CORONAVIRUS INFO PROVIDED BY DR. JIM HARRIS – 9/17/2022

HELLO, 

Below are cited multiple new articles that validate the effectiveness of some of the vaccines against the newer Omicron variants. Even Norwegians and Tomatoes should be convinced to continue taking the vaccines, especially if they have a bit of age on them. Covid is waning in our part of East Texas.

FROM HOPKINS:

1. ”US RESPONSE As the COVID-19 pandemic enters its third fall in the US, the White House has signaled it plans to slowly restructure its response efforts, including the phaseout of the White House COVID-19 Response Team mid-2023. With dwindling federal funds, responsibility for vaccinations and therapeutics is shifting to private industry and consumers within the next 6 months. Any remaining funds are largely being used for vaccination campaigns promoting this fall’s updated boosters and the purchase of at-home, rapid tests for the Strategic National Stockpile and Test-to-Treat locations. Officials are tentatively hopeful that the national public health emergency declaration for the pandemic may be allowed to expire in early 2023. While part of this transition can be attributed to fewer COVID-19 cases, deaths, and related hospitalizations, as well as the widespread availability of vaccinations and therapeutics, most response activities need to wind down due to a lack of new funding from the US Congress. Experts and officials emphasize that the pandemic is far from over, with COVID-19 on track to remain the third leading cause of death in the nation….”

2. Additionally, recent research conducted by economists from Stanford University and Massachusetts Institute of Technology estimates that the labor force shrunk by about 500,000 people due to COVID-19 illness. Millions of people left the workforce for various reasons, including lack of childcare, fear of COVID, and retirement. But this research examines the direct impact of COVID-19 illness, estimating that workers with week-long COVID-19-related work absences are 7 percentage points less likely to be in the labor force one year later compared to otherwise-similar workers who do not miss a week of work for health reasons. In August, the total size of the labor force reached 164.7 million people, exceeding prepandemic levels for the first time. However, workforce recovery is experiencing slow-growth compared to prepandemic numbers, and economic recovery will depend on an expanded workforce in the long term.

3. BRAIN FOG When the COVID-19 pandemic first began, brain fog was not included in the list of possible symptoms. However, many COVID-19 patients report experiencing the condition, both during acute infection and lasting 3 or more months after recovery. Brain fog symptoms appear to be independent of initial disease severity. According to one review of multiple studies, about 22% of individuals report cognitive impairment 12 or more weeks following their initial diagnosis. Brain fog is often described as a disorder of executive function, the set of abilities that includes holding attention, remembering and recalling information, and blocking out distractions. Cognitive tasks that once seemed simple become excruciatingly difficult, and in some cases, impossible. Some people have had to leave their jobs due to an inability to perform their tasks, and many have faced frustration in obtaining medical care, often being dismissed as having anxiety or depression. Complicating the matter is that few clinicians are aware that many viral infections, not only COVID-19, can lead to brain fog and there are few reliable diagnostic tools. 

Other neurological complications have been reported following COVID-19 infection, including stroke, delirium, and encephalitis. A recent study published in the journal Brain showed that patients hospitalized with COVID-19 had elevated levels of sera markers of brain injury, neurofilament light (NfL) and glial fibrillary acidic protein (GFAP). However, no specific pathogenic mechanism was determined responsible. Researchers continue to investigate what leads to brain fog—with possible causes including neuro-inflammation, autoimmune responses, or microclots that inhibit blood flow, and therefore oxygen supply—and are hopeful treatments can be developed.

4. In South Korea, experts are concerned over simultaneous outbreaks of COVID-19 and influenza during the colder fall and winter months, calling for the development of better diagnostic tests, including one that could detect flu and COVID-19 at the same time, and for healthcare services to offer individuals both vaccines during the same visit. …”

5. The Future of Hospitals’: Flexible Space for the Next Pandemic (The New York Times) The early waves of the pandemic came crashing into hospitals, revealing intensive care units without enough beds, hallways and waiting rooms that forced the healthy and sick to commingle, and ventilation systems that became conduits for airborne pathogens. Given that hindsight, many hospitals are remodeling with a philosophy of flexible design, the idea that spaces should be adaptable for different purposes at different times. When the next pandemic comes, they’ll be able to better meet the moment. 

