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:
2021 was the deadliest year in U.S. history, largely due to the pandemic. COVID-19 deaths rose to 415,000, compared to 351,000 in 2020.
On 4/13/22, the U.S. renewed the COVID-19 public health emergency status, which will allow Americans to continue to get free COVID-19 tests , vaccines and treatments for at least another three months. In addition, the CDC has extended the mask mandate on airplanes for at least another two weeks. At this time, the mandate is set to expire on May 3.
March 29, the FDA authorized second booster shot of either the Pfizer/ BioNTech or the Moderna vaccine for those people who
are aged 50 or older or...
are older than 12 (but not necessarily older than 50) and immunocompromised (including people who have had an organ transplant or have a weakened immune system for other reasons).
AND have had their first booster (i.e. theirthird shot overall) at least four months previously.
The CDC later also recommended the extra booster shot for those eligible.
A study published in the New England Journal of Medicine showed that the protection against infection afforded by a fourth shot only lasted for about two months. Nonetheless, the second booster was very effective overall in preventing severe disease. It is still unclear how long this extra protection against severe COVID-19 lasts.
Personally, I think the 4th shot is particularly important to get now for people aged 65 and older....especially if we are facing another COVID-19 surge due to BA.2. For others, I would consider holding off on the 4th shot unless you will be in a higher risk situation (vacation, a big event) in the next two months or so.
BA.2 is now the dominant version of the virus in the U.S., with the Northeast (New York and New Jersey) having the highest incidence of this subvariant.
The BA.2 subvariant is now responsible for 86% of all COVID-19 cases in the U.S.
There is a new COVID strain (called XE) that has been found in the United Kingdom: this strain combines the original Omicron variant with the BA.2. XE currently makes up less than 1% of the cases in the UK and we have no reason to believe at this time that XE is more dangerous or more resistant to vaccines than the earlier variants.
OK: this is kind of interesting: In a study done in the United Kingdom (and published in Nature Medicine), 36 young and healthy volunteers were purposely inoculated with the COVID-19 virus. It took only a tiny droplet (the size of a human cell) to infect someone! The results of the study confirm many of the things we had seen previously: of these 36 volunteers, 18 became infected, with the amount of virus rising steeply for the first 5 days after inoculation. People started developing symptoms 2 to 4 days after inoculation. The amount of virus in the body did NOT correlate with how sick people felt. This means that infected people can feel fine, but still be contagious. The virus could still be found in the body for about 10 days after inoculation. No participants had serious health consequences of the experiment.
A study (Lancet Child &Adolescent Health) found that fewer than 0.5% for children became re-infected with SARS-Cov-2 after initial infection. Moreover, re-infection was not associated with kids getting sicker.
A new government website (covid.gov) will function as a one-stop-shop for people needing vaccines, tests, treatments, and masks. The website includes information on local virus incidence, travel guidance, and places to get anti-viral medication.
According to an article published in Population and Development Review, the pandemic has reduced the world's life expectancy by two years, which is HUGE!
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 National Research Action Plan on Long COVID is a federal initiative to gather improved information on the understanding, diagnosing, and treatment of Long Covid.
We have learned in the past that COVID-19 is associated with the formation of blood clots. A new study (BMJ) found that this risk of blood clots persisted for months after infection.
Incidence/ Prevalence:
The U.S. seven-day average of COVID-19 cases is 28,339 as of April 9. This is up about 10% from the previous week. Nonetheless, hospitalizations and COVID-19 deaths are still at record low rates.
Overall, the number of new COVID-19 cases is still low, though it has risen 18 percent in the last 2 weeks. In Los Angeles County, the number of COVID-19 cases have actually risen 71% in the last two weeks. Numbers are increasing in San Mateo County also. Officials are unclear if this rise is just a "blip in the curve" or the beginning of a surge.
In anticipation of a possible COVID-19 surge, Philadelphia reinstated their indoor mask mandate on April 11.
