The Road goes ever on and on ... Day 398 (898)

The New York Times released an update on a poll it has conducted on several occasions with Morning Consult. In the poll done six months ago, 47 percent of adults who described themselves as "very liberal" said that covid was a "great risk" to their personal health and well-being, a share significantly larger than those expressed by conservatives, moderates, or liberals of the not-very variety. Some 45 percent of liberals under the age of 45 thought the same despite the fact that covid has had more effect on people older than 45. According to a new poll, that 47 percent is now down to 34 percent, a drop larger than that of any of the other six ideological self-identifications. In terms of mask-wearing 28 percent of all adults said that they always wear a mask in public as do 44 percent of "very liberal" people. In the conservative end, 18 percent of "very conservative" and 16 percent of "conservatives" reported wearing masks. I do like this tweet from a "progressive activist": "The inconvenience of having to wear a mask is more than worth it to have people not think I'm a conservative." 

The FDA this morning authorized the reformulation of coronavirus boosters. Pfizer's was authorized for people aged 12 and older; Moderna's, for people aged 18 and older. The CDC still needs to approve; that is expected to happen this week. People could be getting this third, for some, booster as early as next week. It's recommended that a person who got their second booster less than two months ago wait until that time passes before getting the third.

An Israeli study published in the New England Journal of Medicine reports that Paxlovid reduced hospitalizations and deaths in older people but made no difference for people under the age of 65 and at high risk for severe covid. At the same time, a not-yet-peer-reviewed study in Hong Kong did report benefits for patients between the ages of 50 and 64, while Massachusetts General Brigham health system reported that Paxlovid reduced hospitalizations among patients aged 50 to 64 and was of particular benefit to unvaccinated people and obese people. It is worth keeping in mind that Pfizer's clinical trials on Paxlovid were conducted in the days of the Delta variant and included only unvaccinated people. The Israeli study was done under the Omicron variant. That study also did not include "rebound" cases.

US life expectancy at birth is down to its lowest level since 1996--76 years. This does not mean that people aged 75 should worry about next year. The 76 is only relevant to people now being born. I'm finding age to be a very interesting concept right now. I think of something from my childhood and then remind myself that I was a child in the 1960s. I saw a Facebook comment today about reacting to a statement of something that happened 30 years ago and thinking 1970s before realizing that 30 years ago was 1992. If we really are only as young--or old--as we feel, some days I'm barely out of my teens. Others, well, let's not go there.

The ROad goes ever on and on ... Day 397 (897)

With the new booster looming, guidance is appearing about just when to get it. Some general advice I found was to wait three to six months from your last infection or vaccination before getting the new booster. However, there is more specific advice for certain groups who should get any new booster as soon as it is available. Those groups would include immunocompromised people, people over 50, and people with medical conditions that put them at added risk. 

Coronavirus, monkeypox, polio, and now, cases of West Nile virus are rising with new infections in California, Louisiana, Maryland, and New Jersey. Since 80 percent of West Nile cases may be asymptomatic, there is likely spread out there that hasn't been detected yet. 

On the subject of incubation periods and just how and when a disease can be transmitted, an item in JAMA Network Open reports that covid's incubation time has decreased significantly with every new variant, meaning Omicron has the shortest time between infection and symptoms. The incubation period for each variant was noted as 5.00 days for Alpha, 4.5 days for Beta, 4.41 days for Delta, and only 3.42 days for Omicron. For a baseline, the incubation period for the original virus was in the neighborhood of seven to 10 days. The times just noted likely have a bit of a fudge factor in that times were recorded based on people's memories of when symptoms started. In terms of the shortened incubation period, an infectious disease specialist at the Mayo Clinic said, "...if [Omicron] had shown up and not the original strain [in 2020], we wouldn't be talking about one out of 308 Americans being dead, we would probably be talking about one out of 200."

The disappearance of various mitigation measures such as masks and distancing is causing problems for people at higher risk of catching covid. Many don't feel safe traveling now that masks are no longer required on public transit. Older adults in particular need to be more careful. Of the over 146,000 US deaths from covid so far this year, 77% percent were people over the age of 65. A geriatrician comments, "I don't want to be alarmist. I think that's the key here. I think people can live their lives. I'm 63, and I'm doubly boosted, and when I go to the supermarket, I wear my N95."

