I WISH YOU A HAPPY AND SAFE MEMORIAL DAY WEEKEND. 

FROM BECKERS:

1. US has a new dominant COVID-19 strain

FROM THE NYT:

1. Your Lingering Covid Questions, Answered

(J. Harris: Good general reference to keep for Covid. Readable.Keep.)

2. Some universities and schools in the U.S. are reimposing indoor mask mandates.

”…Another Omicron subvariant, known as BA.2.12.1, which spreads more rapidly than previous versions, has become the dominant form of the virus among new U.S. cases, according to federal estimates. For the first time since February, the country is now averaging more than 100,000 new confirmed cases a day, according to a New York Times database, and the widening use of at-home testing means the true number of infections is probably higher…”

3. The White House pushes to get Paxlovid pills into more Covid patients’ hands.

”…Significant obstacles persist in getting Paxlovid to everyone who could benefit from it; more than a million courses of Paxlovid purchased by the government are still available, according to data collected by the Department of Health and Human Services. Because of vague eligibility guidelines that are open to broad interpretation — the medication is authorized for people 12 and older with “mild-to-moderate” Covid-19 who are at risk of severe illness — some doctors are hesitant to prescribe the pill, or require extensive consultation…”

FROM HOPKINS:

1. MONKEYPOX OUTBREAKS UPDATE Read our latest update from May 23 on the monkeypox outbreaks. A new fact sheet also is available. We will continue to analyze the situation and provide updates, as needed. If you would like to receive these updates, please sign up here.

FROM REUTERS:

Canada’s Quebec confirms 15 cases of monkeypox

The Canadian province of Quebec has confirmed 15 cases of monkeypox as of Monday, the provincial health department said on Tuesday.

FROM JAMA:

1. Cardiac Complications More Common After COVID-19 Than Vaccination

2. Transmission and Infectious SARS-CoV-2 Shedding Kinetics in Vaccinated and Unvaccinated Individuals

”…Fully vaccinated individuals had a shorter duration of viable viral shedding and a lower rate of secondary transmission than partially vaccinated or unvaccinated individuals.”

3. Viral Antigen and Inflammatory Biomarkers in Cerebrospinal Fluid in Patients With COVID-19 Infection and Neurologic Symptoms Compared With Control Participants Without Infection or Neurologic Symptoms

” These results suggest that viral components may contribute to central nervous system immune responses without direct viral invasion and highlight the clinical importance of neurologic symptoms.”

4. Association Between the COVID-19 Pandemic and Disparities in Access to Major Surgery in the US

”These findings suggest that the early response to the pandemic did not increase disparities in access to surgical care.”

FROM THE CDC:

COVID-19 Rebound After Paxlovid Treatment

”…A brief return of symptoms may be part of the natural history of SARS-CoV-2 (the virus that causes COVID-19) infection in some persons, independent of treatment with Paxlovid and regardless of vaccination status…”

FROM THE ATLANTIC:

What COVID Hospitalization Numbers Are Missing, By Ed Yong

”…Even when missing people can be replaced, missing knowledge cannot. The pandemic pushed many veteran health-care workers into early retirement, lowering the average experience level in American hospitals. “I don’t think the public really understands how great the loss of this generational knowledge is,” Cabrera told me. In her current job, she had just four days of orientation, which she describes as “shockingly short,” from some people who had been in the ER for less than a year. When inexperienced recruits are trained by inexperienced staff, the knowledge deficit deepens, and not just in terms of medical procedures. The system has also lost indispensable social savvy—how to question an inappropriate decision, or recognize when you’re out of your depth—that acts as a safeguard against medical mistakes. And with established teams now ruptured by resignations, many health-care workers no longer know—or trust—the people at their side….Absurdly, it’s often hard to get people out of the hospital, Sara Wolfson, a geriatrician at Nebraska Medicine, told me. Many elderly patients still need care after they’ve stabilized, but it’s hard to discharge them, because long-term care facilities and home-health agencies are also incredibly short-staffed and unable to accommodate new patients….”