At this time, COVID-19 hospitalizations are at their lowest rates since the summer of 2020!
Treatment
Vaccines:
A report published by the Commonwealth Fund estimated that COVID-19 vaccinations "prevented 2.2 million deaths, 17 million hospitalizations, and 66.1 million additional infections through March 2022." The report also estimates that vaccinations have saved the U.S. $900 billion in health care costs.
A recent study showed (again) that three doses of the Pfizer or Moderna vaccines were 94% effective in preventing death or the need for a ventilator during the Omicron surge. At the same time, two shots were only 79% effective in preventing this.
COVID-19 vaccines are not as effective in preventing hospitalization in kids aged 5 to 11 (New England Journal of Medicine).
Pfizer/ BioNTech:
Yet another study (JAMA Pediatrics) conducted in Israel found that vaccination with the Pfizer/ BioNTech vaccine during pregnancy was safe for the expectant mother as well as for the baby.
Moderna:
Johnson & Johnson: people who previously received one single J&J vaccine can get a Pfizer/ BioNTech or Moderna vaccine 4 months later. More data suggests that the J&J vaccine is not as protective as the mRNA vaccines: a single does of J&J only reduces hospitalization risk by 31%.
Other treatments:
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.
There is a new experimental drug ("sabizabulin") that has been found to cut the incidence of death in half (!!) in patients who are in the hospital with severe COVID-19. Outside experts still need to validate these results. If the efficacy of the medication is confirmed, the company will be applying for Emergency Use Authorization so that this new medication could be used in U.S. hospitals soon.
Yet another study (this one published in the New England Journal of Medicine) showed that the anti-parasitic drug Ivermectin does NOT work to prevent infection or hospitalization in people infected with SARS-Cov-2.
Giving convalescent plasma to people WHO WERE NOT VACCINATED and then developed COVID-19 helped reduce hospitalizations (New England Journal of Medicine).
The anti-depressant fluvoxamine, when taken soon after infection with SARS-Cov-2, seems to reduce the risk of hospitalization for COVID-19. (JAMA Network Open).
The antibody cocktail "sotrovimab," which emergency departments have been giving patients to help prevent severe COVID-19, does NOT protect against the BA.2 subvariant and will no longer be given for COVID-19 patients at this time. Luckily, another antibody medication "bebtelovimab" is still effective in preventing severe disease.
Testing
Starting April 4, Medicare has started paying for up to eight home COVID-19 tests per month. Tests can be picked up at various pharmacies. This coverage will only apply to people enrolled in Medicare Part B.
Our Community and Beyond:
As of March 12, California ended its state-wide mask mandate in schools.
The above notwithstanding, the incidence of COVID-19 in schoolchildren remains low: the week of April 4 saw 43 cases of COVID-19 in the Sequoia Union High School District, which is home to 10,000 students. In comparison, during the COVID-19 surge in January of 2022, there were 710 sick kids in one week!
Non-COVID-19 News
Scientists have finished sequencing the human genome - this is the blue print of our genes that can help understand how our body works and hopefully help medical advances to cure diseases. The project was started about 20 years ago (Science).
A study published in the Journal of the American Heart Association found that eating at least two servings of avocado per week can reduce your risk of a heart attack by 21%.
Insufficient sleep has been tied to increased calorie consumption and increased abdominal fat (Journal of the American College of Cardiology).
About Dr. Sujansky's Life in These Times
My husband and I took an overnight trip to Pacific Grove recently: what a beautiful place (see the pictures)! If you haven't visited recently, I highly recommend it. The weather was gorgeous and the views stunning. Aren't we lucky to live in a part of the world that is so close to such natural beauty!
Other than that, we have had our hands full with Spring Cleaning! As you may recall, we recently re-did our bathroom, and now the rest of the house looks shabby in comparison. So now we are thinking about new carpets, a new coat of paint, new asphalt on the driveway....it never ends!
I want to wish you a Happy Easter and Happy Passover and hope you can enjoy some peace and joy during these turbulent times.
