CORONAVIRUS INFO PROVIDED BY DR. JIM HARRIS – 12/6/2022

Hello,

FROM THE MARSHALL NEWS MESSENGER:

New COVID-19 cases in county low as state cases spike

FROM THE LANCET:

”…If one must make any political arguments with hybrid immunity, it should be that people who had no access to vaccines yet must urgently get them…”

(J. Harris: And, you don’t want to flirt with Long Covid.)

FROM BECKERS:

Flu activity, state by state

FROM HOPKINS SUGGESTIONS:

1. US PANDEMIC MORTALITY On average, more than 300 people in the US die each day from COVID-19. While the death toll is significantly lower than during the peak of the Delta wave, the number is 2 to 3 times higher than the average number of deaths from flu. Increasingly, COVID-19 is becoming a disease of the elderly. In summer 2021, about 58% of COVID-19 deaths occurred among adults aged 65 or older. Today, that proportion is 9 of 10 COVID-related deaths, according to US CDC data. This upward trend is expected to continue, and despite the nation’s pursuit of normalcy, is set to cause significant disruptions to the health system.

Mortality trends have shifted throughout the pandemic. A study published this week in the Annals of Internal Medicine by investigators at Brigham and Women’s Hospital in Boston, Massachusetts (US), found that the proportion of younger people who died from COVID-19 in 2021 surpassed that of 2020, with the median age of COVID-related deaths falling from 78 years old in 2020 to 69 years old in 2021. Researchers calculated years of life lost (YLL) and compared timeframes in 2020 and 2021. Using this calculation, the team was able to assess premature deaths based on the number of years an individual would have lived. In 2021, there were about 21% fewer deaths compared to 2020. However, YLL per COVID-19 death increased by 36%. Better understanding age shifts in COVID-19 mortality can help inform prevention and treatment approaches, public policy, and community measures to minimize the impacts of this increasingly preventable disease.

2. LONG COVID Nearly a third of people in the US with COVID-19 will develop long-term symptoms, according to a recent report from the US Department of Health and Human Services (HHS). Health experts are warning that this collection of post-acute symptoms, commonly known as long COVID, could be the next public health crisis—so far impacting as many as 23 million people, a number expected to grow as COVID-19 continues to circulate. In addition to increased medical expenses, individuals and families dealing with long COVID could face a reduced quality of life, reduced income, higher household debt, and lower retirement savings, further widening existing inequalities and costing the US economy US$3.7 trillion, according to one estimate. A Swiss study published in Nature Communications examined the prevalence of post-COVID conditions among children, with the findings suggesting that risk factors for lingering symptoms included older age, lower socioeconomic status, and having an existing chronic health condition, particularly asthma.

With little known about the underlying causes of lasting symptoms and a lack of a clear definition, healthcare professionals are stuck between wanting more evidence for effective therapies and trying to treat vulnerable and suffering patients. Some people with long COVID are turning to expensive and untested therapies, from vitamin supplements to stem cell treatments. The US NIH created the RECOVER Initiative to learn more about the long-term effects of COVID-19 and recently announced a clinical trial to investigate the antiviral Paxlovid for treatment of long COVID, with results expected in 2024. But many experts argue a more agile research model is needed to more quickly address the growing problem.

3. FUTURE OF VACCINES Global efforts are underway to prepare vaccine research, development, and production facilities for the next pandemic. This week, the Coalition for Epidemic Preparedness Innovations (CEPI) launched its 100 Days Mission, a US$3.5 billion plan to invest in vaccine research and development and achieve equitable access to vaccines for emerging viruses with pandemic potential, with the goal of producing a safe and effective vaccine within 100 days. This effort, if successful, would significantly shorten the time it took scientists to develop shots for COVID-19, a record 326 days. In Africa, Afrigen Biologics & Vaccines, the Biovac Institute, and a variety of partners are working to bring mRNA vaccines—for COVID-19 and other diseases—to the continent and adapt them for the setting, such as doing away with the need for deep freezing and making them more stable at room or refrigerated temperatures. Those involved in the effort hope more African national governments will prioritize vaccine development and manufacturing, ultimately allowing them to own the intellectual property on domestically produced vaccines that can help protect their own populations.

4. SARS-CoV-2 Serology and Self-Reported Infection Among Adults — National Health and Nutrition Examination Survey (CDC MMWR) During August 2021–May 2022, 41.6% of a c.onvenience sample of adults had both anti-spike antibodies (indicating previous infection or vaccination) and anti-nucleocapsid antibodies (indicating previous infection only); 43.7% of these persons were possibly asymptomatically infected. Prevalence of serologic patterns consistent with vaccination without infection was lower among adults who were younger, Hispanic and non-Hispanic Black or African American adults, and persons with less education.

5. As Officials Ease Covid Restrictions, China Faces New Pandemic Risks (NYT) As one country after another succumbed to outbreaks this year, China kept the coronavirus at bay, buying valuable time to prepare for the inevitable: a variant of the virus so shifty and contagious that China, too, would struggle to contain it. But rather than laying the groundwork for that scenario, China stepped up its commitment to “zero Covid,” deploying snap lockdowns and contact tracing. Now, the costs of that approach are piling up, putting China in a bind from which there appears to be no easy escape, scientists said in interviews.

6. Pfizer and BioNTech Submit Application to U.S. FDA for Emergency Use Authorization of Omicron BA.4/BA.5-Adapted Bivalent COVID-19 Vaccine in Children Under 5 Years (Pfizer) Pfizer Inc. (NYSE: PFE) and BioNTech SE (Nasdaq: BNTX) today announced that the companies have submitted an application to the U.S. Food and Drug Administration (FDA) for emergency use authorization (EUA) of their Omicron BA.4/BA.5-adapted bivalent COVID-19 vaccine as the third 3-µg dose in the three-dose primary series for children 6 months through 4 years of age. With the high level of respiratory illnesses currently circulating among children under 5 years of age, updated COVID-19 vaccines may help prevent severe illness and hospitalization.

7. Severe COVID could cause markers of old age in the brain (Nature) Severe COVID-19 is linked to changes in the brain that mirror those seen in old age, according to an analysis of dozens of post-mortem brain samples. The analysis revealed brain changes in gene activity that were more extensive in people who had severe SARS-CoV-2 infections than in uninfected people who had been in an intensive care unit (ICU) or had been put on ventilators to assist their breathing — treatments used in many people with serious COVID-19. The study, published on 5 December in Nature Aging, joins a bevy of publications cataloguing the effects of COVID-19 on the brain.

FROM BECKERS:

1. FDA revokes Eli Lilly’s COVID-19 drug’s authorization

2. With 95% efficacy, drug could eradicate rare sleeping sickness, researchers say

(J. Harris: For ~~guys~~ THOSE who hunt in Africa)

3. Long COVID may cost US economy $3.7 trillion

”…Long Covid will be around long after the pandemic subsides, impacting our communities, our health-care system, our economy and the well-being of future generations,” a November HHS report said. “We can reduce the severity and breadth of that impact, however, if we act collectively and urgently.”

(J. Harris: Read this short article.)

4. Paxlovid safe for pregnant COVID-19 patients, study finds

NEW NIH COVID TREATMENT GUIDELINES

What’s New in the Guidelines on the COVID-19 Treatment Guidelines website.

FROM YOUR LOCAL EPIDEMIOLOGIST:

State of Affairs: December 6, 2022

AND LAST BUT NOT LEASED: