Category: Covid-19

When the virus that causes COVID-19 enters the body, it hijacks cellular proteins and suppresses the human inflammatory response, allowing the virus to spread. University of Florida researchers have discovered a novel way in the lab to fight rapidly evolving strains of coronaviruses by breaking that cycle.

The group created a molecular decoy that blocks two proteins coronaviruses use to evade a normal immune system response. Blocking these proteins prevents the virus from taking hold within human cells, the researchers found. During early tests, short chains of amino acids, known as peptides, inhibited the replication and release of two coronaviruses including SARS-CoV-2. The findings werepublished recently in the journal Frontiers in Immunology.

The UF teams compounds dont attack coronaviruses directly, said Alfred S. Lewin, Ph.D., a professor ofmolecular genetics and microbiology in the UF College of Medicine.

These peptides have the potential to allow our immune system to fight off the virus more effectively, Lewin said.

To establish their findings, the researchers focused on two coronaviruses. One is a seasonal virus that causes upper-respiratory infections like the common cold. Researchers at UF and elsewhere already knew that people with antibodies to it were less likely to develop serious COVID-19 infections.

That potential benefit intrigued Chulbul M. Ahmed, Ph.D., a research assistant professor of molecular genetics and microbiology. Their team developed a peptide known as pJAK2. During testing on human cells, the compound significantly reduced the viruses concentrations and ability to replicate. In SARS-CoV2, the peptide reduced the viruss replication more than tenfold, the researchers found. The cell-penetrating peptides work by acting as a decoy and suppressing two proteins that would otherwise allow invading viruses to thrive.

When the peptide was combined with a second virus-inhibiting protein, viral activity was inhibited even further than with either peptide treatment alone.

A future COVID-19 therapy based on pJAK2 intrigues the researchers for several reasons. It can be synthesized easily and in large quantities at a reasonable cost, Ahmed said. And it has natural origins as a cell-penetrating form of 13 amino acids already found in humans.

The case to be made here is that were not dealing with a foreign substance. Its something that the human body already produces in some form, Ahmed said.

The researchers believe pJAK2 would be most useful as an early-stage therapy that fights the SARS-CoV-2 virus by stimulating an immune response. Several antiviral drugs to treat COVID-19 in its early stages are already on the market, including the well-known remdesivir.

This would be a potentially useful treatment for someone with an early or intermediate-stage infection but certainly not for someone who already has a serious inflammatory response to the virus, Lewin said.

The discovery may also prove to be a preventive treatment for COVID-19, Ahmed said. Testing on the influenza virus revealed both therapeutic and preventive qualities. Ahmed said its reasonable to believe those same characteristics could apply to SARS-CoV-2 and its variants as well as other viruses that lead to herpes, Ebola, the flu and monkeypox.

For influenza, we have shown that it acts both as a prophylactic as well as a therapeutic compound. So this could potentially be given to uninfected family members and primary contacts of the affected individuals to protect them from getting a more serious form of SARS-CoV-2, Ahmed said.

Next, the researchers want to fully test their findings in primary human lung cells before moving to experiments in mouse models and eventually human clinical trials.

Research collaborators included Tristan R. Grams, Ph.D., a Ph.D. candidate in biomedical sciences; David C. Bloom, Ph.D., a professor and chair of the College of Medicines department of molecular genetics and microbiology; and Howard M. Johnson, Ph.D., an emeritus faculty member of the UF department of microbiology and cell science. Research funding was provided by the Shaler Richardson Professorship endowment, Research to Prevent Blindness and multiple National Institutes of Health grants.

Doug Bennett July 13, 2022

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UF researchers discover new way to inhibit virus that causes COVID-19 - University of Florida

The COVID-19 pandemic and Russias war in Ukraine have changed how the EU thinks about the future of its relations with China with significant potential for shifts in policy towards Taiwan.

The latest (virtual) EU-China summit on April 1, in which European leaders wanted to focus on the war in Ukraine, was an astonishing demonstration of the current situation. There was no dialogue, and no new or constructive offers from Beijing were on the table. Each party presented their positions with limited resonance on the other side of the screen. Just weeks later, European allies also acknowledged that Chinas stated ambitions and coercive policies posed a challenge to trans-Atlantic interests and security in NATOs new Strategic Concept.

Relations between Europe and China had been slowly deteriorating for years due to a variety of reasons, ranging from Beijings economic policies including its market distorting practices, industrial policies, and the global investment push challenging European competitiveness to President Xi Jinpings authoritarian advance in Hong Kong and massive human rights violations in Xinjiang.

But previously, the Chinese leadership had either been neutral or even supportive whenever Europe faced a crisis: With Russias 2008 war against Georgia and the annexation of Crimea in 2014, Beijing stayed on the sidelines. During the global financial crisis in 2008 and the subsequent European sovereign debt crisis, Beijing acted as a stabilizer for international markets and even as a supporter of troubled European economies.

This was the version of crisis mode China that Europeans grew accustomed to. And thus, despite growing problems in the bilateral relationship, Beijings assertiveness at home and abroad during the pandemic from zero-COVID to mask diplomacy took Europeans by surprise.

This alone, however, would likely not have been enough to instigate a fundamental reassessment of Chinas priorities. Despite the February 4 joint Sino-Russian declaration, in the early days of the war in Ukraine many EU member states assumed that Beijing would play a constructive role and would have every interest to do everything in its might to stop the bloodshed quickly. The idea that the Chinese leadership would place political over economic considerations still seemed alien to many European policymakers.

After the first few weeks of the war had passed and China showed no sign of changing its rhetoric, doubling down on the narrative that Russia was defending itself against NATOs aggressive expansionism, and amplifying Moscows disinformation in the Global South, it became clear that China was not going to come to Europes assistance. It was also not going to stop Russian President Vladimir Putins aggression, or even stop propping up his regime. Beijings diplomatic support and significantly growing imports are strengthening Putins financial ability to continue his fight.

The European Union is Taiwans largest foreign investor. More than 25% of the islands foreign direct investments came from EU countries in 2020 and 15 of 27 EU member states have representative offices in Taipei. The volume of bilateral trade has risen to more than 68 billion dollars in 2021. While this is much less trade than with China, pandemic-induced supply chain disruptions, as well as global semiconductor shortages, have underscored the need for greater resilience and for like-minded, reliable partners.

Europes position on Taiwan has shifted during the pandemic. Taiwans COVID-19 response was not only remarkable in its effectiveness, but in its support for Europe, including the delivery of protective equipment. This starkly contrasted to Beijings divisive agenda, with its openly hostile rhetoric trying to underscore the inability of democratic governments to handle the pandemic.

The realization of Taiwans central role in semiconductor supplies, coupled with acknowledging the heightened geopolitical tensions and weaponization of trade, have made European governments care more about developments in the Taiwan Strait. Policymakers were starting to take Chinas constant incursions into Taiwans Air Defense and Identification Zone and massive military build-up more seriously, even before Russias invasion of Ukraine.

The European Parliaments October 2021 recommendation to the EU Commissions High Representative for Foreign Affairs and Security Policy on relations with Taiwan demonstrates this: It stated not only that Taiwan and the EU are like-minded partners that share common values, but also lauded Taipeis efforts during the pandemic as a tangible example of Taiwan behaving as a partner, and proof that it should be treated as such. Barely a month later, the first European Parliament delegation visited Taipei.

It was not only the parliament that was becoming more vocal. Commissioner Margrethe Vestager, who is at the forefront of managing the challenges that Chinas market distorting practices pose to European industry, stated that Chinas actions and increasingly aggressive behavior in the Taiwan Strait may have a direct impact on European security and prosperity.

One EU member state decided to take even bolder action. In November last year, Lithuania decided to open a representative office under the name of Taiwan (and not Taipei, the usual form used across Europe for Taiwans quasi-embassies). The result was a massive fallout between Vilnius and Beijing that not only led to a diplomatic relations freeze, but also the virtual halt of economic activity between the two countries. It quickly embroiled the entire EU as Beijing wielded the full force of its market against all those European (and U.S.) companies who have Lithuanian products in their supply chain or produce in the Baltic state for export to China.

EU member states were initially reluctant to support Lithuania, but Beijings attempt to coerce international companies into changing their supply chains was seen as an attack on the European single market. This elicited a strong response, which included speeding up the suggestion to member states to create an anti-coercion instrument to defend Europe against Beijings weaponization of trade relations. But while Taiwan pledged support to the Lithuanian economy, the damage to Lithuania as an investment destination was real. Early in 2022, domestic support in Lithuania for the governments more forward-leaning and values-driven approach was coming under heavy scrutiny at home. Then Russia invaded Ukraine.

The bold move by Vilnius now looks much more strategic. Lithuania had long warned other EU members about Russias intentions and was clear that its position vis--vis China and Taiwan was coming from the same principled approach, even if it pushed other Europeans out of their comfort zone. The connection between Ukraine and what might happen in East Asia was even more immediately drawn something Europe has often resisted entertaining as a real possibility in its policy planning.

Taiwan is not Ukraine. Europes reaction to any potential Taiwan contingency would depend on the circumstances. Unilateral action by Beijing to change the status quo and military aggression would draw a strong reaction: The arsenal of economic sanctions currently on display vis--vis Russia could be aimed at China, but Beijing would likely try to make the decision less clear-cut, potentially framing its own actions as a response to a provocation or accident.

The trend toward enhancing EU-Taiwan relations below the level of challenging the One China policy encourages Europeans to be engaged in case of conflict. This would increase the deterrent effect of any trans-Atlantic response and raise the cost for China to violently change the status quo.

The most active political player will likely remain the European Parliament. The parliament even suggested that the EU should consider [changing] the name of the European Economic and Trade Office in Taiwan to European Union Office in Taiwan in order to reflect the broad scope of ties.

But the European Commission has also already enhanced its approach: After the invasion of Ukraine, the regular trade dialogue with Taipei was held in an upgraded form in early June 2022. Europe is keen for Taiwans help with its semiconductor crunch and wants to attract Taiwans leading companies to set up shop within the EU. Taiwans willingness to support the Western sanctions package vis--vis Russia has further boosted trust. An EU-Taiwan bilateral investment agreement, which Taiwan has proposed, still remains a more distant option.