As would I, Quoted Geriatrician, if I went to the grocery store. I do wear one on all my trips away from home. I no longer feel strange being the only masked person in a crowd even outdoors. There's a certain freedom in not having people able to see if I'm smiling at them or sticking my tongue out.  

The Road goes ever on and on ... Day 396 (896)

The coronavirus seems to be of the out-of-sight, out-of-mind genre now. Not a lot of coronavirus news, and what I found was not in the mainstream media. I hope we're not forgetting about it, though I fear we are. We'll see what happens nest.

A study in the British Medical Journal looked at peer-reviewed articles on the association between regular physical activity and at least one covid outcome. Together, the studies involved almost two million adults. People who engaged in regular physical activity had a lower risk of infection, hospitalization, severe illness, and death related to covid. The greatest benefit came from 150 minutes of moderate intensity activity or 75 minutes of vigorous intensity activity spread over a week's time. Doing more than that much activity had no added effect. Other research has shown that physical activity strengthens the immune system. People who log regular exercise time are also less likely to have some of the comorbidities associated with more severe disease.

The pandemic is opening a dark door on the social media world. As the pandemic has progressed, many people have used social media as an outlet for their grief. This was especially important in the early days when people did not gather together in person to mark someone's death. Before the pandemic, reactions to such posts were generally positive or neutral. The pandemic has replaced those supportive responses with abusive ones. Internet trolls question whether someone really died of covid or died at all, suggest the deceased brought it on themselves with underlying conditions, or say that the deceased wasn't worth remembering.  

Finally, the latest covid surge appears to be lessening. Omicron infections have generally been milder than but have led to as much long covid as earlier variants. Some researchers warn that an extremely large number of Omicron cases means that a flood of long covid cases is looming. The US has recorded in the neighborhood of 38 million infections so far in 2022, or 40 percent of all infections reported since the onset of the pandemic. It's been estimated that 82 percent of Americans have been infected, which means that most new cases are reinfections, some of whom are still wrestling with covid symptoms from one of their earlier infections. Long covid is not well understood, but from what I understand, I don't want to risk developing it, which means continuing to avoid covid as much as possible. 

The Road goes ever on and on ... Day 395 (895)

Not much coronavirus news out there today, and while not really bad news, I'm not sure it would pass for good news. Pfizer boosters targeting both the original and Omicron strains should be available shortly after Labor Day. They will be available to everyone ages 12 and over. The Moderna booster will only be available to people ages 18 and older when it comes out a bit later. The folks who need this the most are senior citizens, an age group into which I crept a year or so ago. Of that age group, people ages 65 and older, some 71 percent have gotten the first booster. Only 41 percent of that 71 percent have gotten a second, meaning it's not at all clear how many will rush out to get the third.

It may not help that funding for "free" vaccinations is drying up. Monkeypox and potential polio outbreaks are diverting resources from the coronavirus. Some state officials, not expecting a big response this fall, want to know why they should push vaccines no one wants. It only makes things worse that the federal government has run out of money to reimburse entities for shots given to uninsured people. The US is depending more and more on vaccination as other preventive measures such as masking or distancing are being weakened. This is not working given the reluctance to be vaccinated and/or boosted. As evidence, the US per capita booster rate is lower than that of about 70 other countries. The covid death rate in the US is 80 percent higher than the rate in Canada and 30 percent higher than the rate in the EU.

If you have not gotten your second set of free covid test kits, ask now or you likely won't get them. Distribution of the free tests ends on Friday or when supplies run out, whichever happens first. We have used some of our kits to test after we've been in groups of unmasked people especially indoors. The Professor also shared a couple with students worried that they might have been exposed. It was nice to have them and not have to debate whether to go someplace to be tested on a "what if, just in case" basis. They have actually now passed their expiration dates, but if needed we will likely still use them. I read somewhere that they would be good for some time after the date on the packaging. That was in response to the question of whether the free test kits were offered in an attempt to get rid of almost-too-old kits.

The Road goes ever on and on ... Day 394 (894)

Another day of wondering if no news is good news. None of my usual sources had anything coronavirus worthy of note, so I'm not noting anything here. Instead I've sewn together fabric to be the back for a quilt I started 25 years ago and am finally finishing. Better late than never. At least the person I'm making it for didn't die in those 25 years.

