Category: Corona Virus

The Wisconsin Department of Health Services' weekly respiratory report shows that statewide, cases of COVID-19 are on the rise.

The Wisconsin Department of Health Services' weekly respiratory report shows that statewide, cases of COVID-19 are on the rise.

LA CROSSE, Wis. (WXOW) -- The Wisconsin Department of Health Services' weekly respiratory report shows that statewide, cases of COVID-19 are on the rise.

This is also true for La Crosse County.

The La Crosse County Health Department Access to Care Manager Bridget Cardinali said they've tracked an increase in three areas.

These include those who seek care at an emergency department or urgent care, how many hospitalizations there are because of COVID and how much is measured within waste water.

According to Cardinali, a summer spike is to be expected.

"Part of it might be more vacations - so as people are traveling to different places or gathering together in different crowd types," Cardinali said. "They might be increasing the chances of that transmission of COVID."

With other respiratory illness also on the rise in Wisconsin, she said it's important to stay home if your sick.

"Those who are immunodeficient, who can't take the vaccine because it's not working for them or their immune system, has a challenge in fighting off any illnesses. We really want to protect those," Cardinali said. "While somebody might be able to get COVID and not even have symptoms, or it feels like a small cold, one of their loved ones or somebody that they live with might have a challenge in fighting off the COVID virus."

She added that when returning to work or activities after being COVID positive, to continue wearing a mask for the next five days.

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Excerpt from:

Cases of COVID-19 are on the rise locally and statewide - WXOW.com

S1: It's time for Midday Edition on KPBS. Covid infections are high in California. We'll talk about the characteristics of this new variant and the risks for long Covid. I'm Jade Hindman. Here's to conversations that keep you informed and inspired and make you think.

S2:

S1: Then we'll talk about the latest variant and what it means for our immunity , plus what the latest research on Covid tells us about long Covid. That's ahead on Midday Edition. Happy Monday ! So there is no shortage of news. Over the weekend , we heard President Joe Biden step out of the presidential race and endorse Vice President Kamala Harris. Lots of news to follow on that front. But here locally , Covid 19 is on the rise. And for many people , it may feel like a thing of the past. But that is an entirely true. In California and across much of the nation , there's been an increase in the number of cases reported. So how is San Diego faring ? Well , joining me with that answer is KPBS health reporter Heidi DeMarco. Heidi , welcome to the show. Hi.

S2: Hi. Great to be here.

S1: So glad to have you here. So you've recently reported on how the county reports show an uptick in Covid cases.

S2: But in San Diego County , officials say they started to see a rise in cases in late May and early June this year. In the last month , the positivity rate of tests increased to more than about 14% , so it prompted them to recommend the public to get tested and vaccinated.

S1:

S2: For example , at one San Diego hospital , they were seeing 30 patients this summer , not 200.

S1: Oh , wow.

S2: So doctors have reported that the last time Covid was the main cause of hospital admission was in the summer of 2022. Mhm.

S1: Mhm. Well , you know , the newest wave of Covid infections are largely coming from what are being called Flirt variants.

S2: The CDC says there's no definitive information yet on whether Covid will be more severe with new variants , or how symptoms might change. The severity of the symptoms typically depend more on the person's immunity and overall health than on which variant they're infected with. Hmm.

S1: Hmm.

S2: So health experts say that it's not likely that the virus is more mild , but rather that our immunity has strengthened both through vaccinations and previous infections. Mhm.

S1: Mhm. Since people have such mild symptoms , it's not likely that a lot of people will even test for Covid. Do you think ? Are they saying anything about that ? You know.

S2: I think you're right. I think that people the symptoms are mild. And so , yes , a lot of people may go undetected. They might not test. And if they do tests , maybe they. And I was going to mention this , but take an at home test. But they're saying that because of the new strains , the tests aren't that reliable anymore. So but then it also depends on it's a personal thing my My immunity might be stronger than yours. It doesn't really matter. On age , you know , there are people that are higher risk. But yes , you may not even know that you're you know , you might just like , think it's just a cold or not even a cold. Maybe I just had a headache. Exactly. So I think a lot of people might go undetected. And this is why it spreads a little more. Yeah.

S1: Yeah , that certainly presents a challenge. Well , UCSD and Scripps Research , they study Covid 19 levels through wastewater testing.

S2: And so every everyone , everyone's wastewater is collected. So he said that the Covid 19 levels in the wastewater , they align with the rising cases being reported by the county , and he attributed it to the new Flirt variants. He said there's some seasonality involved with some of these rises. Summer is a time where a lot of kids are out of school. People are traveling , so that changes in daily behavioral patterns and workflows might be leading to the changes in the way that the virus is spreading.

S1: Well , you also reported that due to this uptick in cases , the county health department is encouraging vaccinations and testing.

S2: The times and locations can be found on our website. You can also use at home test. Although doctors say because of the rise of the new variants , some at home tests might not be as reliable as they used to be. So they do recommend testing at your doctor's office or a local clinic if you feel any kind of symptom.

S1:

S2: They agree that ongoing masking is important , especially if you feel unwell or you're at a higher risk due to age or immunocompromised status.

S1: So basically masking that something we may want to consider still doing and also putting some space between ourselves and other people , definitely.

S2: You know , a lot of people are going back to work. You know , people are traveling out of school. But also , you know , you see San Diego Health. I just spoke to a doctor. They implemented masking inside of the hospital. So they're seeing it as important , even though the numbers are low and they're saying , you know , this is it's much different than it was a couple of years ago. There's still people dying. There's still , you know , people getting infected. And some of us are at higher risk than others. So masking is one way to help protect yourself and protect the community.

S1: Do doctors anticipate the numbers going up in the coming weeks or months ? Definitely.

S2: A little bit of a of a summer surge is what they're calling it. And like the flu , they're seeing it. You know , it may become seasonal. We might you know , these these strains are changing. But like the flu vaccine , they're. It's a guessing game for them to see what is going to work. And they really won't know until the vaccine is out and about. And people are taking it , using it , getting the shots and and hoping for the best. Really.

S1: All right. Well , I've been speaking with KPBS health reporter Heidi DeMarco. Heidi , thank you so much for joining us.

S2: Thank you. Jade.

S1: Still ahead , why our immunity is more vulnerable to this new Covid variant.

S3: So the current variant , it's called CP3 , is significantly different than prior versions of the virus that we've been exposed to.

S1: Hear more when KPBS Midday Edition returns. Welcome back to KPBS Midday Edition I'm Jade Hindman. Coronavirus numbers have jumped significantly across the nation , and the newest wave has brought very high levels of coronavirus detection in California's wastewater. This is the highest the number has been since last winter. We just talked to KPBS health reporter Heidi DeMarco about the local impact of the virus , and now we'll get the bigger picture from Doctor Eric Topol , professor at Scripps Research Translational Institute. Doctor Topol , it's good to have you back on the show.

S3: Great to be with you again , Jane.

S1: Well , I got to know. Covid may seem like a thing of the past for many people , but numbers are on the rise. Why are we seeing this increase right now ? Right.

