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It’s estimated that more than a third of people who have had COVID-19 experience neurological complications such as brain fog that persist or develop 3 months after infection. And two thirds of so-called long haulers still have neurological symptoms after 6 months.
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China’s President Xi Jinping has some good news for Europe — his country’s draconian zero-COVID policies aren’t likely to be dropped.
That’s a relief for European buyers of liquefied natural gas, as China’s economic slowdown has freed up LNG cargos crucial to replacing the Russian gas that used to supply about 40 percent of European demand.
“Regardless of what you think about the Chinese zero-COVID policy, simply looking at it only from the perspective of European gas supplies, it would be very helpful if China continued this policy,” said Dennis Hesseling, head of gas at the EU’s energy regulator agency ACER.
Xi took to the stage Sunday to kick off the week-long 20th Communist Party congress, and he doubled down on the zero-COVID approach, calling it a “people’s war to stop the spread of the virus.”
The once-in-five-year summit is “mostly a political meeting for within the party itself” but it does send crucial signals, said Jacob Gunter, a senior analyst at the China-focused MERICS think tank. So far it indicates China plans to “stick with [zero-COVID] for a while,” he said, adding that’s partly because government pandemic messaging has so spooked the population that lifting it would cause “chaos,” while Chinese vaccine hesitancy also remains high.
Since the outbreak of the pandemic in 2020, China has ruthlessly pursued its policy of crushing the coronavirus, involving snap lockdowns of entire cities accompanied by mass testing, surveillance and border closures. The slowdown in growth and depressed demand led to China’s LNG imports sinking by one-fifth, or 14 billion cubic meters, year-on-year for the first eight months of 2022, according to Jörg Wuttke, president of the EU Chamber of Commerce in China.
China and the EU each imported around 80 million tons of LNG in 2021, but China’s imports will fall to 64 million tons this year, according to data by market intelligence firm ICIS. That’s helping the EU buy gas on the global market and using it to fill the Continent’s storages ahead of the winter heating season.
“Europe is lucky that China has a severe economic downturn which will last well into 2023,” said Wuttke, adding that the drop in demand from China — historically the world’s largest LNG importer — is “roughly equivalent to the entire annual LNG imports of Britain.”
With EU gas storage now over 90 percent full, the conversation in Brussels has already begun to shift to securing enough supplies for next year. At last week’s summit of EU energy ministers, International Energy Agency chief Fatih Birol warned that “next winter may well be even more difficult.”
As things stand, Beijing’s LNG imports are likely to rise back to 2021 levels next year, according to senior ICIS gas analyst Tom Marzec-Manser, with deliveries typically increasing around the winter season and then likely to ramp up again next summer.
China has already ordered its state-owned gas importers to stop reselling LNG to the EU to preserve stocks for the winter season at home.
But if the zero-COVID policy is scrapped, that could lead “to a step-change in growth again,” said Marzec-Manser.
European countries are well aware of this risk.
In a presentation given by ACER during last week’s informal Energy Council, ministers were told that “China’s COVID-driven demand decline in LNG volumes is currently being absorbed” by the bloc. “This raises questions as to when China’s LNG demand may turn back towards normal growth rates,” it added.
Although Russian shipments have fallen to less than 9 percent of EU demand, some Kremlin gas is still getting through. But “that may not be available at all next year,” said ACER’s Hesseling, adding that if there is no Russian gas and Chinese demand comes roaring back, more radical energy-saving measures would be needed in the EU.
EU leaders will meet later this week to discuss further measures to tackle sky-high energy prices in Europe, including measures for next year such as joint gas purchasing.
According to one senior EU diplomat, “competition from Asia [is] mentioned constantly,” adding that “it’s quite evident” a change in Beijing’s lockdown policy “may raise global demand and raise prices.”
“China is indeed a competitor and that needs to be taken into account whatever we might be doing,” they said.
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Data from the U.S. Centers for Disease Control and Prevention show that the flu season is off to an early start, with a rash of flu-like cases reported in Texas, parts of the southeast, New York City and Washington, D.C. One San Diego high school seemingly has a flu outbreak, causing 1,400 students to be absent.
The outbreak at Patrick Henry High School started Monday, doubled on Wednesday, and now, more than half the student body is out sick.
“There was a homecoming dance and game on the weekend prior to this Monday,” Dr. Howard Taras, a physician for the San Diego Unified School District, told CBS News. “You’d think that it would take several days for them to become infectious to others, but it didn’t.”
The CDC said prior to the COVID-19 pandemic, there were 36 million cases of the flu in the U.S. With masking and social distancing, U.S. cases plummeted to just thousands — the lowest ever recorded.
But now, most mandates are gone.
“The last two years, people haven’t been exposed too much influenza, so their immunity to it may be down,” said CBS News chief medical correspondent Jonathan LaPook.
The CDC said it’s safe to get the flu shot and COVID-19 booster together so that you can be prepared for what’s predicted to be a severe flu season.
