CORONAVIRUS INFO PROVIDED BY DR. JIM HARRIS – 6/22/2022

THE HONEYMOON IS OVER AND THE COUNTS ARE SIGNIFICANTLY ELEVATED IN TEXAS, ESPECIALLY EAST TEXAS:

FROM BECKERS:

1. Mark Cuban’s generic drug prices would save Medicare billions of dollars: Harvard study

FROM DR. KATLINE JETELINA, YOUR LOCAL EPIDEMIOLOGIST:

BA.4/5 is sweeping the globe

”…The newest Omicron variant, BA.4/5, is gaining traction, causing case, hospitalization, and death curves to trend upwards in many countries. This variant was first detected in South Africa in early 2022 and caught our attention because it had several mutations on the spike protein…..In the lab, we see that Omicron is getting better at escaping our first line of defense—neutralizing antibodies. ..BA.4/5 does not fully escape immunity. This means, in the short-term, boosters help prevent infection and thus transmission…. BA.4/5 drove a substantial case wave in South Africa regardless of their high level of immunity. Case waves across Europe are now well on their way, too. In the U.K., reinfections are on the rise, even among 60+ year olds.

..We don’t have epidemiological data on duration of booster effectiveness against BA.4/5. Data from the U.K. showed that boosters provided strong initial protection against BA.1 or BA.2 infection but quickly diminished to 0% five months later. We expect BA.4/5 to shorten this timeline even more…..

In Europe, Portugal is the BA.4/5 leader, with 70% of COVID-19 cases accounting for this new variant. With one of the highest vaccination rates in the world, they largely escaped death from Delta. However, now, after recently reaching their BA.4/5 case peak, excess mortality hit the highest level since their vaccination campaign began…In Portugal, increase in hospitalizations is occurring mainly in people over 60 years old. In fact, in a recent analysis, unvaccinated people over 80 had a case fatality rate (CFR) of 9.5% … Among those with only the primary vaccine series, CFR [CASE FATALITY RATE] is 5%; among those with a booster, it is 1.7%….. While Portugal does have a higher booster rate than the U.S., it isn’t perfect. . Vaccines are not perfect, and if we have a virus burning through a population, it can still cause high levels of death among vulnerable pockets, like the elderly….BA.4/5 hospitalizations are now making headway in other European countries…[WITH] the global upswing in hospitalizations as BA.4/5 entered the scene. But, so far, remains much lower than previous peaks….Bottom line:This virus continues to mutate to escape our first line of defense causing (re)infections. If you don’t want to get sick, it’s time to leverage other layers of protection, like masking. Thankfully, other immune system mechanisms continue to work to reduce severe disease. The transmissibility of the virus is causing upswings of hospitalizations and deaths among the most vulnerable of our populations. We aren’t out of the woods yet but we are inching closer and closer to a manageable virus…”

(J. Harris: Dr. Jetelina is a PhD epidemiologist who has a day job and writes this blog at night. She has small children and accepts contributions. I have found her to be well-informed and to have the ability to explain pertinent  basic and new information to laymen and old Internists. The above article is worth reading in its entirety. I subscribed to her efforts.)

AND LASTLY:

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CORONAVIRUS INFO PROVIDED BY DR. JIM HARRIS – 6/21/2022

From Judge Sims and THE MNM:

FROM THE NYT TODAY:

