering from asymptomatic COVID have double the likelihood of acute ischemic strokes (AIS) compared with men of the same age without COVID infection, according to a study last week in JAMA Network Open. Eighteen South Asian men were treated in Singapore for AIS a median of 54.5 days after their initial COVID-19 diagnosis. Twelve (67.7%) had no known pre-existing risk factors. While AIS is a known neurologic complication from symptomatic COVID-19, none of these men experienced respiratory symptoms during their infection. 

2. U.S. to Share AstraZeneca Covid-19 Vaccine Doses With World (WSJ)

The Biden administration is making plans to share millions of doses of the AstraZeneca Covid-19 vaccine and preparing a major effort to help India fight a resurgence of the virus, as calls mount for the U.S. to do more to assist developing countries in confronting the pandemic. The White House said Monday it would share as many as 60 million doses of the AstraZeneca vaccine with the rest of the world. U.S. officials also said they were exploring options to urgently dispatch oxygen and related supplies to India.

3. Brazil Rejects Russia’s Sputnik V Coronavirus Vaccine, Citing Safety Concerns (The Washington Post) Brazilian health regulators have issued a scathing rebuke of Russia’s Sputnik V coronavirus vaccine, rejecting the shot’s approval in a decision late Monday that could impact its use elsewhere in the world. The ruling from Brazil’s Health Regulatory Agency, or Anvisa, cited a range of concerns with the vaccine’s development and production, including what it said was a lack of quality control and efficacy data, as well as little if any information on the shot’s adverse effects. It was not the first time that health authorities have raised concerns about Sputnik V, which was hailed as “safe” and more than 91 percent effective in a peer-reviewed article in the Lancet in February.

LONG HAUL ARTICLES FROM BECKERS:

Related Articles

• ‘Long COVID’ symptoms could linger for up to 9 months, study suggests
• Emerging trends among COVID-19 long-haulers: 6 physicians weigh in
• ‘Not just the most vulnerable’: Who gets ‘long COVID’ & 4 other questions answered
• Not all COVID ‘long-haulers’ are adults
• CDC: Large universities holding in-person classes increase local COVID-19 cases

FROM HOPKINS AND CDC A REAL NURSING HOME STORY WITH PROOF VACINES WORK:

NURSING HOME OUTBREAKS Health officials in Kentucky and experts at the US CDC published a case study of an outbreak at a long-term care facility (LTCF) initiated by an unvaccinated employee. At the facility, 90% of the residents and 53% of the staff received 2 doses of SARS-CoV-2 vaccine. Routine testing identified the outbreak, which began in an unvaccinated and symptomatic healthcare worker. Ultimately, the outbreak involved 46 total cases, including 26 residents and 20 facility personnel. Notably, 18 of the residents and 4 personnel received their second dose of the vaccine more than 14 days before the outbreak. Three (3) residents died, including 2 who were unvaccinated.

The risk of infection among unvaccinated residents was 3 times higher than among vaccinated residents. Similarly, the risk among unvaccinated personnel was 4 times higher than among vaccinated personnel. For this outbreak, the vaccine’s effectiveness against SARS-CoV-2 infection was estimated to be 66% among residents and 76% among employees, and the effectiveness against symptomatic COVID-19 disease was 86.5% among residents and 87% among employees. This is in line with the expected effectiveness based on clinical trial efficacy data. The authors conclude that low vaccination coverage among employees at LTCFs could facilitate introduction of SARS-CoV-2, which could result in outbreaks, even among resident populations with high vaccination coverage. While the authorized SARS-CoV-2 vaccines are highly effective*, COVID-19 risk remains, particularly among individuals at elevated risk for exposure and severe disease. Even as vaccination coverage increases, it is critical to maintain COVID-19 risk mitigation measures until sufficient community protection is in place to bring the pandemic under control. 

*For those vaccines with publicly available Phase 3 clinical trial data. 

1115 Waiver Rescission – What It Means for Texas

(J. Harris: I’m not interested in discussing politics, but Marshall hospitals treat many uninsured patients as well as a large number of Medicaid-funded patients — whose payments are inadequate and not capable of paying a significant amount of the expenses incurred. Marshall is too close to hospitals in Longview and Shreveport to be considered “Rural,” a designation that would help us financially. Around ten years ago, a good local hospital administrator told me that Texas’ approach to Medicaid would bankrupt our hospital as well as many other smaller Texas hospitals. He was correct in his prediction. Many smaller hospitals have closed.  In my opinion, only partially informed, had  Christus not bought the Good Shepherd hospitals in Longview and Marshall, I’m not sure that either would still be functional. What do you think? What do you think about increasing Texas’ participation in Medicaid?  