The Road goes ever on and on ... Day 393 (893)

Another somewhat slow news day. On the coronavirus front, Moderna is suing Pfizer and its German partner BioNTech claiming they used mRNA technology patented by Moderna. Moderna had said in fall 2020 that it would not enforce patents while the pandemic continued. I guess it's ended enough for the suit now. Moderna claims that Pfizer and BioNTech copied two features of patented technology. First, Moderna alleges that Pfizer and BioNTech took four vaccine candidates into clinical testing and eventually went with the one that had the same mRNA technology as the Moderna vaccine. Second, Moderna says that Pfizer and BioNTech copied Moderna's full-length spike protein formulation, something Moderna created years before SARS-CoV-2 emerged. Moderna says that it is not seeking the removal of other vaccines nor for an injunction to prevent their future sale. I have to wonder then if the lawsuit is all about credibility and who gets the Nobel or other noteworthy prize.

And that, believe it or not, is all I found this morning. Due to an unforeseen occurrence, I did not have as long to news-troll than I would otherwise have had, but Moderna's suing Pfizer seemed worthy of mention.  

The Road goes ever on and on ... Day 392 (892)

It did not surprise me to read that the administration of the previous president (who shall not be named) tried to "bully" the FDA to reauthorize hydroxychloroquine. It had been given emergency use authorization in March 2020, but that authorization was revoked in June 2020 after the drug had been found to be ineffective and potentially dangerous. The goal was to help that previous president politically before the election he ended up losing. The FDA was also pressured to approve vaccines so that shots could be started before election day. When this would clearly not happen, the previous president tweeted, "Just another political hit job!"

On the long covid front, it seems that something similar happened after a pandemic in 1889 and the 1918-19 influenza pandemic. Viral infections in general can lead later to debilitating conditions. Danish researchers have found association between neurodegenerative disorders such as Parkinson's and Alzheimer's not just with covid but also with influenza. There is a proposal to begin a National Institute for Postviral Transmission. Some terminology should probably be standardized first. The CDC defines long covid as "a wide range of symptoms that can last more than four weeks or even months after infection." WHO defines it in terms of conditions that are present "for at least two months and cannot be explained by an alternative diagnosis." Both agencies cite similar symptoms including fatigue, shortness of breath, cognitive dysfunction, brain fog, pain, digestive symptoms, depression, anxiety, cough, headache, and sleep disturbances. 

Another slow day. Queen Elizabeth still lives, Ukraine is still at war, and if Kilroy was ever here, he's gone now.

The Road goes ever on and on ... Day 391 (891)

North Korea not too long ago said it had conquered the "fever" thought to be covid. If anyone can explain why China exported 1.23 million face masks and 15,000 pairs of rubber gloves to North Korea in July, I'd love to hear that explanation.

The FDA has authorized Novavax's vaccine for emergency use in adolescents ages 12 through 17. The vaccine has 80 percent efficacy for that age group, and 90 percent efficacy for adults 18 and older. This is the first vaccine to use protein-based technology. Novavax has already started trials on children between the ages of 6 and 11 and is expected to start trials soon on ages six through 23 months and two through five years. 

A University of California at Irvine study on the perception of time during the pandemic had some results I do not find surprising. The study has been published in Psychological Trauma: Theory, Research, Practice, and Policy. The formal term for what the researchers saw happening is "temporal disintegration." Predictors of that disintegration include media exposure, school closures, lockdowns, and financial difficulties. I read that with a big "duh!" 

Finally, a research letter in Lancet Infectious Diseases reports that excess deaths in Massachusetts have been lower than expected in a population in which 80 percent of people are fully vaccinated. Said one of the researchers, "We are finally in a phase now where highly immune populations can start to shoulder COVID-19 waves without the guarantee of excess mortality. Before, a COVID wave meant we knew we would have excess mortality." Hospitalization numbers have not really changed, the only notable change is in deaths. This effect has been dubbed "herd safety" rather than the "herd immunity" touted earlier in the pandemic. 

The Road goes ever on and on ... Day 390 (890)

Both Moderna and Pfizer have requested emergency use authorization of their updated vaccines. It appears no additional human trials will be needed. If the FDA grants the authorization, boosters of the updated vaccine may be available in early to mid-September. Given that I got my second booster in April, around five months ago, I will probably not wait too long before getting in line for the new booster. Of course, it is tempting to wait until October and get flu and covid vaccines on the same visit.

