CORONAVIRUS INFO PROVIDED BY DR. JIM HARRIS – 12/14/2022

FROM THE MARSHALL NEWS MESSENGER:

FROM HOPKINS SUGGESTIONS:

1. EPI UPDATE The WHO COVID-19 Dashboard reports 643 million cumulative cases and 6.62 million deaths worldwide as of December 8. Global weekly incidence remained relatively stable last week, decreasing 1.3% compared to an increase of 16.8% the previous week. A total of 3.04 million cases were confirmed the week of November 28. Weekly incidence fell over the previous week in Africa (-64%)*, South-East Asia (-27%), Western Pacific (-10%), and the Eastern Mediterranean (-4%). The Americas (+14%) and Europe (+4.5%) regions experienced increasing weekly incidence. Global weekly mortality decreased from the previous week, down 17%.

*The WHO dashboard notes that data from the Africa region are incomplete.

UNITED STATES

The US CDC is reporting 98.8 million cumulative cases of COVID-19 and 1.08 million deaths. Incidence for the week ending November 30 remained relatively stable over the previous week, falling to 303,101 cases from 306,856 cases for the week ending November 23. Weekly mortality fell significantly for the week ending November 30, with 1,780 reported deaths compared to 2,634 deaths the week ending November 23. The decline could be a result of delayed reporting due to the US Thanksgiving holiday.

2. MASK USE The US CDC is once again encouraging people to wear masks to help reduce the spread of respiratory illnesses, as hospitalizations rise due to the so-called “tripledemic” of COVID-19, RSV, and flu. The nation appears to be at the start of another COVID-19 wave, with hospitalizations reaching a 3-month high last week. Hospitals are already feeling strain from earlier-than-normal increases in RSV and flu cases and hospitalizations. The US is experiencing the highest levels of hospitalization from flu that it has seen in a decade this early in the season. Experts warn that holiday gatherings present a prime opportunity for respiratory viruses to spread and urge people to take precautions, including mask use, physical distancing, testing, and increased air ventilation. While it is unlikely that widespread mask mandates will return, masking in crowded areas can lower the risk of infection and help decrease the burden on overwhelmed hospitals. 

One more reason to don a mask during the colder months could be to help keep your nose warm. A study published this week in the Journal of Allergy and Clinical Immunology suggests that exposure to cold temperatures hinder immune responses in the upper respiratory tract by killing nearly half of the virus and bacteria-fighting cells in the nostrils, allowing viruses or bacteria to evade this initial immune response. 

3. Authorities are urging indoor masking in major cities as the ‘tripledemic’ rages (NPR) Public health officials are revisiting the topic of indoor masking, as three highly contagious respiratory viruses take hold during the holiday season. Over the past few weeks, a surge in cases of COVID, the flu and respiratory syncytial virus — known as RSV — has been sickening millions of Americans, overwhelming emergency rooms and even causing a cold medicine shortage. The triple threat has been called a “tripledemic” by some health experts. Rochelle Walensky, director of the Centers for Disease Control and Prevention, noted this past week that the simultaneous combination of viruses has been straining healthcare systems across the country.

4. Wrangling Over the International Pandemic Pact Has Begun (Think Global Health) Health officials met this week in Geneva to discuss a rough draft of a pandemic treaty, an international plan to avoid another disaster on the scale of COVID-19. This is the first of many drafts to come, in a process that began with a decision made in December 2021 by the World Health Organization’s (WHO) 194 member states to develop something like a treaty—perhaps an accord, agreement, or other ‘instrument’—to govern the global pandemic response. The project is spearheaded by the WHO and is slated for completion in May 2024.

FROM THE ANNALS OF INTERNAL MEDICINE;

Nirmatrelvir Plus Ritonavir for Early COVID-19 in a Large U.S. Health System

”…In the EPIC-HR (Evaluation of Protease Inhibition for Covid-19 in High-Risk Patients) trial, nirmatrelvir plus ritonavir led to an 89% reduction in hospitalization or death among unvaccinated outpatients with early COVID-19. The clinical impact of nirmatrelvir plus ritonavir among vaccinated populations is uncertain….The overall risk for hospitalization or death was already low (1%) after an outpatient diagnosis of COVID-19, but nirmatrelvir plus ritonavir reduced this risk further.