The article below is written by Tom Luce who I know and trust:

Medicaid expansion picks up bipartisan support in the Texas House, but hurdles remain

AND LAST FOR TODAY:

If at first you don’t succeed, destroy all evidence that you tried.

Bills travel through the mail at twice the speed of checks.

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CORONAVIRUS INFO PROVIDED BY DR. JIM HARRIS – 04/27/2021

HELLO,

1. PLEASE REMEMBER TO VOTE FOR MISD SCHOOL BOARD

2. ETBU VACCINE WALK IN CLINIC TUES, WED, THURS. (PFIZER)

J. Harris: There is a slight increase of Covid patients in the general beds, ie. regular hospital rooms as apposed ot ICU. Young people? 

FROM THE NYT TRACKER FOR THIS AREA TODAY:

FROM HOPKINS MORE REASONS YOU DON’T WANT TO CATCH COVID:

1. High-Dimensional Characterization of Post-acute Sequalae of COVID-19 (Nature) Here, we use the national healthcare databases of the US Department of Veterans Affairs to systematically and comprehensively identify 6-month incident sequalae including diagnoses, medication use, and laboratory abnormalities in 30-day survivors of COVID-19. We show that beyond the first 30 days of illness, people with COVID-19 exhibit higher risk of death and health resource utilization. Our high dimensional approach identifies incident sequalae in the respiratory system and several others including nervous system and neurocognitive disorders, mental health disorders, metabolic disorders, cardiovascular disorders, gastrointestinal disorders, malaise, fatigue, musculoskeletal pain, and anemia.

2. Maternal and Neonatal Morbidity and Mortality Among Pregnant Women With and Without COVID-19 Infection: The INTERCOVID Multinational Cohort Study (JAMA Pediatrics) In this multinational cohort study of 2130 pregnant women in 18 countries, women with COVID-19 diagnosis were at increased risk of a composite maternal morbidity and mortality index. Newborns of women with COVID-19 diagnosis had significantly higher severe neonatal morbidity index and severe perinatal morbidity and mortality index compared with newborns of women without COVID-19 diagnosis. This study indicates a consistent association between pregnant individuals with COVID-19 diagnosis and higher rates of adverse outcomes, including maternal mortality, preeclampsia, and preterm birth compared with pregnant individuals without COVID-19 diagnosis.

3. States with Springtime Covid-19 Surges Appear to Have Turned a Corner (STAT News) Michigan and other states that experienced springtime Covid-19 surges or faced worrisome transmission trends appear to have turned a corner, with drops in new cases in recent days as vaccines reach more people. After hovering at stubbornly high levels or increasing over the past two months, average daily cases in Massachusetts, Minnesota, New Jersey, Illinois, and other states in the Midwest and Northeast have started to fall, providing a breath of relief that the communities are past their most recent peaks. 

4. US TRAVEL ADVISORIES The US Department of State updated its travel advisories, resulting in nearly 80% of countries falling under the “Do Not Travel” category. Previously, the State Department issued Level 4 (Do Not Travel) guidance for only 34 countries, but the recent additions bring the total to more than 150. Among the Level 4 category countries are Austria, Brazil, France, India, Italy, Mexico, Russia, and the UK. The department said the additions were made “to better reflect CDC’s science-based Travel Health Notices” as well as to consider the logistics of testing availability and other travel restrictions for US travelers. The department also noted it is continuing to monitor COVID-19 data across the globe and will regularly update destination-specific advice as conditions evolve.

AND LAST BUT NOT LEASED:(PLEASE EXCUSE “POLITICS” BUT I COULDN’T RESIST THIS MISSIVE FROM SOUTH DAKOTA:

Brad lives in California….. He was sick of the world, of Covid-19, Trump, Russian belligerence, China, global warming, racial tensions, and the rest of the disturbing stories that occupy media headlines….Brad drove his car into his garage and then sealed every doorway and window as best he could….

He got back into his car and wound down all the windows, selected his favorite radio station, and started the car.

Two days later, a worried neighbor peered through his garage window and saw him in the car. She notified the emergency services and they broke in, pulling Brad from the car…

A little sip of water and, surprisingly, he was in perfect condition, but his Tesla had a dead battery.

Brad is a registered California Democrat.

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