AND LASTLY:

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P.O. Box 721

Scottsville Texas

75688

FROM THE MARSHALL NEWS MESSENGER:

FROM BECKERS:

1. COVID-19 cases trend

TWO STATES WHERE CASES ARE RISING:

Texas

Seven-day change: 49.67 percent increase

Seven-day moving case average: 4,477

Arkansas

Seven-day change: 4.11 percent increase

Seven-day moving case average: 290

FROM HOPKINS SELECTIONS

1. A BIG LONG HAUL STUDY:

A Detailed Study of Patients with Long-Haul COVID (FAIR Health) Many patients recover from COVID-19 within a few weeks, but some exhibit persistent or new symptoms more than four weeks after first being diagnosed. Patients with such post-COVID conditions are variously referred to as having long-haul COVID, long COVID or post-acute sequelae of COVID-19 (PASC). Using longitudinal data from a database of over 34 billion private healthcare claim records, FAIR Health studied a total of 1,959,982 COVID-19 patients for the prevalence of post-COVID conditions 30 days or more after their initial diagnosis with COVID-19. To FAIR Health’s knowledge, this is the largest population of COVID-19 patients so far studied for post-COVID conditions. The patients’ post-COVID conditions were analyzed, with the most common conditions identified. Particular attention was given to age and gender, mental health conditions and death.

2. The U.S. May be in a Silent Covid Surge (Washington Post) Coronavirus cases are on the rise again. Top Biden officials warned of the increase in cases yesterday, as the country surpasses an average of 100,000 new infections per day. But that number is a massive undercount and could be anywhere from five to 10 times higher, experts say, since home tests typically aren’t included in official case counts.

FROM JAMA

1. Demographic and Clinical Factors Associated With Anti–SARS-CoV-2 Antibody Levels After 2 BNT162b2 mRNA Vaccine Doses

”…  In this cohort study of 50 individuals, anti–SARS-CoV-2–specific antibody levels at 2, 4, and 6 months after COVID-19 vaccination were inversely correlated with body weight. Young and middle-aged healthy adults weighing less than 55 kg maintained a high antibody level 6 months after the second dose of BNT162b2 vaccination…”

2. Excess Mortality in Massachusetts During the Delta and Omicron Waves of COVID-19

”…More all-cause excess mortality occurred in Massachusetts during the first 8 weeks of the Omicron period than during the entire 23-week Delta period. Although numerically there were more excess deaths in older age groups, there was excess mortality in all adult age groups, as recorded in earlier waves, including in younger age groups.5,6 Moreover, the ratio of observed to expected all-cause deaths was similar in all age groups, and increased during the Omicron period compared with the Delta period….”

(J. Harris: Surprise!)

FROM THE NYT:

1. Health officials in parts of the U.S. see signals in wastewater data hinting at a worsening virus wave.

”…The data has been like a “canary in a coal mine”…Case counts are a “gross underrepresentation,” as many people are opting to take at-home tests instead of going to hospitals or doctors’ offices….“It looks like a surge in slow motion,”…Houston is another city where wastewater data has been showing ominous signs of increasing infections…”

2. New York’s fifth wave

”…This latest wave, which is New York City’s fifth, started in mid-March. At first it was driven by the BA.2 subvariant of Omicron, but now most cases are caused by newer versions — primarily BA.2.12.1, which is more transmissible than its predecessor and made up roughly 73 percent of new cases across New York, New Jersey and Puerto Rico as of mid-May, according to the C.D.C…we’re seeing more than 4,000 confirmed cases a day, but those official numbers dramatically undercount how many people are sick because they don’t incorporate at-home tests….Here’s another metric: A company called Kinsa, which distributes internet-connected thermometers, said that just over 4 percent of its users in New York City reported fevers in recent days. That’s a very high number. In non-Covid years it might be below 1.5 percent...New Covid hospitalizations are at about 150 a day. For comparison, in early January, there were a couple of days when it was over a thousand….Mayor Eric Adams has been very clear that he’s not interested in introducing new restrictions unless the hospital system is in danger of being overwhelmed, and experts say that’s not likely here.

FROM REUTERS:

Explainer: How concerned should we be about monkeypox?