”(During the study period, 12 541 (28.1%) patients were prescribed nirmatrelvir plus ritonavir, and 32 010 (71.9%) were not. Patients prescribed nirmatrelvir plus ritonavir were more likely to be older, have more comorbidities, and be vaccinated. The composite outcome of hospitalization or death occurred in 69 (0.55%) patients who were prescribed nirmatrelvir plus ritonavir and 310 (0.97%) who were not (adjusted risk ratio, 0.56 [95% CI, 0.42 to 0.75]). Recipients of nirmatrelvir plus ritonavir had lower risk for hospitalization (adjusted risk ratio, 0.60 [CI, 0.44 to 0.81]) and death (adjusted risk ratio, 0.29 [CI, 0.12 to 0.71]).”

FROM BECKERS:

1. Variants: Based on projections for the week ending Dec. 10, the CDC estimates that BQ.1.1 accounts for 36.8 percent of cases and BQ.1 accounts for 31.1 percent of cases nationally. All other lineages are decreasing in proportion this week compared to last week.

2. As of Dec. 7, a total of 1,080,472 COVID-19 deaths have been reported in the United States.

 3. About 64 percent of sites across the country are reporting moderate to high virus levels in wastewater. Of these sites, 38 percent are reporting some of the highest levels for those sites since Dec. 1, 2021.

4. About 27 percent of sites are seeing a decrease in virus levels and about 65 percent are reporting an increase.

FROM A READER WHO HAS LITERALLY TRAVELED THE WORLD:

Newsletter: You’re done with masks? That’s too bad, because COVID isn’t done with us

FROM YOUR LOCAL EPIDEMIOLOGIST:

Will trust in science survive the pandemic?

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Because I have several  readers who are physicians  in active practice, I sometimes include articles that some readers  might not enjoy. Allegedly, I save some of the physicians some time. 

From BECKERS:

Fauci, Gottlieb urge self-interpretation amid COVID-19 case undercounts, relaxed mask rules

”…Drs. Fauci’s and Gottlieb’s remarks suggest the U.S. has reached a pandemic stage where self-determination among the public is more emphasized than ever — first to interpret the risk of COVID-19 transmission in their communities, then to decide what mitigation measures to take……I think that we’re dramatically undercounting cases,” Dr. Gottlieb told CBS News. “We’re probably only picking up one in seven or one in eight infections. So when we say there are 30,000 infections a day, there’s probably closer to a quarter of a million infections a day.”…”This is not going to be eradicated and it’s not going to be eliminated,” Dr. Fauci said of COVID-19. “And what’s going to happen is that we’re going to see that each individual is going to have to make their calculation of the amount of risk that they want to take in going to indoor dinners and in going to functions, even within the realm of a green zone map of the country where you see everything looks green but it’s starting to tick up. So you’re going to make a question and an answer for yourself, for me as an individual, for you as an individual. What is my age? What is my status? Do I have people at home who are vulnerable that if I bring the virus home there may be a problem?”

(J. Harris: So we’re back to where we started from: ultimately, responsibility for Covid protection is a personal/family >neighborhood > city >county > state > national >>>then world medical problem — with emphasis on personal and family. We’ve learned a lot and will be able live with Covid. We’ll have to.)

FROM NYT:

1. The city of Philadelphia will reinstate an indoor mask mandate, the first major U.S. city to do so this spring.

”With new coronavirus cases low but rising sharply in recent days, the city of Philadelphia announced on Monday that it will reinstate an indoor mask mandate a little more than a month after lifting it, becoming the first major U.S. city to do so…“This is our chance to get ahead of the pandemic,” said Cheryl Bettigole, the city’s health commissioner, in a news conference…’

‘2. New Drug Slashed Deaths Among Patients With Severe Covid, Maker Claims

”…The new drug, sabizabulin, reduced deaths among hospitalized Covid-19 patients so drastically in a clinical trial that independent safety monitors recommended stopping it early, officials at Veru Inc., the drug’s maker, said. The trial was halted on Friday…..Sabizabulin was given in a 9-milligram dose in a capsule that was taken once a day. It doesn’t require refrigeration, and the capsule can be given by mouth or opened up so that the contents can be added to a feeding tube…The drug is intended only for hospitalized patients at this point, so making it accessible to patients in the United States will be simpler than making it available to outpatients, which requires distributing it to pharmacies and educating general doctors about its use….”

3. (This AM) Experts say it is unclear whether rising cases in the northeastern U.S. are the start of a larger surge. Image

”…Covid outbreaks in elite circles in Washington, D.C., and on Broadway have received a lot of news media attention in recent days, but they appear to be only one part of a broader regional rise in infections: States in the Northeast are now reporting an uptick in cases…“There’s definitely something coming,” William Hanage, an epidemiologist at Harvard, told The Morning. “But depending on all the moving parts, it might be a ripple relative to previous waves….”

4. Virus outbreaks are pushing some U.S. universities to reinstate mask mandates.

”…A small number of U.S. colleges and universities are reinstating mask policies, citing coronavirus outbreaks on campus…But now, while some universities, such as Harvard, are letting professors decide what protocol to follow in the classroom, others are imposing new mask rules:…Rice University reinstated its mask policy for classrooms, regardless of vaccination status. Those who are unvaccinated also must continue to wear a mask in other indoor areas…”

FROM THE LANCET:

1. Estimating global, regional, and national daily and cumulative infections with SARS-CoV-2 through Nov 14, 2021: a statistical analysis

 Conclusion

COVID-19 has had a staggering impact on the world, with 3·39 billion (95% UI 3·08–3·63) people infected with SARS-CoV-2 at least once as of Nov 14, 2021. These findings highlight the potential for COVID-19 to have a continued and profound impact on the world’s population. The vast differences in cumulative proportion of the population infected across countries and territories can help policy makers identify locations whose transmission-prevention strategies should be emulated, as well as those populations at greatest risk of future infection—a factor that should be considered in global vaccine prioritisation. Our statistical approach to estimating SARS-CoV-2 infection, which can be applied routinely and will allow for rapid availability of estimates, will be crucially important for research, science, and policy efforts towards pandemic preparedness, response, and control in the coming months and years. It has and continues to be made freely available to all on a routine basis.

2. AN ANTISPIKE VACCINE TESTED IN CUBA

”…In conclusion, the results of the phase 1-2 trial indicated that Abdala vaccine against SARS-CoV-2 was safe, well tolerated and induced humoral immune responses against SARS-CoV-2 among adults from 19 to 80 years of age. Our findings indicate that the a SARS-CoV-2 recombinant spike protein vaccine studied (Abdala) is a promising candidate that warrants testing in phase 3 studies, in a larger number of individuals older than 19 years of age and a three-dose schedule of 50 μg on days 0-14-28, evaluating vaccine efficacy in the prevention of symptomatic COVID-19 and progression to serious and critical forms of the disease….”

FROM HOPKINS SUGGESTIONS:

1. The Next Leap in Coronavirus Vaccine Development Could Be a Nasal Spray (Washington Post) As the omicron variant of the coronavirus moved lightning-fast around the world, it revealed an unsettling truth. The virus had gained a stunning ability to infect people, jumping from one person’s nose to the next. Cases soared this winter, even among vaccinated people. That is leading scientists to rethink their strategy about the best way to fight future variants, by aiming for a higher level of protection: blocking infections altogether. If they succeed, the next vaccine could be a nasal spray.

2. Mechanical Control of Innate Immune Responses Against Viral Infection Revealed in a Human Lung Alveolus Chip (Nature Communications) Here we use a human lung alveolus chip that experiences cyclic breathing-like deformations to investigate whether physical forces influence innate immune responses to viral infection. Influenza H3N2 infection of mechanically active chips induces a cascade of host responses including increased lung permeability, apoptosis, cell regeneration, cytokines production, and recruitment of circulating immune cells. Comparison with static chips reveals that breathing motions suppress viral replication by activating protective innate immune responses in epithelial and endothelial cells, which are mediated in part through activation of the mechanosensitive ion channel TRPV4 and signaling via receptor for advanced glycation end products (RAGE). RAGE inhibitors suppress cytokines induction, while TRPV4 inhibition attenuates both inflammation and viral burden, in infected chips with breathing motions. Therefore, TRPV4 and RAGE may serve as new targets for therapeutic intervention in patients infected with influenza and other potential pandemic viruses that cause life-threatening lung inflammation.

FROM THE CDC:

COVID-19 Vaccines for Children and Teens

(J. Harris: An assortment of short readable articles related to youth and vaccines)

AND LASTLY FROM DR. MCCLURG IN AUSTIN:

These insults are from an era before the English language got boiled down to 4-letter words:

1. “He had delusions of adequacy ” Walter Kerr

2. “He has all the virtues I dislike and none of the vices I admire.”- Winston Churchill

3. “I have never killed a man, but I have read many obituaries with great pleasure. – Clarence Darrow

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The Covid situation is quiet at present. Tuesday/Wed. counts should be helpful. Apparently, there are many mild cases and not many tests are being done. I will minimize reports unless otherwise indicated. 

BA.2 LINEAGE REPORT (COVID COUNTS WORLDWIDE)

LOCAL COUNTS:

Cardiovascular Disease Even After Mild COVID-19 Is Real

(J. Harris: A readable, well-written case history which makes me want to get another booster.)

FROM JAMA 

Systemic Corticosteroid Use for COVID-19 in US Outpatient Settings From April 2020 to August 2021

”…Despite NIH recommendations, increasing numbers of nonhospitalized patients with COVID-19 were prescribed systemic corticosteroids, often on the day of diagnosis. Use appeared to be more prominent in the South and was not restricted to older patients. Limitations of the study included inability to capture date of symptom onset and indication for use, and potential for misclassifying mild to moderate COVID-19 disease due to overburdened resources and limited ability to accurately capture elements to define disease severity, including oxygen use. Given the increasing use of corticosteroids through August 2021, the potential safety signal,2,5,6 and the lack of efficacy data in patients with mild to moderate COVID-19,1 it is critical that prescribers consider the NIH guidelines in the therapeutic management of nonhospitalized patients with COVID-19.”

Antibiotic Prescriptions Associated With COVID-19 Outpatient Visits Among Medicare Beneficiaries, April 2020 to April 2021

”…During the first year of the COVID-19 pandemic, 30% of outpatient visits for COVID-19 among Medicare beneficiaries were linked to an antibiotic prescription, 50.7% of which were for azithromycin. Randomized clinical trials demonstrated no benefit of azithromycin in treating COVID-19,3,4 and its use for the disease has been linked to antimicrobial resistance.5 The largest number of visits and highest rates of antibiotic prescribing were observed in the ED, perhaps reflecting acuity of care, and urgent care centers had the highest rate of azithromycin prescribing. Telehealth visits had the second highest antibiotic prescribing rate and were close in volume to office visits, emphasizing the importance of optimizing antibiotic prescribing practices in this setting. Antibiotic prescribing occurred at a higher rate for non-Hispanic White beneficiaries than for those from other racial and ethnic groups. Although described in pediatrics, this racial difference has not been well characterized in older adults and warrants further evaluation because it may indicate more services are being provided to White beneficiaries, even if not indicated.6..”

LASTLY:

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CORONAVIRUS INFO PROVIDED BY DR. JIM HARRIS – 4/8/2022

HELLO, 

B2.A is not crowding our hospitals, but it has been identified in all states. I will be away from my computer for several days. 

FROM NYT today:

Cases are spiking in New York City and Washington, D.C.

”Cases have doubled in Washington and have risen about 60 percent in New York City since the last week of March, according to New York Times databases….The virus raced through parts of Washington, as well, where several politicians tested positive this week after attending parties and events…”

FROM HOPKINS SELECTIONS:

1. China Kintor’s COVID Drug Candidate Cuts Hospital, Death Risk in Trial (Reuters) China’s Kintor Pharmaceutical (9939.HK) said on Wednesday its potential COVID-19 treatment proxalutamide effectively reduced the risk of hospitalization and death in a clinical trial involving outpatients with mild to moderate symptoms. The results came from a multi-national clinical trial with over 700 subjects across the world, mostly from the United States, recruited during April-December, 2021, who were given either proxalutamide or a placebo, the company said in a filing.

MORE ABOUT: Proxalutamide

An inhibitor of angiotensin-converting enzyme 2 (ACE2) and transmembrane protease, serine 2 (TMPRSS2) proteins, proxalutamide hinders the SARS-CoV-2 virus’ entry into host cells….

Proxalutamide is an antagonist at the androgen receptor which leads to inhibition of androgen-induced receptor activation and results in formation of inactive complexes that are not able to translocate to the nucleus. It also induces androgen receptor downregulation, furthering adrogen-induced receptor activation. This drug is being investigated for its potential antineoplastic activity and is being investigated specifically against prostate cancer and COVID-19. 

AND LASTLY: I’ve been saving this one for a long weekend:

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J. HARRIS: Covid attacks are cooling off at present. FLU cases are increasing. 

Now is a good time to get your flu shot and keep your Covid Boosters up to date. See your dentist and get your mammograms and checkups. Is your blood pressure doing alright? Avoid sick people and don’t let your family go out if they are even a little bit sick. In areas where the majority of the population is unvaccinated, continue to be wary and masked in crowds. 

 Covid vaccinations and boosters are now available at most area pharmacies, including 4th Boosters. 

Flu and Covid Vaccinations are available at  Harrison County Health Department as are  4th. Boosters for “Immunocompramized” individuals, in various categories that almost include many older individuals. You don’t need a doctor’s statement to prove that you are immunocompromised. You do not have to show any documents. Also, by getting boosters, you will not be “wasting” vaccines that someone else might need. Plenty of Covid vaccine is currently available in the US.  ”Individuals should ask their personal physicians if they are eligible for and need  a 4th Booster.” You must fill out 3 short forms, one of which states that you are ”Immunocompramized” and therefore eligible for the 4th Jab. Various drug stores are able to do this, but they might not be as “enlightened” about 4th Jabs as are the various county Health Departments. The Marshall/Harrison County Health Dept. can be reached at 903 938 8338. You should call for their schedule before going by. (They are next door to the hospital). They are not open for injections every day. You can also get a FLU SHOTS at the Health Dept. if you need it. Talk to your doctor. I can not advise individuals to get a 4th. jab, but I “qualified” and got one. Also, a certain Norwegian Housekeeper is waiting for the 6 months to elapse from the date of her 3rd Jab to get her 4th. 

Omicron sub-variant BA.2 makes up 11.6% of COVID variants in U.S. – CDC

”…Omicron sub-variant BA.2 makes up 11.6% of COVID variants in U.S. – CDC’

(J. Harris: BA.2  probably not as deadly but more contagious than regular Omicron. Vaccines protect against severe disease. Reinfections are not uncommon.

France’s new COVID-19 infections start creeping up again

French health authorities reported 93,050 new COVID-19 infections on Tuesday, the highest daily total since Feb 22, and an increase of 16.6% versus a week ago.

(J. Harris: No mention was made of which Covid strain is in France now, but a Variant B.1.640.2 ( AKA I.H.U)was reported in France and Poland earlier this year, thought to have originated in Cameroon. I would also guess that it could be BA.2 as well since that Variant has been all over Denmark. It seems that most of the Variants that have been recently studied by genetic sequencing are responsive to our current vaccines. Like the Deltas, the Omicron variants are less virulent in vaccinated folks. So, at present most of the more medically sophisticated countries are lessening dependency of quarantines, masks, spacing, crowd avoidance and the like. They are placing more reliance on testing, voluntary isolation, and VACCINATIONS.) 

AND LASTLY:

Lewis Grizzard said: In the south there’s a difference between ‘Naked’ and ‘Nekkid.’ ‘Naked’ means you don’t have any clothes on. ‘Nekkid’ means you don’t have any clothes on and you’re up to somethin’.

Ate salad for dinner. Mostly croutons and tomatoes. Really just one big round crouton covered with tomato sauce and cheese FINE, it was a pizza…. OK, I ate a pizza!  Are you happy now?

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FROM THE ATLANTIC

COVID Won’t End Up Like the Flu. It Will Be Like Smoking.

”…Hundreds of thousands of deaths, from either tobacco or the pandemic, could be prevented with a single behavioral change.

….and that many COVID deaths, like many smoking-related deaths, could be prevented with a single intervention….not to get vaccinated against COVID is, right now, a modifiable health risk on par with smoking, which kills more than 400,000 people each year in the United States..The COVID vaccines are, without exaggeration, among the safest and most effective therapies in all of modern medicine. An unvaccinated adult is an astonishing 68 times more likely to die from COVID than a boosted one. Yet widespread vaccine hesitancy in the United States has caused more than 163,000 preventable deaths and counting. Because too few people are vaccinated, COVID surges still overwhelm hospitals…”

FROM HOPKINS:

1. As Omicron Surged, Covid-19 Spread Through Patients in Hospitals (Wall Street Journal) As the Omicron variant surged through communities across the U.S., it also spread inside hospitals and infected non-Covid-19 patients, reaching a record number, a Wall Street Journal analysis of U.S. government data found. The daily total of patients with Covid-19 that they caught in hospitals reached a record of about 4,700 during the Omicron wave in January, according to the analysis of U.S. Department of Health and Human Services data.

2. California Unveils Plan To Become First State To Treat Coronavirus As ‘Endemic’ Risk (Washington Post) “We are moving past the crisis phase into a phase where we will work to live with this virus,” Gov. Gavin Newsom (D) said at a news conference. “People are looking forward to turning the page,” he added. “They also need to know we have their back, we’re going to keep them safe, and we’re going to stay on top of this.” California’s plan, he said, shifts from a “crisis mentality” to emphasize prevention and adaptability, allowing officials to step up measures to detect and contain fresh outbreaks, as well as to look out for new variants. It also includes more public campaigns against misinformation and the stockpiling of tests and equipment rather than mask mandates and business shutdowns.

FROM JAMA:

Evaluation of Antimicrobial Drug Use and Concurrent Infections During Hospitalization of Patients With COVID-19 in Japan

”…The findings revealed that concurrent infectious diseases rarely occurred despite the infrequent use of antimicrobial drugs during hospitalization among patients with COVID-19 infection, most of whom had noncritical cases. This finding supports the results of recent studies showing that concurrent bacterial infections were uncommon in patients with COVID-19 infection.1-3 Given that most patients with noncritical severity recovered without antimicrobial drugs, the use of most antimicrobial drugs to treat noncritical cases in many hospitals might be unnecessary. Antimicrobial drugs should be used cautiously to treat patients with COVID-19 infection…”

(J. Harris: The usual antibiotics are not indicated in Covid infections.)