Germany is the European country most dependent economically upon China. Putting Taiwan on the map in Berlin is the single most important factor to swing Europes position sustainably. Germanys still relatively new Social Democrat-Green-Liberal government is currently devising its new China strategy, and its position vis--vis Taiwan will be one of the most interesting and hotly debated aspects.

Berlin is not likely to be as bold as Vilnius, but it too has changed its tone. For the first time, the German governments coalition treaty is explicit about the need to maintain the status quo in the Taiwan Strait and support Taiwans participation in international organizations. A document of this kind would usually reference China only as a business opportunity and never even mention Taiwan. Germany could budge the needle and put political weight behind Europes enhanced engagement. For Taipei this means that beyond Washington and Brussels, Berlin needs to be the focus of diplomatic attention.

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How COVID-19 and the war in Ukraine could change EU-Taiwan relations - Brookings Institution

Leon County, along with most of the state of Florida, is listed by the CDC as high risk for COVID-19. But Tallahassee Memorial Healthcare Vice President and Chief Integration Officer, Doctor Dean Watson, says thats not a complete picture.

Data collected by the Centers for Disease Control and Prevention includes people in the hospital who test positive for the coronavirus, but who might be asymptomatic or who are there for another reason.

When we look at it we say, hmmm, our level may not be as high as it is indicated in the CDCs numbers, because we may not have as many infected people in the hospital so maybe we would fall more to the medium level," Watson says.

More than 80 percent of the patients at TMH who have tested positive for COVID are there for reasons not related to the coronavirus.

In general, while the current variants of the virus are spreading easily, the symptoms for most people are less severe. Watson says right now the current COVID variants are acting like a mild virus, much like the flu, but that could change.

You know, as this virus mutates it just happens that it has mutated to the point where it is more of a nuisance than a threat. We hope that it continues to mutate to the point where it acts like a mild infectious virus. But you never know, these viruses mutate rapidly. The next one could be more aggressive. We monitor that on a daily basis." Watson says.

Watson says vulnerable people with preexisting conditions or compromised immune systems can still get very sick or even die from the current COVID variants. He encourages everyone to consider the impact they could have on those around them and says anyone who has been exposed to the virus or who has symptoms should stay home. If staying home is not possible, he says people who are sick should wear an N95 or KN95 masks.

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COVID-19 is spreading in Tallahassee, but most cases are not severe - WFSU

By now, you may knowor besomeone who has had COVID-19 two, three, or even four times. Omicron and its subvariants, which are highly contagious and contain mutations that may allow them to evade the bodys vaccine- and infection-acquired immune defenses, have made reinfections an unfortunate but common part of life.

Experts warn that BA.5, which currently accounts for the majority of cases in the U.S., may be particularly likely to cause reinfections, even among people who have had the virus relatively recently. Scientists have similar concerns about BA.2.75, another transmissible Omicron subvariant that is spreading quickly in some parts of the world, including India, but does not yet make up a significant percentage of new cases in the U.S.

How much should reinfections worry you? Heres what we know so far.

If your body has had practice dealing with the SARS-CoV-2 virus, it should perform better the next time around, ideally keeping your second illness milder.

The body mounts an immune response after either having COVID-19 or getting vaccinated against it. These defenses significantly reduce your chances of experiencing severe disease or dying if you get infected again, says Dr. Jeffrey Cohen, chief of the laboratory of infectious diseases at the National Institute of Allergy and Infectious Diseases. (People who are immunocompromised may not mount a robust immune response, leaving them susceptible to serious outcomes even after a prior exposure or vaccination.)

But getting infected is not a guarantee that you wont get sick again in the future, especially with BA.5 and other Omicron relatives circulating globally.

Triple-vaccinated, previously infected health care workers gained almost no immune benefits (as measured by antibodies, T cells, and other immune responses) after being reinfected by Omicron, according to a study published in the journal Science in June. In other words, their immunity didnt exceed what they had already generated from vaccines and prior infections. People whod been fully vaccinated but never infected did get a bit of a boost.

Another study, published in Nature in May, found that unvaccinated people gained little lasting protection after being infected by Omicron.

Getting an Omicron infection is not a good way of boosting your immune response, says Rosemary Boyton, co-author of the Science study and a professor of immunology and respiratory medicine at Imperial College London. Her study showed that infections during the first Omicron wave are not necessarily protecting you against BA.4 and BA.5 and the subsequent strains. That may be why were seeing people getting frequent breakthrough infections and reinfections.

If reinfections are likely to be mild, is it such a big deal to get sick again? It can be. A study posted online in June as a preprint (meaning it had not yet been peer-reviewed) found that reinfection adds non-trivial risks of death, hospitalization, and post-COVID health conditions, on top of those accumulated from an initial SARS-CoV-2 infection. Organ failure, heart disease, neurologic conditions, diabetes, and more have been linked to SARS-CoV-2 infections.

Study co-author Dr. Ziyad Al-Aly, an assistant professor at the Washington University School of Medicine in St. Louis, says the paper has been misinterpreted a bit; some have incorrectly assumed it means second infections are worse than primary ones. What the paper actually shows, Al-Aly says, is that additional infections come with additional risks. They may be smaller than those of a first infection, but they can pile up over time. If your risk was X, after a first infection, after the second one its X plus Y, he explains.