”…Experts believe the current monkeypox outbreak is being spread through close, intimate skin on skin contact with someone who has an active rash. That should make its spread easier to contain once infections are identified, experts said…..Many – but not all – of the people who have been diagnosed in the current monkeypox outbreak are men who have sex with men, including cases in Spain linked to a sauna in the Madrid region..”Viruses are nothing new and expected,” said Angela Rasmussen, a virologist at the Vaccine and Infectious Disease Organization at the University of Saskatchewan in Canada… a number of factors including increased global travel as well as climate change have accelerated the emergence and spread of viruses. The world is also more on alert to new outbreaks of any kind in the wake of the COVID pandemic, she said.”

(J. Harris: Should you become infected, experts warn not to try and hang from limbs by your imaginary tail.)

FROM AUDREY KARIEL AND HER KIDS: Family Medicine featuring John Cheng, MD – YouTube

*****

AND LAST BUT NOT LEASED:

The likely G.O.P. candidate for Connecticut governor tests positive a day after an anti-mask picnic.

NO JOKE!

1. I’m getting tired of being part of a major historical event.

2. I’m at a place in my life where errands are starting to count as going out.

3. I don’t always go the extra mile, but when I do, it’s because I missed my exit.

AND FROM THE NICE NORWEGIAN LADIES SOCIETY:

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P.O. Box 721

Scottsville Texas

75688

AREA COUNTS ARE SLOWLY CLIMBING BUT AREA DANGER REMAINS “LOW.” NEW NUMBERS ON TUESDAY. HAVE A NICE WEEKEND.

FROM THE NYT:

1. The F.D.A. authorizes Pfizer-BioNTech boosters for children ages 5 to 11.

”…More than eight million of the 28 million children in that age group in the United States have received two vaccine shots, and will now be eligible for the extra dose at least five months after their second shot. (The newly authorized booster dose is the same strength as the first two shots. In a news release on Tuesday, Pfizer said its clinical trial data showed that the additional shot produced a strong immune response in the age group, generating neutralizing antibodies against both the Omicron variant and original version of the virus[NOTE FROM HOPKINS]

FROM HOPKINS SUGGESTIONS:

1. BA.4/BA.5 SUBVARIANTS On May 12, the European Centre for Disease Prevention and Control (ECDC) reclassified the Omicron BA.4 and BA.5 sublineages from variants of interest to variants of concern (VOC). BA.4 and BA.5 were first identified in South Africa in January and February 2022, respectively. Since their identification, they have spread to other parts of the world, including to Portugal, where BA.4/5 currently account for around 37% of cases. Similar to other Omicron subvariants, such as BA.2, BA.4 and BA.5 appear to be significantly more transmissible than previous variants. BA.5 has an estimated growth advantage of 13% over BA.2 under laboratory conditions. Even individuals previously infected with an Omicron variant do not appear to be well protected against infection from BA.4/BA.5. Notably, BA.4/BA.5 contain enough mutations in key sites to evade both naturally acquired immunity and previous vaccinations. Fortunately, BA.4 and BA.5 do not appear to cause more severe disease than previous variants, although more studies are needed to solidify this observation. In the US, BA.2 and BA.2.12.1 still remain the dominant subvariants at this time, but it is likely that more cases will result from BA.4/BA.5 infection as the summer approaches and as more cases are imported from South Africa and Europe. 

2. Moderna last week released data showing its 2-dose SARS-CoV-2 vaccine is safe and effective in inducing strong immune responses and preventing COVID-19 in children aged 6 to 11 years. 

3. ”Around the globe, Australia’s death rate is about one-tenth of the rate in the US. In other words, if the US had the same death rate as Australia, 900,000 people might have been saved. One important trait differentiates the US and Australian responses: trust. At the beginning of the epidemic, 76% of Australians said they trusted the healthcare system, compared with about 34% of Americans, and 93% of Australians said they felt supported by their friends, colleagues, or communities. Australia’s leadership worked quickly to translate much higher levels of public trust in science and institutions, as well as interpersonal trust, into action, urging individuals to take steps that would prove vital to protecting themselves and their communities. Early in the pandemic, Australia’s politicians and public health officials—who adopted a “one voice” cooperative approach—moved to close borders; quarantine international travelers; implement isolation, surveillance, and contact tracing tactics; and enforce long-term lockdowns. Unlike the US, Australia’s non-partisan response to the pandemic, national health insurance program, smaller gaps in income inequality, and a concept of “mateship”—of not wanting to let down one’s neighbor—helped the nation comply with public health guidance and vaccination requirements. All of these measures helped Australia weather the pandemic and reach a vaccination rate of more than 95% among people aged 16 years and older, which is proving vital during its latest surge of cases due to the Omicron variant.”

4. Scent Dogs in Detection of COVID-19: Triple-blinded Randomised Trial and Operational Real-life Screening in Airport Setting (BMJ Global Health)  This large randomised controlled triple-blinded validation study with a precalculated sample size conducted at an international airport showed that trained scent dogs screen airport passenger samples with high accuracy. One of our findings highlights the importance of continuous retraining as new variants emerge. Using scent dogs may present a valuable approach for high-throughput, rapid screening of large numbers of people.

Paxlovid for Covid Infection: 6 Facts

(J. Harris: Good simple article with CDC reference for details.)

The White House opens up another round of free, at-home virus tests to order through the Postal Service.

(J. Harris: It takes about one minute to order these free tests on line.)

FROM BECKERS:

1. Christus Health blocks ransomware attack

FROM JAMA

1. SARS-CoV-2 RNA Can Persist in Stool Months After Respiratory Tract Clears Virus

”…After respiratory samples tested negative, a small proportion of the 113 study participants continued to shed SARS-CoV-2 RNA in their feces—about 4% of them for at least 7 months—and those people were more likely to report ongoing gastrointestinal (GI) symptoms, researchers reported in the journal Med….The findings provide more evidence that SARS-CoV-2 infects the gut as well as the lungs and could help explain why some people with “long COVID” have persistent abdominal pain, nausea, and other GI symptoms, according to the authors.

…In [A] new study, fecal SARS-CoV-2 RNA was detected in about half of the participants within the first week after a polymerase chain reaction–confirmed diagnosis of COVID-19. At 4 months, no participants were still shedding viral particles from the respiratory tract, but 12.7% continued to shed SARS-CoV-2 RNA in feces. At 7 months, 3.8% were still shedding SARS-CoV-2 in feces….”

QUESTIONS RAISED: 1. Why would SARS-CoV-2 linger in the gut longer than in the respiratory tract? 2. Is live, infectious SARS-CoV-2 commonly shed in stool?  3. How might persistent fecal shedding change how wastewater epidemiology interprets findings?   4. Does SARS-CoV-2 directly infect gut tissue?  5. Might the SARS-CoV-2 RNA found in feces at the later time points represent reinfection, not persistent infection? 6. Could persistent SARS-CoV-2 infection of the gut help explain postacute sequelae of SARS-CoV-2, commonly known as long COVID? 

2. First Breathalyzer Test to Diagnose COVID-19

3.Severity and Incidence of Multisystem Inflammatory Syndrome in Children During 3 SARS-CoV-2 Pandemic Waves in Israel

AND LASTLY:

1. There’s a fine line between a numerator and a denominator. (…Only a fraction of people will get this  joke.)

2. What do dentists call their x-rays? 

Tooth pics!

3. Did you hear about the first restaurant to open on the moon? 

It had great food, but no atmosphere.

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P.O. Box 721

Scottsville Texas

75688

DON’T FORGET TO VOTE.

FROM THE NYT:

1. How Often Can You Be Infected With the Coronavirus?

”…“If we manage it the way that we manage it now, then most people will get infected with it at least a couple of times a year,” said Kristian Andersen, a virologist at the Scripps Research Institute in San Diego. “I would be very surprised if that’s not how it’s going to play out.”…Still, the good news is that most people who are reinfected with new versions of Omicron will not become seriously ill. At least at the moment, the virus has not hit upon a way to fully sidestep the immune system….To keep up with the evolving virus, other experts said, the Covid vaccines should be updated more quickly, even more quickly than flu vaccines are each year. Even an imperfect match to a new form of the coronavirus will still broaden immunity and offer some protection, they said…”

(J. Harris: This is a good, short article. )

2. ”We may never bookend the first Covid death with the last, but I long for the day we no longer need to chart them daily.”