6. UNITED STATES

The US CDC is reporting 95.2 million cumulative cases of COVID-19 and 1,046,195 deaths. Daily incidence continues to decline, down to 60,558 new cases per day. This is the lowest average since May 1 and a 54% decrease from the most recent peak on July 16. Daily mortality continues to decline as well, down to 350 deaths per day. This is the lowest average since July 9 and a decrease of 30% from the most recent high on August 12. The CDC reported a slight increase in both daily incidence and mortality on September 12, but this is likely due to delayed reporting over the US Labor Day holiday weekend.*

7. LONG COVID IN EUROPE An estimated 17 million people across the WHO’s Europe region experienced post-acute sequelae or long-term symptoms of COVID-19, also known as long COVID, during the pandemic’s first 2 years, according to a modeling study conducted by the Institute for Health Metrics and Evaluation (IHME) for WHO/Europe. The region comprises 53 Member States across Europe and Central Asia that are home to nearly 900 million people. The report highlights the ongoing public health challenges posed by the condition, which is characterized by cognitive and mental health problems, fatigue, shortness of breath, and other symptoms experienced 12 weeks or more following a COVID-19 diagnosis. 

The report, published September 13, found the number of new long COVID cases identified between 2020 and 2021 rose threefold, driven by the rapid increase in confirmed COVID-19 cases from late 2020 through 2021; women are twice as likely than men to suffer from the condition; and the risk of long COVID increases dramatically among people with severe infections who need hospitalization. WHO officials and the report authors said that although most people fully recover from COVID-19, the findings underline the need for additional analysis and investment to determine the long-term effects of the disease, including implications for the workforce and the need for rehabilitative and support services.

FROM YOUR EPIDEMIOLOGIST:

STILL MORE THAN 400 COVID DEATHS PER DAY IN THE USA

”…We are losing ~400 Americans a day. In the last 7 days, we have lost 2,299 people. During August 2022 alone, we lost 15,284 Americans to COVID-19.

This means COVID-19 remains the third leading cause of death in our repertoire of threats. And it’s largely preventable. In the U.S., death rates are not back to pre-pandemic times; excess deaths are still 10% above “expected.” This is changing our average life expectancy. In fact, the U.S. experienced the sharpest two-year decline in life expectancy in nearly 100 years….

It’s abundantly clear the majority of deaths continue to be among the unvaccinated (20% of Americans are still without even one dose)…In addition, there is a clear dose response with vaccines: the more vaccine doses one has, the more that person is protected from death. According to the CDC, vaccinated people with one booster had 3 times the risk of dying compared to people vaccinated with two boosters. Unvaccinated people had 14 times the risk of dying compared to those with two boosters.

Interestingly, the under- or un-vaccinated are more and more likely to have been infected. So, models are no longer comparing vaccinated people to immune naïve; rather, they are comparing vaccinated (or hybrid immunity) to those with more and more infection-induced immunity. This indirectly highlights a positive effect of vaccines against death compared to infection.

(J. Harris: A quick, easy, and important read. I had no idea that more people in FL are more unwise than many in NY.)

FROM THE LA TIMES:

Coronavirus Today: How universal healthcare could save lives

”…The United States accounts for a little more than 4% of the world’s population, but it’s responsible for about 16% of the world’s COVID-19 deaths…”

(J. Harris: Worth the quick read)

FROM THE NEJM:

Effectiveness and Durability of the BNT162b2 Vaccine against Omicron Sublineages in South Africa

”TO THE EDITOR:

