FROM NYT : (TODAY)
”…Two new versions of Omicron, the coronavirus variant that has swept through the world in the past few months, are circulating in New York State and may be responsible for rising infections in the region over the past few weeks,…In March, the subvariants — called BA.2.12 and BA.2.12.1 — accounted for more than 70 percent of new cases in central New York State, a figure that has now risen above 90 percent….So far, the new viruses do not appear to cause more severe disease than previous variants, the officials said…”
(J. Harris: This was anticipated by most of the big boys who play with the viruses and the spread follows the early trends of spread from Europe then to the US. We know what to do! Stay vaccinated, boosted, and careful.)
FROM THE WASHINGTON POST:
”As colleges grapple with climbing cases – especially along the East Coast – some campuses have decided to bring back masking and testing requirements. Just one week after adopting a mask-optional policy, George Washington University brought back a mask requirement through the end of the semester after 190 people tested positive since April 4. American University similarly reverted to a mask mandate until May 9 after a spike in cases following spring break…”
FROM THE HISTORY CHANNEL: ( THE HISTORY CHANNEL IS BACK!)
”…What does it mean for a disease to be “endemic”?It doesn’t mean the disease disappeared. When epidemiologists use the word “endemic,” they mean that a disease is occurring “at an expected level in a location during a period of time…Endemic” also doesn’t mean that a disease has ceased to be harmful. Malaria, tuberculosis and influenza are all serious and potentially fatal endemic diseases that occur every year. Since the 1940s, countries have built robust international health networks that identify flu strains in order to keep them under control, and avoid the kind of devastation that happened during the 1918 pandemic…”
(J. Harris: Worth taking a look. Hx of CDC and WHO and flu vaccines covered consisely for quick read.)
Despite a rise in infections nationwide, the White House new COVID-19 response coordinator, Ashish Jha, MD, expressed optimism about the current state of the pandemic in the U.S. during his first week on the job….
“If you think about where we are as a country, we are at a really good moment,” said Dr. Jha, who is on leave from his position as dean of Brown University’s School of Public Health in Providence, R.I., told NPR on April 11. “Infection numbers are relatively low. We have fewer people in the hospital right now than at any point in the pandemic. So it is really important to start with, where are we? We’re in reasonably good shape….”
Three takeaways from his conversation with NPR:
1.” A different moment: The goal at this point in the pandemic is not to eliminate all infections. “The goal has got to be to keep infections down and protect people from serious illness,” Dr. Jha said. “We’re in a very different moment than where we were a couple of years ago, where a COVID-19 infection necessarily meant people were at potentially very high risk of having bad outcomes. That is no longer the case if you are vaccinated and boosted,” he told NPR.
2. Lean on local restrictions: Dr. Jha suggested” the responsibility of deciding whether to reinstate pandemic restrictions will largely fall on the shoulders of local governments moving forward. Following a 50 percent rise in cases in the previous 10 days, Philadelphia on April 11 became the first major city in the country to announce it will reinstate its indoor mask mandate April 18…These are decisions that should always be made on a local level, so I like that feature of what Philadelphia is doing,” he said. “[These decisions] should be driven really by the realities on the ground. I can very much imagine in the weeks and months ahead, as you see local cases go up, public health measures go into place. And as infections and hospitalizations fall, public health measures get released. That’s a pretty reasonable way to manage the pandemic.”
3. Preparation over prediction: ”To best navigate the possibility of future surges and [other variants], the nation must prepare during calmer periods, Dr. Jha said. “What we need to be doing right now is preparing for those moments by vaccinating people, by making sure that we have plenty of tests and therapies available. That’s got to be the strategy — not so much predicting exactly what’s going to happen when but preparing for any eventuality that Mother Nature throws at us.” A potential barrier to adequate preparation is stalled pandemic funding in Congress that would cover the cost of testing, vaccines and treatments.’…”
BECKERS SELECTIONS CONTINURED :
1. COVID-19 ESTIMATES IN AFRICA A new meta-analysis of standardized seroprevalence studies indicates that the true number of SARS-CoV-2 infections across Africa may be 97 times higher than the number of reported confirmed cases. The study—led by the WHO Solidarity Response Fund and the German Federal Ministry of Health COVID-19 Research and Development and posted to the preprint server medRxiv—evaluated more than 150 seroprevalence studies from January 2020 to December 2021 and suggests that more than two-thirds of the African population have been infected with SARS-CoV-2. From Q2 2020 to Q3 2021, seroprevalence increased markedly from 3% to 61.5%. According to the study, which is undergoing peer review, rather than the reported 8.2 million cumulative cases in September 2021, there were actually more than 800 million infections. The study also determined that seroprevalence was higher in urban areas than rural areas, with varied seroprevalence among African sub-regions, where Middle, Western, and Eastern Africa exhibited higher seroprevalence. …
…that testing strategy and capacity is a significant factor in the discrepancy between reported cases and the estimated true number of infections. Testing across the continent has largely focused on symptomatic people, particularly where there were supply constraints, resulting in an undercount of exposures and infections. Dr. Moeti highlighted the need for sustained routine testing and surveillance capacity on the continent in order to identify cases among the estimated 67% of people with COVID-19 in Africa who are asymptomatic and monitor for emerging variants.
2. EARLY REINFECTION : A report published April 8 in the US CDC’s Morbidity and Mortality Weekly Report (MMWR) describes 10 individuals who were reinfected with the Omicron variant of SARS-CoV-2 within 90 days of initial infection with the Delta variant. The report represents a significant finding, as reinfection within 90 days of infection is not well understood. Early reports of reinfection were difficult to verify because a positive reading on a nucleic acid amplification test (NAAT) could signal prolonged viral shedding from the initial infection rather than a new infection if taken within 3 months of acute infection. For the report, researchers conducted whole genome sequencing on 10 individuals—8 children and 2 adults—to determine which variant caused the initial and subsequent infections. Only 1 of the patients had received a 2-dose primary vaccine regimen, 2 had received 1 dose, and 7 were unvaccinated. Of 8 patients with available data on symptoms, 6 experienced symptoms during both infections. The authors noted that the patients may have been at increased risk for infection due to lack of vaccination and the high likelihood of exposure to SARS-CoV-2 in schools and the work and living settings of the adults.
FROM HOPKINS (MORE TOMORROW)
Prevalence, Characteristics, and Outcomes of COVID-19–Associated Acute Myocarditis (Circulation) Acute myocarditis (AM) prevalence among hospitalized patients with COVID-19 was 2.4 per 1000 hospitalizations considering definite/probable and 4.1 per 1000 considering also possible AM. The median age of definite/probable cases was 38 years, and 38.9% were female. On admission, chest pain and dyspnea were the most frequent symptoms (55.5% and 53.7%, respectively). Thirty-one cases (57.4%) occurred in the absence of COVID-19–associated pneumonia. Twenty-one (38.9%) had a fulminant presentation requiring inotropic support or temporary mechanical circulatory support. The composite of in-hospital mortality or temporary mechanical circulatory support occurred in 20.4%. At 120 days, estimated mortality was 6.6%, 15.1% in patients with associated pneumonia versus 0% in patients without pneumonia (P=0.044). During hospitalization, left ventricular ejection fraction, assessed by echocardiography, improved from a median of 40% on admission to 55% at discharge (n=47; P<0.0001) similarly in patients with or without pneumonia. Corticosteroids were frequently administered (55.5%).
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