COVID UPDATE:
Many of you have expressed an interest as to whether we are over the COVID hurdle. This newsletter hopefully will serve to enlighten you that we are far from being done with COVID.
'COVID is not done with us': US marks 1 million coronavirus-related deaths: The CDC expects to see COVID-19 hospitalizations and deaths to increase as cases are once again on the rise. The numbers as of Friday May 13,2022; Coronavirus Cases: 84,103,933: Deaths: 1,026,216: Recovered: 81,172,420
As of May 4: PA: reporting 2,132 new cases/day on average, up 61% from two weeks ago
NJ: reporting 3,000 new cases/day on average, up 50% from two weeks ago and DE: reporting 217 new cases/day on average, up 31% from two weeks ago
Almost 30 Percent of COVID-19 Patients Develop 'Long COVID': Almost 30 percent of hospitalized patients and high-risk outpatients with COVID-19 develop post-acute sequelae of severe acute respiratory syndrome coronavirus 2 (PASC), according to a study published in the Journal of General Internal Medicine. In hospitalized patients, the most common persistent symptom was fatigue, followed by shortness of breath (31.4 and 15.4 percent, respectively); in outpatients, anosmia was the most common persistent symptom. Factors independently associated with PASC included hospitalization for COVID-19, having diabetes, and higher body mass index.
Model finds COVID-19 deaths among elderly may be due to genetic limit on cell division: Your immune system's ability to combat COVID-19, like any infection, largely depends on its ability to replicate the immune cells effective at destroying the SARS-CoV-2 virus that causes the disease. These cloned immune cells cannot be infinitely created, and a key hypothesis of a new University of Washington study is that the body's ability to create these cloned cells falls off significantly in old age. According to a model created by UW research professor James Anderson, this genetically predetermined limit on your immune system may be the key to why COVID-19 has such a devastating effect on the elderly. Anderson is the lead author of a paper published March 31 in The Lancet detailing this modeled link between aging, COVID-19 and mortality.
"When DNA split in cell division, the end cap—called a telomere—gets a little shorter with each division," explains Anderson, who is a modeler of biological systems. "After a series of replications of a cell, it gets too short and stops further division. Not all cells or all animals have this limit, but immune cells in humans have this cell life."
The average person's immune system coasts along pretty good despite this limit until about 50 years old. That's when enough core immune cells, called T cells, have shortened telomeres and cannot quickly clone themselves through cellular division in big enough numbers to attack and clear the COVID-19 virus, which has the trait of sharply reducing immune cell numbers, Anderson said. Importantly, he added, telomere lengths are inherited from your parents. Consequently, there are some differences in these lengths between people at every age as well as how old a person becomes before these lengths are mostly used up.
Co-authors include Ezra Susser, Mailman School of Public Health, Columbia University; Konstantin Arbeev and Anatoliy Yashin, Social Science Research Institute, Duke University; Daniel Levy, National Heart, Lung, and Blood Institute, National Institutes of Health; Simon Verhulst, University of Groningen, Netherlands; Abraham Aviv, New Jersey Medical School, Rutgers University.
New Omicron Subvariant Spreading in U.S. as Coronavirus Cases Increase: The U.S. is averaging more than 56,000 new coronavirus cases each day. That’s up from roughly 25,000 infections reported per day in early April. Virtually every infection across the nation is from the omicron coronavirus variant. There are several subvariants of omicron, and BA.2 – sometimes referred to as “stealth omicron” – has been the dominant strain circulating since March.
But another omicron subvariant BA .2.12.1 is quickly increasing, and experts believe it could be even more transmissible than BA.2. BA.2.12.1 is responsible for 29% of new coronavirus infections as of mid-April, according to data from the Centers for Disease Control and Prevention. That’s up from 19% of cases the week prior and 14% of infections the first week in April. “As a reminder, it was the BA.1 omicron subvariant that caused the surge early in the year,” CDC Director Rochelle Walensky said on a call with reporters last week. “Right now, BA.1 is only about 3% of the sequences identified. We are now more commonly finding that BA.2 omicron subvariant, BA.2.12.1 makes up about 68% of circulating virus.
According to Dr Walensky of the CDC, “It appears it might have a transmission advantage of about 25% over the BA.2 subvariant. Additional evaluation is currently underway to understand the impact of BA.2.12.1 on vaccine effectiveness. But importantly, we continue to believe that those who are vaccinated and especially those who are boosted, continue to have strong protection against severe disease, even from BA.2.12.1.”
BA.2.12.1 Subvariant: Concerning, but No Need to Panic Just Yet: BA.2.12.1 has increased from 3.5% of cases a little more than a month ago to nearly 30% of cases last week.
"What we're seeing right now is a version of the virus that is much more transmissible than previous versions of the virus, perhaps, but also less likely to cause severe disease," Perry Halkitis, PhD, MPH, dean of the Rutgers School of Public Health.
Halkitis says that the detection and increasing prevalence of BA.2.12.1 is no surprise.