FROM STAT NEWS:

1. FDA rejects antidepressant seen as possible Covid-19 treatment

FROM WEBB MD:

Smell, Taste Loss Less Likely With Newer COVID Variants

”…Rates of smell and taste loss were 17% for Omicron, compared with 44% for Delta and 50% for Alpha, the investigators found…”

FROM JAMA:

1. Association of Prior BNT162b2 COVID-19 Vaccination With Symptomatic SARS-CoV-2 Infection in Children and Adolescents During Omicron Predominance

”…Among children and adolescents, estimated VE for 2 doses of BNT162b2 against symptomatic infection was modest and decreased rapidly. Among adolescents, the estimated effectiveness increased after a booster dose…” 

2. Protecting Children Against Omicron (AN EDITORIAL)

”…Prior to emergence of the Omicron SARS-CoV-2 variant, and at the time of the issuance of the Emergency Use Authorization (EUA) for the BNT162b2 (Pfizer-BioNTech) COVID-19 vaccine, the efficacy of 2 doses of the 30-µg vaccine in adolescents 12 to 15 years of age and of the 10-µg dose in children 5 to 11 years of age were 100% (95% CI, 75.3%-100%) and 90.7% (95% CI, 67.7%-98.3%), respectively.1,2 However, 2 studies published in this issue of JAMA demonstrate that the estimated vaccine effectiveness among children and adolescents with Omicron is considerably lower than in the initial studies, and protection wanes rapidly, especially with the novel SARS-CoV-2 variants.3,4…Although these 2 studies found relatively short time periods to waning of vaccine effectiveness, hope is on the horizon. As SARS-CoV-2 infections increase in children, hybrid immunity, a combination of immunity induced by vaccine and natural infection, will likely provide additional protection against future infections....The encouraging message should be that although vaccine protection for children and adolescents was lower in the Omicron era than with previous variants and that such protection wanes rapidly, vaccine effectiveness against hospitalization remains high and booster doses confer additional protection.

FROM BECKERS: 

1. Retired baby boomers are flocking to rural areas, boosting hospital demand

”…Retired people are moving to rural areas in search of natural beauty and a slower pace of life, boosting desperate local economies and bringing demand for services, including healthcare, reported The Wall Street Journal May 8. [I COULDN’T OPEN]…At 162 rural spots in the U.S., the population increased faster than the national average, bucking the trend that plagues most rural locations of population decline. Drawn in by natural attractions such as mountains and lakes, more retired people are settling down in areas such as Sevier County, Tenn., that saw a 13 percent increase in population over the past decade. …The influx of retirees brings a boost to the local economies of these sleepy towns. More residents means more consumers for local business, increased school services and a boosted workforce. In Sevier County, a new high school recently opened and a 79-bed hospital opened. 

Can You Use Expired Covid Tests?

”…Expired tests have this problem:…The probability of a false negative result (the test says I don’t have a Covid-19 infection when I do) is higher with an expired test, according to Jared Auclair, director of the Biopharmaceutical Analysis Training Lab at Northeastern….Expired Covid-19 tests are more likely to be inaccurate. Covid-19 tests that are expired should go into the trash.”

DO CATS CARRY AND SPREAD COVID. WHAT TO DO?

(J. Harris: I know of several families who have school age children and house cats and seem to suffer from recurrent bouts of Covid.)

SARS-CoV-2 in animals

(J. Harris: From the American Veterinary Medical Association [AVMA]: Seems to be good information if somewhat less concerned than I about potential Covid spread from the pet cat.) 

DOES THE COVID-19 OMICRON VARIANT SPREAD AFFECT PETS?

(J. Harris: From Texas A&M–the answer is YES.)

AND ON A LITTER SUBJECT:

(READ IT ALOUD)

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P.O. Box 721

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75688

J. HARRIS: Likely we have a new but “mild’ variant creeping into our area. Watch SHV counts and Houston, then Austin and Dallas. 

