Category: Corona Virus

Published: June 26, 2024

Indicators continue to show moderate to high levels of COVID-19 transmission in Ireland.

In week 25 (June 16-22, 2024):

The COVID-19 variant JN.1 remains the dominant lineage in Ireland. The KP.3 variant, a sublineage of JN.1, is increasing in Ireland. It accounted for 21.8% of sequences for weeks 19 to 23 2024. This compares to 1.6% for weeks 14 to 18 2024. While KP.3 appears to have a growth advantage over other variants, there is no evidence that it (or any other currently circulating lineage) is associated with more severe disease.

As in previous waves, widespread circulation of COVID-19 often leads to an increase in people experiencing severe disease. Increased circulation in the community also leads to increased numbers of outbreaks in nursing homes, hospitals and other healthcare settings, putting vulnerable patients at risk of infection and leading to COVID-19-related healthcare staff shortages.

This current wave is a reminder that COVID-19 continues to circulate throughout the year and remains a considerable burden on the population and our health services when circulation is high.

It is important to remain vigilant for COVID-19 symptoms and take steps to prevent spread in both the community and in healthcare settings, to protect vulnerable people at high risk of severe COVID-19 disease.

For advice on preventing the spread of COVID-19 and what to do if you have symptoms, go to:https://www2.hse.ie/conditions/covid19/preventing-the-spread/. If you have any symptoms of COVID-19, even mild ones, stay at home until 48 hours after your symptoms are mostly or fully gone. You should also avoid contact with other people, especially people at higher risk of severe COVID-19.

Guidance on infection prevention and control in health care settings is available at:https://www.hpsc.ie/a-z/respiratory/coronavirus/novelcoronavirus/guidance/guidanceforhealthcareworkers/

Information on COVID-19 trends is updated every Wednesday on theRespiratory Virus Notification Data Hub.

See the rest here:

News: COVID-19 transmission continues at moderate to high levels in Ireland - Health Protection Surveillance Centre

Add topic to email alerts

Receive an email when new articles are posted on

Back to Healio

Together, a group of viruses nicknamed FLiRT have emerged to become the most common SARS-CoV-2 variants in the country.

According to the CDC, in the most recent week with available data, there was a 1.2% increase in SARS-CoV-2 test positivity in the United States, a 14.7% increase in ED visits related to COVID-19 and a 16.7% increase in COVID-19 linked deaths, and COVID-19 hospitalizations increased by 25% during the last week of May.

We asked Bruce Y. Lee, MD, MBA, professor of health policy and management at the City University of New York School of Public Health, about the new variants and the potential for a summer surge in COVID-19 cases.

Healio: What are the FLiRT variants of SARS-CoV-2?

Lee: FLiRT refers to a new group of SARS-CoV-2 omicron variants that have two mutations in their spike proteins. The name comes from the amino acid changes that comprise these mutations: a change of phenylalanine (F) for leucine (L) at position 456 and arginine (R) for threonine (T) at position 346.

These variants are descendants of the JN.1 variant that was dominant in the United States earlier this year and includes various variants whose names begin with the letters JN and KP that are now spreading in the U.S.

In the first week of June, KP.3 accounted for an estimated 33.1% of SARS-CoV-2 infections in the U.S., KP.2 for an estimated 20.8% and KP.1.1 for an estimated 9%.

Healio: Is there anything that worries you about these variants more than other SARS-CoV-2 variants?

Lee: These FLiRT variants appear to be rapidly spreading throughout the U.S. Preliminary data suggest that the Re the effective reproduction number for KP.2 may be 1.22 times higher than the Re for JN.1.

The mutations are in locations of the spike protein where antibodies against the virus typically bind. The big question is whether these will make antibodies less likely to bind to the virus spike protein and thus decrease the protection offered by vaccination or previous SARS-CoV-2 infections. So far, it looks like vaccination remains effective against the FLiRT variants, but more data are needed.

Healio: Is there really a summer surge in COVID-19 cases right now?

Lee: This is difficult to tell since many COVID-19 cases are probably going undiagnosed because many people may not be getting tested when they have been exposed or are experiencing symptoms, unlike earlier in the pandemic.

Many COVID-19 cases are also probably going unreported because many people may not be telling others such as public health authorities when they have tested positive for COVID-19.

Add topic to email alerts

Receive an email when new articles are posted on

Back to Healio

View post:

Q&A: What to know about the SARS-CoV-2 'FLiRT' variants - Healio

IMAGO/Christian Ohde / Via Reuters

New COVID variants have emerged as dominant strains as summer begins. UT Health San Antonio professor and infectious disease specialist and hospital epidemiologist at University Health Dr. Jason Bowling calls them the FLiRT variants because of their unique mutations.

"FLiRT stands for two distinct mutations," Bowling said. "So its an F for an L and an R for a T, and these two mutations in KP.3, KP.2, KP.1, have led to them becoming the new top variants."

The FLiRT variants, KP.3, KP.2, and KP.1, make up more than 60-percent of new COVID cases in the U.S. right now, rapidly pushing out the last dominant variant, JN.1.

"Its thought that maybe these mutations allow them to evade the immune system, and thats why they may be a little bit more transmissible," Bowling said, "and [that's] what might be driving this increased activity were starting to see."

The next boosters from Moderna and Pfizer will target FLiRT variant KP.2, which is a subvariant of JN.1. JN.1 is an Omicron subvariant, as was the XBB.1.5 strain, which was the target of last fall's booster. However, JN.1 and XBB are not part of the same sub lineage, and the FLiRTs are even more distant from the strain used to develop the last booster.

With a potential COVID surge possible before a new booster is developed, should people consider getting another XBB shot?

"I think thats a good question," Bowling said. "I think a lot of people have already made the decision. The people that were interested in the vaccine got it, and then the people that didn't are probably going to be holding out."

