Updates on the Novel Coronavirus (aka COVID-19): What You Need to Know
Information about the spread and about the safety concerns of the novel coronavirus (aka "SARS-Cov-2"), and the disease it causes, COVID-19, is constantly evolving. I will include some details on this topic from previous newsletters, as they remain important - new information will be in BOLD.
General Information:
Last week was the two-year anniversary for the World Health Organization's declaration that COVID-19 was a global pandemic.
The CDC has issued new guidelines on February 25 about mask-wearing. These guidelines would allow about 70% of Americans to stop wearing masks! The new guidelines are based on new COVID-related hospital admissions, the percentage of hospital beds occupied by COVID patients, and the number of new COVID-19 cases per 100,000 population in the last week.
The Transportation Security Administration has extended the mask mandates for commercial airline flights as well as buses, subways, and other public transportation until at least April 18.
Most California schools can lift their indoor masking requirements. Nearly all of the counties in the Bay Area fall into the "low or medium risk" category and could lift their requirements IF local county officers agree.
Local authorities can issue more stringent mask mandates if they like.
California lifted its indoor mask requirement on 3/1/22 (for unvaccinated people...mandates for vaccinated people had been lifted previously) and will lift the requirement for schools and child care facilities on March 12.
The BA.2 subvariant of the Omicron virus now makes up about 11.6% of the circulating SARS-Cov-2 virus in the U.S. Here are some things we know about it:
The BA.2 variant has been around since Omicron was described...so it isn't really "new." It is getting to be more common, however.
It is more contagious than the BA.1 (original) Omicron variant!
It has not led to a new surge on infections in the United States. Even as it may become the dominant variant down the line, it doesn't seem to be associated with an increasing number of cases in the U.S.
Current vaccines are still active against BA.2: vaccines are moderately effective in preventing all infections, but they are very effective in preventing severe infections.
BA.2 doesn't seem to cause more severe disease than prior variants.
Current PCR tests are good at picking up the BA.2 variant.
On March 2, the White House proposed new guidelines to combat the COVID-19 pandemic, which includes increased surveillance of new variants. In addition, the plan is for pharmacies to test people (in the future) for the infection and then directly dispense anti-viral pills. This would allow the country to go from a crisis mode to a way that we could live with the pandemic long-term.
A recent study published in the Annals of Internal Medicine compared people who had been infected with the Delta SARS-Cov-2 variant with those infected with Omicron:
People infected with Omicron tended to be younger (54 years vs 62 years old)
People infected with Omicron were less likely to be obese.
People infected with Omicron were more likely to be vaccinated
Omicron patients were less likely to be short of breath, less likely to be seriously ill, and less likely to die.
Symptoms and Risk Factors:
Long COVID:
Scientists are finding different possible causes of Long COVID syndrome: evidence points to ongoing smoldering infection, nerve damage, ongoing blood clots, and auto-immune antibodies.
The journal Nature recently published an article indicating 16 genetic markers that make people more susceptible to severe COVID-19; these risk factors either predispose people to excess inflammation and blood clotting or are associated with the process of viral replication itself.
Scientists are now beginning to understand the basis of the loss of smell that can been seen with COVID-19 infection (Cell). This issue had stumped researchers in the past, as the cells that let people perceive smell actually do NOT have the receptors that the coronavirus needs to infect cells. However, the surrounding cells do get infected and die and lead to a lot of local inflammation, which affects the smell receptors. This is another example of an over-active immune system of the body causing more harm than good in this infection.
Recent research on monkeys shows that the SARS-Cov-2 virus can infect numerous types of cells in men's genital tracts, leading to erectile dysfunction, a condition occasionally described by survivors of the infection.
Incidence/ Prevalence:
Yes, COVID-19 deaths are plummeting in the United States! Worldwide, however, there are now more than 6 million people who have died of the disease. Other nations are not faring as well as we are (China, Hong Kong, New Zealand, South Korea) and about 4% of all COVID deaths in the world have been seen in the last month!! In Hong Kong and China, the rise in COVID infections may well be related to the low vaccination rates in those places. In Hong Kong, 40% of hte population are not vaccinated and more than 50% of the people older than 70 are not vaccinated! Rates are also rising in parts of Europe, which is thought to be related to the new BA.2 Omicron variant.