The local county school system is catching heat for doing away with covid leave. During the last two years, teachers or other staff coming down with covid could take covid leave, special leave that did not count against whatever sick or annual leave they had accrued. That's said to be gone now; teachers and others testing positive will have to use their sick leave if they want to stay out of the classroom or school building. Sick leave is used for more than the illness of the person who has the leave. Sick leave might be used for caring for a sick child, for example, or medical appointments during pregnancy. I no longer have children in the K-12 schools, but if I did I would not want them in a classroom with a teacher who's testing positive for covid, asymptomatic though they may be and unwilling or unable to use up their accrued leave. The city school system here is keeping covid leave in place for now.

Will a new, improved vaccine contribute to the vaccine fatigue that seems to be growing in many places? One source defined such fatigue as "inertia or inaction towards vaccine information or instruction due to perceived burden and burnout." Precursors of vaccine fatigue are said to include the frequency of immunization demands, vaccine side effects, and misconceptions about the need to vaccinate. Is this fatigue why the turnout for the first booster was not as large as predicted and turnout for the second was even worse? Or are people simply tired of everything about the pandemic, other than those people who would prefer to keep working from anywhere but a business office? Do they think out-of-sight, out-of-mind will make it go away? I would not be surprised to learn that a large number of theses or dissertations were being crafted on the psychology or sociology or public health implications of the last two-plus years.

The Road goes ever on and on ... Day 389 (889)

Back from the alternate universe of the previous post. I commented on a Fecebook post from the Bangor, ME Police Department and mentioned I would wear my handcuff earrings today in honor of LEOs everywhere. That of course inspired a person to ask for a picture. I could not figure out how to post a photo in a comment or reply to a comment, so I put one up here. Of course, when I copied the link into Facebook, it carried the photo with it.

Are we out of the pandemic yet? Dr. Fauci has announced his retirement, but I don't think that's a sign the pandemic is over. He turns 82 on Christmas Eve. We're lucky he didn't retire years ago, as in before the administration in the White House, 2017-2021. I don't want to think what things would be like now had we not had him looking out for us. 

Remember the big push to get covid vaccines for all ages? It seems that as of early August, only five percent of eligible children under the age of five had gotten even a first vaccination, and the number being immunized now is decreasing. Only 30 percent of children between the ages of five and 11 are fully vaccinated. Is this because Americans have lost trust in our national public health system? Quite possibly, between the misinformation, disinformation, and inconsistent information from various sources including the CDC. While elderly people are still the most at risk, that does not mean children can go without vaccination. Of course, children die from influenza each year, and flu vaccines have been around for years. 

As public schools open here in the US, they are reopening in the Philippines after being closed for two years. While online instruction was offered during those two years, not all children had access to the Internet, nor were all parents able to monitor their children's online learning. Even before the pandemic, Philippine education was in trouble. Over 90 percent of students were unable to read and understand simple texts by the age of 10. By November, all 47,000 schools should be open in person five days a week. Given that many households in the Philippines house three (or more) generations, outbreaks that happen in schools could have major ramifications. 

A recent study that tracked symptoms before covid infection and compared participants to controls indicates that one in eight people experience prolonged covid symptoms over many months. If only six percent of adults have prolonged symptoms and two-thirds of adults have had covid, that means that over 10 million Americans have prolonged symptoms. Those most likely to get long covid are younger (between the ages of 30 and 50) and previously healthy. There are 25 trials in progress looking at various treatments, but all are relatively small. I wonder if we'll ever know for sure. 

Handcuff Earrings

It's not a great photo of me, but the earrings show up well. I made them from a necklace of handcuffs I bought at the Spy Museum. Our financial advisor actually paid me to make some for his wife's Valentine'c Day party.

The Road goes ever on and on ... Day 388 (888)

The Road goes nowhere today. I couldn't find any coronavirus news worthy of note. It was difficult to find any coronavirus news at all. Are we there yet? I think not, but maybe Sunday is covid's day of rest. So, Son #2 finished the Leadville 100 Miles with 35 minutes to spare out of the 30-hour limit. Son #1 made it to the halfway point, confessed to a probable case of rhabdomyolysis, and was med-dropped and sent to the ER for evaluation. The Sons had a contingency plan in case one had to be med-evaced, which was the one not being dropped would keep going. It seems that Son #1 was a bit reluctant to leave Son #2 until Son #2 profanely told him to get his ass back in the race. 

