COVID State of Affairs: July 25 Katelyn Jetelina
(J. Harris: Great summary, readable. I am a paid subscriber.)
From THE NYT SATURDAY:
1. Combined nasal and throat testing swabs would detect more Omicron infections, two papers suggest.
”…coronavirus tests that analyze both nasal and throat swabs … pick up more Omicron infections than those that rely on just a nasal swab….
The first paper focuses on 14 people who enrolled in the study before or at the same time that their infections began, allowing the researchers to capture the earliest stage of infection….This group of participants provided a total of 260 nasal swabs, 260 throat swabs and 260 saliva samples over the course of their infections, allowing the scientists to make multiple comparisons between the amount of virus in different specimens and people at different times…
The researchers found significant differences in the viral load of different sample types from the same individuals….
In most participants, the virus was detectable in saliva or throat swabs before it was detectable in nasal swabs. “You can have very high, presumably infectious, viral loads in throat or saliva before nasal swabs,…”
2. New sub-variant ‘Centaurus’ discovered in Australia | Coronavirus | 9 News Australia
(J. Harris: It was hoped that the BA2.75 which started in India would not be an important varisn. Now called “Centaurus” in Australia, it isn’t as deadly as some variants, but much like BA .5 in the US, it is filling up some of the hospitals. Most of the world’s deaths from Covid are in folks over about 74.)
FROM LOCAL EPIDEMOLOGIST:
1. NORVAX: MIX AND MATCH DATA. PLUS SUMMARY OF THE NEW “OLD” VACCINE
1. 3. Time-Release Microparticles Could Deliver “Self-Boosting” Vaccines (GEN) Most vaccines, from measles to COVID-19, require a series of multiple shots before the recipient is considered to be fully vaccinated. To make that easier to achieve, MIT researchers have developed microparticles that can be tuned to deliver their payload at different time points, and which could be used to create what the scientists describe as “self-boosting vaccines.” Using these particles, which resemble tiny coffee cups sealed with a lid, researchers could design vaccines that would need to be given just once, and would then “self-boost” at a specified point in the future. The particles can remain under the skin until the vaccine is released and then break down, just like resorbable sutures. The same strategy could also feasibly be used to deliver a range of other therapeutics, including cancer drugs, hormone therapy, and biologic drugs.
2. Polio: An unfortunate reminder of the decline in routine vaccinations
(J. Harris: We have the first acute polio case in the US in quite a while.)
From THE CDC:
Correlation Between Clinical and Wastewater SARS-CoV-2 Genomic Surveillance, Oregon, USA (CDC EID) SARS-CoV-2 variant proportions in a population can be estimated through genomic sequencing of clinical specimens or wastewater samples. We demonstrate strong pairwise correlation between statewide variant estimates in Oregon, USA, derived from both methods (correlation coefficient 0.97). Our results provide crucial evidence of the effectiveness of community-level genomic surveillance.
1. Effect of Text Message Reminders and Vaccine Reservations on Adherence to a Health System COVID-19 Vaccination Policy
”Question Can a behavioral nudge delivered through text messages with a reserved date for vaccination over a 2-week period accelerate employee adherence with a health system COVID-19 vaccination policy?
Meaning This randomized clinical trial found that a behavioral nudge delivered by text message with a reserved date for vaccination accelerated adherence to a health system COVID-19 vaccination policy; however, other approaches may be needed to change overall adherence rates by the time of the policy deadline.”
2. Association Between Vaccination and Acute Myocardial Infarction and Ischemic Stroke After COVID-19 Infection
This study found that full vaccination against COVID-19 was associated with a reduced risk of AMI [HEART ATTACK] and ischemic stroke after COVID-19. The findings support vaccination, especially for those with risk factors for cardiovascular diseases.
3. Updated US Infection- and Vaccine-Induced SARS-CoV-2 Seroprevalence Estimates Based on Blood Donations, July 2020-December 2021
”…In this study of US blood donations, the combined seroprevalence from infection or vaccination reached 94.7% by December 2021. Despite this, record levels of infection and reinfections were reported as the Omicron variant became predominant in early 2022.2 The high infection rates are likely related to increased transmissibility and enhanced immune escape mutations of the Omicron variant, along with waning protection from previous vaccination and infection.3-5 During 2021, the infection-induced seroprevalence increased more in regions with low vaccination rates compared with those with high ones. The ability of SARS-CoV-2 variants to cause widespread transmission in the setting of high seroprevalence illustrates the value of COVID-19 vaccines, including recommended booster doses, to maximize protection.
FROM HOPINS SUGGESTIONS:
1. “…Published July 19 in Science, a study of spike protein function and neutralizing capability of 7 different SARS-CoV-2 vaccines against Omicron sublineages shows that a large number of the sublineage mutations lead to enhanced ACE2 binding and reduced plasma neutralizing activity. However, homologous or heterologous boosters markedly increased neutralizing antibody titers against BA.1, BA.2, BA.2.12.2, and BA.4/5 across all vaccines evaluated to provide sufficient protection against Omicron-induced severe disease. The vaccines evaluated included mRNA vaccines from Moderna and Pfizer-BioNTech, viral-vectored vaccines from J&J-Janssen, AstraZeneca-Oxford, and Sputnik V, as well as the Novavax and Sinopharm vaccines that use different platforms.