The U.S. contributed to 16% of the deaths of the last million deaths worldwide. This is the highest percentage of any nation.
The CDC recently published an article that looked at specific COVID antibody levels in people and found that over 140 million Americans have been infected with COVID-19 in the past! This number is twice as high as previously thought. Indeed, it seems that 43% of the country (as well as 58% of kids!) have been infected by the virus at some time.
Treatment
Vaccines:
People who get COVID-19 vaccines and boosters from different manufacturers seem to be better protected against the virus than those that stick with the same manufacturer.
Booster shots seem to lose much of their efficacy of preventing any infection after about four months. Luckily, they are still very good (78% effective) at preventing hospitalization and death after four months. These results were recently published by the CDC.
Pfizer/ BioNTech:
The FDA stated on February 11 that they were holding off on authorizing the vaccine for kids under 5 until they had more data on the three-shot series. Pfizer hopes to have more information on the three-shot series by early April.
The Pfizer/ BioNTech vaccine has been found to be much less effective in kids aged 5 to 11. While the vaccines is still good at keeping children out of the hospital, it does NOT protect much at all in getting the infection in general (medRxiv). The decreased effectiveness of the vaccine in this age group may well be related to the significantly lower doses used for these young children.
Moderna: This week, Moderna plans on sending federal official data on how well its vaccine works in kids under the age of five. In addition, it plans on releasing information on vaccine trials in kids aged six to 11 soon.
Johnson & Johnson
Novavax:
There is a new vaccine made by Sanofi and GSK that is proving to be very effective in early trials: after two doses, the vaccine was 75% effective against moderate disease and 100% against severe disease and hospitalizations. The vaccine is antigen based and therefore uses technology that has been around for decades and is used for flu shots.
Other treatments:
The COVID-19 pill made by Merck ("molnupiravir")will soon be made by 27 different generic pharmaceutical companies and help supply 11 countries.
Pfizer's new pill "Paxlovid" to treat COVID-19 is likely to work against the Omicron variant. Treatment is authorized for people who test positive for the virus AND are vulnerable to becoming severely ill due to the disease, based on risk factors such as age, diabetes, or compromised immune systems. Tests have now begun to look at how effective and safe Paxlovid is for kids (aged six to 17) who are at high risk of severe disease. Results are expected by the end of the year.
Testing
Also, as of January 18, you can get free home rapid COVID-19 tests from the government: each household is entitled to four tests. The federal administration is now even allowing Americans to order a second round of four tests per household. It is very easy to sign up: go to
Covidtests.gov.
Luckily, at home tests are much more readily available now in stores.
Our Community and Beyond:
As of February 16, most indoor masking mandates for vaccinated individuals have been lifted. Nonetheless, masking is still mandatory in health care facilities, on public transportation, correctional settings, as well as long-term care and senior care facilities. On February 28, California officials will reassess the need for masking in schools.
A Menlo Park-based biotech company, Avellino Labs, is offering free PCR-based COVID-19 tests 7 days a week (between 9 am and 5:30 pm). The testing will occur at the office's parking lot at 4300 Bohannon Drive. Appointments are not necessary. Turn-around time will be 48 hours.
As of March 12, California will end its state-wide mask mandate in schools.
San Mateo currently has vaccinated 84.9% of all of its residents and 68.8% of eligible residents have received a booster also.
Non-COVID-19 News
A recent study in the Journal of General Internal Medicine confirms what many of us know: blood pressure measurements that patients take at home are more accurate than the ones obtained in the doctor's office. This is likely due to the lower stress environment at home. So, for those of you checking your blood pressure at home already, please keep it up! Home readings provide very important information!
Ok, this piece of information is sort-of related to COVID-19: Dengue fever is a serious disease found in Latin America and Southeast Asia. It is spread via mosquitos. Well, it seems that the restriction on movement associated with the pandemic has led to a plummeting of Dengue cases as well (Lancet)....a surprising finding as Dengue is not spread by people breathing and coughing on each other!