1. A Chinese Omicron study finds a low risk of severe illness, renewing debate over the ‘zero Covid’ policy.

2. Deaths stay near pandemic lows, despite another virus surge.

3. CALL TO OVERHAUL THE US PUBLICK HEALTH SYSTEM

”…While other countries have centralized public health authorities, public health in the United States is largely managed at the state and local level. The Centers for Disease Control and Prevention, the federal public health agency, does not have the authority to compel states to act — it cannot, for example, investigate outbreaks of infectious disease in a particular state unless it has an invitation from state officials to do so….State health agencies and the C.D.C. have a long history of working collaboratively, but throughout the pandemic, elected state officials — particularly those in red states — have been reluctant to cede control. When the C.D.C. asked states to sign agreements to share vaccination data with the federal government, for example, a number of states balked….The Senate health committee has passed a bipartisan measure that would require the C.D.C. director to be confirmed by the Senate, and that calls for additional steps to improve coordination among the nation’s public health agencies....The commission’s recommendations are more sweeping. The panel… calls for the creation of a new position — Under Secretary for Public Health — within the Department of Health and Human Services, to oversee the national public health system…The under secretary would coordinate the work of more than a dozen federal agencies that play a role in public health, and would have the power to set minimum health standards for the states…“Our system of public health is a federalist system with states and localities having considerable autonomy — and appropriately so, as they adapt to the needs of their states and communities,” Dr. Hamburg said in an interview. “However, the public health protections that individuals receive shouldn’t be wholly dependent on where you live. There should be a core set of expectations.”

(J. Harris: We need to make significant changes in the US Public Health System, from top to bottom, in my opinion. The system seems rudderless and politically hindered at the top and poorly functional in many locales — including and especially in rural areas. Local public health systems, medically, could be more efficient with more guidance and supervision by well-trained public health experts and physicians with mandates and necessary follow-up audits, especially when future medical epidemics arise as they will. …..It appears to me that the Texas Department of Health Services has functioned very well during the Covid Pandemic and has improved as the crisis deepened, especially in the dissemination of general information and data to medical practitioners, institutions, and the public. Unfortunately, like many other rural, “red” and undereducated areas, the vaccination rates in most Texas Counties are absolutely pitiful, The Marshall-Harrison Department of Health is fortunate to have a well-educated, highly motivated leader, but we don’t seem to have a good local system of information dissemination (broadband???). Also, it would be nice if there were more state and national solution programs available for epidemiological control in times of crisis. Need I say that I would have approved of the incarceration and isolation of “Typhoid Mary” way back when?)

FROM HOPKINS SELECTIONS:

1. Covid Vaccine Hesitancy Threatens Flu Vaccine Uptake (CIDRAP) Polarized views and worries about COVID-19 vaccination had spillover effects on flu vaccination in adults, according to researchers who examined data over two pandemic years on both vaccines by state. The authors of the study say the findings are a warning of declining trust in public heath, which comes at a vulnerable time as eased COVID-19 measures put populations at risk for the return of disease threats such as flu. Late-season flu activity is still under way in some parts of the United States, and health officials are closely watching Australia, where an early-season surge is already worse than some of the country’s pre–COVID pandemic flu seasons. The group, based at University of California-Los Angeles Health Services, published its findings yesterday in a letter to the New England Journal of Medicine.

FROM THE NYT:

C.D.C.’s science advisers grapple with assessing two very different vaccines for the youngest Americans.

”…Unvaccinated people aged 5 and older had 10 times the risk of dying of Covid-19, compared with those who received at least two shots of the vaccine,…. The figures “provide real world-evidence that most deaths from Covid-19 are preventable through vaccination…”

The two vaccines[for young children] differ in almost every aspect. For young children receiving the Moderna vaccine, the Food and Drug Administration has authorized two doses of 25 micrograms each, one-fourth the amount used for adults, spaced four weeks apart…But according to the data presented on Friday, two doses of the Pfizer vaccine — each just three micrograms, or one-tenth of the adult dose — fell short of producing strong immunity against the virus in young children…To be effective, the Pfizer-BioNTech vaccine will need to be administered in three doses: the first two spaced three weeks apart, and a third at least two months after that…Pfizer has reported that three doses of its vaccine has an effectiveness of about 80 percent against symptomatic illness. But that estimate is based on infections in just three children who were immunized in the company’s trials, the C.D.C. committee members noted.

(J. Harris: Pediatricians will ”call the shot” and tell you which and when to vaccinate young children. At this time, Moderna might be the best choice?)

FOLLOW TEXAS COVID VARIANTS

(J. Harris: This is a good site to play with as the variants come and go.)