Hospital rates are not impacted in our area at this time. … What about in late May? I don’t know but I am worried. We don’t

test much in Harrison County so our initial rates will always be artificially low. I have some doubts about the validity of the available

home administered rapid Covid tests. I don’t find the color codes Threat Warnings of much benefit. They are too slow to be of much value.

FROM THE NYT (Tuesday)

1. This is why a Covid vaccine mandate is unlikely in New York City schools this fall.

”…The American Academy of Pediatrics continues to recommend vaccination for all children and adolescents ages 5 and older, including for those were previously infected. But jumping from that to a mandate is a big step…”

2. A company with an early contract to produce coronavirus vaccine hid evidence of problems.

”…A report sheds new light on Emergent executives’ own worries about deficiencies in the company’s quality control systems at its troubled Baltimore plant; no contaminated doses were ever released to the public.”

FROM BECKERS:

1. US may see ‘pretty sizable’ fall COVID-19 surge, Dr. Ashish Jha warns

”The U.S. may see a “pretty sizable wave” of COVID-19 infections this fall and winter as the virus continues to evolve and immunity wanes, White House Covid-19 Response Coordinator Ashish Jha, MD, said May 8 on ABC News’ “This Week.”

Federal health officials are looking at a range of disease forecasting models, which suggest the U.S. could experience a large surge in late 2022, similar to the last two winters, according to Dr. Jha. On May 6, the White House projected 100 million COVID-19 infections could occur this fall and winter, according to The Washington Post….”If we don’t get ahead of this thing … we may see a pretty sizable wave of infections, hospitalizations and deaths this fall and winter,” he said. “Whether that happens or not is largely up to us as a country. If we can prepare and if we can act, we can prevent that….More funding to purchase COVID-19 vaccines and therapeutics will be crucial to stave off a potential surge, according to Dr. Jha. The Biden administration is asking Congress for an additional $22.5 billion in emergency aid to support these efforts…If Congress does not do that now, we will go into this fall and winter with none of the capabilities that we have developed over the last two years,” Dr. Jha said.

FROM HOPKINS:

1. White House Documents Detail a Looming Squeeze on Covid-19 Boosters (STAT News) The White House could run out of Covid-19 vaccines if it moves forward with plans to encourage all adults to get a second Covid-19 vaccine booster dose by roughly Sept. 1, according to a tranche of budget documents sent to Congress that have not previously been made public. Although Food and Drug Administration officials have hinted that all American adults may be encouraged to get second boosters this fall, right now, second booster doses are only available to people over the age of 50.

The budget documents make it clear that if the administration does want to push second boosters, it will need more money to make it happen: it needs at least 87 million more vaccines for adult boosters, and another 5 million more for first boosters for kids.

2. FDA Dramatically Narrows Use of Johnson & Johnson Covid-19 Vaccine (POLITICO) The Food and Drug Administration has restricted the use of the Johnson & Johnson Covid-19 vaccine to adults who are unable or unwilling to get the Pfizer-BioNTech or Moderna mRNA shots. The decision comes after the agency completed an updated risk analysis of developing thrombosis with thrombocytopenia syndrome, or TTS, a rare and possibly fatal combination of blood clots and low platelet counts one to two weeks after receiving the vaccine, the agency said Thursday. Given the severity and urgency of the syndrome, and the availability of other Covid-19 vaccines, FDA decided that the benefits of Covid-19 protection from the Johnson & Johnson vaccine outweigh the risk of TTS only for those who cannot or will not receive other forms of vaccination.

FROM THE NYT (last week)

The Vanishing Variants: Lessons from Gamma, Iota and Mu

(J. Harris: A readable Mu (and variant) article about why some variants are more “successful” than others and why some of our attempts at control are not likely to be helpful.)

FROM SCIENTIFIC AMERICAN:

A Guide to the Different Omicron Subvariants

(J. Harris: A short readable understandable variant article.)

