1. Public Health Experts Sketch a Roadmap to Get from the Covid Pandemic to the ‘Next Normal’ (STAT News) A new report released Monday charts a path for the transition out of the Covid-19 pandemic, one that outlines both how the country can deal with the challenge of endemic Covid disease and how to prepare for future biosecurity threats. The report plots a course to what its authors call the “next normal” — living with the SARS-CoV-2 virus as a continuing threat that needs to be managed. Doing so will require improvements on a number of fronts, from better surveillance for Covid and other pathogens to keeping tabs on how taxed hospitals are; and from efforts to address the air quality in buildings to continued investment in antiviral drugs and better vaccines. The authors also call for offering people sick with respiratory symptoms easy access to testing and, if they are positive for Covid or influenza, a quick prescription for the relevant antiviral drug.
(J. Harris: A booklet which I have not yet read.)
FROM BECKERS: A SUMMARY OF THE ABOVE BOOKLET
”…Secondary attack rate of SARS-CoV-2 in Norwegian households was moderately higher when the index case had the Omicron variant rather than the Delta variant….There were 31 220 households with 1 index case (mean age, 30 years; 51% male), comprising 80 957 nonindex members (mean age, 31 years; 50% male), of whom 11 643, 41 015, and 28 299 belonged to a household in which the variant of the index case was Omicron, Delta, or nonclassified, respectively. The mean age of nonindex members of households in which the index case had the Omicron variant was 33 years, and 49% were male, compared with 31 years and 50% for Delta.
Secondary attack rate was 25.1% (95% CI, 24.4%-25.9%) when the variant of the index case was Omicron, 19.4% (95% CI, 19.0%-19.8%) when it was Delta, and 17.9% (95% CI, 17.5%-18.4%) when it was nonclassified (Table). In the adjusted logistic regression model, the OR of nonindex household members testing positive was 1.52 (95% CI, 1.41-1.64) when the variant of the index case was Omicron and 0.93 (95% CI, 0.88-0.98) when it was nonclassified compared with Delta…”
(J. Harris: So, if someone in the house in Norway got Covid, there was about a 25% chance that another family member would be infected.Norway has “90% primary vaccination and increasing booster vaccination coverage.”)
”…The following is a summary of some recent studies on COVID-19. They include research that warrants further study to corroborate the findings and that has yet to be certified by peer review…Omicron infections are contagious for at least 6 days…Patients infected with the Omicron variant of SARS-CoV-2 remain contagious for just as long as patients infected with earlier variants, according to a small study….Regardless of which variant or whether or not they had been vaccinated or boosted, study participants “shed live virus for, on average, about 6 days after symptoms (began), and… about one in four people shed live virus for over 8 days,” said Dr. Amy Barczak of the Massachusetts General Hospital in Boston, who coauthored a report posted on medRxiv ahead of peer review.
”…March 7 (Reuters) – Scientists have pinpointed 16 new genetic variants in people who developed severe COVID-19 in a large study published on Monday that could help researchers develop treatments for very sick patients….
The results suggest that people with severe COVID have genes that predispose them to one of two problems: failure to limit the ability of the virus to make copies of itself, or excessive inflammation and blood clotting….The genetic analysis of nearly 56,000 samples from people in Britain showed differences in 23 genes in COVID-19 patients who became critically ill, when compared with the DNA of other groups included in the study, including 16 differences that had not been previously identified……
The new findings could help guide scientists in their search for existing drugs that might be useful for treating COVID-19.
FROM NYT TODAY:
”…With normal aging, people lose a tiny fraction of gray matter each year. For example, in regions related to memory, the typical annual loss is between 0.2 percent and 0.3 percent, the researchers said…
But Covid patients in the study — who underwent their second brain scan an average of four and a half months after their infection — lost more than noninfected participants, experiencing between 0.2 percent and 2 percent additional gray matter loss in different brain regions over the three years between scans. They also lost more overall brain volume and showed more tissue damage in certain areas.
(J. Harris: This is another good reason to get vaccinated and stay boosted.)
”…Advanced age is a key risk factor for morbidity and mortality associated with SARS-CoV-2 infection. Therefore, older adults have generally been prioritised for COVID-19 vaccination. Moreover, lower vaccine immunogenicity and more pronounced waning of humoral immunity in older individuals than in younger individuals have prompted early booster campaigns.1 The omicron variant (B.1.1.529) of SARS-CoV-2 shows substantial resistance to vaccine-induced serum neutralising activity and hence is of particular concern.2 Although booster immunisations can elicit omicron-neutralising activity,3 their immediate and long-term effects in older individuals are not known, which limits informed guidance on vaccination strategies in this susceptible population…
In the absence of omicron variant-specific vaccines, booster immunisations are crucial to restore vaccine effectiveness against severe outcomes.5 We found that booster immunisations can effectively elicit omicron variant-neutralising activity in the majority of older individuals. Although our analyses were limited to four sampling timepoints and different pre-boost and post-boost observational periods, our results suggest that neutralising activity against different variants decreases at similar decay rates. Although neutralising activity does not equal protection from infection, our findings suggest that previous observations on waning humoral immunity can guide subsequent booster vaccination strategies in the older population.”
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