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
Most of the SARS-Cov-2 we are seeing in the U.S. is the "EG.5" (known to its many fans as "Eris") variant. This is a variant of the XBB strain. It doesn't seem to be more dangerous than previous variants. As mentioned in the past, the new vaccine that is likely to come out in September should offer protection for this strain. Other variants are circulating as well and there is no single dominant variant, as there has been in the past.
There is another new variant emerging, the "BA.2.86." We have seen this in the U.S., Denmark, and Israel. It has many more mutations than previous variants and so is being tracked closely at this time. The CDC is looking into whether this variant may be more likely to cause infection in people who were previously ill with the virus or were vaccinated...But so far, only a handful of BA.2.86 cases have been seen in the U.S.
The new COVID-19 vaccine should be available in late September. You will be able to get it at most pharmacies. Our office does not have the ultra-cold freezers (and back up generators) needed to store the vaccines, so we can not offer any COVID-19 vaccination.
Unfortunately, many parts of the country are seeing an increase in COVID-19 cases (see below).
The federal administration is awarding $1.4 billion in funding to new projects that may protect us from COVID-19 in the coming years. Pharmaceutical companies, nonprofits, and non-governmental organizations will be the recipients of the money.
Symptoms and Risk Factors:
Yet another study (eClinical Medicine) found that people who have cognitive issues after COVID-19 infection can continue have issues with their mental acuity for up to two years.
The NIH is launching several studies looking at possible treatments for Long-COVID. Such possible treatments include Paxlovid (not just for acute COVID-19, but also for Long-COVID).
There is some (small) good news about Long-Covid: the most recent data obtained from the CDC suggests that the number of people suffering from Long-Covid is coming down: in June, 2022, 7.5% of adult Americans had Long-Covid, while in June, 2023, that number had come down to 6%. Unfortunately, 26% of people with Long-Covid still struggle to perform daily activities. We are seeing Long-Covid more often in middle-aged adults (aged 35 to 44) rather than in the very young or very old.
Incidence/ Prevalence:
For the last six weeks, COVID cases have been increasing again: compared to last week, hospitalizations due to COVID-19 have been up 12% and emergency department visits have been up 17%. And overall we are seeing about 50% more cases than one month ago. Data from U.S. hospitals suggests that COVID-19 levels are highest among people aged 75 or older - similar to what we saw last winter.
Overall, however, the numbers are still much lower than in the past: at this time one year ago, we had about 4,700 people hospitalized with COVID-19; now, that number is closer to 890 (though it was 750 last week...).
This means we need to be extra careful in testing ourselves when we have any symptoms, to help avoid infecting others if we are positive. And wear a mask if you have any symptoms, even if you are negative...
Treatment
Vaccines:
The new vaccines are scheduled to come out in late September, 2023. They will target the circulating XBB variants, strains that have mutates from the original Omicron variant. Three companies (Moderna, Pfizer, and Novavax) will be manufacturing the new vaccines.
With the recent increase of COVID-19 cases, the misinformation that has dogged the pandemic is rising again also. The FDA wants to remind us that ivermectin, the anti-parasitic agent used to combat a number of worm-related-diseases, has NOT ONLY been shown to be INEFFECTIVE in treating COVID-19, but has also been shown to increase hospitalizations. Major health organizations including the American Medical Association similarly have advised against the use of ivermectin.
Other treatments:
The anti-viral Paxlovid has recently gained full FDA approval, so it is no longer an "experimental" treatment for COVID-19.
Testing
Nothing new to report....
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.
At this time, there are several manufacturers making the new RSV vaccine. It is now available and you can get it at most pharmacies. We will not have the RSV vaccine in our office
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.
We were seeing increased counts of RSV in the local wastewater supply, but the numbers seem to be coming down again (thankfully).
INFLUENZA:
Wastewater studies done at the Palo Alto Regional Water Quality Control Plant suggest increasing levels of influenza even now. This fact remind us that influenza is a disease that exists year-round, though we see it more often in the fall and winter.
You can get the flu shot at our office starting late September. No appointments are necessary, but it may be a good idea to call the office first to let us know you are coming.
OTHER MEDICAL NEWS:
A study in the journal Nutrition found that replacing mayonnaise and margarine with olive oil can reduce your likelihood of dying of dementia. Also, consuming a spoonful of olive oil per day can reduce the risk of dying of dementia by 28% (!!!)...now that is easy to do and perhaps all of us should start!
On the subject of diet: I think we all have heard the data on bad soft drinks and diet soft drinks are for you. Well, a recent study showed that people who drank one or more sugar-sweetened beverage per day had a much higher incidence of liver cancer and death from chronic liver disease.
A recent study (Lancet Rheumatology) found that people with hip or knee arthritis who continued to exercise and walk do much better than those who did not. So, if you have arthritis, do please continue to try to stay active to help mitigate the course of the disease.
Our Community and Beyond:
Remember to come to our office to get your annual flu shot (starting late September). No need to have an appointment, just come in (but you may want to call first to make sure everything is ready for you!)
About Dr. Sujansky's Life in These Times
Thank you to all of you who have sent me recommendations on exploring San Francisco. I have already taken advantage of many of them, but have much work to do still! Now that my sons are back to college (or living abroad), I will have more opportunities to see the city. Some highlights so far have included
watching the movie "Batman" at the San Francisco Symphony.
Taking walking tours of the Ferry Building, the Castro, and the Haight.
Watching Cirque Du Soleil.
Watching a movie at the 100-year-old Castro Theater.
Checking out the farmer's market in the Ferry Building
Hiking in the Marin Headlands (see picture).
Going to a baseball game.