S3: It is a significant wave that's developed. And we're not we're not necessarily seeing the end of it. It's related to two major things. The virus has continued to evolve. so the current variant , it's called CP3 , is significantly different than prior versions of the virus that we've been exposed to. Along with that , of course , there's the waning immunity , because whether it's from a vaccine or a prior infection , uh , doesn't last that long , uh , past six months or so. Added to those features about the virus evolution in our immunity waning is , of course , that we continue to try to make believe the virus isn't out there , and so we don't do anything to try to prevent infections , largely because some people do , but they're the minority and that's adding to the problem. Mhm.

S1: Mhm. Well how is this very different. Yeah.

S4: Yeah. So this CP3.

S3: Uh , you know , back in April , I wrote about this flirting with a new Covid wave. Uh , with a was the title of a essay. And , you know , there was a so-called flirt variance. There was a major new variant that popped up just before that. Uh , and it took a while for it to pick up enough new mutations to become dominant in this country. So , you know , we're only getting genome sequencing readouts from the CDC every two weeks now. But the last one has shown that this CP3 is taking over. It's now responsible for the vast majority of infections in the US , and also for why we're seeing a significant wave. It's a problem because it is more infectious , and it also is more evading our immune system , which is already compromised to some degree because we're far out from a booster vaccine or a prior infection. So it's basically the constant evolution of the virus where we don't constantly adapt , we our immunities and good enough to withstand a long term. Vaccines are not durable enough for this virus. So the virus is kind of racing ahead and we're not keeping up with it. Right.

S1: Right. Well , I mean , I was going to ask if this variant , this flirt and CP3 , if the variant is evading our vaccines at all.

S3: Well , just to some extent. So the f , L and the T and flirt stand for two of the mutations key mutations it picked up. But now there's a few more that have added to this current CP3. Uh , and so it doesn't fully evade our immune system. There aren't as many people , proportionately , who get a Covid infection now who get very sick , who wind up in the hospital. So we we it's partially evading our immune system now. We still have people who are getting very sick and even dying , but fortunately because of some immunity to the virus , um , it's less of that. So that's the good thing about having four years in our back , uh , uh , as far as having exposure in vaccines and boosters , but it's just not good enough , uh , to give full , um , immune recognition when it sees this spike protein coming to contact to our upper airway. Yeah.

S1: Yeah.

S3: I mean , we saw more gastrointestinal side effects in recent months , but overall , you know , the same things as far as , uh , sore throat , cough , runny nose , uh , are some of the dominant symptoms.

S1: Our our at home tests still effective at detecting it ? Yes.

S3: As far as we know , uh , it's the latest variant of CP3 , um , which has another new mutation called 311. Uh , does have a deletion. It's possible it will be trickier , but so far as we know , the the rapid tests are still working pretty well. Wow.

S1: Wow. All right.

S3: And it was about this very point , what has been going on with long Covid over the course of the pandemic. And what's fascinating is that because of vaccination , it dropped at least 50 to 70%. The the rate of people developing long Covid , but still now , uh , it's over 3%. So whether it's a new infection , most people have had Covid now or a reinfection , the chance of getting long Covid now is over 3% , whereas prior to vaccination it was well over 10%. So we've made progress. But still that 3% chance is is worrisome because long Covid , as you all know , is a very difficult thing to have to deal with. We have no treatment and it can be severely disabling. Right.

S1:

S3: Uh , we don't have a treatment yet. There are more trials that are getting started to test things , but it's very frustrating because , uh , these folks , so many of them have really been incapacitated. Their lives have been changed , and we don't have much to offer them at this point. I hope that's going to change in the times ahead. Yeah.

S1: Yeah.

S3: What we discussed that we have some immunity to the virus , almost all of us , or , you know , 90 some percent of us have been exposed to the virus directly. And a lot of those folks of the vast majority have had vaccinations , uh , with or without boosters , so the chance of getting very severe illness requiring hospitalization is much reduced. But there still is that chance , particularly in people who are older , age 65 and older , or have some immune system compromised. So these are the people that are really at high risk. And that brings up another point , Jade , is that we aren't ready with the new vaccine booster. It's not going to be ready until about Labor Day. So we have six weeks or so with a booster that's basically directed towards an obsolete version of the virus. And so it's unfortunate. It takes time to get these boosters made , and it's going to be a good match for CP3. Uh , although six weeks from now , who knows what the virus will start to evolve further. But a booster right now would give added protection , particularly for the high risk people that I just mentioned. Hmm.

S1: Hmm.

S3: So we're seeing a lot of Covid , uh , at Scripps Health and throughout San Diego. There's more people that have been hospitalized in some time. And of course , I think everyone knows that more people who have recently had Covid in our region , and we don't know whether this is the , um , you know , the end of this wave. Uh , there have been summer ways throughout the pandemic. It's a silly notion that it's , uh , an annual event like flu , that it's seasonal , like that. We've had at least two ways , you know , every year of this pandemic. So , um , we have to adjust to the point that if , firstly , that Covid is not going away , we need a nasal vaccine. We need a pan coronavirus universal coronavirus vaccine. And the two we get those things. We have to cope with things and we have these gaps now months of gaps with a successful directed booster vaccine. And had that been available , you know , weeks ago , it would have helped a lot of people from getting infected or getting the sequela of the infection.

S1: Let me ask you this.

S3: I do think , though , educating people about the things that we can do. Uh , you know , the masks are still highly worthwhile. High quality masks , uh , like Kn95 or N95 masks. And , you know , we have to have our guard up about being in crowds , you know , being indoors especially that is , and our attention to better ventilation , um , better air quality. These are such important things. We've never stepped up. And in fact , as you know , Jade , there are states that are trying to mandate not to have mass , which is such a paradox because they work , they help , and that's just feeding into , you know , really pseudoscience that masks are unhelpful. Yeah.

S1: Yeah.

S3: Uh , for people older and if they've , uh , you know , have multiple chronic illnesses or immune system , uh , issues , it's time now to take this seriously. You don't want to get Covid and you don't want to get long Covid. So that means , you know , the mitigation factors that we know well need to be put in place. Uh , and that starts , you know , with mask and , and , uh , avoiding indoor situations where , you know , uh , being with people who are untested and possibly infected , all those sorts of things. But as soon as the booster is available , uh , in Labor Day , it would be really prudent to get it. Um , and that's a problem because so few Americans , you know , went and had the booster that was available almost a year ago , September 2023. But it's going to be available , and it's going to be really important to get it. For those people who are at high risk. Short of that , you know , there's the idea you could still get the current booster , which is another way to , you know , to deal with things , but it just isn't that good a match. It doesn't. It's not going to offer nearly as good protection as getting what's called the CP two booster that will be available in the next six weeks.

S1: Given how quickly this virus evolves , will the booster that's coming out be effective against this variant should it mutate again ? Yeah.

S3: You're you're hitting a really important point here , Jade , because it will the virus will continue to evolve. You can count on that whether it will evolve substantially. The hope is not that it does always take time. This this uh , pre CP3 if you will , variant showed up in the spring and it took a few months to get where we are right now. So we're going to have a little bit of time over the course of September , October. But eventually , yes , it will morph to something different. It'll keep challenging us. The whole purpose of this virus is to find hosts , infect them , infect them again if need be , whatever it takes. That's the mission of the virus and we don't respect it. We keep thinking , oh , Covid , it's it's all past tense. It couldn't be further from the truth. Yeah.

S1: Yeah. And , you know , to go back to the symptoms of this particular mutation and variant , I often hear a lot about gastrointestinal issues. Is that something a common symptom with this. Yes.

S3: Yes. Yes yes. I mentioned that a bit earlier that as opposed to the early Covid major variants , that's what evolved over time. So yes , the more recent variants , it's more likely to have some , uh , GI symptoms. Uh , sure. But some people of course , don't have that. As you know , there's lots of different symptoms , uh , that people manifest when they get Covid. Uh , sometimes it can be more GI. More. Most of the time , though , it's still cough. Um , you know , upper airway , um , issues that are the dominant symptoms. Yeah.

S1: Yeah.

S3: We've done nothing to eradicate this virus. All we've done is just , you know , become delusional that the virus is going to not hurt anybody. Uh , it's still looking to find people to infect. And , um , you know , we got to keep our guard up. But , moreover , we know of things that we can quash this virus with. If we had , you know , things like nasal vaccines that were effective or we had a shot that worked against all variants , not just the one , you know , the flavor of the month. Um , then we could really prevail. But we have not , um , you know , doubled down on those. We have projects , of course , that are trying to get those right now , but they're still moving slowly. Nothing's going to happen in 2024 for those important goals. But you know what ? We do need to take this virus seriously , and we have an opportunity to really be in control of it. But we haven't put that priority. We haven't put the resources. We haven't accelerated the chance to to be the ones in charge of the virus , rather than being the ones who are succumbing to the virus.

S1: I've been speaking with Doctor Eric Topol , professor and founder of Scripps Research Translational Institute. Doctor Topol , thank you so much for joining us , as always.

S3: Thank you Jane.

S1: Coming up , the one thing people may be missing when they think about Covid.

S5: One of the talking points that sort of left out always in these surges is to protect yourself , not just from Covid 19 , but from the long term risk of long Covid.

S1: KPBS Midday Edition returns after the break. Welcome back to KPBS Midday Edition. I'm your host , Jade Hindman. We've been talking about the current landscape of Covid. As the summer surge continues , more people are noticing symptoms that persist long after initial infection. In fact , the CDC found that 17 million adults in the U.S. reported having long Covid. I'm here with journalist Miles Griffiths. He is the co-founder and editor of The Sick Times , an independent news site dedicated to covering long Covid. Miles , welcome.

S5: Thanks so much for having me on today , I appreciate it.

S1: So glad you're here.

S5: Long Covid is typically diagnosed about three months after a Covid 19 infection. Long Covid affects almost every organ system of the body. Um , so this leads to a really wide presentation of symptoms , um , which can be I think the the stat is about 200 different symptoms. Um , so it can present differently in different people and age groups. So it can look a little bit different in children as it does in adults. But some of the main symptoms that people experience are really profound fatigue. So it's not just being tired but fatigue that interferes with your everyday life. They might experience trouble standing up for longer periods of time. You might feel faint , dizzy. Another big one is cognitive dysfunction. Memory problems. There's a lot of research showing the different effects of Covid and long Covid on the brain.

S1: And new ones are still emerging , right ? I mean , what are we seeing for years into the pandemic ? Yeah.

S5: So the other thing about long Covid is it can kind of come and go and can get worse with more reinfections of Covid 19. So a lot of people who have been sick with long Covid in early 2020 , um , have seen their symptoms change over time. However , some have had the exact same symptoms for four years , so it's very person dependent. Yeah.

S1: Yeah. Well , I mean with more than 200 symptoms and things like you mentioned , symptoms like fatigue and and cognitive dysfunction does long Covid looks similar to other chronic conditions.

S5: There are some yeah. One comparisons to myalgic encephalomyelitis um which is sometimes called chronic fatigue syndrome. We've known for a long time that , um , viruses can cause long term , um , health issues and other diseases later on , whether they're cancers or autoimmune diseases. So long Covid might fit into that. There's a lot of research on it. I think there's over 24,000 papers that have been published so far in the last four years. Hmm.

S1:

S5: It is about 7% of adults , as you quoted earlier , is about 17 millions of Americans in the US. So the population of California , around 7% of adults in it would kind of give us a good number. So I would guess it's in close to the millions. Yeah.

S1: Yeah. But you know , with so many symptoms , how are doctors able to diagnose long Covid ? I mean , does that make it. Does the fact that there are so many symptoms make it harder to track ? I explain that it can. Yeah.

S5: Yeah. One of the most helpful things is keeping track of when you when you start to experience symptoms. If you do , because Covid can be asymptomatic , it can be tricky. So that's why it's important to test after you may have had an exposure or once you start to experience symptoms. That way you can track it to a Covid 19 infection , which will give you a little bit more of a clue. But there's a lot of symptoms that are quite common. So if you have that profound fatigue , if you have cognitive dysfunction , brain fog , these things that are persisting for a long time , it's important to listen to your body and tell your doctor what's going on and they can help diagnose. However , not all doctors are on up to date with the latest long Covid research , so a lot of patients struggle to find good care and be believed they're still an issue , even for years , on to find good care. So one of the best places to go to is usually a long Covid clinic , as they are seeing a lot of these patients and there are a few in Southern California.

S1:

S5: It depends on the clinic , the doctor and provider. So a lot of patients are being left out. They're being gaslit , and they're not really getting the care that they need when acquiring this really serious disease. Mhm.

S6: Mhm.

S1: With that in mind , tracking the numbers of people who have maybe who perhaps have long Covid is pretty difficult then. Right. If doctors aren't able to diagnose it well.

S5: There are no approved treatments for long Covid. This is , I think , something that gets left out a lot is I think our society just sort of thinks , oh , you know , things will just clear up and they'll be treatments that people can can get , but that's not the case. So there are no approved treatments. There's a ton of research going into long Covid right now , trying to find biomarkers and other things that will kind of help find the root cause so that we can treat it. So right now , one of the most important things people can do after a Covid infection is rest. As long as they can try to avoid high impact cardio and these types of things after a Covid 19 infection and avoiding Covid 19 infections in the first place that you don't end up with. Long Covid are important measures , and there are some ways to like manage symptoms because there are similarities with other diseases. There are some treatment options that help , but they do not cure the disease. So unfortunately , a lot of people have been sick now with Long-covid for almost for over four years now. And while they might have had some increase in the quality of life they experience , it's still very low compared to someone without the disease.

S1: Well , say someone presents with fatigue.

S5: So if there are other markers in blood tests or of things , you can diagnose those. And then there are some some things that come along with long Covid including disodium omega. So you can do things like a tilt table test. And this can help better diagnose some of the the diagnosis is under the bigger umbrella of long-covid.

S1: What's a tilt table test. Yeah.

S5: Yeah. So this is for dysautonomia and postural orthostatic tachycardia syndrome Pots. It's called. And this is when you stand up and you feel really dizzy and you could faint. So a lot of people with Long-covid experience this. Um , and a tilt table test is basically a way to measure your heart rate as you go from lying to standing. But you can do this at home too , by taking your heart rate and their resources available. For this , you can take your heart rate , lying and standing between certain intervals of time. And if your heart rate is at certain variables , then you can. It'll give you a much better clue if you might have pots.

S1: So are there other causes for something like pots ? Yeah.

S5: So Pots has been around before the pandemic. So it's likely triggered by other viral infections. So this is sort of talking about your question earlier of long Covid relating to other diseases. So there are these other diseases and conditions that around before the pandemic that are triggered by infections. So long Covid fits into this camp and as an umbrella term , there are lots of different diagnoses underneath it from cardiovascular. Covid can trigger diabetes. So there's a bunch of different health issues that can arise after Covid 19 infection that are included in the long Covid umbrella.

S1:

S5: We still don't have a lot of great and robust research on why these things happen following following infections , but a lot of it is emerging. Like , for instance , we know that multiple sclerosis Ms. is likely caused by Epstein-Barr virus , which is mono. So a lot of people get mono in the United States. We know that these viruses lead to diseases in the long term. And so for that one , it it happens about ten years after after initial infection. So that one was hidden for a long time because it's very hard to trace back to , to what it is. But researchers were able to figure that out. The difference with long Covid is the pandemic started. Covid 19 is so infectious , so , so many people got sick. And through online , online communities and the way we're able to share information now , so many people were able to figure out that they were getting sick from their Covid 19 infections and were able to name long Covid within three months of sort of when the pandemic was officially declared. Mhm.

S1: Mhm.

S5: A lot of the the name of long Long-covid came from patient advocacy , people finding , you know , sharing their experiences , their symptoms. Um , and this led to recognition of the disease from the World Health Organization , the CDC and major other health organizations around the world. Mhm.

S1: Well , long-covid can affect any age group. Right. So what what stories are you seeing there ? You know , I know it can happen in children. How does it present ? Yeah.

S5: So in children , it's it's complex because a lot of children aren't able to specifically sort of talk about their symptoms and address exactly what's happening to them. It can hide. So some of the biggest things to look for that advocacy groups and medical professionals have talked about is sort of just changes in behavior. So this can be sort of lack of attention , more fatigue , more tiredness , not wanting to do , you know , activities that they used to love doing before they got a Covid 19 infection. Hmm.

S6: Hmm. Wow.

S1: Well , you actually found the sick times after developing long Covid. Tell me about that. Yeah.

S5: Yeah. So I , um , I was a writer and journalist , um , before the pandemic began. Um , and then I got Covid 19 in early 2020. Started to experience long term symptoms , um , almost a month after that infection. And that's pretty that's common with long Covid. Symptoms can follow within weeks or months following the infection and then set in. Then I began to understand the disease more as it was named through this patient advocacy , and then began to report on it over the last few years. And then my colleague Betsy LaTourette and I founded the Sick Times last year as a nonprofit newsroom. And we are covering Long-covid mainly because we wanted a place for patients and a place that specifically addresses long Covid , as a lot of the time it's sort of left out in more mainstream news narratives , especially sort of during surges like we're in right now. One of the talking points that sort of left out always in these surges to protect yourself , not just from Covid 19 , but from the long term risk of long Covid , which aren't usually as presented to the community , presented in public health as a warning that long Covid can affect you , can affect anyone of any age group , and it can last for years. Mhm.

S1: Do you since you've been kind of dealing with long Covid , do you look at it as a disability.

S5: I do , yeah. Identifies as disabled. And this is very common with a lot of people with long Covid. It can be extremely debilitating. Many people can aren't able to work at all. Some can only work part time. It presents in a wide spectrum of severity from yeah , a more mild. Maybe you're able to get through your every day to severe , which is people who are completely bedbound. Some can't talk , some can't participate in any of the activities that they did before and just confined to their rooms. So it's it's a wide swath of wide presentation of severity , and it can get worse over time or with more subsequent Covid 19 infections.

S1:

Read more:

What to know about the COVID-19 FLiRT variants - KPBS

India may have had 11.9 lakh excess deaths due to the effects of the COVID-19 pandemic in 2020, an international team of researchers has reported in the journal Science Advances.

The estimate is at odds with the Indian governments repeated claim that far fewer people died than they would have without the pandemic in that year. It also stands on firmer footing than many previous estimates previous studies because the studys authors used data from the fifth National Family Health Survey (NFHS-5), conducted in 2019-2021.

Using this exceptionally large dataset helps to address major gaps in knowledge about pandemic mortality in India that stem in part from incomplete administrative data and low-quality survey data, they wrote in their paper, published on July 19.

The researchers used NFHS-5 data collected in 2021, of 7.6 lakh people in households in 14 States and Union territories. This sub-sample, they wrote, is representative of about one fourth of Indias population. Based on this data, they found that the overall life expectancy in India in 2020 was comparable to that a decade prior, dropping by 2.6 years at birth between 2019 and 2020. This, they estimated, translated to a 11.9 lakh excess deaths around the country.

An important reason for the life expectancy decline is reportedly because more people aged younger than 60 years lost their lives in 2020. They also estimated the life expectancy of women at birth declined by one year more than it did for men at birth.

Based on numbers of the socio-economic indicators the NFHS tracks, the researchers also wrote, Relative to high-caste Hindus, the gap in life expectancy at birth for [Scheduled Caste groups] increased from 4.5 years in 2019 to 5.9 years in 2020; for [Scheduled Tribe groups], it increased from 2.2 to 5.0 years, and for Muslims, it increased from 2.2 to 6.3 years.

The studys first author and a University of Oxford research fellow, Aashish Gupta, told PTI, Marginalised groups already had lower life expectancy, and the pandemic further increased the gap between the most privileged Indian social groups, and the most marginalised social groups in India.

By 2022, the U.S. had officially recorded the most number of deaths due to COVID-19. On the other hand modelling studies by various independent scientists had suggested India may have recorded the most deaths overall in 2020-2023, up to 5 million, due to COVID-19 as well as the lockdown and disruptions in global supply chains.

On July 20, the Ministry of Health and Family Welfare issued a statement disputing the studys findings, saying, The excess mortality reported in the Science Advances paper in 2020 over the previous year is a gross and misleading overestimate. The study is erroneous and methodology followed by the authors has critical flaws; the claims are inconsistent and unexplainable. The all-cause excess mortality in 2020 compared with the previous year in India is markedly less than the 11.9 lakh deaths reported in the Science Advances paper.

The Ministry also disputed the studys use of NFHS-5 data and said it wouldnt be representative of national data. The paper had acknowledged this limitation: Although our 2021 subsample is similar to the full NFHS-5 sample on many characteristics, the subsample has a different social and religious composition compared to the full sample and that its data is geographically clustered in 14 states and union territories. For these reasons, our results from analyses of the subsample may not provide a full understanding of changes in mortality at the national level...

But the authors also added that changes in mortality in this subsample might not have been so different from regions that are not in this subsample. Indias third national [seroprevalence survey] shows that disease spread was similar in the subsample states compared to states that were not in the subsample.

