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
A study from the Proceedings of the National Academy of Sciences may offer hope for future COVID-19 vaccines: current vaccines target the spike protein, which has changed its composition frequently as the virus mutates. However, a different enzyme (called PCIF1) seems to change very little as the virus mutates. If scientists could target this protein rather than the spike protein, then perhaps vaccines could maintain their efficacy for longer....
Studies show that wild animals such as rodents or deer can get infected with the SARS-Cov-2 virus without getting too ill. As a consequence, such animals present a reservoir for the virus to persist and mutate, and then re-infect humans at a later date.
The name of the currently circulating SARS-Cov-2 strain is "XBB"....sounds a bit like a Star Wars character, doesn't it?!
The vaccines to help prevent COVID-19 are now included in the schedule of CDC recommended childhood vaccinations. They are NOT required vaccines to attend schools or at workplaces.
Some of us have come to think of the omicron COVID-19 variant much like the flu....however, a recent article (JAMA Network Open) compared outcomes in people hospitalized with COVID-19 and those with influenza: 50% more people died with COVID-19 infection than with influenza.
A recent study (Lancet) suggests that if you get ill with COVID-19, you are protected for the next 10 months from getting severe COVID-19.
Symptoms and Risk Factors:
Long COVID:
The symptoms associated with Long COVID tend to resolve after about one year (BMJ).
According to a study in JAMA Internal Medicine, women who have a healthy lifestyle (normal weight, non-smokers, moderate alcohol, healthy diet, exercise, sleeping adequately) prior to contracting COVID-19 are less likely to develop Long Covid.
As mentioned previously, COVID-19 is associated with a greater risk of developing diabetes in the 90 days after infection. Luckily, vaccination against the virus seems to mitigate that risk (JAMA Network Open).
Incidence/ Prevalence:
COVID-19 hospitalizations continue to drop weekly!
Unfortunately, examination of wastewater in the Bay Area suggests that COVID-19 incidence may be rising again.
Treatment
Vaccines:
A combination of vaccination and past infection is very protective: such people had a 97% reduced incidence of severe infection in the year following their last vaccine/ disease (Lancet Infectious Diseases).
And remember: the bivalent COVID vaccine (available since 9/2022) is proving to be very important in preventing severe COVID-19:
the mortality rates of unvaccinated people compared to those who have received the bivalent COVID vaccine are 14 times higher.
the mortality of of people who "only" got the older, monovalent covid vaccines is 2.6 times higher compared to those who received the bivalent booster.
Pfizer/ BioNTech
Moderna: In a Swiss study, people who got the older monovalent COVID-19 booster were more likely to develop hives that lasted more than 6 weeks (JAMA Network Open).
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
Other treatments:
It seems that treatment with zinc (25 mg twice daily) is helpful for people who have mild to moderate COVID-19. People older than 65 or those with other risk factors for severe disease benefitted most (CID).
There is a new anti-viral medication ("pegylated interferon lambda" or "PEG-lambda") that has been found to reduce hospitalizations by 50%, in patients who were already vaccinated against COVID-19 (New England Journal of Medicine). Unvaccinated people saw a reduction of hospitalization of 89%! This research has just come out in our backyard at Stanford University. This medication is administered in a single shot only. Side effects were minimal. Also, this medications proved to be effective against all of the various SARS-Cov-2 variants that were tested, which is great. I don't think PEG-lambda is available outside of clinical trials yet, but hopefully soon!
Also, there is another new medication currently known as "VV116" that is taken by mouth and seems to be just as effective as Paxlovid in the treatment of COVID-19 (New England Journal of Medicine). Also, people in the trial who got VV116 had fewer side effects than the ones who got Paxlovid. VV116 is not yet on the market in the U.S., but it is great that we will (hopefully) have another treatment option soon!
Paxlovid:
Recall that we had some concerns about Paxlovid leading to rebound COVID-19 disease after use. However, two independent studies suggest that this is NOT the case. Covid-19 rebounds (when people feel worse after having previously "turned the corner") occurs in about 5% of infections, whether or not Paxlovid is used (Lancet Infectious Diseases; Annals of Internal Medicine).
In the past, we have noted an unusual association between infection with COVID-19 and the subsequent increased development of diabetes. Well: recently, we have learned that the common diabetes drug "metformin" helps to decrease the viral load in COVID-19 infections and associated with a 58% reductions in hospitalizations and a 42% reduction in long COVID. (Medscape Medical News).
Testing
The FDA has authorized a new over-the-counter at-home test that will check for influenza as well as COVID-19. It's a nasal swab and gives you results in 30 minutes or less...this sounds great, as it's often hard to distinguish between the flu and COVID-19 based on symptoms alone.
INFLUENZA:
You may have heard of the very severe cases of bird flu that are going around and causing the death in 58 million birds - this is the worst bird flu outbreak in over 10 years. Right now, humans rarely get this strain of influenza and are safe. However, scientists are concerned that this new bird flu virus will mutate so that humans can get infected also...let's hope it doesn't come to that!
The flu vaccine that was developed for this 2022/ 2023 flu season is turning out to be quite effective! The vaccine is 68% effective in preventing hospitalizations in children. Unfortunately, it is only 30-44% effective in preventing hospitalizations in people with weakened immune systems.
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.
Moderna is developing a vaccine against RSV. A recent trial found that it was 82% effective in preventing severe RSV in people older than 60.
Pfizer has also just developed a vaccine against RSV to protect newborns and hopes to have it approved by August, 2023. The vaccine is given to the pregnant mother, who then passes on the resultant antibodies to the fetus. Studies show the vaccine to be 82% effective in preventing severe RSV disease in newborns.
NOROVIRUS:
Norovirus causes severe diarrhea and vomiting. It's been around for decades, but cases seem to be surging right now. Young children and the elderly are most at risk. It is very contagious, so be careful!
OTHER MEDICAL NEWS: Nothing here today!
Our Community and Beyond:
California will be closing dozens of state-run COVID-19 testing and treatment sites. Sites that are running on only 50% capacity will close by the end of January, 2023.
Today, February 28, is the last days of California's emergency order for COVID-19.
At this time, California has seen over 100,000 deaths due to COVID-19.
About Dr. Sujansky's Life in These Times
Not much new in the life of the Sujansky family, I'm afraid.
I completed another two knitting projects (two shawls, attached below).
I've actually been enjoying the torrents of rain we have had of late....I love lying in bed listening to the rain on the roof and know how blessed we are to have a roof over our heads.
For those of you who may not know, lent has started last week. Even if you are not Christian or religious, I think it's a good opportunity to either to break some old bad habits (I'm giving up sweets) or to adopt some new good habits. This can even be fun: you can try out new hobbies, resolve to meet friends more often, or just be kinder to yourselves. Let me know what you come up with, if anything!
Stay dry!