CORRESPONDENCE FROM NEJM:

Protection against the Omicron Variant from Previous SARS-CoV-2 Infection

Overall, in a national database study in Qatar, we found that the effectiveness of previous infection in preventing reinfection with the alpha, beta, and delta variants of SARS-CoV-2 was robust (at approximately 90%), findings that confirmed earlier estimates…Such protection against reinfection with the omicron variant was lower (approximately 60%) but still considerable. In addition, the protection of previous infection against hospitalization or death caused by reinfection appeared to be robust, regardless of variant.

”…Among the patients with reinfection, progression to severe Covid-19 occurred in one patient with the alpha variant, in two patients with the beta variant, in no patients with the delta variant, and in two patients with the omicron variant. None of the reinfections progressed to critical or fatal Covid-19…”

(J. Harris: This is more information from a study we looked at a week or so ago from Qatar involving a very young (31-35  Y/O) population. This second letter indicates some protection against the Omicron variant from the previous infections with other Covid organisms was found (60%) as well as milder disease with all the organisms.  Perhaps, at least with young people, subsequent  future reinfections won’t overwhelm our hospitals and morgues?)

LASTLY:

I plan to introduce Geriatric Ice Dancing at subsequent Winter Olympics.  I expect to enter in the ”Big Boy Classification” which will include Belly Spinning. And remember, “Big Boys don’t cry!”

I don’t mean to brag, but I finished my 14-day diet food supply in 3 hours and 20 minutes

Norwegian Cake of the Day:

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CORONAVIRUS INFO PROVIDED BY DR. JIM HARRIS –2/16/2022

My son called last night to tell me that there was a rumor in town that I was dead. Wow. No. It wasn’t me. It was Mark Twain. 

But like Lewis Grizzard said” Elvis is dead and I’m not feeling so good myself.”

OMICRON COVID CASES UP IN S. KOREA

Record high of 90,443 new Covid cases in South Korea Wednesday

The country has administered Covid vaccines to 44,757,215 people, or 87.2 per cent of the total population, and the number of fully vaccinated people stands at 44,249,882, or 86.2 per cent.

Coronavirus: from South Korea to Singapore, Omicron-fuelled wave pushes cases to record highs

”…South Korea has largely been a Covid-19 mitigation success story, thanks mainly to widespread wearing of masks, social distancing and aggressive testing and tracing….The country reported 57,049 new infections on Tuesday, with 134 people dying from the disease. Fatalities are lower than during the peak of the Delta wave, when more than 2,000 people died in a day, leading the government to ease some restrictions in cities while still warning people against gathering.

In Malaysia, 22,133 new cases were recorded on Tuesday, the fifth consecutive day with more than 20,000 daily infections.

Health director general Noor Hisham Abdullah said more than 99 per cent of the new cases were asymptomatic or with mild symptoms.

(J. Harris: These cases are said to be “Omicron.” I have not yet see sub variant studies.)

FROM BECKERS:

4 possible scenarios for the pandemic’s next act

(J. Harris: SHORT, READABLE, TO THE POINT, LIKELY)

FROM ANNALS OF INTERNAL MEDICINE

The Incidence of SARS-CoV-2 Reinfection in Persons With Naturally Acquired Immunity With and Without Subsequent Receipt of a Single Dose of BNT162b2 [PFIZER] Vaccine

”A statistically significant decreased risk … for reinfection was found among persons who were previously infected and then vaccinated versus those who were previously infected but remained unvaccinated. In addition, there was a decreased risk for symptomatic disease … among previously infected and vaccinated persons compared with those who were not vaccinated after infection. No COVID-19–related mortality cases were found……….This analysis showed that persons who were previously infected with SARS-CoV-2 gain additional protection from a subsequent single-dose vaccine regimen. Nonetheless, even without a subsequent vaccination, it seems that reinfection is relatively rare, at least in the first year after infection (13, 44), although the study was done before the emergence of the Omicron variant. The long-term effects of reinfection are still unknown. Therefore, policies regarding vaccination of convalescent persons of different age and risk groups will also depend on prioritization of resources in terms of global vaccination deployment.”