The Ministrys statement contended that another flaw was related to possible selection and reporting biases in the included sample due to the time in which these data were collected, at the peak of the COVID-19 pandemic.

It also disagreed with the researchers statement in the paper that the NFHS-5 allowed an alternative window with which to estimate deaths to COVID-19 and its effects in India considering administrative data from Indias Civil Registration System (CRS), which have been used for many existing estimates of excess mortality in India ... do not capture all births and deaths, are unavailable for many states, and were disrupted by Indias severe lockdown in 2020.

The Ministry said the Civil Registration System ... recorded a substantial increase in death registrations (over 99%) in 2020. However, Dr. Gupta told The Hindu, The governments own National Family Health Survey found death registration coverage to be 71%. It is likely that the lockdown further reduced registration coverage. So the claim that death registration is above 99% is hard to buy.

Here is the original post:

India may have had 11.9 lakh excess deaths due to pandemic in 2020: study - The Hindu

A new variant of coronavirus known as FLiRT has taken hold in the Netherlands this summer and people can still become extremely ill, experts say.

One in 80 people taking part in the public health institute RIVMs infection monitor, tested positive for coronavirus in the past week. In the week of April 15, for example, no positive tests were reported at all.

Waste water analysis, the most important monitor of how the virus is spreading, shows the number of coronavirus particles is now 14 times higher than at this time last year. It is now even higher than in July 2021 when the government relaxed the strict coronavirus measures, leading to a surge in autumn infections.

The current wave, says professor Marion Koopmans, is causing far fewer people to become seriously ill and hospital admissions are barely rising, despite the surge in infections.

Most people, she told the AD, are well protected against the virus because they have either had it earlier or have been vaccinated.

Nevertheless, Koopmans and the RIVM stress that coronavirus can lead to long-term health problems such as Long Covid. The chance is lower, but it is still there, Koopmans said. We are still getting new cases.

The basic rules introduced during the main pandemic sneezing into your elbow, working from home and wearing masks should become part of our everyday behaviour, she said. As with flu, people who are in poor health can become extremely ill, she said. Simple measures can help protect them.

The summer surge shows that coronavirus is not seasonal, Alma Tostmann from Radboud University hospital told the Volkskrant. We are currently in a phase in which new variants lead to a rise in infections, even if it is summer, she said.

Research institute Nivel said last week that the number of coronavirus patients reporting to their family doctor remains low but that there is an upward trend and that the over-65s are most likely to be affected.

The government will launch a new vaccination round for the over-60s and younger people with certain health conditions in mid-September. The first invitations will begin to arrive at the end of August.

FLiRT takes its name loosely from its scientific moniker.

See the article here:

Summer coronavirus surge FLiRT takes hold in the Netherlands - DutchNews.nl

The new COVID-19 variant FLiRT is rapidly spreading through the Netherlands, and the amount of coronavirus particles in the sewage is now even higher than in the Dancing with Jansen summer of 2021. But hospital admissions are barely increasing, so there is no reason to panic, virologist Marion Koopmans told AD.

The best indicator of how actively the virus is spreading is the sewage water measurements, Koopmans said. Currently, the number of coronavirus particles found in the sewage is 14 times higher than at this time last year. It is even higher than in the summer of 2021, when the Delta variant was spreading quickly, and the governments over-enthusiasm for relaxing measures caused a wave of infections.

The current wave is in many ways incomparable to the 2021 situation, Koopmans, a professor of virology at Erasmus MC in Rotterdam, stressed to AD. The current variants make people a lot less sick. You now see that the number of hospital admissions is barely increasing despite the rising number of coronavirus infections. Most people are also well protected against the virus through vaccinations and previous infections, resulting in often milder symptoms.

Despite this, Koopmans and the public health institute RIVM are stil concerned about Long Covid, when Covid-19 symptoms last for a year or longer. The chance is gradually decreasing, but it is still there, Koopmans said. New cases continue to emerge. So that is something to take into account.

FLiRT is a group of Omicron subvariants that are just different enough to bypass immunity. Officially, the subvariants are called KP.2, JN.1.7, but to keep things simple, scientists have named the group as a whole the FLiRT variant.

See the original post here:

New Covid-19 variant quickly spreading through NL; Biggest summer outbreak since 2021 - NL Times

President Joe Biden tested positive for Covid-19 on Wednesday while he was in Las Vegas for a series of events, the White House said.

In a statement, White House press secretary Karine Jean-Pierre said Biden tested positive following his first event in Las Vegas.

He is vaccinated and boosted and he is experiencing mild symptoms, Jean-Pierre said. He will be returning to Delaware where he will self-isolate and will continue to carry out all of his duties fully during that time. The White House will provide regular updates on the Presidents status as he continues to carry out the full duties of the office while in isolation.

Biden was already scheduled to head to Delaware after his trip to Las Vegas.

Biden was tested after he experienced upper respiratory symptoms, Bidens doctor said in a statement released by the White House. Dr. Kevin OConnor is the presidents physician; the White House did not attribute the statement to him by name.Bidens symptoms included a runny nose, nonproductive cough and general malaise, the statement said.

His doctor said he has already taken his first dose of Paxlovid, a medication that is associated with reducing the chance of hospitalization or death.

Biden does not have a fever, and his respiratory rate is normal, according to the doctor.

When Biden arrived later at the Las Vegas-area airport, he responded to a question about how he was feeling by saying, Good, I feel good.

En route to Delaware, Biden tweeted, "I'm sick." He followed it up two minutes later with a post saying, "of Elon Musk and his rich buddies trying to buy this election," with a link to donate to his re-election campaign. Musk endorsed former President Donald Trump moments after Saturday's assassination attempt.

Biden, 81, has kept a full schedule in Nevada this week after questions were raised about his health and capabilities after a dismal debate performance in late June.

Both Biden and Trump, 78, have had Covid. Biden last tested positive in 2022. Trump tested positive in 2020.

News of Bidens Covid test was announced at the conference where he was scheduled to speak Wednesday.

Regrettably, I was just on the phone with President Biden, and he shared his deep disappointment at not being able to join us this afternoon. The president has been at many events, as we all know, and he just tested positive for Covid," said Janet Murgua, president of UnidosUS, which bills itself as the largest Latino advocacy organization in U.S.

Biden, who had been expected to speak at the group's event in Las Vegas, was about an hour and a half late before the announcement was made.

Top campaign officials Jen O'Malley Dillon and Julie Chavez Rodriguez informed campaign staff members of the Covid test in a 6:40 p.m. ET email.

"The president is doing fine and looking forward to being back on the campaign trail as soon as he is COVID free," the email said.

Biden said in an interview with BET on Tuesday that he would drop out of the presidential race if he developed a medical condition that prevented him from running.

The Centers for Disease Control and Prevention said in March that people who test positive for Covid no longer need to isolate for five days.

The CDC's latest guidance recommends that people who test positive stay home and away from others, noting that people can resume normal activity after symptoms are improving and there is no fever without "fever-reducing medication" for at least 24 hours.

The CDC encourages people to continue to wear masks and maintain distance from others for five days after they resume regular activities.

Biden was not wearing a mask as he walked to Air Force One after having tested positive; neither were the staff members boarding with him.

Megan Lebowitz is a politics reporter for NBC News.

Mike Memoli is an NBC News correspondent.

Tara Prindiville and Rebecca Shabad contributed.

Read more from the original source:

Biden tests positive for Covid-19 and will self-isolate in Delaware, White House says - NBC News

President Biden tested positive for the coronavirus Wednesday, placing a renewed spotlight on covid-19 and the precautions the broader public can take as a summer wave of the disease sweeps over much of the United States.

In a statement, the White House said Biden is experiencing mild symptoms and plans to self-isolate at his home in Rehoboth Beach, Del., while continuing to work. The president, who previously tested positive for the coronavirus in 2022, told reporters he was doing well after landing at Dover Air Force Base late Wednesday.

President Biden arrived at Dover Air Force Base, as he headed back home to Rehoboth, Del., after testing positive for covid on July 17. (Video: The Washington Post)

Coronavirus levels in wastewater were considered high or very high in 26 states, the Centers for Disease Control and Prevention reported last week, but the nations approach to the pandemic has evolved significantly over the years meaning it can be difficult to determine how best to stay safe. Heres what to know.

When sick with symptoms of a respiratory virus, such as the coronavirus, the CDC advises individuals to stay home and isolate until both their overall symptoms have improved and they have been fever-free without using fever-reducing medication for 24 hours.

For five days after that, it recommends taking extra precautions such as wearing a mask, improving air circulation, physical distancing and testing. The CDC also recommends taking these precautions if covid is circulating widely in the community.

People who are asymptomatic do not need to stay home but should take those extra precautions, said Demetre Daskalakis, director of the CDCs National Center for Immunization and Respiratory Diseases.

If people do not have a fever, they should still isolate until their overall symptoms have improved for 24 hours, he said.

The stay-at-home guidance gets trickier when there are others in a household.

In that case, Daskalakis advises people with coronavirus to keep their distance from others if possible and to use additional precautions, such as masking or improving air circulation.

The currents coronavirus vaccines were developed with a formula targeting the defunct XBB variants but still offer some protection against the latest variants. An updated vaccine is expected in the late summer or fall.

Staying up to date with coronavirus vaccines significantly lowers the risk of getting very sick, being hospitalized, or dying from covid-19, the CDC says.

The CDC recommends adults 65 and older get a second dose of the current coronavirus vaccine, and everyone ages six months and older get the updated vaccine when it is available.

Experts say patients who have not recently been infected or vaccinated should consult their doctors about the trade-offs of getting an outdated shot for protection amid the summer covid wave or waiting for the new version expected to be available in the coming months.

While doctors are seeing far fewer hospitalizations for covid, older individuals remain at the highest risk and still can get quite ill, Tara Vijayan, an infectious diseases specialist at UCLA Health, wrote in an email, noting that taking antivirals early and getting vaccinated can mitigate that risk.

If an older adult tests positive, Vijayan recommends considering taking Paxlovid, which President Biden took Wednesday, or molnupiravir, which may have similar benefits. Doctors are divided on whether younger, otherwise healthy adults should take Paxlovid.

If people are charged for Paxlovid, which is no longer free, they can apply for support from patient assistance programs to cover out-of-pocket costs, or ask a provider or pharmacist to help.

For older adults looking to protect themselves, Vijayan said it is reasonable to consider masking indoors, especially in crowded or poorly ventilated spaces. She emphasized, however, that close family members are by far the most common source of infection.

Vijayan encourages relatives of older adults to take a test if they have signs of an upper respiratory tract infection and stay away from older family members until they are no longer contagious.

These days, most cases are caused by new KP variants, which are part of a group called FLiRT, and LB.1. They are more effective than their predecessors at infecting people who have some immunity from vaccines or previous infections. The new variants do not seem to cause more severe infections and deaths.

The new vaccines under development target the KP.2 strain, which is similar to the other commonly circulating variants.

Preeti Malani, an infectious-diseases physician at the University of Michigan, told The Washington Post earlier this month that the clinical difference is minor, if any.

Read more here:

Biden just got covid. What are the latest coronavirus guidelines? - The Washington Post

Since 2020, the condition known as long COVID-19 has become a widespread disability affecting the health and quality of life of millions of people across the globe and costing economies billions of dollars in reduced productivity of employees and an overall drop in the work force.

The intense scientific effort that long COVID sparked has resulted in more than 24,000 scientific publications, making it the most researched health condition in any four years of recorded human history.

Long COVID is a term that describes the constellation of long-term health effects caused by infection with the SARS-CoV-2 virus. These range from persistent respiratory symptoms, such as shortness of breath, to debilitating fatigue or brain fog that limits peoples ability to work, and conditions such as heart failure and diabetes, which are known to last a lifetime.

I am a physician scientist, and I have been deeply immersed in studying long COVID since the early days of the pandemic. I have testified before the U.S. Senate as an expert witness on long COVID, have published extensively on it and was named as one of Times 100 most influential people in health in 2024 for my research in this area.

Over the first half of 2024, a flurry of reports and scientific papers on long COVID added clarity to this complex condition. These include, in particular, insights into how COVID-19 can still wreak havoc in many organs years after the initial viral infection, as well as emerging evidence on viral persistence and immune dysfunction that last for months or years after initial infection.

A new study that my colleagues and I published in the New England Journal of Medicine on July 17, 2024, shows that the risk of long COVID declined over the course of the pandemic. In 2020, when the ancestral strain of SARS-CoV-2 was dominant and vaccines were not available, about 10.4% of adults who got COVID-19 developed long COVID. By early 2022, when the omicron family of variants predominated, that rate declined to 7.7% among unvaccinated adults and 3.5% of vaccinated adults. In other words, unvaccinated people were more than twice as likely to develop long COVID.

While researchers like me do not yet have concrete numbers for the current rate in mid-2024 due to the time it takes for long COVID cases to be reflected in the data, the flow of new patients into long COVID clinics has been on par with 2022.

We found that the decline was the result of two key drivers: availability of vaccines and changes in the characteristics of the virus which made the virus less prone to cause severe acute infections and may have reduced its ability to persist in the human body long enough to cause chronic disease.

Despite the decline in risk of developing long COVID, even a 3.5% risk is substantial. New and repeat COVID-19 infections translate into millions of new long COVID cases that add to an already staggering number of people suffering from this condition.

Estimates for the first year of the pandemic suggests that at least 65 million people globally have had long COVID. Along with a group of other leading scientists, my team will soon publish updated estimates of the global burden of long COVID and its impact on the global economy through 2023.

In addition, a major new report by the National Academies of Sciences Engineering and Medicine details all the health effects that constitute long COVID. The report was commissioned by the Social Security Administration to understand the implications of long COVID on its disability benefits.

It concludes that long COVID is a complex chronic condition that can result in more than 200 health effects across multiple body systems. These include new onset or worsening:

Long COVID can affect people across the lifespan from children to older adults and across race and ethnicity and baseline health status. Importantly, more than 90% of people with long COVID had mild COVID-19 infections.

The National Academies report also concluded that long COVID can result in the inability to return to work or school; poor quality of life; diminished ability to perform activities of daily living; and decreased physical and cognitive function for months or years after the initial infection.

