CORONAVIRUS INFO PROVIDED BY DR. JIM HARRIS – 8/4/202

COVID COUNTS ARE HIGH LOCALLY.

FROM THE NYT

1. By Jonathan Wolfe on 3 August:

”…Is the virus endemic?

Even though people across the world are trying to move on from Covid, it’s still here, all around us…Case in point: Half of all infections during the pandemic have taken place this year, … Given the current pace, it’s possible that more than 80 percent of all Covid cases will ultimately take place in 2022…

What do the coming months look like?

There are a lot of variables. [To] synthesize all of them, I would say that I think it’s likely that, for the foreseeable future, we’re living primarily with Omicron variants. That means the virus will find new ways to evade our immune response without totally eliminating the immune protections that we carried before….

In the fall, we will begin to see some limited rollout of new next-generation vaccines, but they won’t fundamentally change the trajectory of immune protection going forward. And we have very limited implementation of other social and political measures, such as mandating better air quality in schools and transportation systems and things along those lines….

”Where does that leave us? …That this is really an old person’s disease now. That was true at the beginning of the outbreak, but it’s becoming even more true now. It’s quite possible that we’ll see increasing relative vulnerability among the old, which is to say people who are in middle age are going to feel pretty safe living a totally normal life… But [older people] may not ever. That’s because they have a much harder time building up immunity, which means they lose the benefits of the vaccines and previous exposure much more quickly…We’re also seeing a significant death toll this year. We’ve more or less normalized it. We could have roughly equivalent numbers of especially elderly people dying as we did in the first years of the pandemic — and that’s tragic.”

FROM BECKERS:

Why we may be in ‘omicron land’ for a while

FROM HOPKINS SELECTIONS:Is the virus endemic?

Even though people across the world are trying to move on from Covid, it’s still here, all around us….attention to the US CDC’s guidance regarding isolation after COVID-19 diagnosis or a positive SARS-CoV-2 test. The CDC currently recommends isolation for a minimum of 5 days after the onset of symptoms or positive test. To end isolation, those who were symptomatic should wait until their fever has subsided for at least 24 hours and other symptoms are improving—and those leaving isolation should wear a mask in public through Day 10. Notably, the CDC indicates that individuals can test before they end their isolation, but the guidance emphasizes that testing is optional (ie, as opposed to recommended) for anyone who “wants to.” Those who elect to test and obtain a positive result should remain in isolation. The isolation and testing protocol implemented for President Biden went “above and beyond” the CDC recommendations, and CDC Director Dr. Rochelle Walensky indicated that the CDC must issue guidance that is feasible for most people to follow. Recent studies have demonstrated that many individuals continue to test positive for 6 days or longer, and most can shed the virus for 8 days or longer, which could enable them to infect others if they end isolation after 5 days. In light of this evidence, some experts have called on the CDC to revisit its guidance to slow transmission, particularly in light of the current Omicron surge.

2. ”… millions of people in the US have post-COVID-19 conditions, also known as long COVID. The US CDC estimates that nearly 1 in 5 individuals who have had COVID-19 continue to report long-term symptoms lasting 3 months or longer. Many of them have left their jobs because they have symptoms, such as fatigue or brain fog, that hinder their ability to perform daily or work tasks. Under federal guidance, people with long COVID can qualify for disability, meaning employers must offer accommodations to their workers. But many people with long COVID say negotiating accommodations or finding support from social assistance programs remains difficult. Some experts advocate for a better definition of the condition to facilitate diagnosis, more robust educational campaigns to warn people of the risk for long COVID, and more support for people with the condition. More than 100,000 US residents are diagnosed with COVID-19 everyday, some for a second or third time, and evidence suggests people who are infected more than once are at greater risk of long-term health consequences. It will be years before we fully understand the disease’s impacts on the public health, employment, and health coverage landscapes.

FROM THE ATLANTIC

This COVID Summer Is Nothing Like the Last One

”…We need multiple approaches to reduce transmission. It’s going bonkers right now, and this is not a sustainable way to coexist with this virus. I’m not saying that people need to have mask mandates forever, but when transmission rates are this high, it is a good idea to think about masking, to think about testing more often, paying attention to who is up-to-date on their vaccines and making sure that our approaches are complementing each other…

”It is true that hospitalization and death rates are down, but the more people you have infected, even a very small percentage can turn into an untenable number of hospitalizations and deaths. And every infection carries the risk of long COVID, or taking people away from school or work or their family. And the worrisome thing is, for the past few months, we’ve been at this bizarre plateau in terms of case counts not really coming back down and looking better…There’s not a lot of data to go off, so I’m going to be tentative here. I think we can expect them to be an improvement, but I can’t tell you if it’s going to be a 5 percent improvement or a 60 percent improvement. The other big asterisk on this is, what’s going to be around in September? Is it still going to be BA.5, is it going to be BA.6, or is it going to be another variant entirely?…We need multiple approaches to reduce transmission. It’s going bonkers right now, and this is not a sustainable way to coexist with this virus. I’m not saying that people need to have mask mandates forever, but when transmission rates are this high, it is a good idea to think about masking, to think about testing more often, paying attention to who is up-to-date on their vaccines and making sure that our approaches are complementing each other.

FROM EPIDEMOLOGIST:

How is monkeypox spread?

(J. Harris: This is concise and short. It will be all I have to say about Monkey Pox).

FROM THE LA TIMES:

Coronavirus Today: Experts are taking a softer stance on masking; it’s a different pandemic

(J. Harris: This is a good updated mask article. The majority of my readers are older folks with more than a few preexisting maladies — just like I have. I’m not going to goof off now and take careless chances at this late date. In addition, I don’t want to be dragging ass around in my last years with Long Covid. Masks and vaccinations and prudence have worked so far. Besides, I have to take care of both The Norwegian and Milton.)

FROM THE NEJM:

Grieving in a Pandemic

Viral and Symptom Rebound in Untreated COVID-19 Infection

”… Findings: In both the primary and secondary analyses, 12% of participants had viral rebound. Viral rebounders were older than non-rebounders (median 54 vs 47 years, P=0.04). Symptom rebound occurred in 27% of participants after initial symptom improvement and in 10% of participants after initial symptom resolution. The combination of high-level viral rebound to ≥5.0 log10 RNA copies/mL and symptom rebound after initial improvement was observed in 1-2% of participants. Interpretation: Viral RNA rebound or symptom relapse in the absence of antiviral treatment is common, but the combination of high-level viral and symptom rebound is rare.”

FROM JAMA

Association of Receiving a Fourth Dose of the BNT162b Vaccine With SARS-CoV-2 Infection Among Health Care Workers in Israel

Question:

Was there a benefit of vaccinating health care workers with a fourth dose of BNT162b2 vaccine during the Omicron variant outbreak of the COVID-19 pandemic?

Findings In this multicenter cohort study of 29 611 health care workers in Israel, the breakthrough infection rate among those who received 4 doses was 6.9% compared with 19.8% in those who received 3 doses.

Meaning These findings suggest that a fourth vaccine dose was effective in preventing breakthrough COVID-19 infections in health care workers, helping to maintain the function of the health care system during the [OMICRON] pandemic.

AND LASTLY, A SIGN SENT TO ME BY A CERTAIN NORWEGIAN: