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.
COVID-19
General Information
There are many different strains of the COVID-19 virus circulating in the U.S. right now.
There was an interesting study in the Journal Clinical Infectious Diseases that looked at the omicron variant. It seems that omicron is most contagious 4 days after onset of symptoms. This also means that if you test negative for COVID the day after you start feeling sick, you should re-test daily for another few days, as the test may not be positive early on.
Early trials on new COVID-19 vaccines are ongoing: one is an intranasal vaccine by Codagenix, which uses the whole virus and therefore can induce immunity to various parts of the virus...however, similar vaccines developed for the flu shot in the past have had their difficulties, so this is not a "slam dunk" yet...
In the first 8 months of this year, 63% of people hospitalized with COVID-19 were older than 65. In addition, older people were much more likely to end up in the ICU. Of these hospitalizations, more than 75% of the patients had not been vaccinated for the SARS-Cov-2 virus (Morbidity and Mortality Weekly).
A study published in Jama Network Open found that people with a past COVID-19 infection were more prone to develop a variety of autoimmune diseases. Interestingly, people who had been vaccinated and then developed COVID-19 did NOT have a higher chance such a subsequent autoimmune process.
LONG COVID:
LONG COVID: it turns out that other respiratory viruses can also cause symptoms that lasts months or years after infection, not just SARS-Cov-2 (Lancet). But people with Long Covid are more likely to feel light-headed or dizzy and were more likely to have problems with smell and taste; other viruses were more likely to cause lasting cough or diarrhea.
At this time, over 18 million Americans have had to deal with Long-Covid. In fact, 3.4% of Americans are currently suffering from Long-Covid (CDC). Women and girls are more likely to have Long-Covid than men/ boys.
Survivors of COVID-19 are NOT more likely to die than those that did not get COVID-19 (Jama Internal Medicine).
Scientists are finding differences in the blood of people who have long-Covid compared to people without the condition (Nature). This will be helpful in diagnosing Long-Covid in the future as well as better understanding the nature of this condition. Also, MRI scans of the lungs of people with Long-Covid are often different than in those without (Lancet Respiratory Medicine).
A new study (published in the journal Cell) shows that people with Long-Covid have lower-than-normal serotonin levels...these low levels might be able to explain ongoing issues with memory and concentration. This finding also opens the door to possible future treatments of Long-Covid that involve the serotonin system.
Incidence/ Prevalence:
COVID cases and hospitalizations continue to decrease.
Treatment
Morbidity and Mortality Weekly found that pregnant women who received the COVID vaccine were able to pass protective antibodies to the fetus.
The Department of Health and Human Services has met with representatives of the insurance industry to make sure that the COVID-19 shots are covered for all.
We have a new COVID-19 vaccine, this one made by Novavax. It received emergency use authorization on October 3, 2023. The EUA was based on non-clinical data indicating that this vaccine elicites an immune response in Rhesus monkeys. It is NOT an mRNA vaccine: rather, it was made with more traditional protein-based technology and may be appropriate for people who have concerns about the mRNA vaccines.
A recent study looking at the anti-viral Paxlovid found that, in a real-world setting, it is only 37% effective in preventing hospitalizations :( (JAMA Network Open)...prior studies had shown the medication to be 89% effective. However, the medication was still quite effective in preventing hospitalizations in people who had a moderately or severely compromised immune system.
Testing
The administration has announced a new program providing free COVID tests: after September 25, people can request up to 4 free tests per household at the website "covidtests.gov." The FDA did note that some of these tests may seem to be past their expiration dates. However, the tests are not really expired and should still be accurate.
Other Infectious Diseases:
RSV:
RSV is a virus that causes lung diseases in young children and older adults. Most older adults who get seriously ill with RSV live in senior living communities or have multiple other medical problems.
The new RSV vaccine CAN be taken at the same time as the flu shot, but the flu shot MAY be more effective if it is taken separately from the RSV shot.
According to the CDC, it is less common for older adults to be hospitalized for RSV when compared to COVID-19 or the flu, but RSV hospitalizations tend to be more serious.
Pregnant women are advised to get the RSV vaccine, as this will help protect the newborn infant.
We are seeing more RSV in Northern California, especially in kids younger than six years old.
There is a lot we don't yet know about the RSV vaccine - like how long a single vaccine will be effective: will we need another one in one year? in five years? However, a recent study (AReSvi-006 study) showed that the vaccines seems to be effective for at least two RSV seasons...perhaps more.
INFLUENZA:
You can get the flu shot at our office now. No appointments are necessary, but it may be a good idea to call the office first to let us know you are coming.
There is not a lot of flu activity in the U.S. for now. It doesn't seem likely that we will have an early flu season. Hopefully, this season won't be a bad one overall!
Only Southeast Asia seems to be seeing a lot of flu.
New trials are looking a novel flu vaccines that could possibly produce a vaccine that could last for more than one year!
MALARIA:
For the first time in decades, we have found cases of malaria (!!) acquired in the U.S. from local mosquitoes. So far, only Florida, Texas, and Maryland have seen cases of indigenous malaria.
The WHO has just authorized a new malaria vaccine. It seems to be about 75% effective and protection can last at least 2 years; a previous malaria vaccine was only 30% effective.
OTHER MEDICAL NEWS:
A study published in the American Journal of Clinical Nutrition found that people who consume an average of two servings of red meat per week are more likely to develop diabetes down the road. Also, red meat consumption was associated with higher weight.
Our Community and Beyond:
nothing here right now...
About Dr. Sujansky's Life in These Times
I have heard that a number of you guys skip directly to this part of the newsletter, relegating the rest of the newsletter information for an appropriate setting, like getting your teeth cleaned. That's fine! It's hard to always be reminded of this new virus in our midst and I understand the impetus to tune it out sometimes.
So, on to happier topics! Fall is in the air, though the summer temperatures are still here also, which is a happy combination in my mind. My husband and I have been busy in our quest to explore San Francisco: we recently listened to an amazing classical guitar artist in the Palace of Fine Arts in SF. We also took a great hike through the Presidio with some great views of the City. Finally, we are practically emptying our bank accounts in our attempts to get to know the great restaurants here.
Halloween is around the corner, so we'll see what fun things there are in San Francisco for that...I know there is supposed to be a family-friendly street fair in the Castro, so that could be interesting.
On an entirely different note: as you know, we usually have an Obagi skin care event twice a year. The next event will be from November 13 to 30 and will involve a 20% discount of all Obagi products. This time, however, we will not have individual consultations with a skin care specialist. We may bring that back in May...
Take care all of you!