Even if a reinfection doesnt make you very sick right away, it could increase your chances of developing chronic post-COVID health issues, the paper suggests.

Second infections are less likely [than first infections] to be severe, Cohen says. But there can be damage even from that second infection.

Long COVID is one of the most feared risks of infection, and it can happen even to fully vaccinated people who have mild cases of COVID-19. The latest federal data suggest about one in five adults who catch COVID-19 will develop Long COVID symptoms, which can include fatigue, cognitive dysfunction, chronic pain, and more.

Cohen says its not clear yet whether someone is more or less likely to develop Long COVID after a second infection compared to their first, but there have been documented cases of people developing long-haul symptoms after a reinfection. It certainly is possible, Cohen says, but theres not yet enough data to say how common that outcome is.

Youre almost rolling the dice again, Al-Aly says. You may have been one of the lucky ones initiallybut it doesnt really mean thats going to happen every time.

Catching COVID-19 is always something to avoid as much as possible, using strategies like staying up-to-date on vaccinations, wearing a high-quality, well-fitting mask indoors, improving indoor ventilation, and asking everyone to take a rapid test before group gatherings.

But realistically, without comprehensive public-health strategies in place, and with variants like BA.5 causing new waves of disease, avoiding COVID-19 in the Omicron era is difficult for an individual to do without living in a bubble, Al-Aly says.

Cohen says that reality underscores the importance of developing new tools, such as multi-strain vaccines that could protect against both current and future variants. Some experts are also excited by the possibility of nasal vaccines, which could hopefully slow transmission by building immune reservoirs where the virus typically enters the body. Both products are currently in development, but not yet ready for public distribution.

Reducing the number of reinfections is necessary not only for individuals health but also for public health, Boyton says. Medically vulnerable and immunocompromised people wont be safe as long as the virus is spreading widely, and everyone is at risk if it continues to mutate as it repeatedly infects large chunks of the population. There is a danger that if you allow a virus to circulate in a vaccinated population at high transmission levels, she says, that it can then further mutate into something that is more pathogenic.

In Boytons opinion, the benefits of reducing transmission are great enough to justify continuing public-health measures like masking on public transportation. Policymakers and individuals, she says, should be motivated to slow the virus spread as much as possible.

Its not a trivial illness to catch, even if you dont get hospitalized or die, she says.

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Write to Jamie Ducharme at jamie.ducharme@time.com.

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COVID-19 Reinfections Are CommonAnd They Aren't Harmless - TIME

This is the weekly edition of CNNs coronavirus newsletter. Look out for your roundup every Wednesday. If you havent subscribed yet, sign up here.

CNN

Nearly two-and-a-half years since the coronavirus pandemic began, the most infectious and transmissible variant yet has arrived.

Repeated Covid-19 waves have left millions of people dead, with only vaccines helping to blunt the toll. Now the virus is spreading again evolving, escaping immunity and driving an uptick in cases and hospitalizations. The latest version of its shape-shifting, BA.5, is a clear sign that the pandemic is far from over.

The newest offshoot of Omicron, along with a closely related variant, BA.4, are fueling a global surge in cases 30% over the past fortnight, according to the World Health Organization (WHO).

In Europe, the Omicron subvariants are powering a spike in cases of about 25%, though Dr. Michael Ryan, the executive director of WHOs Health Emergencies Program, has said that number may actually be higher, given the almost collapse in testing. BA.5 is on the march in China, ratcheting anxieties that major cities there may soon re-enforce strict lockdown measures that were only recently lifted. And the same variant has become the dominant strain in the United States, where it accounted for 65% of new infections last week, according to the Centers for Disease Control and Prevention (CDC).

We have been watching this virus evolve rapidly. Weve been planning and preparing for this moment. And the message that I want to get across to the American people is this: BA.5 is something were closely monitoring, and most importantly, we know how to manage it, said Dr. Ashish Jha, the White Houses Covid-19 response coordinator, in a news briefing on Tuesday.

On the same day, WHOs Emergency Committee said Covid-19 remained a Public Health Emergency of International Concern its highest level of alert, first declared on January 20, 2020 amid rising cases, ongoing viral mutation and increasing pressure on already overstretched health systems. In a statement, the committee, which is made up of independent experts, highlighted challenges to the ongoing global Covid-19 response, including a drop-off in testing and spotty genome sequencing, raising the question of just how accurately any nation might reasonably be able to monitor BA.5.

Official data dramatically undercount the true number of infections in the US, epidemiologists say, leaving the nation with a critical blind spot as the most transmissible coronavirus variant yet takes hold. Some experts think there could be as many as 1 million new infections every day in the broader US population 10 times higher than the official count.

As for how to manage the new wave, Jha urged Americans aged 50 and older to get second booster shots. Adults who are up to date with vaccinations are less likely to be hospitalized than those who are unvaccinated. But only about one in four adults in the US over 50 have gotten their recommended second boosters, data collected by the CDC show.

US health officials are urgently working on a plan to allow second Covid-19 boosters for all adults, a senior White House official confirmed to CNN on Monday, amid fears that younger adults immunity may be waning as Covid-19 cases rise with the dominance of BA.5.