Son #1 said the second half, going back over the same 50 miles in reverse, was rough. There were times he didn't think he'd make it. He also kept checking for signs that he might also be developing rhabdo. For those who wonder, here's the CDC definition: 

Rhabdomyolysis (often called rhabdo) is a serious medical condition that can be fatal or result in permanent disability. Rhabdo occurs when damaged muscle tissue releases its proteins and electrolytes into the blood. These substances can damage the heart and kidneys and cause permanent disability or even death.         

Son #1 made it to the ER after changing shuttle vehicles a couple of times. They gave him IV fluids and did several sets of blood work. hey made him spend the rest of the night there. About the time Son #1 finished 100 miles, Son #2 was being discharged after a night of being awakened repeatedly to check his condition. 

The Sons were smart about it. I could not be happier or prouder of them. As they sometimes say, they do stupid things, but they do them smartly. Running 100 miles at altitude, while not stupid, is not without risk, but they handled it. I imagine that both of them are sound asleep right now. They drive to Denver and fly back tomorrow. They say they'll both enter the lottery for next year's race. They also say they will both be ready for the 100 mile race they're running here in four weeks. Stupid they may be, but at least they are smart about it. 

The Road goes ever on and on ... Day 387 (887)

I couldn't find much covid news this morning, so I'll start with The Kiddos. They just left the aid station located 38 miles into the 100 miles that constitute the race. This means they are about to start a climb of about 3,000 feet. Then they will run down the far, up a bit, and then they turn around and do it all in reverse. They don't run ultras to win, place, or even show; they run them to finish; fingers crossed that they can finish this, arguably the hardest race they've run due to the elevation. I was able to set up text alerts so that whenever they pass an aid station, I get the relevant info such as time, pace, etc. 

Back to covid. The Professor and I tested ourselves this morning just in case we picked something up on our masked tour of Thomas Jefferson's Monticello on Monday. We both tested negative. The guidelines say to test two days in a row after a possible exposure, so we'll repeat the tests tomorrow. 

A fresh covid outbreak in Tibet has stranded thousands of Chinese tourists. So far there are 216 confirmed cases and 3,479 asymptomatic ones. People went to vacation spots to escape the possible city lockdowns, and now they're locked in those places. The beach resort of Hainan reported enough cases this week to raise China's total to a three-month high. One issue in Tibet is its remoteness; there is limited medical capacity and experience. 

K-12 schools are in the process of starting for the year. New York City has made some changes to how they deal with covid. First, there are no longer general vaccine mandates; however, vaccination is required for some extracurricular activities including some sports. Teachers, staff, and visitors to schools must be vaccinated. There are no longer general mask mandates, though masks will be available. Students who test positive will have to wear masks on days six through 10 after their first positive test or the onset of their symptoms. Last year, families had to complete daily health questionnaires; these are now a thing of the past. At-school exposure means two tests, 24 hours apart, on days four and five after exposure. Anyone with symptoms should stay at home. Students and staff will each get four tests per month, and there will be no PCR testing at schools. A positive test means isolation for five days. A person can return on the sixth day if symptoms are gone or improving. Masks will be required until 10 days from the test or the onset of symptoms. The public schools here start this week. It will be interesting to see what covid policies they have in place.

The Road goes ever on and on ... Day 386 (886)

Long covid gets some attention today. It seems that the post-covid risk of neurological and psychiatric disorders can last for up to two years, longer than for any other respiratory infection. Such disorders include cognitive deficit (brain fog), dementia, psychotic disorders, epilepsy, and seizures. The incidence of anxiety and depression also rises with the excess risk of those disorders disappearing in a matter of months. New cases of neurological and psychiatric disorders have been diagnosed two years post-covid. Children have no increased risk of mood disorders, but can develop all the same disorders adults can; the likelihood of children developing such disorders is less than that for adults.

Healthcare professionals and severely affected covid patients are questioning whether the US is loosening things up too quickly. Says a clinical associate professor at the Stanford University medical school, "It feels somewhat like a personal affront, like all our sacrifices mean absolutely nothing because in the end, no one cares." As for whether the pandemic has lessened "enough," a WHO spokesperson notes, "We are still very much in the middle of the pandemic with intense transmission globally with close to a million cases daily and sadly over 14,000 people dying every week. With such high levels of transmission it is not surprising that the SARS-CoV-2 virus continues to evolve."

The CDC has been lax in defining just what constitutes the "high-quality mask" they advise infected or exposed people to wear. I'll stick with the N-95 or equivalent. As for general mask-wearing, a mask study recently found that being an active smoker decreased a person's risk of testing positive. However, should a smoker test positive, their symptoms will likely be worse than those of a non-smoker.

On the home front, The Sons are in Colorado and will be running the Leadville Trail 100 tomorrow. That's 100 miles. The Sons have run 100-milers before, but never one that starts at an altitude of 9,000 feet. The race starts Saturday at 4:00 am Mountain Time. Assuming the altitude and/or weather don't do them in, they'll be finishing Sunday morning. If covid news is in short supply tomorrow, I can always post how those crazy kids are doing.

The Road goes ever on and on ... Day 385 (885)

Wastewater surveillance may be the future of disease tracking. It has been used extensively during the coronavirus pandemic and recently helped verify the return of the polio virus. There are hints that the West Nile virus may be resurging, but I have not heard that in conjunction with wastewater sampling.

The Marshall Islands in the Pacific were one of the last places on earth to identify a first case of the then-novel coronavirus. Two travelers tested positive there in October 2020. The islands also recorded no covid cases in 2021. There is a natural barrier to a disease getting started on an island; the coast offers a natural defense. Unfortunately, when a disease gets started, that same coast limits spread and focuses it back to the island's interior. Now, in just over one week, over 4,000 covid cases have arisen in a population of just 60,000.

POTUS had two rounds of covid, and FLOTUS is in her first. She was vacationing in South Carolina when she tested positive and will remain there until she tests negative on two consecutive tests. POTUS was, as might be expected, in close contact with FLOTUS and will now wear a mask for 10 days. He will also be tested more often.

Remember the stimulus payments given earlier in the pandemic? It seems that billions of dollars of that relief aid was stolen. There are about 39,000 ongoing investigations of the two million potentially fraudulent applications. The statute of limitations on some relevant offences has been extended from five years to 10. While I was surprised at the large numbers, that the fraud happened was not surprising. The funds were given out based on the honor system. I mean, no one ever lies on the honor system, do they?

Finally, the FDA is considering basing decisions about authorizing new boosters on studies with mice, not humans. Public opinion on this is split with expert comments ranging from "bizarre" to "something better." Those favoring the switch note that the current vaccines have been tested on so many humans the safety is clear. When I read something like this, my mind immediately jumps to science fiction novels in which something known absolutely to be okay really isn't, and the negative effects take long enough to develop that a very large number of people have already received it. Just my $0.02 worth.

The Road goes ever on and on ... Day 384 (884)

The White House is saying that if the bivalent vaccines meet FDA standards, they will likely be available in early- to mid-September. Given that September is but two weeks away and CDC as well as FDA approval would be needed, my bet would be on mid- to late-September, and I would not be surprised if things slip into October. Given that I had my second booster in early April, I'll likely go for the next booster as soon as it's available, especially if I can get my flu shot at the same time. 

According to the White House coronavirus guru, the White House is trying to "get out of the acute emergency phase" in which the government buys and distributes vaccines, treatments, and tests. It seems that commercialization of some or all of those products may begin this fall. I'm wondering how much each will cost and whether private insurance will cover part or all of the costs.

Near the start of the pandemic, in April 2020, some scientists started looking at the Bacillus-Calmette-Guerin (BCG) vaccine developed in the early 1900s to treat tuberculosis. It bolsters the immune system as a whole, not acting against any specific invader. Could it provide a measure of universal protection? A small study done before the coronavirus vaccines were available found one of 96 people treated with BCG got covid, while 6 of 48 untreated controls did. A Greek trial found that BCG reduced covid infections by two-thirds while also lowering rates of other respiratory infections. On the other hand, studies in the Netherlands and South Africa found no effect. Data from the largest study are still being analyzed. The BCG vaccine is composed of a live attenuated bacterium of which there are different strains. The Tokyo strain is particularly potent while the Denmark strain is the easiest to obtain. The number of doses of BCG that a person gets may also be important. Some researchers currently studying BCG are looking at its potential use in the next pandemic; they believe the current vaccines are effective and don't need replacing. 

