Updates on New Infectious Disease Threats: What You Need to Know
Information about COVID-19 as well as other infectious diseases is constantly evolving. I am hoping to summarize some of that in these newsletters. New information will be in BOLD.
COVID-19
General Information
According to the CDC, the new bivalent booster shots have been found to be quite effective: they reduce the risk of hospitalization by 50% (compared to people who had gotten the older booster shots only). Another study found that in people older than 65 who had received the new bivalent booster, the risk of hospitalization was 80% lower than in unvaccinated people.
The newest Omicron variant that is sweeping the nation is called XBB.1.5: it accounts for more than 40% of the new cases in the U.S., up from just 1% one month ago. At this time, only 8% of new COVID-19 infections in Northern California are due to XBB.1.5. This variant doesn't seem to be more severe than earlier variants, just much more contagious.
The NIH has launched a virtual platform to improve access to anti-viral medications for people with COVID-19. This program will be piloted in parts of Pennsylvania.
Due to the high incidence of COVID-19 in China, travelers arriving in the U.S. from that part of the world must provide a negative COVID-19 test results on entry.
Symptoms and Risk Factors:
Long COVID: a recap:
Long COVID refers to COVID-19 patients who continue to have symptoms 3 months after onset of the disease.
Long COVID is very common and can affect about one third of people who get infected.
People who have severe acute COVID-19 are more likely to develop Long COVID.
Most cases do resolve, but about 3% of people are severely affected in their daily activities.
People who have been vaccinated and boosted are less likely to get long COVID.
Omicron seems to cause less Long COVID.
Multisystem inflammatory syndrome in children (MIS-C) may be more common than previously realized. A recent study (JAMA Network Open) suggested that 17% of COVID-19 hospitalizations in kids resulted in this condition.
As discussed previously, heart attacks and strokes are more common in people who have acute COVID-19. However, this risk seems to be present only in the first month after infection (PlosOne).
Incidence/ Prevalence:
Across the county, COVID-19 cases, hospitalizations, and deaths continue to rise. Luckily, the increase in hospitalizations and deaths are far below what we have seen in earlier disease surges. At this time, about 47,000 people are hospitalized with COVID-19 in the United States. The Northeast is seeing most of these increased cases.
Although the number of people hospitalized due to the disease are rising in much of the United States, hospitalizations in the Bay Area have plateaued and are much lower than in past winters.
COVID-19 is still responsible for the deaths of 350 to 400 Americans daily, which corresponds to 128,000 to 146,000 people per year. By comparison, about 12,000 to 52,000 die per year of the flu and 39,000 to 43,000 people die of car accidents.
Since onset of the pandemic 3 years ago, San Mateo County has had about 180,000 cases of confirmed COVID-19 - a number which does NOT include the many people who tested positive with home tests only. 871 people in the county have died of the disease. If we look at all of California, about 100,000 people of died of COVID-19.
Treatment
Vaccines:
Pfizer/ BioNTech:
On December 9, U.S. regulators authorized the new bivalent COVID-19 booster for kids under the age of 5 - not just as a booster, but as part of the initial series. The bivalent booster would take the place of the third shot in the initial vaccination series.
Moderna:
On December 8, U.S. regulators authorized the new bivalent COVID-19 booster for kids under the age of 5 - not just as a booster, but as part of the initial series. The bivalent booster would take the place of the third shot in the initial vaccination series.
Johnson & Johnson:
The FDA has restricted the use of this vaccine to those people who can't get an mRNA vaccine OR specifically request the J&J vaccine.
Novavax:
This vaccines is protein-based, and therefore employs a different technology than was used with either the J&J or the mRNA vaccines. In fact, the technology has been used for decades.
Testing
Nothing new here, folks....
INFLUENZA:
A lot of people are still getting infected with the flu, but the numbers seem to have peaked and are now going down.
RSV:
RSV is a virus that leads to symptoms much like the flu. It is seen most often in kids and older adults.
RSV cases continue to decline.
OTHER MEDICAL NEWS:
There is new medication ("lecanemab") being tested in the treatment of early stage Alzheimer's Disease. In a study looking at 1,700 people, scientists found that the medication delayed the worsening of symptoms by about 5 months (New England Journal of Medicine). However, more than 25% of patients had side effects on the mediation. Doctors are still debating the safety of this medication, especially as the benefits are still not clear. This medication was approved by the FDA on 1/6/2023 for the treatment of MCI (mild cognitive impairment) and early dementia. The list price for lecanemab is $26,500/ year. It is not currently covered by Medicare.
LISTEN UP: This is important!
There is a new California law (AB 1278) that requires all physicians to inform their patients via email or mail about the money physicians have been given by pharmaceutical companies in the prior years. More particularly:
The Open Payments database is a federal tool used to search payments made by drug and device companies to physicians and teaching hospitals. It can be found at
Consider yourselves informed!
Our Community and Beyond:
Peninsula hospital is getting very full! this is largely due to increased cases of influenza and COVID-19.
About Dr. Sujansky's Life in These Times
Happy New Year! I am looking forward to great things, fun experiences, and learning new things in 2023.
We went skiing in Canada (Revelstoke in British Columbia) over the holidays and had a great time. Both of my sons came along and we enjoyed skiing, relaxing, and eating together. The best part: my kids were a "captive audience" there: because we were nowhere near their friends, they had to spend time with us! On New Year's Eve, each one of us had to write a new year's resolution and put these into a hat. This way, each of us had to draw a resolution that we would not necessarily have come up with ourselves....a bit of a worrisome proposition! In my case, I am now committed to keeping a daily journal for the foreseeable future!