Is that smart or should you get another shot? For more on the potential summer COVID surge and the new "FLiRT" variants, listen to host Bonnie Petries conversation with Dr. Jason Bowling.

Follow this link:

What you need to know about COVID FLiRT variants - Houston Public Media

Update to event: As of 6 p.m. East African Time (EAT) 5 April 2023, a total of 12,289,728 COVID-19 cases and 256,985 deaths (case fatality ratio[CFR]: 2.1%) were reported by the 55 African Union (AU) Member States (MS). This represents 2% of all cases and 4% of all deaths reported globally. Forty-two (76%) AU MS are reporting CFR higher than the global CFR (1%). Fifty-three MS have reported COVID-19 cases infected with the Alpha (50 MS), Beta (45), Delta (52), Gamma (3) and Omicron (51) variants of concern (VOC). Additionally, 32 MS have reported the presence of the Omicron BA.2 sub-variant, two MS reported the Omicronsublineage (XBB.1.5) and 11 Member States have reported the Omicron sublineage (BF.7 or BA.5.2.1.7). Fifty-four (98%) MS are currently providing COVID-19 vaccination to the general population. Cumulatively, 1.1 billion doses have been administered on the continent. Of these doses administered, 542.4 million people have been partially vaccinated, and 422.7 million have been fully vaccinated. Eritrea is the only AU MS yet to start the COVID-19 vaccination rollout. For Epi week 13 (27 March 2 April 2023), 2,466 new COVID-19 cases were reported, which is a 43% decrease in the number of new cases reported compared to the previous week (12). The Southern region accounted for 63% of the new COVID-19 cases reported this week, followed by the Eastern (13%), Northern (13%), Western (6%) and Central (5%) regions. Last week, 13 new COVID-19 deaths were reported in Africa, which is a 38% decrease in new deaths reported compared to the previous week (21 deaths). The Southern accounted for 77% of the new COVID-19 deaths reported this week, followed by Northern (23%). This week, no deaths were reported in the Central, Eastern and Western regions. More than 73 thousand tests were conducted during the past week, reflecting a 111% increase in the number of tests compared to the previous week. The weekly % test positivity decreased by 3% compared with the previous week (12%). Since February 2020, over 126.1 million COVID-19 tests have been conducted in Africa.

Visit link:

Africa CDC Weekly Event Based Surveillance Report, June 2024 Africa CDC - africacdc.org

An incubation period is the time from exposure to an infectious agent to when you actually develop symptoms. Most people do not develop symptoms immediately after exposure to a virus or bacteria. It will take time for the virus or bacteria to infect you enough to feel sick.

For example, the Centers for Disease Control and Prevention (CDC) report that COVID-19 symptoms may present anywhere from two to 14 days after exposure to the virus. A food-borne bacterial infection like Salmonella can cause symptoms within 6 hours to six days. Conversely, the flu virus has an incubation period of one to four days.

This article will cover incubation period examples, factors that might affect the incubation period, when to isolate, what happens after the incubation period, and more.

FG Trade / Getty Images

The incubation period is the time from acquiring an infection until the onset of symptoms.

You will not develop symptoms immediately after acquiring a virus, bacteria, or fungus. It will take time for the organism to multiply and infect enough of the body's cells for your body to react to it and for you to feel sick.

You may not know you have an infection during the incubation period, but you will feel sick once the infection has developed enough.

Incubation periods in infectious diseases can help provide information during an outbreak, including when symptoms start and when someone is most likely to transmit the infection. They can also offer insight into disease severity and how long an illness might last. Incubation periods will vary based on the type of virus or bacteria.

The incubation period for COVID-19 will vary by the virus variant. Meta-analyses of studies published in 2021 identified an average incubation period of 6.5 days from exposure to onset of symptoms. Studies on the Delta variant have reported an incubation period of 4.3 days, and studies on Omicron have reported an average incubation period of three to four days.

COVID-19 testing can detect SARS-COV-2the virus that causes COVID-19at specific points during the infection, often when symptoms start. If you test too early or too late, you may get a false negative and unknowingly spread the virus.

Start of an incubation period: The average COVID-19 incubation period is around five days. Symptoms of COVID-19 can appear as early as two days and as late as 14 days after exposure to the virus. The incubation period starts when you first come in contact with the virus and become infected.

During this time, the coronavirus will invade cells in your body and replicate. You might be contagious during this time, and studies have found that you are more likely to spread the virus during incubation.

This is often because people who do not know they have the virus will not take precautions to prevent infection spread. But anyone with COVID-19 can spread the virus despite symptoms, variant type, and vaccine status.

End of incubation period:The start of symptoms ends the incubation period. Symptoms and symptom severity will vary from person to person. Once you experience symptoms, you can quickly spread the virus via tiny respiratory droplets or aerosol particles that leave the body with sneezing, coughing, or speaking.

Influenza, referred to as "the flu," is an infectious respiratory virus caused by influenza viruses. Symptoms can range from mild to severe and may include fever, sore throat, runny nose, muscle pain, and headache.

Start of incubation period: The incubation period for the flu is between one and four days, but this varies from person to person. The average incubation period is two days, which means most people develop symptoms two days after exposure to an infected person.

The incubation period may be affected by infectious dose (amount of virus you are exposed to), the route infection (how the virus enters the body), and your pre-existing immunity (if you had previously been exposed or vaccination status).

End of incubation period: Symptoms of the flu start at the end of the incubation period. But you can spread the virus to others at least a day before you notice symptoms. You are most contagious the first day you experience symptoms. Older adults, children, and people with weakened immune systems might be contagious for longer.