The report points out that many health effects of long COVID, such as post-exertional malaise and chronic fatigue, cognitive impairment and autonomic dysfunction, are not currently captured in the Social Security Administrations Listing of Impairments, yet may significantly affect an individuals ability to participate in work or school.

Whats more, health problems resulting from COVID-19 can last years after the initial infection.

A large study published in early 2024 showed that even people who had a mild SARS-CoV-2 infection still experienced new health problems related to COVID-19 in the third year after the initial infection.

Such findings parallel other research showing that the virus persists in various organ systems for months or years after COVID-19 infection. And research is showing that immune responses to the infection are still evident two to three years after a mild infection. Together, these studies may explain why a SARS-CoV-2 infection years ago could still cause new health problems long after the initial infection.

Important progress is also being made in understanding the pathways by which long COVID wreaks havoc on the body. Two preliminary studies from the U.S. and the Netherlands show that when researchers transfer auto-antibodies antibodies generated by a persons immune system that are directed at their own tissues and organs from people with long COVID into healthy mice, the animals start to experience long COVID-like symptoms such as muscle weakness and poor balance.

These studies suggest that an abnormal immune response thought to be responsible for the generation of these auto-antibodies may underlie long COVID and that removing these auto-antibodies may hold promise as potential treatments.

Despite overwhelming evidence of the wide-ranging risks of COVID-19, a great deal of messaging suggests that it is no longer a threat to the public. Although there is no empirical evidence to back this up, this misinformation has permeated the public narrative.

The data, however, tells a different story.

COVID-19 infections continue to outnumber flu cases and lead to more hospitalization and death than the flu. COVID-19 also leads to more serious long-term health problems. Trivializing COVID-19 as an inconsequential cold or equating it with the flu does not align with reality.

More:

Long COVID puzzle pieces are falling into place the picture is unsettling - The Conversation

TTHealthWatch is a weekly podcast from Texas Tech. In it, Elizabeth Tracey, director of electronic media for Johns Hopkins Medicine in Baltimore, and Rick Lange, MD, president of the Texas Tech University Health Sciences Center in El Paso, look at the top medical stories of the week.

This week's topics include nasal sprays and upper respiratory infections (URIs), nirmatrelvir/ritonavir (Paxlovid) in prevention, endometriosis and ovarian cancer, and diabetes after COVID.

Program notes:

0:53 COVID infection and nirmatrelvir/ritonavir

1:49 Did not reduce infection risk

2:51 Not noticed a difference with variants

3:14 Nasal sprays, behavioral interventions for URI

4:14 Stress management might help

5:14 Reduced antibiotic use

6:14 Stress reduction makes us less susceptible

6:35 Type 1 diabetes and COVID infection

7:32 Attacks pancreas and accelerates progression

8:32 Same thing in adults?

8:42 Endometriosis and ovarian cancer risk

9:44 597 women with ovarian cancer

10:45 If they have same origin it might provide insight

11:45 Arises in the fallopian tubes

12:35 End

Transcript:

Elizabeth: Can nasal sprays reduce the duration of colds?

Rick: Diabetes after COVID infection.

Elizabeth: The relationship between ovarian cancer and endometriosis.

Rick: Can Paxlovid prevent COVID infection for someone who has been exposed?

Elizabeth: That's what we're talking about this week on TTHealthWatch, your weekly look at the medical headlines from Texas Tech University Health Sciences Center in El Paso. I'm Elizabeth Tracey, a Baltimore-based medical journalist.

Rick: And I'm Rick Lange, president of Texas Tech University Health Sciences Center in El Paso, where I'm also dean of the Paul L. Foster School of Medicine.

Elizabeth: Rick, it's been a bit since we have talked much at all about COVID. Our habit, of course, during the pandemic was to feature that material first. Now that we are having a pretty significant amount of COVID spreading around the country, why don't we turn to one of your two?

Rick: Yeah, Elizabeth, and I'm actually surprised that the infection rate has gone up, especially during the summer. It's interesting to note that initially if someone had COVID, the rate of a secondary attack among their household contacts was about 10% to 12%. But now with the new variants, it's as much as 60% to 80%.

All right. If we take Paxlovid, nirmatrelvir, and ritonavir -- because we know that that can be effective in high-risk individuals in reducing the severity of infection -- can we prevent infection in people that have been exposed to household contacts? [The study] took about 2,700 participants that did not have COVID at baseline, but they had a post-contact, someone in the household that did develop COVID.

They randomized them to receive either placebo or they received Paxlovid -- a typical dose -- either for 5 days or for 10 days, and what they discovered was statistically those who received Paxlovid did not have a decrease in the incidence of subsequent development of COVID. Those individuals that received placebo, only 3.9% developed COVID. For those that received 5 to 10 days of Paxlovid, the rate was about 2.4%.

You might ask why is the rate so low? Well, 90% of these individuals were already seropositive. They either received vaccines in the past or they had a previous infection. There were some side effects from taking the Paxlovid. They are relatively mild. The major one is dysgeusia -- that means an abnormal taste in your mouth. But the fact that it didn't significantly reduce the rate tempers our enthusiasm for giving it to a large population.

Elizabeth: Nobody wants to take anything that isn't really going to work. Let's mention that this is in the New England Journal of Medicine. Would this also suggest to you that maybe this variant is less susceptible to the machinations of Paxlovid?

Rick: That's certainly a possibility, because we know that the antibodies that we administered with the very early variants haven't been subsequently beneficial with the most recent ones. When we talk about Paxlovid in the treatment of individuals, we have not noticed a difference with variants. I'm not sure that explains it. Again, I think one of the major reasons is, so many people have been exposed or have been vaccinated that their risk of developing COVID after being exposed is relatively low and we can't get any lower with Paxlovid.

Elizabeth: Let's turn from here to The Lancet. This is sort of a corollary and maybe it could help as far as COVID is concerned. In fact, some of their populations did get COVID. It's nasal sprays and behavioral interventions compared with usual care for acute respiratory illness in a big primary care setting. This was in the U.K.

This randomized, controlled, open-label parallel-group trial of 332 general practitioner practices, and they enrolled adults who were older than 18 years of age with at least one comorbidity or risk factor that would increase their risk of adverse outcomes due to respiratory disease.

These folks were randomized 1:1:1:1, and they were either given 1) a gel-based spray of this material called carrageenan. This was 2 sprays per nostril at the first sight of an infection or after potential exposure up to 6 times a day; 2) saline spray, same behavior; or 3) a brief behavioral intervention where they were given access to a website that would promote physical activity and stress management. This is based on previous information from studies that suggested that those might reduce one's severity of upper respiratory infections; then 4) usual care. There were just shy of 12,000 who had complete data.

Compared with the usual care group, who had a mean of 8.2 days of illness, the folks in both the gel-based and the saline group had 6.5 days of illness. I would take that reduction, no problem. Then as far as the behavioral website, 7.4 days, so slightly less. That was kind of protective, rather than treating what was going on. That's their speculation. Then they did say that their most common adverse event was headache or sinus pain in the gel-based group.