COVID-19 vaccine info for trusted messengers: Kids <5 years My Toddlers Already Had COVID-19. I’m Still Getting Them Vaccinated Right Away

(J. Harris: written by a young female epidemiologist who puts out a nice email frequently.)

Rapid, scalable assessment of SARS-CoV-2 cellular immunity by whole-blood PCR

”…As the deployment of vaccines attenuates the pandemic3, vaccine effectiveness and the duration of protective immunity will need to be systematically assessed and monitored at a global level. Long-term protection from viral infection is mediated by both humoral (antibodies) and cellular immunity4. Quantification of SARS-CoV-2-specific IgG and neutralizing antibodies is often used as a marker of immune protection5, but measurement of T cell responses is rarely performed because of the associated technical challenges. ...Fast, high-throughput methods for measuring the level and duration of protective immune responses to SARS-CoV-2 are needed to anticipate the risk of breakthrough infections. Here we report the development of two quantitative PCR assays for SARS-CoV-2-specific T cell activation. …”

(J. Harris: I have a few readers that might understand this article. I can follow some of it. The article below helps.)

A New Test Can Help Reveal If You’re Immune to COVID-

(J.Harris: FROM TIME 

”…But an international group of researchers recently developed a different tool to help assess COVID-19 immunity: a blood test that can measure T cells, white blood cells that work alongside virus-fighting antibodies to mount an immune response. Their work is described in a new study published in Nature Biotechnology….Testing for antibodies only tells part of the story, since T cells are also a critical piece of the body’s immune response. And while antibody levels drop off significantly within a few months of vaccination or infection, cellular immunity can last up to a year, Guccione says. “Monitoring both will give us a much clearer picture [of immunity] and will hopefully inform our re-vaccination strategies,” Guccione says. The wide use of this test could help define how long protection lasts and how often booster doses are needed.

How Long-COVID Risk Varies By Variant

(J. Harris: good quick read.)

”…The Omicron variant is less likely to give you long COVID than a previous strain of the virus, British researchers say…..But because the Omicron variant is far more contagious than Delta, more people get infected with Omicron and, therefore, more experience long COVID, they added…For the study, Steves and her colleagues used the U.K.-based ZOE COVID Symptom study app to collect data on 56,000 people infected with the Omicron strain. They were compared with more than 41,000 people infected with the Delta strain…The upshot: Odds of getting long COVID were 20% to 50% lower with Omicron than Delta. The odds were dependent on a patient’s age and time since vaccination.

Paxlovid rebound symptoms rare, Mayo study finds

”…Last month, an FDA official cautioned that the antiviral treatment couldn’t block recurring symptoms. Pfizer CEO Dr. Albert Bourla disagreed, arguing a symptom relapse was rare…

The CDC issued an alert May 24 warning that some Paxlovid patients were symptomatic two to eight days after testing negative.

With an 89 percent efficacy rate in diminishing symptoms, Paxlovid is currently the nation’s most popular COVID-19 treatment.

Moderna’s vaccine had fewer side effects than Pfizer’s in study

”…An observational study of nearly half a million inoculated people found the Pfizer and Moderna COVID-19 vaccines had similar side effects, but the risk was lower in Moderna’s…

Of the 433,762 veterans studied over a 38-week period, receivers of the Pfizer shot had a higher risk of ischemic stroke, kidney injury, myocardial infarction and other thromboembolic events compared to those jabbed with Moderna’s vaccine, according to the research published June 13 in JAMA…

Side effect risk of both mRNA-based vaccines was relatively low overall. The median age in the study was 69, and men made up 93 percent of participants.

AND LASTLY:

NORWEGIAN FATHERS DAY JOKES: (TRANSLATIONS AVAILABLE)

1. If you see a crime at an Apple store, are you an iWitness?

2 The wedding was so beautiful, even the cake was in tiers.

3. I used to be able to play the piano by ear, but now I have to use my hands.

4. To whoever stole my copy of Microsoft Office, I will find you. You have my Word!

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P.O. Box 721

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75688