The common cold is a viral infection of the upper respiratory tract, affecting the nose, throat, sinuses, and larynx (voice box). Symptoms include sore throat, runny nose, sneezing, coughing, headache, and low-grade feverbetween 99 degrees F (37.2 C) and 100.4 degrees F (38.0 C). Different viruses are associated with the cold, including rhinoviruses, adenoviruses, and enteroviruses.

Start of incubation period: The incubation period for the common cold is short, ranging from two to five days. The appearance of symptoms will depend on the virus you were exposed to.

For example, if you have been exposed to a rhinovirus, you can expect symptoms between 12 to 72 hours after exposure. Other cold viruses may have more extended incubation periods.

End of incubation period: The incubation period for the cold will end when symptoms start. You may experience a scratchy throat, a runny nose, or fatigue early on, and after that, sneezing and a sore throat. As soon as symptoms appear, you are contagious and can spread the virus.

Symptoms will peak by day four, and you will experience body aches, coughing, and congestion as your body fights off the virus. Most people recover within a week, but full recovery could take up to two weeks.

Chickenpox is an illness caused by the varicella-zoster virus. It causes an itchy rash and small fluid-filled blisters. It can spread quickly to people who have not had it before and who are unvaccinated.

Start of incubation period: The incubation period for the varicella-zoster virus is 10 to 21 days after exposure. During the incubation period, the virus will enter the body and spread, but there will be no symptoms.

End of incubation period: At the end of the incubation period, a prodromal stage of one to two days starts where you will experience flu-like symptoms, including fever, sore throat, headache, and fatigue. Adults are more likely to have these symptoms, while children will only develop a rash.

You are most contagious during this time and can spread the virus to others. Once the rash appears, it will start as small red bumps on the face, chest, and back, spreading to other skin areas. These bumps will become fluid-filled and eventually crust over and fall off.

As blisters heal, they will be itchy and painful. Full recovery could take up to two weeks.

Bacterial infections can affect various body areas, including the skin, lungs, brain, and blood. You can get a bacterial infection after direct contact with bacteria from an infected person (i.e., touching, kissing, coughing, sneezing, etc.), exchanging body fluids, contact with infected surfaces, and consuming contaminated food or water.

Examples of bacterial infections include food poisoning, respiratory infections, skin infections, gastrointestinal infections, urinary tract infections, and sexually transmitted infections (STIs).Incubation periods and symptoms will vary based on the type of bacteria involved.

Strep throat, a respiratory infection caused by group A streptococcus, has an incubation period of two to five days. You then develop a sore throat, fever, and other symptoms.

E. coli infections (from contaminated food and water) can have an average incubation period of three to four days, while Bacillus cereus infections (from food improperly stored) can have an incubation period of 30 minutes to 15 hours. The incubation period for bacterial gastroenteritis caused by Campylobacter bacteria is one to five days.

Each STI has its own incubation period. For example, the incubation period is one to 14 days for gonorrhea and seven to 21 days for chlamydia.

Antibiotics are used to treat bacterial infections. You are no longer contagious after treatment, although this can sometimes differ depending on the bacterial cause.

Incubation periods will vary depending on the infection type, the pathogen's strength, and exposure dose. Vaccine status and prior infection usually do not affect incubation periods.

Depending on the cause of the disease, the incubation period could be a few hours to several months. For example, the incubation period for the stomach flu could be less than 24 hours, while the incubation period for hepatitis A could be up to 50 days.

The incubation period will start after exposure to the infection source and before symptoms start. Exposure to the infection source does not mean you will become infected or that you will develop symptoms. One 2021 research review found that asymptomatic (no symptoms) COVID-19 affects about 40.5% of people who test positive for the virus.

Viral and bacterial pathogens can cause minor harm or severe harm. The incubation period may depend on the pathogen's strength based on the harm it might cause.

For example, highly virulent (harmful) pathogens will almost always lead to disease when they hit the body and have a short incubation period. Less virulent pathogens or avirulent (not harmful) ones may cause an initial infection that takes longer to cause symptoms. These types of pathogens will cause a mild disease or may be asymptomatic.

The exposure dose (also called viral dose) is the amount of infectious virus transmitted from one person to another. Some studies on COVID-19 find that higher or more potent viral doses can make some people more contagious than others.

The likelihood of becoming infected with COVID-19 may increase based on how much exposure you have had to an infected person.

The incubation period ends when you first notice symptoms of an illness after exposure to a pathogen.

For most viral illnesses, you will be contagious at some time during the incubation period and then throughout the time symptoms are present. Some viruses can still be transmitted after you no longer have symptoms.

People with COVID-19 are the most contagious in the first two days before and three days after symptoms develop. You could be contagious up to 10 days after symptoms start, especially if you have a more severe disease.

For the common cold and the flu, you can transmit the virus to others at least a day before you notice symptoms, and you are most contagious the first day you experience symptoms.

If you test positive for the flu or COVID-19, it's important that you take certain precautions to reduce the chances of spreading the infection.

If you have respiratory virus symptoms, the CDC recommends that you:

Chickenpox is highly contagious, and you will be the most contagious one to two days before you develop a rash. You will continue to be contagious until blisters have crusted, so you must isolate for the entire time to avoid spreading the virus to others. According to the CDC, you are no longer contagious after you have had no new lesions for 24 hours.

Some bacteria and viruses may remain in the body after infection and can continue to be transmitted to others after symptoms resolve. Examples include herpes, hepatitis, methicillin-resistant Staphylococcus aureus (MRSA), and Salmonella.

Some ways to reduce the risk of infections are handwashing, not sharing personal items, covering your mouth with sneezing and coughing, getting vaccinated, wearing face masks, practicing food safety, and practicing safer sex (i.e., limiting partners and using condoms consistently).

The incubation period of a virus or bacteria is the time it takes to develop symptoms after infection. The COVID-19 incubation period is two to 14 days. Timelines for incubation periods will vary based on the infection type, strength of the pathogen, and exposure dose. Vaccine status and prior infection usually do not affect incubation periods.