CDC GUIDELINES FOR LONG COVID DX AND HELP:

Long COVID or Post-COVID Conditions

FROM REITERS:

South Africa Covid-19 Test Positivity Rate Nears Record

AND LASTLY:

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P.O. Box 721

Scottsville Texas

75688

WE GOT 4 INCHES OF RAIN YESTERDAY

FROM BECKERS:

COVID-19 hospitalizations up in 40 states

”…The more contagious omicron subvariant BA.2 makes up 68.1 percent of new cases in the U.S., according to the latest estimates from the CDC. Rhode Island has the highest proportion of BA.2 cases of all states, according to the latest ranking of states by the subvariant’s prevalence…”

FOR HOPKINS:

1. Comparative Effectiveness Over Time of the mRNA-1273 (Moderna) Vaccine and the BNT162b2 (Pfizer-BioNTech) Vaccine (Nature) Observational data incorporating cases of Delta VOC have suggested a higher rate of infection in individuals immunized with two doses of the BNT162b2 vaccine compared with two doses of the mRNA-1273 vaccine, suggesting that the real-world performance of the vaccines may differ from one another. We therefore conducted a retrospective cohort study that examined the incidence and severity of Covid-19 infections as a function of the time from vaccination in over 3.5 million individuals across the United States who were fully vaccinated via either the mRNA-1273 or the BNT162b2 vaccine, including over 8800 infections.

2. More Uniformly Infectious, More Treatable, More Genetically Predictable: How Coronavirus is Getting Closer to Flu (STAT News) SARS-CoV-2 remains a long way from being ordinary. It has not yet found seasonal cadence — take the recent surge in Europe and the U.K., which comes just weeks after the initial Omicron wave subsided — and it’s still capable of inflicting mass death and disability (see Hong Kong’s lethal last few months). But there are signs that the virus — and our relationship to it — is shifting in subtle ways that make it more like seasonal flu than it was at the start of the pandemic. One of the most intriguing shifts involves how Covid now spreads from person to person. Also, flu and SARS-CoV-2 are starting to resemble each other at a more basic level too — how they evolve.

FROM JAMA:

1. Studies Examine Risk of Hearing Loss After COVID-19 Vaccination

(J. Harris: Apparently it happens — but rarely.)

2. NOT COVID RELATED BUT POTENTIALLY USEFUL:

A. First Donepezil Transdermal Patch Approved for Alzheimer Disease

B . First Amphetamine Transdermal Patch Approved for ADHD

FROM THE NYT 

1. The global death toll during the pandemic far exceeds what countries have reported, the W.H.O. says.

”… a startling glimpse of how drastically the death counts reported by many governments have understated the true toll of the pandemic…

”…In the United States, the W.H.O. estimated that roughly 930,000 more people than expected had died by the end of 2021, compared with the 820,000 Covid deaths that had been officially recorded over the same period… Overall, roughly 14.9 million more people worldwide died in 2020 and 2021 than would have been expected to in normal times, the experts estimated. Most were victims of Covid itself, they said, but some died because the pandemic made it more difficult to get medical care for ailments such as heart attacks. The previous toll, based solely on death counts reported by countries, was six million…Much of the loss of life from the pandemic was concentrated in 2021, when new and more contagious variants drove surges of the virus even in countries that had fended off earlier outbreaks…Nearly a third of the excess deaths globally — 4.7 million — took place in India, according to the W.H.O. estimates…Scientists also noted that excess death rates were not necessarily indicative of a country’s pandemic response: Older and younger populations will fare differently in a pandemic, regardless of the response. And the W.H.O. experts said that they did not account for the effects of heat waves or conflicts…W.H.O. officials cited Britain as an example of a country that had accurately recorded Covid deaths: Their analysis found that about 149,000 more people than normal had died during the pandemic, nearly identical to the number of Covid deaths Britain reported… a statistician at Ludwig Maximilian University of Munich, who has studied excess deaths in Germany, said that the country’s rapidly aging population meant that the W.H.O. analysis may have underestimated the number of people who would have been expected to die in a normal year. That, in turn, could have produced overestimates of excess deaths…”

