Coronavirus Tidbits #312 September 15, 2024

@JPWeiland:

Cases will still be high for a good few weeks here but the trajectory down is good. It won't be increasing.

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@michaelhoerger

Nationally, we appear to have passed the peak of our late-summer wave, and it's not pretty.

At peak: >1.3 million daily infections

2.8% (1 in 36) actively infectious

Transmission higher than 90.5% of the pandemic

We are likely to have our worst September, worst October, and potentially worst November of transmission. We expect to bottom out around 850,000 daily infections in early November, before the winter surge picks up.

Statistics to reinforce the significance of the ongoing pandemic:

1.1 million daily infections on average the next month

2.2% (1 in 45) actively infectious any given day of the next month

High-risk in classroom-sized settings

>1.5 million resulting Long COVID cases from infections derived during the next month

you can estimate the percent of your state actively infectious by looking up the CDC Level on their website and multiplying it by 0.330.

https://www.cdc.gov/nwss/rv/COVID19-statetrend.html

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SARS-CoV-2 Rapidly Evolves in People with Advanced HIV

people with advanced HIV—as defined by reduced numbers of immune cells called CD4⁺ T cells—had dozens of SARS-CoV-2 variants in their bodies, compared to just one major variant in most people without HIV and people with HIV who had higher numbers of CD4⁺ T cells.

https://www.niaid.nih.gov/news-events/sars-cov-2-rapidly-evolves-people-advanced-hiv?

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Covid transmission

A study published yesterday in JAMA Network Open suggests that 70.4% of nearly 850,000 US household COVID-19 transmissions originated with a child.

among 516,159 participants, 51.4% of whom were children. In these households, 38,787 transmissions occurred, 40.8% of which were child to child, 29.6% child to adult, 20.3% adult to child, and 9.3% adult to adult. The median serial interval between the index and secondary cases was 2 days.

children contributed more to inferred within-household transmission when they were in school, and less during summer and winter breaks, a pattern consistent for 2 consecutive school years."

https://www.cidrap.umn.edu/covid-19/more-70-us-household-covid-spread-started-child-study-suggests

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People with HIV might be at an increased risk of long COVID

estimated that 52% of people with HIV with SARS-CoV-2 infection developed at least one LC symptom. Results from the random-effects model showed that HIV infection was associated with an increased risk of LC (odds ratio 2.20). The most common LC symptoms among people with HIV were cough, fatigue, and asthenia.

https://onlinelibrary.wiley.com/doi/10.1111/hiv.13708

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Long-COVID rate among disabled people double that of able-bodied

Over 40% of COVID-19 survivors who had disabilities before the pandemic had symptoms for 3 months or longer in 2022, compared with 19% of those without disabilities, further widening health disparities, finds a new report published in the American Journal of Public Health.

"We knew from previous research during the pandemic that people with pre-existing disabilities were having more difficulties getting the vaccines and were more likely to be exposed," lead author Jean Hall, PhD, said in a KU press release. "They not only have higher rates of long COVID, but they also have greater barriers to care, whether it's transportation, costs or other challenges."

People with disabilities are also more likely to have severe COVID-19 symptoms, face treatment refusals, and be admitted to a hospital, the researchers said.

https://www.cidrap.umn.edu/covid-19/long-covid-rate-among-disabled-people-double-able-bodied

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Covid accounted for about one in six cases of sepsis

from March 2020 to November 2022. This study marks the first time researchers have used EHR review method to study viral sepsis.

https://hms.harvard.edu/news/sars-cov-2-caused-more-deadlier-cases-sepsis-thought

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SARS-CoV-2 evolves faster in the brain

A new study published in Nature Microbiology has revealed that SARS-CoV-2, the virus responsible for COVID-19, evolves more rapidly in the brain than in the lungs, possibly explaining some of the neurological symptoms associated with the disease.

The researchers found that SARS-CoV-2 evolved differently in the brain compared to the lungs. In the lungs, the virus looked similar to the original strain used to infect the mice. However, in the brain, the virus had accumulated more mutations, particularly in the spike protein. These mutations often disrupted the furin cleavage site.

One of the key findings was that viruses with these spike protein mutations were better at infecting the brain. When the researchers used these brain-adapted viruses to directly infect the brains of other mice, the mutations persisted. Interestingly, when the brain-adapted virus spread back to the lungs, it tended to revert to its original form. This suggests that different parts of the body create different selective pressures on the virus, influencing how it evolves.

vaccination did not significantly alter how the virus evolved in the brain compared to the lungs.

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Molnupiravir for Long Covid

found that people who took molnupiravir: • Felt better and had fewer and less severe COVID-19 symptoms at 3 and 6 months • Used less healthcare and missed less work or school at 3 and 6 months • Had a lower risk of having new COVID-19 cases in their household at 3 months, but not at 6 months However, the differences between the two groups, while statistically significant, were small. full paper: https://openread.academy/en/paper/reading?corpusId=508359319…

https://thelancet.com/journals/laninf/article/PIIS1473-3099(24)00431-6/fulltext… https://thelancet.com/journals/laninf/article/PIIS1473-3099(24)00436-5/fulltext…

[A big problem is that Molnupiravir selects for (and promotes) resistant organisms. It should NOT be used as an antiviral for Rx acutely, either, as Paxlovid is better]

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RECOVER - Researching Covid to Enhance Recovery

Big NIH meeting Sept 23-25. [RECOVER has sucked up all the NIH funds and, thus far, squandered them.]

won’t require masks so they’ll do social distancing instead?? In an indoor meeting. That’s supposed to inspire confidence in their scientific grasp of our disease. -- @CHRomatowski

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Avian Flu:

No clear exposure source in Missouri H5 avian flu case

early genetic analysis suggests that the virus is closely related to the one infecting dairy cattle, federal health officials said. Results so far suggest that the virus is closely related to the one circulating in dairy cows,

Since March, the USDA has confirmed H5N1 in 203 herds across 14 states.

https://www.cidrap.umn.edu/avian-influenza-bird-flu/no-clear-exposure-source-missouri-h5-avian-flu-case

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Missouri: CDC can't investigate latest bird flu case in a human The agency’s investigators can’t look into the infection further unless state authorities request their help. So far, Missouri hasn’t made such a request." Kansas City Star - https://t.co/r9HbHraUe4

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Other:

Bats and infant mortality:

New research shows how vital biodiversity is to thriving humanity: In US counties where bats declined from white-nose syndrome, insect numbers surged, leading to a 31% rise in pesticide use and subsequently *an 8% increase in infant mortality*! (correlation, not causation)

https://www.science.org/content/article/my-jaw-dropped-bat-loss-linked-death-human-infants