You are typically contagious during the incubation period. The incubation period ends when symptoms start. You might be the most contagious the first day or two after symptoms start.

If you are sick, there are steps you can take to prevent spreading the infection to others. For COVID-19 and other respiratory viruses, it is recommended that you isolate until you are fever-free for at least 24 hours (without taking fever-reducing medication). It's also important to take added precaution for five days after isolation.

Excerpt from:

Infectious Incubation Period Defined - Plus, Examples - Verywell Health

Arizona health officials confirmed nearly 2,300 COVID-19 cases last week an 8% increase from the previous week and more than an 80% increase from last month.

"There is definitely an up trend and the numbers are slightly higher compared to last year at the same date," said Dr. Joel Terriquez, medical director of infectious disease with the Arizona Department of Health Services.

But, Terriquez said, hospitalizations and deaths from the virus remain low.

"By now, most of us have either been exposed to some type of COVID infection or been immunized, so I think that most of us will maybe continue to develop very mild illness or even asymptomatic infection," Terriquez said.

Still, Terriquez recommends Arizonans keep up-to-date with vaccines. He said higher risk groups may want to avoid crowds or take added precautions as the virus spreads.

More here:

COVID-19 cases continue to rise in Arizona - KJZZ

An aerial view shows painted circles in the grass to encourage people to keep a distance from each other at Washington Square Park in San Francisco. The photo is from May 22, 2020. Josh Edelson/AFP via Getty Images hide caption

We regularly answer frequently asked questions about life in the era of COVID-19. If you have a question you'd like us to consider for a future post, email us at goatsandsoda@npr.org with the subject line: "Coronavirus Questions." See an archive of our FAQs here.

We all remember those early days of the pandemic. I used to run with a mask on outdoors with no one in sight. (Imagine my relief to learn that outdoor air effectively disperses pathogens). I wiped off groceries in case they were contaminated. (Experts now say its reasonable to just wash your hands thoroughly after touching stuff.)

And I tried to stay 6 feet away from well, everyone in public. Thats what the Centers for Disease Control and Prevention recommended back in 2020. Remember those strips of tape plastered to sidewalks leading into banks and in grocery store checkout areas so you wouldnt accidentally get too close to the next person.

Then in the newly released transcript of a congressional hearing from earlier this year, Dr. Anthony Fauci stated that the 6-foot rule sort of just appeared and wasnt based on data.

Those who never liked the idea of physical distancing were thrilled! Ha ha, CDC was wrong!

Now here we are in the summer of 2024. Theres a new, more transmissible variant of COVID-19 circulating and CDC is predicting a summer surge.

This new variant is not considered as likely as past variants to bring on severe disease. But there are people who face a greater risk of serious COVID because of age or infirmities. And no one wants to get sick right before or during a trip.

So the frequently asked question is: Does distancing yourself from others who could be contagious with COVID-19 help in any way? Or has the idea of distance been debunked?

To answer those questions, lets start by digging into distance.

Did they just pull "6 feet" out of a hat?

The idea behind the CDC recommendation was that putting space between yourself and others was a way to avoid pathogens exhaled by people with COVID.

Was 6 feet just a made-up number? After all, the World Health Organization only suggested 3 feet as a safety zone.

A kinda weird (and relatively ancient) history lesson may offer up a clue.

In the late 1800s, scientists asked people to rinse their mouths with bacteria (editors note: yuk) and then just talk. Crazy!

And what happened? They saw bacteria landing on plates up to a distance of about 6 feet away, says Linsey Marr, an aerosols expert and professor of civil and environmental engineering at Virginia Tech.

But, if they waited longer several hours -- to collect the plates, allowing time for respiratory particles to drift around the room and settle, they saw bacteria landing on plates much farther than 6 feet away," she adds.

So yeah, 6 feet is not a magic number for avoiding airborne pathogens.

Its not like if you go one inch further youre suddenly in a danger zone. Its more like a speed limit, suggests Dr. Abraar Karan, a infectious disease fellow at Stanford University. Theres no data to say 55 mph is significantly safer than 56. But you have to have a cutoff thats reasonable.

The ABCs of transmission

Now lets take a detour from distance and think about how COVID spreads. Early in the pandemic, the idea was that the sick person spewed out relatively big, wet droplets that could come into contact with others. These droplets would eventually fall to the ground due to gravity.

But in 2024, there isnt much evidence supporting that route of transmission, says Marr, who did pioneering work to establish that much tinier airborne aerosols can nab you. (She won a MacArthur genius grant last year for her research.)

And how far can an aerosol fly? The distance depends on their size and air currents, she says. Their pathway could easily be hundreds of feet before they reach the ground.

So yes, in theory you could be a lot farther than 6 feet from a sick person and still fall victim to their exhaled pathogens. But .

Why distance does still matter

Heres the thing: Even with this revised understanding of the spread of COVID, the closer you are to the person with COVID, the higher your risk of catching it.

As you get farther away from the infected person, aerosols become more diluted, so the chance of inhaling [particles] usually goes down with distance, says Marr.

As an analogy, Marr suggests you think about cigarette smoke. Smaller COVID particles behave like cigarette smoke. If youre close to someone who exhaled a big puff of smoke, youre exposed to more than if youre farther away. The farther away you get, the better.

Need more convincing? In a study of COVID transmission on a plane from one infected passenger in business class, those who caught the virus were also seated in business class. The study, published in Emerging Infectious Diseases in 2020, reports: We found a clear association between sitting in close proximity to case 1 and risk for infection.

Lets sum up with a quote from Marr: Distance matters, but theres nothing magical about 6 feet.

And an observation from Karan: People always knew this. You stay away from someone who looks visibly sick. And while your family members and friends would likely warn you to stay away if theyre feeling sick, you cant count on that happening in a crowd of strangers.