What makes BA.5 different? Eric Topol, a cardiologist and professor of molecular medicine at Scripps Research, has called BA.5 the worst version of the virus weve seen. He explained in a recent newsletter: It takes immune escape, already extensive, to the next level, and, as a function of that, enhanced transmissibility, well beyond earlier versions of Omicron.

In other words, BA.5 can easily evade immunity from previous infections and vaccines, increasing the risk of reinfection. Though the variant does not appear to lead to more severe illness, in an interview with CNN on Monday, Topol said that given the extent of BA.5s immune evasion, he expects to see an escalation in hospitalizations, as weve seen in Europe and elsewhere that the variant has taken root. One good thing is it doesnt appear to be accompanied by the ICU admissions and the deaths as previous variants, but this is definitely concerning, he added.

Public health experts in the US may take some solace from the trajectory of the variant in Europe. WHOs Ryan said last week that while many European countries are experiencing a jump in hospitalizations, what were not seeing is an increase in intensive care unit admissions, so the vaccines are very much still working and it is those gaps in immunity that are causing the problem.

But still, steep reductions in Covid-19 surveillance worldwide are hindering epidemiologists efforts as they race to trace the virus evolution.

Sub-variants of Omicron, like BA.4 and BA.5, continue to drive waves of cases, hospitalization and death around the world, WHO Director-General Tedros Adhanom Ghebreyesus said in a media briefing on Tuesday. Surveillance has reduced significantly including testing and sequencing making it increasingly difficult to assess the impact of variants on transmission, disease characteristics, and the effectiveness of counter-measures.

New waves of the virus demonstrate again that the Covid-19 [pandemic] is nowhere near over, he added.

Q: How should I protect myself amid the new Covid-19 wave?

A: At this point in the pandemic, many people may not want to plan their lives around Covid-19 anymore especially if theyre generally healthy. On the other hand, those with underlying health conditions or who have concerns about long-haul symptoms are still trying to play it safe. Given just how contagious the new Omicron subvariants are, avoiding infection does require some planning and consideration, CNN Medical Analyst Dr. Leana Wen explains.

I dont think that most people should have to change their daily activities, but I do think people need to be aware of their risk of contracting Covid-19 if they dont take additional precautions, Wen said. The question to ask yourself, she added, is this: How much do I want to continue to avoid infection?

For individuals who want to reduce their risk, Wen advises that they stay up to date with their boosters (in the US, everyone age 5 and older can receive a first booster, and those 50 and older can receive a second booster for a total of four shots). She also recommends wearing a high-quality N95 mask or equivalent in indoor, crowded settings, and staying outside for large gatherings as much as possible something easier to do in the summertime.

For those who find masks uncomfortable, Id encourage mask-wearing in the highest-risk settings for example, mask while in a crowded security line at the airport and during boarding and deplaning, she said.

Send your questions here. Are you a health care worker fighting Covid-19? Message us on WhatsApp about the challenges youre facing: +1 347-322-0415.

First Covid vaccine mandate enforced in mainland China

Beijing last week announced a Covid-19 vaccine mandate for residents wanting to enter public venues, becoming the first city in mainland China to do so as it attempts to contain the spread of BA.5, Nectar Gan writes. Those who are not suitable for vaccination will be exempt from the requirement, a city official said, without clarifying how they can provide the proof needed for exemption.

The vaccine mandate comes as Beijing reported three cases of the highly contagious Omicron subvariant. Several Chinese cities have imposed new curbs after detecting BA.5. Shanghai, which only recently emerged from a two-month lockdown, identified its first case on Friday and will perform two rounds of Covid tests this week. An outbreak of BA.5 has already shut down the northwestern city of Xian, home to 13 million people, where entertainment, sports and religious venues have been closed, and restaurants limited to takeaway and delivery services.

Casinos in the gambling hub of Macao were ordered to shut for the first time since February 2020 because of a Covid outbreak, sending shares of their operating companies plunging, and fears of new lockdowns in Shanghai undermined the broader China market. Chinese stocks remained under pressure after Mondays sell-off fueled by the threat of new Covid restrictions, especially the tech sector, Laura He reports.

Drug-resistant infections and deaths have risen among hospital patients

The US had made significant progress in fighting drug-resistant infections in recent years. But those gains were largely erased during the Covid-19 pandemic, with hospital-acquired infections and resulting deaths rising 15% in 2020, according to new data, Deidre McPhillips reports.

A special report released Tuesday by the CDC found that more than 29,400 people died from antimicrobial-resistant infections in the first year of the pandemic nearly 40% of those deaths were among people who got the infection while in the hospital. The full number is probably even higher, given that data for half of the 18 pathogens identified as threats are unavailable or delayed.

WHO has called antimicrobial resistance a silent pandemic, and drug-resistant infections were linked to nearly 5 million deaths globally in 2019. The Covid-19 pandemic probably contributed to the increased risk in the US, particularly because many people delayed care or left infections untreated either because of closed clinics or fear of exposing themselves to Covid-19 which can increase the risk of developing drug resistance.

Pulse oximeters dont work as well for people of color

Often when Dr. Thomas Valley sees a new patient in the intensive care unit at Michigan Medicine in Ann Arbor, he clamps a pulse oximeter on their finger one of the many devices he uses to gauge their health and what course of care they require, whether they are a child having seizures, a teenage car accident victim or an older person with Covid-19.

But recently, Valley, an assistant professor in the University of Michigans Division of Pulmonary and Critical Care, realized that the small device may yield less accurate oxygen readings in patients with dark skin. If the device isnt calibrated correctly, the darker pigmentation can affect how the light is absorbed by the sensor, leading to flawed oxygen readings and patients being discharged when they shouldnt.

The findings of Valley and his colleagues add to a growing body of research dating back to the 1980s that suggests flawed pulse oximeter readings among Black and brown patients can be a real and life-threatening issue in medical care. But the public has only recently been made more aware of this health disparity, and US health officials have announced plans to investigate the accuracy of pulse oximeters, Jacqueline Howard reports.

Advice for anxious new moms

Edith Bracho-Sanchez, director of pediatric telemedicine and assistant professor of pediatrics at Columbia University Irving Medical Center, didnt think shed be an anxious mom. But that changed when she had her son. I stress over every decision I make for William. I make long pro and con lists, I discuss everything with my partner, sleep on things and ultimately, I pray, she wrote in a recent column for CNN.

Knowing how difficult it is to make decisions big and small she said she understood why some parents might struggle with the choice to vaccinate their children against Covid-19. This is why she says she did it, and her advice to anxious new moms like her:

Were always waiting for something, whether its in line for our morning coffee, on hold with customer service, or the next Covid-19 booster shot. How can we make it feel less excruciating? CNNs Chief Medical Correspondent, Dr. Sanjay Gupta, talks with waiting expert Professor Kate Sweeny to understand the science of waiting, why we evolved to hate it, and what we can do to deal with waits in our day-to-day lives. Listen here.

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The 'worst variant' is here - CNN

He reported that the Emergency Committee on COVID-19 last Friday concluded that the virus remains a Public Health Emergency of International Concern.

And while acknowledging that we are in a much better position than at the beginning of the pandemic, he reminded that new waves demonstrate the COVID-19 pandemic is nowhere near over.

Tedros outlined interlinked challenges presented now by the virus, beginning with sub-variants of Omicron, like BA.4 and BA.5, which continue to drive waves of cases, hospitalizations and deaths globally.

He observed that reduced surveillance, including testing and sequencing, has made it increasingly difficult to assess the impact of variants on transmission, disease characteristics, and the effectiveness of measures to counter the disease.

Tedros also pointed to diagnostics, treatments and vaccines that are not being deployed effectively.

The virus is running freely, and countries are not effectively managing the disease burden based on their capacity, in terms of both hospitalization for acute cases and the expanding number of people with post COVID-19 condition, often referred to as long-COVID, he said.

He highlighted adisconnect inCOVID-19riskperception between scientific communities, political leaders and the general public, describing it as a dual challenge of communicating risk and building community trust in health tools and public health social measureslike masking, distancing and ventilation.

The WHO chief argued that we should not take for granted tools that have prevented infections, hospitalizations and deaths and must continue to employ masking, improved ventilation and testing and treatment protocols.

He underscored the importance during next weeks G-20 finance ministers meeting, of governments financing WHO and the vaccine equity mechanism, the ACT-Accelerator; reviewing and adjusting COVID-19response plans based on current epidemiology; reversing the reduction in surveillance and testing; and effectively share anti-virals.

Planning and tackling COVID-19 should also go hand-in-hand with vaccinating for killer diseases like measles, pneumonia and diarrhoea, Tedros underscored. Its not a question of either/or, its possible to do both.

Turning to monkeypox, the WHO chief told journalists in Geneva that there are currently 9,200 cases throughout 63 countries,

Next week the Emergency Committee for the disease will reconvene to examine trends, the success so far of countermeasures and next steps tackling the outbreak.

In the meantime, WHO continues to battle the stigma around the virus, coordinate vaccine sharing, and drive forward research and development.

I again stress that we must work to stop onward transmission and advise governments to implement contact tracing to help track and stem the virus as well as to assist people in isolation, Tedros highlighted.

Genomics the study of a person's complete set of DNA or genome have been essential throughout the COVID-19 pandemic in both initially detecting the virus and later, new variants, according to the UN health agency chief.

He highlighted the work of the WHO Science Council, which he set up a year ago. Its purpose is to provide advice on advances in science and technology that impact health and is integral to the development of tests, treatments and vaccines.

Citing WHOs ten-year global genomic surveillance strategy, Tedros said that it covers disease detection, develops tests, and shares data for new health tools to be developed and deployed.

Further, genomics has massive potential beyond pathogen surveillance, for human health, he continued, urging countries to invest in scaling up genomic sequencing and bio-analysts training.

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As virus spreads 'freely' COVID-19 'nowhere near over': Tedros - UN News

As the Omicron variant continues to mutate and cause unprecedented rates of infection in children, it is critical to understand their long-term immunity after contracting COVID-19. In adults, it is known that COVID-19 antibodies may persist as long as 12 months after infection. One JAMA study compared COVID-19 immune response in children versus adults.

The single-center, prospective cohort study enrolled 252 COVID-19 family clusters from April 1, 2020-August 31, 2021. Included families were 4 or more weeks after infection, had children younger than 15 years, and at least 1 family member with a history of COVID-19. As this study was analyzing only natural immunity, vaccinated families were excluded.