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Oct. 12, 2022 – About 1 in 20 people with long COVID continue to live with symptoms at 18 months, and another 42% reported only some improvement in their health and wellbeing in the same time frame, a large study out of Scotland found.
Multiple studies are evaluating people with long COVID in the hopes of figuring out why some people experience debilitating symptoms long after their primary infection ends and others either do not or recover more quickly.
This current study is notable for its large size – 96,238 people. Researchers checked in with participants at 6, 12 and 18 months, and included a group of people never infected with the coronavirus to help investigators make a stronger case.
“A lot of the symptoms of long COVID are non-specific and therefore can occur in people never infected,” says senior study author Jill P. Pell, head of the School of Health and Wellbeing at the University of Glasgow in Scotland.
Ruling Out Coincidence
This study shows that people experienced a a wide range of symptoms after becoming infected with COVID-19 at a significantly higher rate than those who were never infected, “thereby confirming that they were genuinely associated with COVID and not merely a coincidence,” she says.
Among 21,525 people who had COVID-19 and had symptoms, tiredness, headache and muscle aches or muscle weakness were the most common ongoing symptoms.
Loss of smell was almost 9 times more likely in this group compared to the never infected group in one analysis where researchers controlled for other possible factors. The risk for loss of taste was almost 6 times greater, followed by risk of breathlessness at 3 times higher.
Long COVID risk was highest after a severe original infection and among older people, women, Black and South Asian populations, people with socioeconomic disadvantages and those with more than one underlying health condition.
Adding up the 6% with no recovery after 18 months and 42% with partial recovery means that between 6 and 18 months following symptomatic coronavirus infection, almost half of those infected still experience persistent symptoms.
Vaccination Validated
On the plus side, people vaccinated against COVID-19 before getting infected had a lower risk for some persistent symptoms. In addition, Pell and colleagues found no evidence that people who experienced asymptomatic infection were likely to experience long COVID symptoms or challenges with activities of daily living.
The findings of the Long-COVID in Scotland Study (Long-CISS) were published Wednesday in the journal Nature Communications.
‘More Long COVID Than Ever Before’
“Unfortunately, these long COVID symptoms are not getting better as the cases of COVID get milder,” says Thomas Gut, DO, Medical Director for the Post COVID recovery program at Staten Island University Hospital in New York City. “Quite the opposite – this infection has become so common in a community because it’s so mild and spreading so rapidly that we’re seeing more long COVID symptoms than ever before.”
Although most patients he sees with long COVID resolve their symptoms within 3 to 6 months, “We do see some patients who require short-term disability because their symptoms continue past 6 months and out to 2 years,” says Gut, who is also , hospitalist at Staten Island University Hospital / Northwell Health.
Patients with fatigue and neurocognitive symptoms “have a very tough time going back to work. Short-term disability gives them the time and finances to pursue specialty care with cardiology, pulmonary and neurocognitive testing,” he says.
Support the Whole Person
The burden of living with long COVID goes beyond the persistent symptoms. “Long COVID can have wide-ranging impacts — not only on health but also quality of life and activities of daily living [including] work, mobility, self-care and more,” Pell says. “So, people with long-COVID need support relevant to their individual needs and this may extend beyond the health care sector, for example including social services, school or workplace.”
Still, Lisa Penziner, RN, Founder of the COVID Long Haulers Support Group in Westchester and Long Island, NY, says while people with the most severe cases of COVID-19 tended to have the worst long-COVID symptoms, they’re not the only ones.
“We saw many post-COVID members who had mild cases and their long-haul symptoms were worse weeks later than the virus itself,” says Penziner.
Penziner estimates that 80% to 90% of her support group members recover within 6 months. “However, there are others who were experiencing symptoms for much longer.”
Respiratory treatment, physical therapy and other follow-up doctor visits are common after 6 months, for example.
“Additionally, there is a mental health component to recovery as well, meaning that the patient must learn to live while experiencing lingering, long-haul COVID symptoms in work and daily life,” says Penziner, who is also director of special projects at North Westchester Restorative Therapy & Nursing.
In addition to ongoing medical care, people with long COVID need understanding, Penziner says.
“While long-haul symptoms do not happen to everyone, it is proven that many do experience long-haul symptoms, and the support of the community in understanding is important.”
Limitations of the Study
Pell and colleagues note some strengths and weaknesses to their study. For example, “as a general population study, our findings provide a better indication of the overall risk and burden of long-COVID than hospitalized cohorts,” they note.
Also, the Scottish population is 96% white, so other long-COVID studies with more diverse participants are warranted.
Another potential weakness is the response rate of 16% among those invited to participate in the study, which Pell and colleagues addressed: “Our cohort included a large sample (33,281) of people previously infected and the response rate of 16% overall and 20% among people who had symptomatic infection was consistent with previous studies that have used SMS text invitations as the sole method of recruitment.”
“We tell patients this should last 3 to 6 months, but some patients have longer recovery periods,” Gut says. “We’re here for them. We have a lot of services available to help get them through the recovery process, and we have a lot of options to help support them.”
“What we found most helpful is when there is peer-to-peer support, reaffirming to the member that they are not alone in the long-haul battle, which has been a major benefit of the support group,” Penziner says.
If you or someone you know is experiencing long COVID and could benefit from peer support, Penziner can be contacted at [email protected]
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Moderna
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Merck (ticker: MRK) will pay
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About The Study: Full vaccination status compared with controls was associated with lower mortality among critically ill patients who required invasive mechanical ventilation owing to COVID-19–related acute respiratory distress syndrome in this study including 265 patients. These results may inform discussions with families about prognosis.
Authors: Ilias I. Siempos, M.D., D.Sc., of the National and Kapodistrian University of Athens Medical School in Athens, Greece, is the corresponding author.
To access the embargoed study: Visit our For The Media website at this link https://media.jamanetwork.com/
(doi:10.1001/jamanetworkopen.2022.35219)
Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, conflict of interest and financial disclosures, and funding and support.
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About JAMA Network Open: JAMA Network Open is the new online-only open access general medical journal from the JAMA Network. On weekdays, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.
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They’re leading the way in part because the federal government has made only limited efforts, says Lisa McCorkell, a co-founder of the Patient-Led Research Cooperative. The international group was founded in spring 2020 by researchers who are also long COVID patients.
“It’s a big reason why long COVID isn’t talked about as much,” McCorkell says. “It’s definitely a national issue. But it trickles down to state and local health departments, and there’s not enough resources.”
The government clinics may be accessible to people without insurance and often are cheaper than clinics at private hospitals.
Harborview has treated more than 1,000 patients with long COVID, and another 200 patients are awaiting treatment, says Jessica Bender, MD, a co-director of the University of Washington Post-COVID Rehabilitation and Recovery Clinic in Seattle’s First Hill neighborhood.
At Harborview, Bender says the public hospital’s post-COVID clinic initially began with a staff of rehabilitation doctors but expanded in 2021 to include family and internal medicine doctors. And it offers mental health programs with rehabilitation psychologists who instruct on how to deal with doctors or loved ones who don’t believe that long COVID exists.
“I have patients who really have been devastated by the lack of support from co-workers [and] family,” Bender says.
In Campbell County, WY, the pandemic surge did not arrive in earnest until late 2021. Physical therapists at Campbell County’s Health Rehabilitation Services organized a rehabilitation program for residents with long COVID after recognizing the need, says Shannon Sorensen, rehabilitation director at Campbell County Health.
“We had patients coming in showing chest pain, or heart palpitations. There were people trying to get back to work. They were frustrated,” Sorensen says.
Myalgic encephalomyelitis and chronic fatigue syndrome activists have embraced the fight to recognize and help long COVID patients, noting the similarities between the conditions, and hope to help kickstart more organized research, treatment and benefits for long COVID sufferers and ME/CFS patients alike.
In Ft. Collins, CO, disability activist Alison Sbrana has long had myalgic encephalomyelitis. She and other members of the local chapter of ME Actionhave met with state officials for several years and are finally seeing the results of those efforts.
Colorado Gov. Jared Polis has created the full-time position of policy adviser for long COVID and post-viral infection planning.
“This is one way forward of how state governments are (finally) paying attention to infection-triggered chronic illnesses and starting to think ahead on them,” Sbrana says.
New York City’s Health + Hospitals launched what may be the most expansive long COVID treatment program in the nation in April 2021. Called AfterCare, it provides physical and mental health services as well as community support systems and financial assistance.
A persistent issue for patients is that there isn’t yet a test for long COVID, like there is for COVID-19, says Amanda Johnson, MD, assistant vice president for ambulatory care and population health at New York Health + Hospitals. “It’s in many ways a diagnosis of exclusion. You have to make sure their shortness of breath isn’t caused by something else. The same with anemia,” she says.
California’s Department of Public Health has a detailed website devoted to the topic, including videos of “long haulers” describing their experiences.
Vermont is one of several states studying long COVID, says Mark Levine, MD, the state health commissioner. The state, in collaboration with the University of Vermont, has established a surveillance project to determine how many people have long COVID, as well as how severe it is, how long it lasts, and potential predispositions.
The University of Utah in Salt Lake City established a comprehensive COVID-19 clinic more than a year ago that also handles long COVID patients, says Jeannette Brown, MD, PhD, an associate professor at the school and director of the COVID-19 clinic.
Jennifer Chevinsky, MD, MPH, already had a deep understanding of long COVID when she landed in Riverside County, CA, in the summer of 2021. She came from Atlanta, where as part of her job as an epidemic intelligence service officer at the CDC, she heard stories of COVID-19 patients who were not getting better.
Now she is a deputy public health officer for Riverside County, in a region known for its deserts, sizzling summer temperatures and diverse populations. She says her department has helped launch programs such as post-COVID-19 follow-up phone calls and long COVID training programs that reach out to the many Latino residents in this county of 2.4 million people. It also includes Black and Native American residents.
“We’re making sure information is circulated with community and faith-based organizations, and community health workers,” she says.
McCorkell, at the Patient-Led Research Cooperative, says there is still much work to do to raise public awareness of the risks of long COVID and how to obtain care for patients. She would like to see a national public health campaign about long COVID, possibly spearheaded by the CDC in partnership with local health workers and community-based organizations, she says.
“That,” she says, “could make a big difference.”
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The U.S. is at risk of prolonging the COVID pandemic if it fails to back an initiative that aims to get vaccines, diagnostics and treatments to lower-income countries, a congressional group has told President Joe Biden.
In a letter to Biden from the group led by Earl Blumenauer, a Democrat from Oregon, the group urged him to back the World Trade Organization’s agreement in June to ease exports of lifesaving therapies.
“With more than 600 million shots in arms, 21,500 free testing sites, the ability to order at-home tests for free, and more treatments available now than at any point in the pandemic, the outlook in the United States is better than ever. Unfortunately, however, the prospect for many low-income countries is not so positive — putting the United States’ own success in jeopardy,” the lawmakers wrote.
The letter was sent ahead of a meeting of the WTO council for trade-related aspects of IP rights that is due to kick off Thursday.
The group noted that lower-income countries are facing a higher risk of severe illness, hospitalization and death as only a small percentage of their populations are vaccinated. Just 19% of people in those countries are vaccinated, compared with about 75% in high-income countries, according to the Multilateral Leaders Taskforce on COVID-19, a joint initiative of the International Monetary Fund, the World Bank, the World Health Organization and the WTO.
U.S. known cases of COVID are continuing to ease and now stand at their lowest level since late April, although the true tally is likely higher given how many people are testing at home, where the data are not being collected.
The daily average for new cases stood at 43,149 on Wednesday, according to a New York Times tracker, down 23% from two weeks ago. Cases are rising in most northeastern states by 10% of more, while cases in the western states Montana, Washington and Oregon are rising.
The daily average for hospitalizations was down 11% at 27,184, while the daily average for deaths is down 8% to 391.
Coronavirus Update: MarketWatch’s daily roundup has been curating and reporting all the latest developments every weekday since the coronavirus pandemic began
Other COVID-19 news you should know about:
• China’s huge Xinjiang region has been hit with sweeping COVID travel restrictions ahead of a key Communist Party congress later this month, the Associated Press reported. Trains and buses in and out of the region of 22 million people have been suspended, and passenger numbers on flights have been reduced to 75% of capacity in recent days, according to Chinese media reports. The region is home to minorities who have been forced into prison-like re-education centers to force them to renounce their religion, typically Islam, and allegedly subjected to human-rights abuses.
• Five current or former Internal Revenue Service workers have been charged with fraud for illegally getting money from federal COVID-19 relief programs and using a total of $1 million for luxury items and personal trips, prosecutors said, the AP reported. The U.S. attorney’s office in Memphis said Tuesday that the five have been charged with wire fraud after they filed fake applications for the Paycheck Protection Program and the Economic Injury Disaster Loan Program, which were part of a federal stimulus package tied to the pandemic response in 2020.
• Peloton Interactive Inc.
PTON,
said it plans to cut about 500 jobs, roughly 12% of its remaining workforce, in the company’s fourth round of layoffs this year as the connected fitness-equipment maker tries to reverse mounting losses, the Wall Street Journal reported. After enjoying a strong run early on in the pandemic, Peloton has struggled since the start of the U.S. recovery, and CEO Barry McCarthy, who took over in February, said he is giving the unprofitable company another six months or so to significantly turn itself around and, if it fails, Peloton likely isn’t viable as a stand-alone company.
Don’t miss: Peloton CEO says ‘naysayers’ are looking at the company’s $1.2 billion quarterly loss all wrong.
Here’s what the numbers say:
The global tally of confirmed cases of COVID-19 topped 619.9 million on Wednesday, while the death toll rose above 6.55 million, according to data aggregated by Johns Hopkins University.
The U.S. leads the world with 96.6 million cases and 1,061,490 fatalities.
The Centers for Disease Control and Prevention’s tracker shows that 225.3 million people living in the U.S., equal to 67.9% of the total population, are fully vaccinated, meaning they have had their primary shots. Just 109.9 million have had a booster, equal to 48.8% of the vaccinated population, and 23.9 million of those who are eligible for a second booster have had one, equal to 36.6% of those who received a first booster.
Some 7.6 million people have had a shot of one of the new bivalent boosters that target the new omicron subvariants that have become dominant around the world.
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Newswise — LOS ANGELES (Oct. 5, 2022) – An international team of researchers has demonstrated that among patients hospitalized for influenza, those who were vaccinated had less severe infections, including reducing the odds for children requiring admittance to an intensive care unit by almost half.
In addition, the researchers found that deaths among hospitalized adults, 65 or older, who had been vaccinated were 38% lower compared to those who had not been vaccinated.
“A common complaint about influenza vaccine is that they are typically 40-60% effective against infection – or the ‘what’s the point?’ complaint. So it is important to note that although everyone in this study was hospitalized, vaccinated individuals were less likely to be severely ill or die, suggesting that you are likely to have far less severe consequences if vaccinated,” said Dr. Annette Regan, UCLA Fielding School of Public Health assistant professor of epidemiology and lead author of the peer-reviewed research, published this week in the October edition of The Lancet Infectious Diseases. “This is an important point, especially in light of the upcoming influenza season coupled with ongoing COVID-19 activity, both this season and into the future.”
Globally, influenza contributes to 9.5 million hospitalizations, 81.5 million hospital days, and 145,000 deaths each year. Vaccination offers the best method of preventing influenza illness, reducing illness in the general population by 40–60%, experts say.
Specifically, The Lancet analysis found that three groups routinely targeted for influenza vaccination experiences less severe illness. Children who had received only part of their first series of influenza vaccines had 36% lower chances of being admitted to an intensive care unit (ICU), and children who had fully completed their first series of influenza vaccines had 48% lower chances of admission to ICU compared to unvaccinated children, the researchers found.
The study – “Severity of influenza illness associated with seasonal influenza vaccination among hospitalized patients in four South American countries” – is the product of an international team of researchers from the United States, Argentina, Brazil, Chile, and Paraguay, and drew on data from all four South American countries over a period of seven years. Data were obtained through the Network for the Evaluation of Vaccine Effectiveness in Latin America and the Caribbean, influenza (REVELAC-i) which is coordinated by the Pan American Health Organization (PAHO).
“Although several studies have reported drops in influenza illness following influenza vaccination, the results have focused predominantly on adults in the United States, and this study aimed to evaluate the severity of influenza illness by vaccination status in a broad range of age groups, and across multiple South American countries,” said Dr. Marta Von Horoch, a co-author who serves as coordinator of the National Immunization Program in Paraguay. “We were very pleased to work with our partners in the U.S. and across the continent, and these findings demonstrate, quite clearly, the importance of influenza vaccination for children and adults, no matter where they live.”
The study – the first-ever on this scale in South America – examined influenza-related hospitalization rates and outcomes across all four countries from 2013-19. Specifically, the analysts reviewed the outcomes for some 2,747 patients hospitalized with confirmed influenza virus infection, in three age groups – children aged 6–24 months, adults aged 18–64 years, and adults aged 65 years or older.
Given the reality that vaccination rates have fallen, in the U.S. and globally during the COVID-19 pandemic, including among children, the findings should help make clear the benefits of timely, pro-active immunization campaigns to the public, the researchers said.
“With influenza season approaching this winter and influenza vaccines now available, these results highlight the importance of getting vaccinated for flu for anyone six months of age or older – as CDC recommends,” Regan said. “It is critical that healthcare providers and the public understand the risks of missing out on vaccinations – it is so much better to prevent a serious illness than to suffer through it, for the patient and everyone in their community.”
PRINCIPAL INVESTIGATOR: Regan, also a faculty affiliate with UCLA’s Bixby Center on Population and Reproductive Health, has taught at the university since 2019. She earned her PhD from the University of Western Australia in 2016. As part of her doctoral work, Regan established one of the largest population-based cohorts to investigate the safety of influenza vaccination in pregnancy and Australia’s first rapid surveillance system for monitoring the safety of vaccines given during pregnancy. She is also currently leading a large U.S. study on COVID-19 vaccination during pregnancy. Regan has served as an epidemiologist with the Western Australia Department of Health (2013-16) and Epidemiologist for the U.S. Centers for Disease Control and Prevention (2007-11). She is also on faculty at the University of San Francisco’s School of Nursing and Health Professions.
METHODS: Using surveillance data from four South American countries, the team examined indicators of severity of illness among influenza-associated hospitalizations, including length of hospital stay, admission to ICU, and death in hospital. Data collection conformed to a common protocol, reducing heterogeneity in measurements. As a result, the researchers were able to evaluate the health effects associated with influenza vaccination in a large sample of three priority groups, including children aged 6–24 months. The large sample size also enabled analyses by influenza virus subtype and by number of pre-existing health conditions. The results for each group was subjected to separate statistical analyses.
FUNDING: This work was supported by a grant from the U.S. Centers for Disease Control and Prevention (CDC) through cooperative agreements with the Pan American Health Organization and the World Health Organization.
CITATION: Regan A, Arriola CS, Couto P, et al. Severity of influenza illness associated with seasonal influenza vaccination among hospitalised patients in four South American countries, 2013–19: a surveillance-based cohort study. Lancet Infectious Diseases, S1473-3099(22)00493-5.
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The UCLA Fielding School of Public Health, founded in 1961, is dedicated to enhancing the public’s health by conducting innovative research, training future leaders and health professionals from diverse backgrounds, translating research into policy and practice, and serving our local communities and the communities of the nation and the world. The school has 761 students from 26 nations engaged in carrying out the vision of building healthy futures in greater Los Angeles, California, the nation and the world.
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Newswise — As COVID-19 wreaks havoc across the globe, one characteristic of the infection has not gone unnoticed. The disease is heterogeneous in nature with symptoms and severity of the condition spanning a wide range. The medical community now believes this is attributed to variations in the human hosts’ biology and has little to do with the virus per se. Shedding some light on this conundrum are Associate Professor SUMI Tomonari from Okayama University, Research Institute for Interdisciplinary Science (RIIS) and Associate Professor Kouji Harada from Toyohashi University of Technology, the Center for IT-based Education (CITE). The duo recently reported their findings on imbalances in the host immune system that facilitate persistent or severe forms of the disease in some patients.
The researchers commenced their study by computer simulations with models based on a host’s immune system and its natural response to SARS-CoV-2 exposure. Mathematical equations for the dynamics of cells infected by SARS-CoV-2 were plugged in to predict their behavior. Now, the immune system has messenger cells known as dendritic cells (DCs). These cells report information (in the form of antigens) about the invaders to the warriors, or T cells, of the immune system. The model showed that at the onset of infection, DCs from infected tissues were activated and then antibodies to neutralize SARS-CoV-2 gradually started building.
To investigate long-term COVID-19, the behavior of DCs 7 months after infection was evaluated by the computer simulation. the baseline model simulation revealed that DCs drastically decreased during the peak of infection and slowly built up again. However, they tended to remain below pre-infection levels. These observations were similar to those seen in clinical patient samples. It seemed like low DC levels were associated with tenacious long-term infection.
The subsequent step was to understand if DC function contributed to disease severity. It was found that a deficiency of the antigen-reporting function of DCs and lowered levels of chemicals known as interferons released by them were related to severe symptoms. A decrease in both these functions resulted in higher amounts of virus in the blood (viral load). What’s more, the researchers also found two factors that affected the virus’s ability to replicate in the host, namely, antigen-reporting DCs and the presence of antibodies against the virus. Anomalies in these functions could hamper viral clearance, enabling it to stay in the body longer than expected, whereas a high ability of these immune functions suppresses viral replication and yields prompt viral clearance.
Components of immune signalling that directly affect the outcome of COVID-19 infection were revealed in this study. “ Our mathematical model predicted the persistent DC reduction and showed that certain patients with severe and even mild symptoms could not effectively eliminate the virus and could potentially develop long COVID,” concludes the duo. A better understanding of these immune responses could help shape the prognosis of and therapeutic interventions against COVID-19.
Background
Dendritic cells and the immune system: Dendritic cells (DCs) are part of the body’s innate immune system and are present in areas that come in close contact with pathogens such as the skin, respiratory tract, and gastrointestinal tract. When these tissues are infected, the DCs collate information about the pathogen and display it. DCs are now activated and transform into antigen-presenting cells (APCs). APCs then migrate to the lymph nodes where T cells reside to report this information. The T cells then migrate to and kill the invading pathogens. DCs also play a role in inflammation, a protective mechanism of the body, by releasing interferons. Interferons are chemical messengers that warn neighboring cells of a viral infection.
It is known that although the numbers of DCs do not change with age, their function is impaired. Since older patients have a higher proclivity for developing severe COVID-19, the patterns of DC function in severe infection were thus investigated by the computer simulation experiments.
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Newswise — In widely covered remarks during an interview with 60 Minutes correspondent Scott Pelley, President Biden claimed, “the pandemic is over.” Biden elaborated, adding, “we still have a problem with COVID, we’re still doing a lot of work on it, but the pandemic is over. If you noticed, no one’s wearing masks, everybody seems to be in pretty good shape. And so I think it’s changing, and I think this is a perfect example of it.”
According to the Washington Post, Biden’s remarks caught some senior officials off guard, particularly since the U.S. government has started its fall vaccination campaign. Although the Centers for Disease Control and Prevention announced more relaxed COVID-19 guidelines last month, the agency specifically said that the pandemic was not over in a press release issued on August 11th. Therefore, this statement has earned a rating of “Half True.”
With the rollout of boosters of life-saving vaccines, new treatments, and a large population already infected, the U.S. is in a less vulnerable place than it was in 2020. However, the death toll, while lower than before, is still at around 400 deaths per day from COVID-19 in the U.S. Many health experts say we’re not out of the woods yet.
“Saying that the pandemic is over has much larger and more serious ramifications, it means we take away resources allocated by Congress and other agencies. We must be careful about saying it is over. We still need resources to continue vaccination and to address vaccine hesitancy.” says Bernadette Boden-Albala, MPH, DrPH, Founding Dean and Director of the UCI Program in Public Health.
The end of masking restrictions and relaxing of other major guidelines has given many Americans a sense of moving on from the national health crisis that has festered for more than two years. Biden’s remarks, though perhaps an oversimplification, reflect national sentiment. However, COVID-19 is still very much evident in our U.S. population, and will likely continue for the foreseeable future.
“This is in great part due to human behaviors and motivations,” says Halkitis, “including subpar vaccination uptake, which continues to place all of us at risk for infection.”
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At a press briefing earlier this month, Ashish Jha, the White House’s COVID czar, laid out some pretty lofty expectations for America’s immunity this fall. “Millions” of Americans, he said, would be flocking to pharmacies for the newest version of the COVID vaccine in September and October, at the same appointment where they’d get their yearly flu shot. “It’s actually a good idea,” he told the press. “I really believe this is why God gave us two arms.”
That’s how I got immunized last week at my local CVS: COVID shot on the left, flu shot on the right. I spent the next day or so nursing not one but two achy upper arms. Reaching high shelves was hard; putting on deodorant was worse. And it did make me wonder what would have happened if I’d ignored Jha’s teleological advice and gotten both jabs in the same arm. Maybe my annoyance would have been lessened. Or perhaps the same-side shots would have made the soreness in my left arm way worse. When I posed this puzzle to immunologists, vaccinologists, and pharmacists, I got back a lot of hems and haws. For the millions of Americans who will be getting two-shot appointments by fall’s end, they told me, the choice really does come down to personal preference in the absence of clear data: You’ve just gotta pick a side. Or, you know, two.
On the one hand (sorry), there are the vaccine double-downers. Sallie Permar, a pediatrician at Weill Cornell Medicine, and Stephanie Langel, an immunologist at Duke University, both said they’d probably get both shots in the same shoulder; so would Rishi Goel, an immunologist at the University of Pennsylvania. “Personally, I’d rather have one arm that’s slightly uncomfortable than both,” Goel told me.
On the other hand, we’ve got Team Divide-and-Conquer. Several experts said they’d follow the White House protocol of splitting shots left and right. Ali Ellebedy, an immunologist at Washington University in St. Louis, told me he’d prefer to have two slightly sore arms to one totally dead one. Jacinda Abdul-Mutakabbir, a pharmacist at Loma Linda University, says she generally recommends that her patients get the vaccines on separate sides “for comfort.” Last year, she opted to get the flu shot and a COVID booster within a few inches of each other, and “I wanted to chop my arm off,” she told me. “Never again.”
The deciding logic here should be pretty intuitive, Permar told me. Two shots on one side might be expected to double how sore that arm will get, though the experience of each vaccine recipient will depend on a bevy of factors, including the ingredients in the shots and that person’s infection and vaccination history, as well as their immune-system health. Also, for people like my husband—who’s prone to very heavy vaccine side effects—the choice may not matter at all. He was so knocked out by the fever and chills that came with his COVID-flu-shot combo, he couldn’t have cared less which arms got the shots.
I dug around for studies examining the consequences of the one-versus-two-arm choice and found only one: a Canadian trial from 2003, which vaccinated a few hundred sixth-graders at two dozen middle schools against group C meningitis and hepatitis B at the same time. Roughly half the kids got both shots in the same arm; the others received one on each side. (Some kids in the latter group requested that their shots be administered by a pair of nurses who could plunge both syringes at the same time.) Among students in the same-arm group, 18 percent ended up with tenderness at the injection site that they rated “moderate or severe.” But those kids fared better than the ones in the two-arm group, 28 percent of whom experienced moderate or severe tenderness in at least one arm, and 8 percent of whom had it in both arms at the same time.
But those results apply only to that group of kids in that setting, with those two specific vaccines; there’s no telling whether the same trends would be seen with flu shots and COVID shots when given to children or adults. Michela Locci, an immunologist at the University of Pennsylvania, told me she suspects that combining flu and COVID inoculations in the same arm could actually drive extra side effects: “The overall inflammation might be higher,” she said.
Many pediatricians, who often have to administer four or five shots to a baby at once, are habitual splitters. “If there’s more than one vaccine syringe to give to a baby, generally, two legs are used,” Permar told me. (Kids usually upgrade to arm shots sometime in toddlerhood—it’s all about finding a muscle that’s big enough for the needle to hit its mark.) Doctors also have a nerdy reason to split shots between arms or legs. “If there’s a local reaction to the vaccine,” Permar said, “you can identify which vaccine it was if you separate them by space.” (For the record, I had a more painful reaction in my left arm, where I got the COVID shot. Others I’ve spoken with have reported the same disparity.)
The CDC advocates for separating vaccination shots by at least one inch of space. Per the agency, if a COVID shot is being given at the same time as a vaccine “that might be more likely to cause a local injection site reaction,” the shots should be dosed into “different limbs, if possible.” Two types of flu shots cleared for use in people 65 years and older—the high-dose vaccine and the adjuvanted one—fall into that category. But the different-limb advice doesn’t seem to apply to other flu shots, including those cleared for use in younger adults and kids.
However someone ends up taking simultaneous flu and COVID shots, the placement is unlikely to affect how much protection the vaccines provide. There could be an argument for letting “each side focus on its own thing,” says Gabriel Victora, an immunologist at Rockefeller University. “But it probably doesn’t make a whole lot of difference.” Children routinely get combo vaccines, such as DTaP and MMR, each of which combines multiple disease-fighting ingredients in a single syringe. The triple-threat formulas work just as well as injecting their individual parts. The immune system is used to multitasking: It spends all day being bombarded by microbes, so there’s good reason to believe that with vaccines, too, our body will see simultaneous shots “as independent events,” Goel told me.
Which arm gets picked for which shot, though, will affect where the jab’s contents end up. After a vaccine is injected, its immunity-inducing ingredients meander to the nearest lymph node, such as the ones in the armpits. There, hordes of immune cells fight over the vaccine’s bits, and the fittest and fiercest among them are selected to leave the lymph node and fight. Here, again, doubling up on one arm shouldn’t be an issue, Goel said: The immune-cell boot camps in these lymph nodes have “a good amount of real estate.”
It might even be a good idea to stick the same limb—and thereby, the same lymph node—every time you get another dose of a particular vaccine. After immune cells in a lymph node spot a particular bit of pathogen, some of them march off into battle, but others may hang around like reserve troops, mulling over what they’ve learned. A couple of recent studies, one of them in mice, hint that repeated delivery of the same ingredients to those veteran learners could give the body a slight edge—though the extent of that advantage “might be marginal,” Victora told me. Still, Langel, of Duke, told me jokingly that because she usually gets all of her vaccines in her “non-writing” arm, the lymph node beneath it could now be especially superpowered—a “nice bonus” for her defenses on the whole.
That said, no one should stress too much about getting a shot in the “wrong” arm. “It’s not like you’re immune on the left side and not on the right side,” Goel told me. Immune cells travel throughout the body; there is no midline DMZ. Permar even points out that getting the newly formulated COVID vaccine, which includes new ingredients tailored to fight Omicron subvariants, on the opposite side from the previous rounds could help its ingredients reach a fresher slate of cells. “I think you could convince yourself either way,” she told me. Which, honestly, leaves me totally at peace with my choice. Apart from arm achiness, I had no other side effects—and in a way, I preferred the symmetry of the one-on-each-side injections.
With all that said, it’s worth briefly acknowledging a third option: Splitting the flu and COVID vaccines into separate visits. I was, before my most recent COVID shot, some 10 months out from my previous dose. But it felt awfully early for my flu shot, which might be better timed for peak protection if taken later in the season. Still, the allure of getting it all over with was too tantalizing, especially because I happen to have a lot of travel up ahead. In the grand scheme of things, the bigger, more important choice was opting into the shots at all.
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Claim:
New CDC guidance is final proof, that these vaccines do not offer any protection against spread!
Claim Publisher and Date: Twitter users on 2022-08-11
On Thursday, the Centers for Disease Control and Prevention revised their guidelines on minimizing the impact of COVID-19. Much of the updates involve the lifting of quarantine requirements to those exposed to the virus. For example, social distancing is now recommended to be done as needed based on individual health risk and community transmission level. The new guidelines also deemphasize screening people with no symptoms, and update COVID-19 protocols in schools. One major point that has grabbed the attention of skeptics of the leading authority of public health in the U.S. is how the recommended prevention strategies no longer draw a distinction between people who are vaccinated and those who are not. People who are exposed to the virus no longer must quarantine at home regardless of their vaccination status. Although the new guidelines still emphasize the importance of vaccination and other prevention measures, including antiviral treatments and ventilation, many are using the new guidelines as proof that the vaccines don’t work. We find this claim false. The recommended vaccines to prevent severe illness from COVID-19 have been proven to be effective.
Previous guidance suggested that someone who was unvaccinated and was in close contact with someone infected should quarantine for five days, even if they tested negative and had no symptoms. A vaccinated person could skip quarantine. Under the new guidelines, there is no quarantine recommendation. Does this invalidate the efficacy of the vaccines? No. The new guidelines could be construed as a pragmatic approach on the current climate, after taking cautious measures for over two years.
The CDC said it is making changes now because vaccination and prior infections have granted many Americans some degree of protection against the virus, and treatments, vaccines and boosters are available to reduce the risk of severe illness.
The COVID-19 vaccines, such as the authorized vaccines by Pfizer and Moderna, are effective at preventing serious illness. As mentioned in previous fact checks, many studies show that they are also effective at preventing infection. More information on the effectiveness and safety of the vaccines can be read here.
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