Layers of safety

So bottom line: Keeping a degree of distance from others can help but should be viewed as one arrow in a quiver of strategies to reduce your risk of catching COVID.

The amount of time youre exposed to a sick person matters. If youre going to dash into a store and just breeze past a bunch of customers, some of whom might be infectious with COVID or other diseases, your odds of getting infected are very low, says Karan. The less time the better (although again, theres no magic number).

You might try to keep gatherings outside outdoor air is your best friend when it comes to dispersing pathogens.

If youve had COVID or been vaccinated, that can help you fight off a new infection or at least reduce the severity of disease if you do catch the virus.

A good mask (think N95 or K95) that fits and is worn properly (dont let your nostrils peek out) is the gold standard. You cant always control the distance factor, says infectious disease professor Dr. Preeti Malani of the University of Michigan. But a mask is incredibly effective, she says. And whats the cost of wearing a mask on the plane? Nothing, really!

Abraar Karan notes that he and colleagues at the hospital where he works do mask up when seeing patients with respiratory diseases and arent catching COVID.

And keep some COVID tests handy at home or in your trip supplies just in case you have some symptoms that could be allergies, a cold ... or COVID.

How do you figure out what to do? Our experts say: It depends on you.

If youre concerned about COVID youre the person whos going to be responsible, says Malani. Others arent going to protect you.

You might amp up your protective measures if

Your age or medical history puts you at high risk for severe disease.

Youre a caregiver for someone at risk.

Youll be venturing into an indoor venue with lots of strangers a gym, a rock concert, a crowded bus, subway car or plane.

Youre planning a trip or family get-together and want to make sure you dont accidentally infect a more vulnerable family member.

Theres also something you can do for the good of humanity, too. And it involves distance.

I cant stress this enough, says Malani. If youre not feeling well dont put others at risk. In other words, stay home!

See original here:

Coronavirus FAQ: Is the 6-foot rule debunked? Or does distance still protect you? - NPR

When the National Institutes of Health (NIH) launched a $1 billion dollar research effort in 2021 focused on long COVID, hopes were high that it would lead to some answers for the mysterious riddle of the complex condition. Now, more than 3 years later and with total funding of about $1.6 billion, critics contend the federal government has little to show for its efforts.

Disappointment runs high among long COVID specialists and patients, who cite poor scientific coordination, few treatments that go beyond symptom management, and a lack of clinical trials focused on pharmaceutical interventions.

Grace McComsey, MD, who leads one of the 15 nationwide long COVID centers funded by the federal Researching COVID to Enhance Recovery (RECOVER) Initiative in Cleveland, contended that RECOVER isn't getting enough credit for what it's trying to do, and critics need to be more realistic about how long things will take. If you look at long COVID through the lens of other diseases such as HIV, it took many years and many billions of dollars to find viable treatments, she said.

Righting the ship will not be easy, but for the 17 million Americans in desperate need of treatment for long COVID, there's no other option, said Ziyad Al-Aly, MD, a global expert on long COVID and chief of research and development at the Veterans Affairs St. Louis Health Care System.

He argued that officials running the NIH program, known as the RECOVER Initiative, have been too defensive about the effort and not as open to helpful changes that would move it forward.

"Monday morning quarterbacking isn't just about criticizing RECOVER, it's about being constructive and providing the tools to make positive changes," said Al-Aly. He added that those at the top have been defensive of criticism, which is making matters worse. "We can't correct course if we don't make changes. We'll end up hitting the same wall again and again."

Improving coordination among researchers of long COVID is a great place to start, Al-Aly said. "We all want to move the ball forward, so let's put our heads together and do it," he said.

He recommended establishing an advisory board that includes the nation's top experts on long COVID. "Getting these people together in a room to discuss the best ways to allocate resources would help," he said.

Long COVID has proven to be distressingly similar to other post-viral syndromes such as myalgic encephalomyelitis/chronic fatigue syndrome, according to a June 2023 article in the journal Frontiers of Medicine. Physicians who have worked on these conditions are also important resources for investigating the disease, he said. They shouldn't be on the sidelines. Many of those at the top of RECOVER aren't experts in these types of conditions, Al-Aly said.

Another overarching concern with RECOVER and with the condition as a whole is that researchers are still largely focused on symptom management rather than looking more deeply into the biological mechanisms driving this disease.

"We need to have large-scale research at the molecular level to find treatments that could lead to long-term sustained remission of long COVID rather than just managing symptoms," said Nisha Viswanathan, MD, director of the Long COVID Program at UCLA Health. If we don't develop a better understanding of the disease's mechanism and how to diagnose it at a molecular level, we're never going to truly be able to treat it, she said.

Another criticism of RECOVER is that it's heavy on observational studies, which make up 47% of the budget thus far rather than prospective clinical trials. Observational studies don't test potential treatments that could work for long COVID, rather, they follow participants on their current treatment regimen to see how they're fairing.

Patients with long COVID such as Charlie McCone, 34, of San Francisco, are also pushing for more clinical trials. He's a former marketing executive who lost his job due to long COVID in 2022. Now a patient advocate, he said that for the millions of patients like him depending on NIH to execute, the past 3 years have largely been a wash.

"The patient community needs clinical trials more than anything else. That's the bread and butter here," said McCone. He said a plethora of off-label pharmaceutical drugs such as antivirals, immunomodulators, antihistamines, and anticoagulants target the pathology of the disease, and NIH should be vigorously investigating them.

Case studies showed people improving on certain medications, but when patients go to their doctors to ask for them, they can't get access because there are no clinical trials. One example is low-dose naltrexone for the treatment of extreme fatigue associated with long COVID, which was shown in a January 2024 article in the journal Clinical Therapeutics to improve symptoms in patients taking the medication. Patients want to know if these treatments will work on a larger scale.

Right now, RECOVER is only studying a few pharmaceutical medications, and one of them is Paxlovid, an antiviral medication that failed in its first trial to improve symptoms in patients with long COVID.

Viswanathan said that NIH should also avoid putting all researchers' eggs in one bucket and rather start testing a variety of treatments to see what might show promise so that those can expand into larger trials. "We should be diversifying the things that we're looking at to help manage our patient's symptoms rather than doubling down on just a few options for helping them," she said.

Additionally, McCone said NIH needs to take the focus off of what he called soft therapies, using things such as melatonin. Last month, the agency announced it would be testing the over-the-counter sleep supplement as a potential treatment for sleep disturbances due to long COVID. Other treatments, such as exercise therapy, have also been criticized by patients as not taking the condition seriously enough or being ineffective.

"We need pharmaceutical interventions that have a plausible mechanism for intervening with the pathophysiology of this disease," said McCone.

Still, some experts contend that constantly pointing the blame isn't helping matters.

McComsey admitted things aren't perfect but said that RECOVER has enrolled and retained nearly 20,000 people from an extremely diverse group of patients with nearly 18 papers that have been published or will be published soon. Clinical trials don't happen overnight, said McComsey, because you have to design the studies, enroll patients, and ensure their safety. "No one else in the world is doing anything like this," she said.

But for patients like McCone, who has now lived with long COVID for the entirety of his 30s, things aren't happening fast enough, and his frustration is mounting. He's lost his job, his hobbies, and is now largely a homebound millennial.

"For me and millions of people suffering like I am, the stakes for RECOVER couldn't be higher," he said.

See the original post:

How to Fix $1.6 Billion Long COVID Program: Experts Weigh In - Medscape

In a recent study published in the journal Nature, a group of researchers analyzed early cellular response dynamics to severe acute respiratory syndrome coronavirus2 (SARS-CoV-2) in seronegative individuals using single-cell multi-omics profiling, identifying key cellular states and immune responses associated with different infection outcomes.

Summary figure highlighting the key finding from the study. These includes; 1) distinct temporal differences in the cellular dynamics observed between the different infection groups; 2) several novel conserved antiviral responses and higher baseline expression ofHLA-DQA2in participants who were exposed to the virus but who did not go on to develop a sustained infection; 3) novel characteristics of sustained infection, with a rapid relay observed in the blood compared to the site of inoculation, a dynamic local ciliated response occurring early on during infections (pre-symptoms) and a temporally restricted, distinct, SARS-CoV-2 specific activated T cell population which leads to immunological memory; and 4) the identification of public motifs in SARS-CoV-2 specific activated T cells. In addition, our work provides community tools for inference of specific TCR motifs (Cell2TCR) in activated T cells, a detailed publicly available reference database underpinning the detection of future biomarkers and antigen (Ag) targets for therapeutic applications. Schematic created with BioRender.com. Study:Human SARS-CoV-2 challenge uncovers local and systemic response dynamics.

Coronavirus 2019 (COVID-19), caused by SARS-CoV-2, is a potentially fatal disease that has become a severe global health emergency. Severe outcomes are linked to disrupted antiviral and immune responses, including impaired type I interferon responses and altered T lymphocyte (T) and B lymphocyte (B) cell dynamics. Accurate detection of immune responses is challenging due to heterogeneous factors such as viral dose, strain, and clinical features like comorbidities. Understanding the dynamics of SARS-CoV-2 infection, particularly early phases of exposure, is crucial. Studies often miss capturing these early events in natural infections, making pinpointing antigen-responding T cell activation and expansion difficult. Further research is needed to accurately delineate early immune response dynamics to SARS-CoV-2 to better understand and mitigate severe COVID-19 outcomes.

Sixteen healthy adults aged 18-30 years, seronegative for SARS-CoV-2, participated in a human SARS-CoV-2 challenge study for Single-cell RNA sequencing (scRNA-seq) sample processing and analysis. This study, conducted by a government task force, Imperial College London, Royal Free London NHS Foundation Trust, University College London, and hVIVO, took place from June to August 2021. Additionally, 20 healthy adults from earlier cohorts had blood and nasal samples processed for bulk Ribonucleic Acid (RNA)-seq, with 10 receiving pre-emptive remdesivir. Volunteers were screened for anti-SARS-CoV-2 antibodies and excluded if positive. The study followed ethical guidelines, and informed consent was obtained from all volunteers.

a, Illustration of the study design and cohort composition.b,c, Uniform manifold approximation and projection (UMAP) plots of all nasopharyngeal cells (n=234,182), colour coded by their broad cell-type annotation (b), by the infection group (c, top) and by days since inoculation (c, bottom). Only cells from sustained infection cases are shown inc, bottom. Treg, regulatory Tcell;ASDC, AXL+SIGLEC6+dendritic cell.d,e, UMAP plots as inbandc, but showing all PBMCs (n=371,892). CTL, cytotoxic T lymphocyte; DN, double negative.f, Fold changes in abundance of nasopharynx-resident broad immune cell-type categories. Immune cell abundance was scaled to the total amount of detected epithelial cells in every sample before calculating the fold changes over days since inoculation compared with pre-infection (day1) by fitting a GLMM on scaled abundance. Fitted fold changes are colour coded and we used the local true sign rate and BenjaminiHochberg procedure to calculate false-discovery rates (FDRs), which are shown as the size of each dot. The mean cell-type proportions over all cells and samples are shown in the green heatmap to the right of the dot plot to aid the interpretation of changes in cell-type abundance. Illustration inawas created using BioRender (https://www.biorender.com).