ADDITIONALLY FROM SCIENCE ARTICLE: ”…The recent evaluation of intranasal vaccine administration could also be important to not only prevent severe disease but also curtail viral infection and transmission through induction of mucosal immunity (75–78). For these reasons, it is important to monitor new variants, assess the effectiveness of currently available vaccines, and continue to test and implement new vaccination strategies that may provide stronger, longer lasting, or broader protection against SARS-CoV-2 and the entire sarbecovirus subgenus…”
2. US PANDEMIC PREPAREDNESS The administration of US President Joe Biden is reorganizing the US Department of Health and Human Services to elevate the Office of the Assistant Secretary for Preparedness and Response (ASPR) from a staff division into an independent operating division—similar to the US CDC, FDA, and NIH—responsible for leading the nation’s responses to future pandemics and health emergencies. Under the reorganization, ASPR will now be known as the Administration for Strategic Preparedness and Response, and efforts to stand up the new division will be phased in over the next 2 years. ASPR oversees the Strategic National Stockpile, the national Medical Reserve Corps, and contracts for and distribution of vaccines and certain medicines in health emergencies. Though many current and former HHS officials welcomed the move, other experts say that shifting some health emergency coordination responsibilities to ASPR could undercut response efficacy, create confusion and tension, and does not address ongoing challenges at CDC, which has much closer relationships with states.
3. Prior Omicron Infection Protects Against BA.4 and BA.5 Variants (Nature) The Omicron BA.4 and BA.5 subvariants of SARS-CoV-2 have proven to be stealthier at evading people’s immune defences than all of their predecessors. But recent research shows that previous infection with an older variant (such as Alpha, Beta or Delta) offers some protection against reinfection with BA.4 or BA.5, and that a prior Omicron infection is substantially more effective. That was the conclusion of a study that evaluated all of Qatar’s COVID-19 cases since the wave of BA.4 and BA.5 infections began1. The work, which was posted on the medRxiv preprint server on 12 July and has not yet been peer reviewed, feeds into broader research on “how different immunities combine with each other”, says study co-author Laith Abu-Raddad, an infectious-disease epidemiologist at Weill Cornell Medicine-Qatar in Doha.
FROM SCIENTIFIC AMERICAN:
People with Long COVID May Still Have Spike Proteins in Their Blood
”...this spike protein found in the blood could be a “biomarker,” specifically for long COVID…”
”… researchers still haven’t pinned down what causes the condition or how to treat it…..Now researchers may have found a marker for the disabling condition: a piece of SARS-CoV-2, the virus that causes COVID, floating around in the blood of some long COVID sufferers well after their initial infection… detecting a fragment of SARS-CoV-2 in blood samples from long COVID sufferers up to a year after their original infection. The fragment is a spike protein, one of the protrusions around the outside of SARS-CoV-2 that give this coronavirus its namesake corona, or crownlike appearance. During an initial COVID infection, the spike protein typically breaks off into smaller pieces when it penetrates human cells, but the spike proteins observed in this study were still in one piece. The findings have not yet been peer-reviewed….“If you had an infection, and you cleared it, then normally, you would not see [the spike protein] because all the antibodies you produced would clear everything that enters the bloodstream,… Instead, …tissues such as those in the gut and brain could be a haven for SARS-CoV-2 within the body, preventing long COVID patients from fully clearing their infections and acting as a source of spike proteins. “Maybe the virus can just persist there. It evades the immune system somehow.”……[A] “The presence of circulating viral proteins may be helpful to identify which subset of long COVID patients might have the persistent viral etiology”—the version of long COVID caused by the ongoing presence of SARS-CoV-2 in the body—…The rest of the long haulers might suffer from other causes.” These other causes could include… [B] an overblown immune response that leads COVID patients’ body to develop immune proteins—“autoantibodies”—that attack its own cells in the same way they would attack an intruder such as a virus or bacterium. These autoantibodies have been found in people’s body during an initial COVID infection, as well as in the bodies of some long COVID patients…. [C]Another possibility is that a COVID infection makes people more susceptible to other viruses already present in the body, such as the Epstein-Barr virus. This pathogen lies dormant in most people but has been found reactivated in some long COVID patients…
Oral vaccine shows promise; hypertension ups COVID hospitalization risk
BA.2.75 a ‘scariant,’ not the next variant to worry about, experts say
While there will likely be new COVID-19 variants to worry about in the future, omicron relative BA.2.75 is not the next big one to fret over, experts predict…
“BA.2.75 is a scariant. It’s not spreading anywhere besides a couple of provinces in India without BA.5 to compete with,” Eric Topol, MD, founder and director of the Scripps Research Translational Institute in San Diego, said in a July 19 tweet, citing a graph based on data from global data-sharing virus platform GISAID that indicates the strain hasn’t spread much outside of several states in India. “There will be other new variants to be concerned about, but it doesn’t look like this is one of them.”
As new variant spreads, a crucial drug to protect the most vulnerable goes vastly underused
(J. Harris: An IV drug against Covid for immunocompromised patients.)
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