FROM JOHNS HOPKINS SELECTIONS:

1. Heart-disease Risk Soars After COVID — Even With a Mild Case (Nature) Even a mild case of COVID-19 can increase a person’s risk of cardiovascular problems for at least a year after diagnosis, a new study shows. Researchers found that rates of many conditions, such as heart failure and stroke, were substantially higher in people who had recovered from COVID-19 than in similar people who hadn’t had the disease. What’s more, the risk was elevated even for those who were under 65 years of age and lacked risk factors, such as obesity or diabetes. Al-Aly and his colleagues based their research on an extensive health-record database curated by the United States Department of Veterans Affairs. The researchers compared more than 150,000 veterans who survived for at least 30 days after contracting COVID-19 with two groups of uninfected people: a group of more than five million people who used the VA medical system during the pandemic, and a similarly sized group that used the system in 2017, before SARS-CoV-2 was circulating.

2.  HHS Awards Nearly $55 Million to Increase Virtual Health Care Access and Quality Through Community Health Centers (HHS) The Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), awarded nearly $55 million to 29 HRSA-funded health centers to increase health care access and quality for underserved populations through virtual care such as telehealth, remote patient monitoring, digital patient tools, and health information technology platforms. This funding builds on over $7.3 billion in American Rescue Plan funding invested in community health centers over the past year to help mitigate the impact of COVID-19.

(J. Harris: Surely Harrison County should be eligible for some of these type fund? We are definitely a medically underserved area.)

AND FINALLY:

More from Lewis Grizzard: I know lots of people who are educated far beyond their intelligence.

We all get heavier as we get older, because there’s a lot more information in our heads. That’s my story and I’m sticking to it.

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P.O. Box 721

Scottsville Texas

75688

HELLO,

FROM THE MNM WITH WEEKLY CASE NUMBERS:

J. Harris: Since Harrison County has only vaccinated 40% of the population and since new Covid Variants can be transmitted by virtually anyone: vaccinated, recovered, unvaccinated, recovered + vaccinated — I plan to continue using my mask when indicated by the Three C’s (Closed, Crowded, and/or Close)

NEW FROM JAMA

Association of COVID-19 Vaccination With Symptomatic SARS-CoV-2 Infection by Time Since Vaccination and Delta Variant Predominance

Among adults, the OR for the association between symptomatic SARS-CoV-2 infection and COVID-19 vaccination (as an estimate of vaccine effectiveness) was higher during Delta variant predominance, suggesting lower protection. For mRNA vaccination, the steady increase in OR by month since vaccination was consistent with attenuation of estimated effectiveness over time; attenuation related to time was greater than that related to variant.

”…The findings are consistent with a steady decline in estimated mRNA vaccine effectiveness over time, separate from variant-specific differences in protection.”

In this analysis, the pattern of attenuation related to the time since vaccination for mRNA vaccines was consistent before and after the emergence of Delta as the predominant variant…More recent data from this same testing platform suggest that 2 doses of mRNA vaccine offer less protection against infection with the Omicron variant than against infection with the Delta variant, but the pattern of attenuation over time since vaccination was similar for both variants… Together these data suggest that while the starting point for protection among recent recipients of 2 doses of mRNA vaccine can differ across variants, declines in effectiveness over time may be more predictable. It will be important to evaluate whether protection from booster doses wanes in a similar fashion as that of 2 doses.

(J. Harris: Most of the vaccinated older folks that I know are now waiting for a 4th Booster and hope it will be at least as good as was the 3rd. Others are interested in a “Mix and Match.” of mRNA vaccines.)

FROM BECKERS: (Has audio as well)

32% of older adults develop new medical conditions after COVID-19

FROM THE LANCET:

Transitioning to endemicity with COVID-19 research

(J. Harris: From a medical research point of view, most efforts have been directed to Covid for the last 2 years. Ultimately, this might prove costly?)

”…The vast research effort that has gone into COVID-19 over the past 2 years should be celebrated as a great human achievement—it has given us the tools to turn a pandemic disease into a manageable, endemic one. Better vaccines and treatments will be required to maintain this success, and large parts of the world’s population still do not have access to vaccines. However, research organisations, funding bodies, and industry should now lead a compensatory effort that, applying lessons learned from combatting COVID-19, redirects research towards the control of infectious diseases (and, indeed, non-communicable diseases) that take a toll of human life year in and year out…”

FROM JOHNS HOPKINS CITATIONS:

1. Waning 2-Dose and 3-Dose Effectiveness of mRNA Vaccines Against COVID-19–Associated Emergency Department and Urgent Care Encounters and Hospitalizations Among Adults During Periods of Delta and Omicron Variant Predominance — VISION Network, 10 States, August 2021–January 2022 (CDC MMWR) Vaccine effectiveness (VE) against COVID-19–associated emergency department/urgent care (ED/UC) visits and hospitalizations was higher after the third dose than after the second dose but waned with time since vaccination. During the Omicron-predominant period, VE against COVID-19–associated ED/UC visits and hospitalizations was 87% and 91%, respectively, during the 2 months after a third dose and decreased to 66% and 78% by the fourth month after a third dose. Protection against hospitalizations exceeded that against ED/UC visits.