Participant 11, who had low pre-inoculation antibody levels, was classified as having an abortive infection, which did not alter the study's conclusions. Participants were followed for one year post-inoculation, with no long-COVID symptoms reported at the final time point. Physiological observations were normal. After discharge, two participants reported receiving a vaccine or a community infection before their day 28 follow-up. Enzyme-Linked ImmunoSpot (ELISpot) tests revealed immune responses in subsequent samples. Participants were intranasally inoculated with a wild-type pre-Alpha SARS-CoV-2 virus, and nasal and throat samples were collected to evaluate viral kinetics. Nasopharyngeal swabs and Peripheral Blood Mononuclear Cells (PBMCs) were processed for single-cell sequencing to analyze immune responses.

In the present study, 16 seronegative young adults were intranasally inoculated with a pre-Alpha SARS-CoV-2 virus strain. Extensive screening excluded participants with severe disease risk factors or comorbidities. Participants received the lowest quantifiable inoculum dose, resulting in no serious adverse events and resolved symptoms.

The study analyzed local and systemic immune responses at single-cell resolution. Baseline measurements were taken before inoculation, followed by time series analyses of cellular responses in blood and nasopharynx. Six participants developed sustained infections, defined by consecutive viral load detections and symptoms. Three individuals had sporadic positive polymer chain reaction (PCR) tests and were classified as transient infections. Seven participants remained PCR-negative but showed early innate immune responses, termed abortive infections. The infection rate was comparable to that in a closed household of unvaccinated individuals.

scRNA-seq and single-cell T cell receptor (TCR) and B cell receptor (BCR) sequencing were performed at up to seven time points. Cellular indexing of transcriptomes and epitopes by sequencing (CITE-seq) quantified 123 surface proteins in PBMCs. More than 600,000 single-cell transcriptomes were generated, including 371,892 PBMCs and 234,182 nasopharyngeal cells. Predictive models and marker gene expression annotated 202 cell states, enabling detailed local and systemic response analysis.

Generalized linear mixed models (GLMMs) quantified changes in cell-type abundance over time. Immune cell types infiltrated the inoculation site after SARS-CoV-2 exposure. Sustained infections showed immune infiltration starting at day 5, while transient infections had immediate infiltration at day 1. Abortive infections showed minimal changes except for early Cluster of Differentiation (CD)4+ and CD8+ T cell infiltration.

Gene expression analysis revealed that interferon response genes were the dominant infection-induced module in sustained infections. Interferon signaling was activated in all cell types in both blood and nasopharynx, peaking earlier in blood. This rapid systemic response was validated with bulk RNA-seq data. Myeloid cell redistribution between circulation and tissues was observed during early infection. Mucosal-Associated Invariant T (MAIT) cell activation was detected across all infection groups, indicating rapid viral sensing. Viral RNA peaked at day 7, with hyperinfected ciliated cells identified as major virion producers.

Ciliated cells showed dynamic responses, including acute-phase and interferon-stimulated states. Activated T cells, identified through peptide-Major Histocompatibility Complex (MHC) staining and scRNA-seq, expanded significantly at day 10 after inoculation, resembling a typical antigen-specific adaptive immune response.

The study revealed multiple immune response states that precede clinical symptoms, including MAIT cell activation and a decrease in inflammatory monocytes. These responses emerged even when SARS-CoV-2 exposure did not lead to COVID-19, suggesting their potential as biomarkers of immediate immune response. In sustained infections, a new acute phase response (APR) in ciliated cells and a distinct state for activated T cells with SARS-CoV-2-specific TCRs were identified. Interferon signaling was activated globally in circulating immune cells before the site of infection. These findings provide a detailed time-resolved description of early immune responses to SARS-CoV-2.

Excerpt from:

Study reveals early immune responses to SARS-CoV-2, offering insights for future COVID-19 treatments - News-Medical.Net

You're watching Coronavirus in Context. I'm Dr. John Whyte, Chief Medical Officer at WebMD. Today we're going to talk about the impact of COVID-19 on kids. And my guest is Dr. Burke Harris. She's a pediatrician and surgeon general of the state of California. Dr. Burke Harris, thanks for joining me.

NADINE BURKE HARRIS

JOHN WHYTE

NADINE BURKE HARRIS

And so some of the ways that, um, kids can manifest stress, um, are really, you know, changes in their sleeping patterns. For little kids, changes in their toileting habits. So, you know, a kid who's been potty trained, they can have a little bit of that regression and, uh, you know, go back to wetting or something along those lines.

And then as kids get older, we see, you know, some kids have, uh, they don't necessarily say that, oh, you know, I'm feeling stressed. They may have tummy aches. They may have headaches. And for older kids like teenagers, we-- they may be more irritable or they could even be more withdrawn.

JOHN WHYTE

NADINE BURKE HARRIS

JOHN WHYTE

NADINE BURKE HARRIS

I think for, uh, some kids, asking how are they keeping in touch with their friends, how is so-and-so doing, that is, um, particularly for teenagers who stay in touch with their friends either via social media or through, um, you know, or through text or other technology.

Asking some of these rand-- you know, roundabout questions can help us understand, uh, whether or not our-- our kids are staying connected to their social networks. I think for littler kids, it's-- you can just, you know, really straightforwardly ask if they have any concerns.

Ask-- you know, what have they heard about the coronavirus and if they have any worries. And give them an opportunity to share, in their own language, what they've heard, you know, what they're nervous or scared about, and then correct any misperceptions that may be going on.

JOHN WHYTE

NADINE BURKE HARRIS

So-- so I think that, uh, you know, although of course we want to put limits on kids' screen time. We, at the same time, have to recognize that, you know, it's OK for-- for us to give ourselves a break and give our kids a little bit of a break as well.

