Coronavirus and Avian Flu Tidbits #307, Aug 11, 2024

Covid continues to increase.

Just plugged today's CDC numbers into my new forecasting model (releases Mon). My initial reaction was "Jesus Christ. That's bad. That's really really bad."

If you live in the West in particular, it's currently about as bad as last winter. About 1 in 23 infectious out West. pic.twitter.com/eJa1inG8md

— Mike Hoerger, PhD MSCR MBA (@michael_hoerger) August 10, 2024

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US positivity exceeds 40% at Walgreens, for only the second time since pandemic test records began at the store. https://walgreens.com/healthcare-solutions/covid-19-index

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@JP Weiland: 1,000,000 new infections/day

1 in every 33 people currently infected

74% higher than 12 month avg.

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Just plugged today's CDC numbers into my new forecasting model (releases Mon). My initial reaction was "Jesus Christ. That's bad. That's really really bad."

If you live in the West in particular, it's currently about as bad as last winter. About 1 in 23 infectious out West. pic.twitter.com/eJa1inG8md

— Mike Hoerger, PhD MSCR MBA (@michael_hoerger) August 10, 2024

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In Europe, percent positivity is above 20%, per WHO. They add, "Wastewater surveillance suggests that the circulation of SARS-CoV-2 is two to 20 times higher than what is currently being reported. Such high infection circulation rates in the northern hemisphere’s summer months are atypical for respiratory viruses, which tend to spread mostly in cold temperatures."

At least 40 Olympians have Covid--likely more. I predicted there would likely be an outbreak in a recent post. There is so much stupid behavior there, with people with known Covid not even masking, let alone isolating. And those athletes who felt they had to compete despite being ill face a much higher risk of long Covid.

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China - New XDV.1 variant

Faces New COVID-19 Surge with Recombinant Variant XDV.1 Recent reports from China reveal a concerning resurgence of COVID-19 driven by a new recombinant variant, XDV.1, which combines Delta and Omicron strains.

https://thailandmedical.news/news/breaking-parts-of-china-witnessing-a-covid-19-resurgence-driven-by-a-new-recombinant-delta-and-omicron-variant-xdv-1

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Nassau County Legislature passed the ‘Mask Transparency Act’ 

One pro-mask attendee was manhandled and arrested. The mood was very hostile and others were also harassed and traumatized, I'm told. It is now a misdemeanor for anyone 16 and older to wear a face mask in public in Nassau county. Private businesses can prohibit masks on their premises. While there are (in theory) medical and religious exemptions, those will be decided by the police. Police can fine people wearing a mask $1,000 and sentence them to jail time.

Video of the woman being dragged out here

Note: this is being driven by Democrats Gov. Kathy Hochul and Mayor Eric Adams, although Nassau county Dems didn't vote on the bill.

It’s important to be outspoken advocates for your health and rights. Email and write your legislators (e.g., https://covidadvocacyny.org/stopmaskbanny) to protest this in NY and prevent it from spreading nationally (bans are proposed elsewhere, e.g. North Carolina and LA). Read my post on mask bans here.

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Join Masks for Equity and Senior & Disability Action for a virtual teach-in on Tuesday August 20, 10:30 PM, Register: http://bit.ly/maskbanteachin.

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Masks and PPE:

Now personal protective equipment (PPE) is in plentiful supply online and in any retail drugstore. Yet, unfortunately, any notion that the country’s underlying supply chain problem has been resolved is just an illusion—one that masks a grim reality. Far from being in a better place with respect to PPE, the United States now stands on the verge of a near-complete inability to manufacture these critical supplies.

The United States still doesn’t manufacture a significant amount of PPE, and several domestic companies that responded to the call to produce PPE are now closed or on the brink of bankruptcy. With many hospitals struggling to remain financially stable, the US healthcare system has reverted to purchasing cheap and often subpar imports of medical supplies like PPE and syringes from nations with lower quality and safety standards, contributing to a significant supply-chain vulnerability and public-health risk.

https://thebulletin.org/2024/07/how-the-us-gained-and-then-lost-the-ability-to-make-medical-masks/?utm_source=Newsletter+&utm_medium=Email&utm_campaign=MondayNewsletter07292024&utm_content=DisruptiveTechnologiesBio_MedicalMasks_07252024

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New Long Covid review:

Mechanisms of Long COVID include viral persistence, immune dysregulation, mitochondrial dysfunction, complement dysregulation, prothrombotic inflammation and microbiome dysbiosis. Details in our review. (Zalaly, Eric Topol Hannah Davis, Akiko

https://nature.com/articles/s41591-024-03173-6

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Walz and Long Covid:

There are more than 400,000 people in Minnesota with Long Covid. MN became the first state to dedicate funding to Long Covid and associated conditions (ME/CFS, POTS)

https://www.motherjones.com/politics/2024/08/tim-walz-minnesota-long-covid-funding-harris-vp/

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Other:

Avian flu:

"the federal government’s initial response suggests that, rather than heeding the lessons from Covid-19, elected officials and other key decision makers may be relying on a dangerous type of revisionism that could lead to more deaths, should H5N1 cause a pandemic...

During the pandemic, well-described weaknesses in the U.S. public health response were often masked by overconfidence, as some elected officials and political appointees continually reassured Americans that the country had “the tools” to respond adequately to this new threat. The types of testing and surveillance problems that marred the response to Covid-19 are now being repeated with H5N1, with recent genetic analyses suggesting that the virus circulated undetected in cattle for months.³ Because of inadequate testing, the actual number of cases among dairy and other agricultural workers is also unknown. As with meatpacking facilities in the early months of the Covid-19 pandemic, the reluctance of dairy-farm employers to cooperate with health officials has hampered widespread testing and surveillance.

The initial response to H5N1 has also suffered from fractured lines of jurisdiction among government entities...

[Worth reading in entirety: free link-

https://www.nejm.org/doi/full/10.1056/NEJMp2406427?query=TOC&cid=DM2354746_Non_Subscriber&bid=-1830325263

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H5N1 infections in 2 Michigan farm workers

described in a letter to NEJM. Also, there is a list of confirmed H5N1 outbreaks, raising the national total to 190 from 13 states. Colorado is the hardest hit state, with 63 of the confirmed outbreaks.

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2 (unrelated) human cases of H3N2v novel flu, 1 each in CO & MI:

CO: – @CDPHE  reported a case in a person <18y – Attended agricultural event prior to illness – Sought care week ending July 13, 2024; not hospitalized – No illness among close contacts – Investigation ongoing

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State fairs cause worry:

“What we do at fairs kind of violates every tenet of biosecurity that we preach, and we do it on public display, and we charge the public,” Bowman told CIDRAP News. “As great as fairs are for agricultural education, they create situations with multiple species from different farms housed in one spot.”

Bowman likens state and county fairs to the Southeastern Asian live-animal markets, so often seen as epicenters for zoonotic spillover events.

H5N1 has now been implicated in 172 outbreaks in 13 states, with more than a dozen human cases in agricultural workers. All human cases have been mild, with case-patients recovering fully.

“Are we giving the opportunity for H5 to reassort with endemic swine virus?” he asked. “We know we have fairly regular incursions of influenza in pigs and maybe it becomes a pig-adapted virus.”

Moreover, the transmission dynamics of H5N1 in cattle are still not clear.

https://www.cidrap.umn.edu/avian-influenza-bird-flu/experts-consider-h5n1-avian-flu-unknowns-state-fairs-loom

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Dengue:

the global Dengue fever outbreak continues to expand in August 2024.

Dengue outbreaks are being reported by 90 countries in 2024, with most of these cases reported in the Region of the Americas.

As of August 8, 2024, 43 countries and territories in the Region have reported over 11.1 million Dengue cases and about 6,135 related deaths this year.

The updated data is over 120% greater than recorded throughout 2023.

In the United States, the U.S. CDC reported on August 7, 2024, that 52 jurisdictions, led by Florida, New York/New Jersey, and Puerto Rico, had confirmed 3,290 dengue cases.

https://www.precisionvaccinations.com/2024/08/08/6135-dengue-related-deaths-confirmed-americas

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Amy Maxmen:

Countries around the world are sharing genomic sequences from H5 bird flu viruses with @GISAID. But the US is withholding some valuable information. "Metadata such as sampling date and location are unfortunately missing from recent datasets" https://gisaid.org/resources/gisaid-in-the-news/highly-pathogenic-avian-influenza-outbreak-in-the-united-states/

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Ebola

Another Ebola outbreak?

From STAT’s Helen Branswell: The Democratic Republic of the Congo may have another Ebola outbreak on its hands. The World Health Organization told STAT it has been informed of seven suspected cases in Bas-Uélé, in a remote and difficult-to-access province in north-central DRC, along the border with the Central African Republic. Of the seven, five have died. If this is confirmed to be Ebola, it would be the country’s 16th known outbreak and the 10th in the past decade.

Samples from three of the suspect cases tested negative for Zaire ebolavirus — the Ebola type that has caused most of DRC’s outbreaks. But the samples were apparently of poor quality and the National Institute of Biomedical Research in Kinshasa recommended additional specimens be collected and submitted. Testing also needs to be done to rule out other Ebola species and Marburg, a related virus that causes similar disease. DRC was the site of the first confirmed Ebola outbreak, in 1976, and has recorded more outbreaks than any other country.

https://marketing.statnews.com/morning-rounds-august-8-2024?

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Monkeypox

mpox cases have risen by 160% on the continent this year compared with 2023.

While 96% of cases have been recorded in the Democratic Republic of the Congo (DRC), several other African countries this week have reported new outbreaks, including Kenya, Cote d’Ivoire, and the Central African Republic (CAR).

 "clade 1b," a new mpox lineage identified in the DRC last year that is highly transmissible and has a higher CFR than clade 2,

The Case Fatality Rate (CFR) for clade 2 is less than 1%, while 1b’s CFR is roughly 6%.

There is evidence in the DRC that clade 1b is spreading both through household transmission and sexual transmission, with clade 1b and clade 2 outbreaks occurring simultaneously.

https://www.cidrap.umn.edu/mpox/mpox-cases-spiking-10-african-nations

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Deadlier strain of mpox spreads outside of Congo - by Jon Cohen

https://www.science.org/content/article/deadlier-strain-mpox-spreads-more-african-countries

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Only 200,000 doses of mpox vaccine are available.

10 million doses are needed. That's just 2% of what is needed to control the outbreak. This is why it’s vital to scale up manufacturing capacity in Africa