2.Vaccine Scientists Have Been Chasing Variants. Now, They’re Seeking a Universal Coronavirus Vaccine (Washington Post) Volunteers are rolling up their sleeves to receive shots of experimental vaccines tailored to beat the omicron variant — just as the winter coronavirus surge begins to relent. By the time scientists know whether those rebooted vaccines are effective and safe, omicron is expected to be in the rearview mirror. Already, mask mandates are easing. People are beginning to talk about normalcy. The disconnect highlights the exhausting scientific chase of the last year — and the one that lies ahead. And it underscores a more pressing, overarching conundrum: Is chasing the latest variant a viable strategy? Instead of testing and potentially deploying a new shot when a new variant pops up, what if a single vaccine could thwart all iterations of this coronavirus and the next ones, too?

AND LAST BUT NOT LEASED:

 A Birthday Cake my Norweigan Housekeep made recently:

Another cake she made last month:

No joke.

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iExposed Us 

P.O. Box 721

Scottsville Texas

75688

HAPPY VALENTINES DAY

FOR YOUNG WOMEN AND YOUNG COUPLES TO READ:

FROM BECKER:

COVID-19 can destroy placenta and lead to stillbirth, study finds

(J. Harris: This is another good reason young women SHOULD get vaccinated — even more so if they might get pregnant. Good summary article that is easy to understand.)

Among pregnant women, the coronavirus can severely damage the placenta, leading to fetal asphyxiation and stillbirth, according to research published Feb. 10 in the Archives of Pathology & Laboratory Medicine.….The findings underscore the importance of vaccination among pregnant women, according to health experts.

FROM JAMA: 

    Among pregnant and postpartum individuals, SARS-CoV-2 infection was associated with an increased risk of a composite outcome of maternal mortality or serious morbidity from obstetric complications.

Challenges in Inferring Intrinsic Severity of the SARS-CoV-2 Omicron Variant

(J. Harris: This is a readable, referenced letter regarding Omicron in S. Africa. It points out that there’s still a lot we don’t know about the Omicron Variants.

”… caution is warranted when it comes to making inferences about omicron’s intrinsic traits, particularly its severity, on the basis of population-level observations…On the contrary, omicron’s immune-evasion capability has enabled it to infect many people who wouldn’t have been infected by previous variants, which has fueled its rapid spread and allowed it to more quickly infect nonimmune people, thereby offsetting what appears to be a moderately lower intrinsic severity and exacerbating overcrowding of hospital systems and demands on caregivers…More time and careful comparisons controlling for age, preexisting immunity, detection bias, lag time, hospital capacity, and other factors will be required to determine omicron’s intrinsic virulence…”

FROM THE NEW YORK TIMES:

Some long Covid sufferers try to exercise but end up feeling worse.

”…These exercise-induced problems are not, however, merely the byproduct of becoming out of shape. The effects “are very, very different from normal and simple detraining… They also don’t seem to be the result of lung or heart injury…Yet when the long Covid patients exercised on a stationary bicycle, Dr. Systrom found that some veins and arteries were not working properly, preventing oxygen from being delivered efficiently to their muscles…Nobody knows why these blood vessel problems occur… but another …recent studies suggested that long Covid patients experience damage to a certain kind of nerve fiber involved in how organs and blood vessel function.

A FOOTBALL ARTICLED BY MARSHALL’S FAVORITE NEW YORK TIMES WRITER, KEN BELSON

For N.F.L. Perfection, a Steep Price

AND LAST BUT NOT LEASED, IF A DAY OR TWO LATE:

Subject: Add for  Super Bowl Tickets: In case you’re interested: A buddy of mine has 2 Super Bowl tickets which are, 40 yard line box seats. He paid $7,500 each, but he didn’t realize last year when he bought them, that the game was going to be on the same day as his wedding…. If you’re interested, he’s looking for someone to take his place…It’s at Calvary Church in San Clemente at 3 pm. The bride’s name is Nicole, she’s 5’4″, about 115 lbs — good looking and good cook too. She’ll be in the white dress. Call for more details.   

ESPECIALLY  ON VALENTINES DAY, NEVER FALL FOR A TENNIS PLAYER. LOVE MEANS NOTHING TO THEM. 

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iExposed Us 

P.O. Box 721

Scottsville Texas

75688