From Lancet:

1. Contextualising evidence-based recommendations for the second wave of the COVID-19 pandemic in India

During the second wave of the COVID-19 pandemic in India, which began in March, 2021, demand on the health-care system has far exceeded capacity. Despite crippling shortages, patients are prescribed a battery of ineffective therapeutic interventions.1 Ivermectin, hydroxychloroquine, and herbal cocktails continue to receive state patronage.2,  3,  4 On May 8, 2021, 2-deoxy-D-glucose was given emergency authorisation, stating that it will “save precious lives” without any published evidence that it impacts mortality.5 An entrenched culture of polypharmacy and gestalt-driven practice among physicians has resulted in indiscriminate and unwarranted use of remdesivir, favipiravir, azithromycin, doxycycline, plasma therapy, and most recently baricitanib and bevacizumab, regardless of disease severity or drug efficacy. Excessive and inappropriate use of steroids could be contributing to the alarming rise of mucormycosis in patients recovering from COVID-19.

In rural India, where health-care infrastructure is threadbare, and families are poor, patients can ill afford such expensive mistakes. Honing in on the most high yield and affordable interventions, we propose recommendations for testing and management, optimised to India’s current resource-constrained context (table). Every clinical touchpoint should be used to underscore masking, distancing, and vaccination.

DNA test to predict odds of severe COVID-19 draws scrutiny

(J. Harris: These tests are a virtual scam at this time. Someday, there may be some value in this approach.)

From Becker Citations:

1. CDC urges COVID-19 vaccinations at discharge

2. 3 things to know about COVID-19 vaccine boosters

(J. Harris: Important and an understandable read-good news.)

How a rampant coronavirus variant blunts our immune defences

“….Alpha’s ability to outstrip previously circulating variants could stem from mutations in its spike protein that allow it to enter cells more efficiently… Alpha also has tricks linked to mutations outside the spike protein. These mutations probably mean that within hours of infecting a person, Alpha suppresses the rapid-response defence that the body mounts against all invaders. By blocking this ‘innate immune response [interferon]’, the virus buys itself more opportunities to infect other people….cells from the human airway produced interferon, an immune protein that kick-starts the body’s defences on the arrival of a pathogen. The team found that cells infected with Alpha produce much less interferon than do cells infected with previously circulating SARS-CoV-2 variants. Alpha’s suppression of interferon production helps the variant to stick around for longer in the body.

The team attributes this over-expression to a mutation outside the spike protein, in genes that are important for viral replication. The latest paper “highlights the importance of looking beyond the spike protein for new mutations…”


1. The mRNA Vaccine Revolution is Just Beginning (WIRED) The scope of mRNA vaccines always went beyond any one disease. Like moving from a vacuum tube to a microchip, the technology promises to perform the same task as traditional vaccines, but exponentially faster, and for a fraction of the cost. “You can have an idea in the morning, and a vaccine prototype by evening. The speed is amazing,” says Daniel Anderson, an mRNA therapy researcher at MIT. Before the pandemic, charities including the Bill & Melinda Gates Foundation and the Coalition for Epidemic Preparedness Innovations (CEPI) hoped to turn mRNA on deadly diseases that the pharmaceutical industry has largely ignored, such as dengue or Lassa fever, while industry saw a chance to speed up the quest for long-held scientific dreams: an improved flu shot, or the first effective HIV vaccine.


What we know about Delta, the new coronavirus variant:

“…It’s more dangerous to be unvaccinated now than it was to be unvaccinated this time a year ago. We know the virus is changing in ways that make it more dangerous. And so if you encounter the virus now, you’re encountering a more problematic pathogen…The U.K. is delaying its reopening because of Delta.. 

[but] given the trajectory we’ve been on for the past several weeks, shutdowns like last spring’s may not be necessary. But we can’t completely forecast things such as how the virus is going to change…we never had a national lockdown in the U.S. throughout this entire thing. And now that the vaccines are here, we have this incredibly powerful weapon. Keeping vaccination rates high and sharing our vaccines with the world could be a way to further ensure that the U.S. doesn’t need to turn to lockdowns at all…[ther is] a lot of optimism from experts in recent weeks. [some experts think] if we haven’t fully turned a corner in this country, we’re in the process right now…It’s not like we’re going to reach utopia by October. But we still have more vaccines in the pipeline.

Deaths of younger people from Covid-19 have upended Hispanic American families.




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