Data are limited regarding the effectiveness of the BNT162b2 vaccine (Pfizer–BioNTech) against the BA.4 and BA.5 sublineages of the B.1.1.529 (omicron) variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that drove the recent fifth wave of infection in South Africa.1 We previously reported a vaccine effectiveness of 70% after two doses of the BNT162b2 vaccine against severe disease during the fourth wave of omicron infection driven by the BA.1 sublineage in South Africa.1,2….. after either two doses or three doses of the BNT162b2 vaccine, we found rapid waning of vaccine effectiveness against the current sublineages of the omicron variant with respect to protection against hospitalization. Our data indicate that boosting maintains vaccine effectiveness against severe disease caused by the current omicron sublineages, although the evidence of rapid waning of durability indicates the need for regular boosting as early as 4 months after the last dose or the need for vaccines to incorporate variants of concern to maintain protection.

(J. Harris: So keep getting your Covid Boosters when the CDC says to do so — like right now. A later study is said to show “A booster dose of mRNA-1273 after the initial two-dose vaccination resulted in neutralization titers against the BA.2.75 variant that were similar to those against BA.1 and BA.2 and higher than those against BA.5 (letter).”

FROM JAMA:

COVID-19-Associated Hospitalizations Among Vaccinated and Unvaccinated Adults 18 Years or Older in 13 US States, January 2021 to April 2022

”Findings  In this cross-sectional study of US adults hospitalized with COVID-19 during January 2022 to April 2022 (during Omicron variant predominance), COVID-19-associated hospitalization rates were 10.5 times higher in unvaccinated persons and 2.5 times higher in vaccinated persons with no booster dose, respectively, compared with those who had received a booster dose. Compared with unvaccinated hospitalized persons, vaccinated hospitalized persons were more likely to be older and have more underlying medical conditions.

Meaning  The study results suggest that COVID-19 vaccines are strongly associated with prevention of serious COVID-19 illness.

FROM NATURE :

Association between BNT162b2 vaccination and reported incidence of post-COVID-19 symptoms: cross-sectional study 2020-21, Israel

”…we compared vaccinated individuals with those unvaccinated and those uninfected, in terms of post-acute self-reported symptoms. Of the 951 infected, 637(67%) were vaccinated. In the study population, the most prevalent symptoms were: fatigue (22%), headache (20%), weakness of limbs (13%), and persistent muscle pain (10%). After adjusting for age, time from beginning of symptoms to responding to the survey, and baseline symptoms, those who received two vaccine doses were less likely than unvaccinated individuals to report any of these symptoms (fatigue, headache, weakness of limbs, persistent muscle pain) by 62%, 50%, 62%, and 66% respectively, (Risk ratios 0.38, 0.50, 0.38, 0.34, p < 0.04 in the listed sequence). Compared to the 2447 included individuals who never reported SARS-CoV-2 infection, double-vaccinated participants were no more likely to report any of the mentioned symptoms. Vaccination with 2+ doses of BNT162b2 was associated with a reduced risk of reporting most of the common post-acute COVID-19 symptoms. Our results suggest that BNT162b2 vaccination may have a protective effect against longer term COVID-19 symptoms.

FROM THEN ANNALS OF INTERNAL MEDICINE (? REPEAT)

Effectiveness of a Fourth Dose of COVID-19 mRNA Vaccine Against Omicron Variant Among Elderly People in Singapore

”Discussion: Our study found that 4 doses of BNT162b2 or mRNA-1273 reduced the risk for symptomatic SARS-CoV-2 infection, hospitalization, and severe COVID-19 illness versus 3 doses among persons 80 years of age or older, corroborating studies in a younger cohort in Israel (4, 5). In Singapore, the risk reductions in hospitalization and severe disease were helpful in managing the case surge from BA.5, avoiding the need to tighten control measures as was done for the Omicron BA.1/BA.2 wave in January through April 2022. Consistent with findings of sustained protection against severe disease from Israel (6), we found no waning of this protection after 60 days.”

FROM BECKERS:

2022 the most financially difficult year for hospitals, health systems since start of pandemic

AND LAST BUT NOT LEASED:

How about a blonde joke?

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