"The fact is that the virus continues to circulate in the population, and it is never going to disappear in the population until you reached a point where everyone in the world is immunized or had antibodies, and you have herd immunity. But we never got there in the United States, and we certainly never got there in the world."
BA.2.12.1 likely will pick up speed in other parts of the country, as it has in the Northeast, Halkitis said -- with one caveat. "The advantage we have right now is that we're at a time of the year where respiratory disease tends to decline because of the weather, so maybe we're not going to see that surge. But beware, September and October are just around the corner."
Nine Omicron symptoms affecting fully vaccinated — and two early signs you might have it: Cough, runny nose, fatigue, sore throat, headache, muscle pain, fever, sneezing and nausea. Experts also suggest there are two distinct symptoms that could be a sign a positive test is around the corner: fatigue and dizziness/ fainting.
COVID risks: High blood pressure, diabetes and heart problems boost chance of death in unvaccinated: Those who are unvaccinated and have high blood pressure, diabetes or heart artery disease were found to be at up to three times greater risk of serious outcomes – including lung failure, admission to intensive care, kidney problems, and death. And up to 2.5-fold increased risk of other COVID-19 related complications.
When comparing the three medical conditions, individuals with diabetes were at the highest risk of developing severe lung failure. Prior to the emergence of COVID-19, these conditions were already known to be common predictors of heart attack and stroke.
Patients found to have heart issues also had higher chances of developing other complications, including severe lung failure, known as acute respiratory distress syndrome, and acute kidney injury. They also required higher rates of intensive care admission and invasive mechanical ventilation.
Successful vaccination programs have drastically reduced the social and economic burdens of COVID through altering the disease course and effective prevention of severe disease.
Scientists find an important cause of COVID-19 deaths in older people. Your immune system’s ability to combat COVID-19, like any infection, largely depends on its ability to replicate the immune cells effective at destroying the SARS-CoV-2 virus that causes the disease.
These cloned immune cells cannot be infinitely created.
Scientists from the University of Washington and elsewhere suggest that the body’s ability to create these cloned cells falls off significantly in old age.
This genetically predetermined limit on your immune system may be the key to why COVID-19 has such a devastating effect on the elderly.
Fourth COVID jab can give higher immunity than initial booster, study find: A fourth dose of a COVID vaccine can ramp up the body’s immune defenses beyond the peak achieved after a third dose, research suggests.
A second booster – often a fourth dose of a COVID vaccine – is currently offered in the UK to those aged 75 or over, people living in care homes for older people, and those over the age of 12 who are immunosuppressed. Now researchers say they have found a fourth dose can rescue immune responses that have waned since a third jab.
“We’ve demonstrated a fourth dose of COVID-19 vaccines can produce a substantial boost to both the antibody and cellular immunity when you give them more than six months after the third dose,” said Prof Saul Faust, who led the trial and is director of the NIHR Southampton clinical research facility.
Most People Catch the COVID Virus one of three ways:
You're Not Vaccinated: The number one factor that puts people at risk of getting COVID is not getting the vaccine. Many point to the fact that people who have been immunized against COVID are still getting the virus as their reason for not getting vaccinated. It is true that because the vaccine we are still using was explicitly developed for the original virus in December 2019 and COVID has continued to mutate, the vaccine has become less effective. The vaccine was 95% effective and is now 60% or less. However, it still offers a level of protection that should not be discounted and getting vaccinated provides greater protection to others since the vaccine helps reduce the spread of COVID-19. Each new variant of the virus has been much more infectious than the original. We should do all we can to protect ourselves and those around us, mainly the elderly or those with underlying medical conditions such as obesity, cardiovascular disorder, respiratory disorder, etc. Their level of risk is much higher and they need to take precautionary measures based on their medical circumstances and risk tolerance.
You're Not Wearing a Proper Mask: COVID is an airborne illness and it is surprisingly easy to prevent, which leads us to the second habit that puts people in danger of getting COVID, not wearing a mask or wearing it improperly. While nothing is 100% effective, the N95s offer the highest level of protection against infection of COVID-19 at a rate of 90% to 95% effectiveness. If you don't have access to an N95 mask, it is important to wear the most protective mask possible. If it is a cloth mask, you should wash and dry it daily to keep it clean. It's also important to remember to wear masks properly. They should fit well by completely covering your mouth and nose and fit snugly against the sides of your face leaving no gaps. Masks should not be pulled low on your nose, below your nose, or below your mouth.
You're Attending Large Indoor Gatherings: The third habit that puts people in danger of getting COVID-19 is not limiting our time in large groups and enclosed spaces, especially when not wearing masks. COVID-19 is an airborne disease and the very fine droplets and particles dispersed from an infected person coughing, speaking or singing will spread through the air in a room and accumulate. These particles can also linger in the air even after the infected person leaves the room. Having large gatherings outside or bringing fresh air indoors by opening windows and doors will decrease the risk of infection but not 100%.
Until next time, Stay Safe, Stay Healthy and get Vaccinated. Vaccines work.
James A Vito,D.M.D.