2. A new subvariant is spreading rapidly in the United States.

”…The coronavirus is constantly mutating. While some variants seem to vanish, causing little ripples of surges in their wake, others have kept driving large outbreaks. Experts say a new form, BA.2.12.1, is spreading rapidly and will likely in the next weeks become the dominant form of the virus in the United States. There’s no indication yet that it causes more severe disease…virtually every reported infection across the nation is from an Omicron subvariant, and although BA.2 is still the dominant form, BA.2.12.1 is quickly gaining ground…[ EXPERTS] expects rising infections to spread from the Northeast to the South then the West, driving more outbreaks. “We’re already seeing it here in Louisiana,” said Dr. Queen, who oversees genetic analysis for the virus at the university. “Our most recent sequencing runs of community samples have all been BA.2.12.1, and those samples are from mid-April….But reported cases are likely an undercount of the virus’s true spread, since access to at-home tests has increased and the results are often not officially reported…“We’re in this phase of pandemic fatigue and complacency,” he said. “And while we need to balance the weight of mental health with the risk of contraction, as a result we’ve seen an uptick not only in the Omicron variant but other respiratory illness….”

3. Virus cases spread after White House Correspondents Dinner.

”…On Saturday, the comedian Trevor Noah stood before a ballroom of 2,600 journalists, celebrities and political figures at the White House Correspondents Dinner, and asked: What are we doing here?…“Did none of you learn anything from the Gridiron Dinner? Nothing,” Mr. Noah said, referring to another elite Washington gathering in April, after which dozens of attendees tested positive for the coronavirus. “Do you read any of your own newspapers?”

FROM HOPKINS SELECTIONS”

BOOSTER DOSES The debate over whether additional SARS-CoV-2 vaccine booster doses are needed continues to heat up as several Omicron subvariants are driving increasing transmission rates in the United States and abroad. A study from Israel published on May 5 provides evidence that a second booster dose for the Pfizer-BioNTech vaccine is capable of protecting against infection for 4 weeks and severe disease for 6 weeks. However, the WHO has yet to release an official recommendation for additional booster doses, and many health officials remain skeptical about the widespread administration of boosters since neutralizing antibodies tend to wane rapidly after the first and second booster in healthy populations. One point of agreement among experts is that elderly and immunocompromised individuals receive the most benefit from additional doses of vaccine, and the US FDA has authorized additional booster doses for adults aged 50 and older. Notably, 42% of COVID-19 deaths in the US at the beginning of 2022 were among vaccinated individuals, the majority of whom were not boosted. Additional countries such as Israel, Denmark, and Singapore also have authorized second booster doses for certain high-risk populations. US health officials appear confident they will have enough information to decide whether a second booster dose is necessary for the wider population at some point this summer. A major consideration for additional doses is whether the original vaccine formulation is sufficient or if Omicron-specific vaccine formulations are needed. 

FROM THE LANCET:

AN EDITORIAL: 5 POINTS “THE NEXT PHASE AND BEYOND”

1. ”…the pandemic situation is not the same everywhere in the world. China, for example, continues to employ its so-called dynamic zero COVID strategy of mass testing, quarantining of those testing positive, and lockdown of districts or even whole cities (most recently Shanghai)

2. … the global vaccination strategy is far from on track.

3. … vaccine inequity is mirrored by slow and delayed access to one of the few effective oral treatments for COVID-19—paxlovid…When taken early, paxlovid reduces the risk of hospitalization and death by 89%…

4. … now is the time to plan, learn from mistakes, and create strong resilient health systems, as well as national and international preparedness strategies with lasting funding.

5 … Nationally, countries need independent inquiries into their responses to COVID-19. Learning from mistakes is never easy and governments can be reluctant to even accept that they have been made. When the UK High Court ruled last week that it was unlawful to discharge hospital patients to care homes without COVID-19 testing, the UK Government claimed to have acted on the best evidence available at the time. This is a blatant lie. The evidence for asymptomatic transmission was clearly available by late January, 2020.”

AND LAST BUT NOT LEASED:

MILTON TOMATO HAS A NEW  110 POUND GUARD DOG TO PROTECT AGAINST WILD HOGS

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