The other thing that happened that was really great in this study was that everybody who participated in any intervention used fewer antibiotics. This sounds like this is a pretty quick and easy way to try to reduce symptomatology to make people feel better, and reduce antibiotic use when it comes to URIs.

Rick: Elizabeth, this was a really well-done study where they used a really low cost -- I mean, we're talking about saline -- nasal spray that's easy to administer and effective. If you have upper respiratory tract symptoms -- by the way, almost all of us have a cold every year -- it reduced the duration of the symptoms by 3 days. It reduced antibiotic use by 25% and I think it ought to modify how we treat individuals. It's one of those common reasons people visit their general practitioner, and they won't leave unless they get an antibiotic prescription. We know that contributes to antibiotic resistance. I think this is a really well-done study.

Elizabeth: I will say two other things about it. Their speculation, of course, is that what happens with the stuff in the nose, whether that's the carrageenan-based or the saline-based nasal spray, is that it mechanically removes the virus rather than allowing it to adhere and then do all of its stuff after that. They also note that this advice to use a physical activity and stress management website resulted in a modest reduction in the incidence of disease. Their speculation, of course, is that stress reduction relative to increased physical activity makes us less susceptible. That clearly is something I would like to see followed up and studied in a more robust way.

Rick: Yep. No, there are clear advantages to obviously keep your immune state healthy.

Elizabeth: Let's move on, then, back to COVID, and that's in JAMA.

Rick: We have previously reported that the incidence of type 1 diabetes seemed to increase during the COVID pandemic. Type 1 diabetes is an autoimmune disease. Something has triggered an immune response that attacks the pancreas. It's no longer able to secrete insulin, so we have to administer it. Based upon that information, what these investigators wanted to know is, if we have kids and they have presymptomatic type 1 diabetes, does COVID infection accelerate that where they will develop clinical diabetes over the next 3 to 6 months?

There were 509 kids, the average age was 4 years old, but it included individuals that were 1 to 6 years of age. What they were able to determine was that from February of 2015 to 2020 is that the incidence per 100 person-years of developing type 1 diabetes was about 6.4 for every 100 person-years. For those who developed COVID infection, that rate doubled.

This viral infection with the COVID virus somehow stimulates an immune response that attacks the pancreas and accelerates the progression to type 1 diabetes. When kids get a viral infection and their body attacks that, they also develop antibodies to their own pancreas. The fact that this occurs with COVID shouldn't be terribly surprising, but it's not really been proven in a way until this particular study was done.

Elizabeth: One of the things I have a question about is, what in the world is prediabetes and how do you identify that?

Rick: These were kids that had had blood tests that showed that they had autoantibodies to their pancreas.

Elizabeth: Why would you look for that?

Rick: This particular study was done in Germany. It was part of a screening program, Elizabeth, so we wouldn't typically do that, for example, in the routine clinical setting.

Elizabeth: What would you say are the practical implications of this observation?

Rick: We certainly need to be aware of this so that in kids that develop this or other viral infections, we certainly should be aware that they could develop diabetes. The other question you have to ask, is the same thing true in adults? The other implication is, do vaccines help prevent this? We can use this as a launching pad to see whether vaccines help prevent this and also to identify this condition in adults.

Elizabeth: Remaining in JAMA, let's turn to a study about endometriosis typology and ovarian cancer risk. I think that this whole picture of ovarian cancer has really been changing a whole lot. Most of the folks I talked to are saying that, gosh, in fact, it's not ovarian cancer at all. It's fallopian tube cancer that ultimately migrates its way to the ovaries and that in women who are at risk, or who have risk factors like BRCA1 or 2 mutations, prophylaxis and removing the fallopian tubes might be a good idea.

This study was informative to me in a lot of ways, this notion that endometriosis has a bunch of types and also that ovarian cancer does too. This is using data from the Utah Population Database (UPDB). They matched almost 79,000 women with endometriosis in a 1:5 ratio to women without endometriosis.

Their mean age at first diagnosis of endometriosis was 36 years. They had 597 women who developed ovarian cancer. It was higher in those women with endometriosis compared to those without, almost 4 times higher. Their risk of what is called type 1 ovarian cancer was especially high, 7 times higher.

The ovarian cancer risk is highest in women with two types of endometriosis: what's called deep infiltrating and/or ovarian endometriomas. For all ovarian cancers, we really need to carefully assess types of endometriosis and then subsequently potentially counsel women who have it that their index of suspicion with regard to developing ovarian cancer is also way higher.

Rick: Women that have endometriosis -- and about a third of them may -- it's associated with an increased risk of ovarian cancer. You said type 1 and type 2. The type 1 is generally slow-growing, less likely to spread, and more responsive to estrogen. The type 2 is faster-growing and it doesn't respond to estrogen. If they have the same origin, then the endometriosis may give us some insight into ovarian cancer, either prevention or treatment.

Ultimately, we would like to be able to screen for it. We know that if you just screen the general population, you don't do a very good job of identifying ovarian cancer early enough to treat it. But maybe if we take these high-risk individuals, maybe they are the ones that the cancer screening should be offered to and maybe it will be effective in that circumstance. For those reasons, I think this is a study that requires further follow-up.

Elizabeth: No question about that. I think that there are a couple of things that are noteworthy. This notion that endometriosis, which is often associated with cramping and really painful menses, could be, I'm going to call it, almost a masking against some of the early symptoms of ovarian cancer, which, as we know, are extremely nonspecific. I am wondering if women become accustomed to that feeling during their menstrual cycle if that's something that causes them to not be that tuned in to some changes that might predict ovarian cancer.

Then the other thing is that this idea that it really arises in the fallopian tubes has a lot of traction, and removing the fallopian tubes is fairly benign if you're finished with childbearing, and sounds like it could be something that would be a useful strategy.

Rick: If in fact the ovarian endometriosis is a risk factor for ovarian cancer, then maybe just removing the fallopian tube alone may not prevent that. The ovaries may have to be addressed as well.

Elizabeth: On that note then, that's a look at this week's medical headlines from Texas Tech. I'm Elizabeth Tracey.

Rick: And I'm Rick Lange. Y'all listen up and make healthy choices.

See the original post here:

Nasal Sprays for Respiratory Infections; Paxlovid in COVID Prevention - Medpage Today

Hawaii is among 21 states with very high levels of the COVID-19 virus in local sewage, according to the latest figures from the Centers for Disease Control and Prevention.

Other western states that show very high levels of COVID-19 include Alaska, California, Oregon, Washington, Idaho, New Mexico, Texas, Utah, and Wyoming.

As of July 17, Hawaiis COVID-19 weekly count was at 937 cases. The 7-day daily average of cases came out to 135 cases.

The CDC says that the national COVID levels in wastewater have been heightened for the second week in a row.

The FliRT subvariant is the most recent strain to hit the country, and the CDC says the latest findings show that it makes up about 80% of the cases nationally.

The Wastewater Viral Activity Levels are categorized into minimal, low, moderate, high or very high as follows:

For more information on COVID-19 and wastewater, click here.

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CDC finds 'very high' levels of COVID-19 in Hawaii's sewage - Hawaiipublicradio