The investigators collected blood samples from all patients, analyze the immunologic response to COVID-19 with quantified antispike receptor-binding domain (S-RBD) IgG using chemiluminescent immunoassay. All patients with positive COVID-19 serologic tests at their enrollment were followed up for longitudinal clinical and serological evaluation. Demographic characteristics, medical history, and vaccination status data were also collected.

Families were identified via the University Hospital of Paduas COVID-19 Family Cluster Follow-Up Clinic, and underwent serologic screenings at 1-4 months, 5-10 months, and 10-18 months after infection. Follow-up was halted if patients received any COVID-19 vaccine of had negative serologic test results. The data were anonymized and entered into a web-based database, using the Vanderbilt University Research Electronic Data Capture (REDCap) platform.

Of the 902 study participants (from 252 family clusters), 697 had a confirmed COVID-19 infection. This included 351 children, who averaged 8.6 years of age, and 346 parents, who averaged 42.5 years of age. A total of 96.7% (n = 674) of the COVID-19 infections were asymptomatic or mild.

The investigators found that anti-SARS-CoV-2 spike receptor-binding domain IgG persisted for 12 months after COVID-19 infection in all age groups. Notably, younger children had significantly higher antibody peaks at every follow-up point in time. Specifically, children younger than 3 years were found to develop levels of binding antibodies 5-fold higher than adults older than 18 years.

These results are significant for clinicians and for parents looking to best protect their children against COVID-19. mRNA COVID-19 vaccinations are now approved for children as young as 6 months of age, but in making this recommendation, the Vaccine and Related Biological Products Advisory Committee (VRBPAC) noted that the number of children experiencing severe or fatal infection is low. Thus, for the time being, prior infection may be sufficient protection for young children with natural immunity. The purpose of authorizing COVID-19 vaccines for children 6 months and older, VRBPAC said, is to ensure all parents can make the vaccination decisions that best fit their families.

Link:

After Mild Infection, Children Retain Long-Term COVID-19 Immunity - Contagionlive.com

COVID-19 was the third leading cause of death in Maine in 2021, trailing only cancer and heart disease, and it has had a range of secondary impacts on the health of Mainers, according to a new report released by health officials Wednesday.

The 2022 Maine Shared Community Health Needs Assessment, which includes detailed breakdowns for each county and for a variety of population groups, also highlights concerns about mental health, access to health care, a shortage of mental health providers and rising rates of substance use.

The assessment, conducted every three years, shows how the pandemic has impacted health systems and individuals, including historically disadvantaged populations, such as Black people, immigrants, people who identify as LGBTQ and people who are homeless.

While our quantitative data pre-dates the COVID-19 pandemic, the 2021 community health needs assessment outreach took place during the pandemic, and participants noted its impacts in deep and meaningful ways, the report states. It was impossible not to recognize the pandemics impacts on healthcare, health outcomes, behavioral health, and social support systems, especially for those who experience systemic disadvantages.

Over the last two years, COVID-19 has surpassed unintentional injury, chronic lower respiratory disease and strokes to become the third leading cause of death here. Only cancer and heart disease kill more Mainers.

COVID-19 also was the third leading cause of death in the United States between March 2020 and October 2021, according to an analysis of national death certificate data by researchers at the National Cancer Institute, part of the National Institutes of Health. As in Maine, heart disease was the number one cause of death, followed by cancer. Accidents and stroke were the fourth and fifth leading causes of death nationwide.

Mental health care was identified as a top priority by providers in all 16 Maine counties and through surveys at community-sponsored events that informed the report. A lack of access to mental health services and the increased stress caused by the pandemic among young people were areas of top concern.

The report notes widespread concern that the current health care workforce cannot meet mental health needs, which is increasing visits to emergency departments at hospitals.

Community members were concerned that the pandemic exacerbated mental health issues across the state, leading to increased isolation, trauma, and stress, the report states. Those with a mental health diagnosis noted extremely long waitlists for services, highlighting a need for more high-quality mental health services.

Drug and alcohol use, which can exacerbate other mental and physical health problems, was another top concern identified in the report. Maines rate of fatal overdoses in 2021 was nearly 75 percent higher than the national average, with 37.2 people per 100,000 residents in Maine experiencing a fatal overdose, compared to 21.5 per 100,000 nationally.

Participants also perceived an overall lack of preventive services and treatment options across the state, such as psychiatrists, counselors/social workers, and harm reduction and prevention outreach, the report states. However, there was an acknowledgment from participants that recent efforts to support individuals with substance use issues have been working and have had a real impact on their communities.

The Maine Shared Community Health Needs Assessment is a collaboration between the Maine Center for Disease Control and Prevention, Central Maine Healthcare, MaineGeneral Health, MaineHealth, and Northern Light Health.

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COVID-19 now the 3rd leading cause of death in Maine - Press Herald

Recently, debates surrounding COVID-19 vaccine boosters have been heating up. As the Omicron variant continues to dominate and mutate, the Food and Drug Administrations (FDAs) Vaccine and Related Biological Products Advisory Committee (VRBPAC) voted to recommend including an Omicron component in upcoming COVID-19 booster vaccines.

However, some experts, including the 2 of 21 VRBPAC members who voted against the recommendation, worry this sends a message that current COVID-19 boosters offer insufficient protection. A recent study, published in JAMA, examined the efficacy of current COVID-19 vaccine boosters against Omicron in a high-profile, highly vaccinated cohort: the National Basketball Association (NBA).

The investigators compared the incidence of COVID-19 infections in NBA players and staff who did receive a booster shot versus those who did not. Players and staff were included if they were tested for COVID-19 more than once from December 1, 2021-January 15, 2022. They were tested with a nucleic acid amplification test when symptomatic, after known exposure, or during daily enhanced surveillance testing implemented after multiple players on a team tested positive.

The NBA mandated COVID-19 vaccination for staff, but not for players. Staffers had to be fully vaccinated by October 1, 2021, and if eligible, had to receive a booster dose by January 5, 2022. Overall, NBA players and staff had similar masking recommendations, though players could unmask while on the court and head coaches could unmask during games.

The investigators performed genome sequencing for all confirmed infections to determine the COVID-19 variant, though some failed due to inadequate sample volume, viral load, or genome coverage. Full vaccination was defined as 2 doses of an approved 2-dse vaccination course (Pfizer-BioNTech or Moderna) or 1 dose of the 1-dose approved Johnson & Johnson vaccine. Vaccination status was considered as a time-varying exposure.

Using hazard ratios from an Andersen-Gill Cox proportional hazards model, the investigators compared time to infection between individuals who were fully vaccinated and those who were full vaccinated and boosted. Study outcomes included confirmed COVID-19 infections, symptomatic infections, hospitalizations, and deaths. COVID-19 infections were not included if they occurred after vaccination but before 14 days had elapsed. The models were adjusted for age and prior COVID-19 infection.

Of 2613 NBA players and staffers, 67% were followed through the entire 45-day study period, for a total of 10890 person-days contributed by fully vaccinated individuals and 74165 person-days from fully vaccinated and boosted individuals. The NBA cohort was 88% male and averaged 33.7 years of age.

Through the course of the study, the proportion of study participants fully vaccinated and eligible for a booster decreased from 26% (n= 682) to 8% (n = 205). The proportion of those fully boosted increased from 49% (n = 1282) to 85% (n = 2215). The rest of the NBA cohort were in other categories, such as vaccinated but not yet eligible for a booster, or within 14 days of their booster.

The fully vaccinated and boosted NBA players and staffers experienced 608 confirmed infections. They were overall significantly less likely to contract COVID-19 than the fully vaccinated individuals who had not been boosted despite eligibility, for a hazard ratio of 0.43. No hospitalizations nor deaths occurred in the NBA cohort. Notably, Omicron was the dominant variant during the study period, accounting for 93% of 339 sequenced COVID-19 infections.

This young, healthy, highly vaccinated NBA cohort was frequently monitored for COVID-19. The study showed that booster vaccinations significantly reduced COVID-19 infections during the Omicron wave. As this population was recently boosted, it may not adequately reflect waning vaccine efficacy over time. The investigators recommended further research to assess the need for additional COVID-19 booster doses.

See the rest here:

COVID-19 in the NBA: Omicron Infection by Booster Vaccination Status - Contagionlive.com

In 1999 two social psychologists, Dunning and Kruger, described the phenomenon of illusory superiority: a cognitive bias in which people who are unskilled, yet unaware of their lack of competence, have an inflated self-assessment of their own abilities and a lack of insight to recognise their incompetence. Dunning and Kruger also described a cognitive bias in which people who do excel and are highly expert tend to underestimate their knowledge and performance by overestimating these in others, and they fail to recognise their own exceptional abilities.12

It seems that this cognitive bias has played a part in the public narrative and debate around our pandemic response. The covid era has seen plenty of people with no relevant background or experience steaming confidently into the media arena and often arguing with professional experts about their specific disciplines and daily work, often seemingly unaware of just how much they dont know.

Im not talking here about legitimate and multifaceted debates about the evidence base around covid prevention, transmission, and management or public policy responses. Experts debating and contesting empirical evidence and hence the best policy approaches are not usually showing illusory superiority. However, some of the most confident debaters are often way outside the mainstream of expertise in the field theyre commenting on or seeking to influence, even if theyre scientifically literate and skilled in analysing (and sometimes very selectively presenting) data to bolster particular lines of argument.

For me, where the more genuine Dunning-Kruger effect has been most apparent has been on social mediaincluding dedicated sites, groups, or hashtagsusually dominated by people who oppose covid health protection measures. I worry that all of this exemplifies a wider societal breakdown of trust in experts and trained professionalsnot least those who are telling us things we dont want to hear and supporting public health measures in our lives that we dont want to see.

Combating the Dunning-Kruger effect requires a willingness to reflect, to challenge oneself or be challenged, to get objective feedback, and to improve our knowledge or skill and learn from people with more expertise. But I guess that, psychologically, that feels like a less safe space.

Meanwhile, perhaps those individuals who are highly competent and credible among their expert peers should go out of their way to communicate with the rest of us in plain language and accessible formats, to enhance our understanding and help avoid the normalisation of false belief systems that are over-confidently asserted by inexpert people.

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David Oliver: Covid-19 and the Dunning-Kruger effect - The BMJ