JOHN WHYTE

NADINE BURKE HARRIS

Getting out and doing some exercise every day, really important. We make sure that the kids get on their bikes and, you know, go around the-- go around the park and have an opportunity to get some of that energy out. Um, also, even though kids are not going to school every day, I think keeping those regular routines is really important. So going to bed at the same time each night, waking up at the same time each morning, and having some regular routines. Having the kids have an opportunity to-- to share in setting those routines I think is really important. Um, and we have a lot of fun with, you know, nutrition. There's a lot more cooking that goes on during the pandemic time, uh, which is a lot of fun.

But we make sure that the kids are getting healthy meals, because it's very easy for all of us to be, you know, craving some of those high sugar, high fat foods. And that's not just because, you know, we're at home. It's because when we feel stressed, stress hormones like cortisol actually cause our bodies to crave high sugar, high fat foods. And so having good nutrition is actually really important to helping to regulate the stress response.

JOHN WHYTE

NADINE BURKE HARRIS

But the other thing that's also really important that we often forget as parents and caregivers is that one of the most important things for children's well-being is our own well-being, right? In scary situations, what kids do is they instinctively look at their parents and caregivers.

And if we're freaking out, that gives them the signal that they-- that they should be freaking out. And so our ability to put our own oxygen mask on and do that self care so that we can be well regulated actually helps our kids be able to regulate themselves.

JOHN WHYTE

NADINE BURKE HARRIS

The tolerable stress response where the body is affected by it, but through the buffering effect of caring relationships, the body returns to that natural biological balance. And there's something that's even called a positive stress responses, which is, you know, a little bit of stress that's self-limited can actually lead to further growth and development.

And so the thing that I'm really optimistic about is that with that safe and nurturing relationships and with that buffering care, I think that there's an opportunity to keep the stress into that positive or tolerable range and out of the toxic range.

And I think there's a lot of, um, growth and connection, a deepening of a sense of empathy, and a-- a level of development that can happen right now that, uh, I think ultimately has an-- an opportunity to be a time of growth.

JOHN WHYTE

NADINE BURKE HARRIS

JOHN WHYTE

Hide Video Transcript

JOHN WHYTE

NADINE BURKE HARRIS

JOHN WHYTE

NADINE BURKE HARRIS

And so some of the ways that, um, kids can manifest stress, um, are really, you know, changes in their sleeping patterns. For little kids, changes in their toileting habits. So, you know, a kid who's been potty trained, they can have a little bit of that regression and, uh, you know, go back to wetting or something along those lines.

And then as kids get older, we see, you know, some kids have, uh, they don't necessarily say that, oh, you know, I'm feeling stressed. They may have tummy aches. They may have headaches. And for older kids like teenagers, we-- they may be more irritable or they could even be more withdrawn.

JOHN WHYTE

NADINE BURKE HARRIS

JOHN WHYTE

NADINE BURKE HARRIS

I think for, uh, some kids, asking how are they keeping in touch with their friends, how is so-and-so doing, that is, um, particularly for teenagers who stay in touch with their friends either via social media or through, um, you know, or through text or other technology.

Asking some of these rand-- you know, roundabout questions can help us understand, uh, whether or not our-- our kids are staying connected to their social networks. I think for littler kids, it's-- you can just, you know, really straightforwardly ask if they have any concerns.

Ask-- you know, what have they heard about the coronavirus and if they have any worries. And give them an opportunity to share, in their own language, what they've heard, you know, what they're nervous or scared about, and then correct any misperceptions that may be going on.

JOHN WHYTE

NADINE BURKE HARRIS

So-- so I think that, uh, you know, although of course we want to put limits on kids' screen time. We, at the same time, have to recognize that, you know, it's OK for-- for us to give ourselves a break and give our kids a little bit of a break as well.

JOHN WHYTE

NADINE BURKE HARRIS

Getting out and doing some exercise every day, really important. We make sure that the kids get on their bikes and, you know, go around the-- go around the park and have an opportunity to get some of that energy out. Um, also, even though kids are not going to school every day, I think keeping those regular routines is really important. So going to bed at the same time each night, waking up at the same time each morning, and having some regular routines. Having the kids have an opportunity to-- to share in setting those routines I think is really important. Um, and we have a lot of fun with, you know, nutrition. There's a lot more cooking that goes on during the pandemic time, uh, which is a lot of fun.

But we make sure that the kids are getting healthy meals, because it's very easy for all of us to be, you know, craving some of those high sugar, high fat foods. And that's not just because, you know, we're at home. It's because when we feel stressed, stress hormones like cortisol actually cause our bodies to crave high sugar, high fat foods. And so having good nutrition is actually really important to helping to regulate the stress response.

JOHN WHYTE

NADINE BURKE HARRIS

But the other thing that's also really important that we often forget as parents and caregivers is that one of the most important things for children's well-being is our own well-being, right? In scary situations, what kids do is they instinctively look at their parents and caregivers.

And if we're freaking out, that gives them the signal that they-- that they should be freaking out. And so our ability to put our own oxygen mask on and do that self care so that we can be well regulated actually helps our kids be able to regulate themselves.

JOHN WHYTE

NADINE BURKE HARRIS

The tolerable stress response where the body is affected by it, but through the buffering effect of caring relationships, the body returns to that natural biological balance. And there's something that's even called a positive stress responses, which is, you know, a little bit of stress that's self-limited can actually lead to further growth and development.

And so the thing that I'm really optimistic about is that with that safe and nurturing relationships and with that buffering care, I think that there's an opportunity to keep the stress into that positive or tolerable range and out of the toxic range.

And I think there's a lot of, um, growth and connection, a deepening of a sense of empathy, and a-- a level of development that can happen right now that, uh, I think ultimately has an-- an opportunity to be a time of growth.

JOHN WHYTE

NADINE BURKE HARRIS

JOHN WHYTE

Originally posted here:

Coronavirus in Context: Building Resilience in Children: How Parents Can Turn a Stressful Situation into an ... - WebMD