An article in Science reports on blood abnormalities found in people with long covid. Some are similar to or the same as in Chronic Fatigue Syndrome. One is lowered cortisol levels. Cortisol helps the body control inflammation, glucose, sleep cycles, and more. Blood analysis also  showed that the body's T cells are still fighting some infection.

The CDC director says that the CDC failed to respond quickly enough to the coronavirus and needs an overhaul. Among the goals would be prioritizing public health needs and efforts to control continuing outbreaks. And I now have CDC guidance to quote the next time someone asks me why I'm taking virus mitigation so seriously:

If you are at higher risk for severe illness, the CDC advises taking more personal precautions than others. 

That pretty much sums up how I'm treating the coronavirus for now and possibly longer. I'll test myself over the weekend to see whether covid managed to find me in the Monday crowds at Monticello.

The Road goes ever on and on ... Day 383 (883)

A new study has been published looking at covid and the brain. The study matched 401 covid patients with no-covid controls and looked at MRIs before and after covid infection. The major findings were post-covid cortical atrophy, cognitive decline, and reduction in global brain size. I find that last one quite interesting. If I were a stand-up comic, I might follow that list of three with the question why couldn't it be a reduction in hip size rather than brain size. 

Discussion continues to be given to certain points of the CDC's latest guidance. In terms of assessing risk, the CDC looks at hospitalization data, with the counterargument being that it should instead look at case data given asymptomatic or mild symptoms keeping many patients out of hospitals but very capable of spreading the virus. Currently, 39.7 percent of US counties are rated high transmission risk according to hospitalization data; using case numbers puts 94 percent of counties at high risk. CDC's philosophy of "living with covid" ignores much of the scientific evidence. In addition to the calculation of transmission risk mentioned above, the five-day isolation after testing positive is not based on any data of how long covid patients are infectious.  The Evusheld anti-viral that can prevent covid for six months so far has only been given to about six percent of immuno-compromised people. The CDC continues to define "full" vaccination as having had only the initial dose(s); boosters are considered an add-on. Finally, some experts say that the CDC is not giving long covid enough attention. 

Customers broke out of an Ikea store in Shanghai when faced with the prospect of being locked inside. A customer had been in contact with someone positive for covid, and health officials wanted to keep all those who might have been exposed in one place. The shoppers must now quarantine themselved for two days followed by five days of health monitoring. Other sites that have been locked down successfully include hot pot restaurants, gyms, and offices.

The UK has become the first country to approve a bivalent vaccine that targets the original viral strain as well as the Omicron variant. The one approved is Moderna's. Pfizer's is still in process; AstraZeneca is not updating their vaccine. The groups to be offered the bivalent booster in autumn are health and social care staff, everyone ages 50 and older, people over the age of five who are at greater risk, pregnant women, and people over the age of five who live with someone with a weakened immune system. I'm not going to try to guess when we will have a bivalent vaccine ready here.

The Road goes ever on and on ... Day 382 (882)

Taking another day off here. Walking around all morning and into the afternoon, often in the rain, was pretty tiring. However, I can now check visiting Thomas Jefferson's Monticello off the list of things I wanted to get done this year. I may actually do a covid self-test in a couple of days. The guide and the four of us, all with science backgrounds, were the only people on the tour wearing masks. We stayed masked, even outdoors, when closer than "socially distant" from other people. Fingers crossed that was enough.

The Road goes ever on and on ... Day 381 (881)

Company is coming this afternoon, and there is still CHAOS left to deal with. That's CHAOS as in Can't Have Anyone Over Syndrome. Breaking news on the viral front is that WHO wants to rename monkeypox. They have already started calling the two strains by something other than the place of origin. I wonder when they will get to Spanish flu, Marburg virus, and Middle Eastern Respiratory Syndrome. (At least I think that's the full name for MERS.)

The Road goes ever on and on ... Day 380 (880)

The times they are a-changin'! The Coronavirus Briefing put up by The New York Times is becoming the Virus Briefing, issued on Monday, Wednesday, and Friday. They say, "We will continue our expansive coverage of the coronavirus, but will also keep close tabs on other viral threats and health issues." As might be expected, the spread of monkeypox and resurgence of polio helped them make the decision. Monday and Friday, the briefing will present a "short breakdown of news you need to know." On Wednesday, it will present 'in-depth coverage of the latest developments."

The relationship between long covid and mental health goes both ways. Electronic records of over 150,000 covid patients were compared to those of patients who had not had covid. None of the covid patients had been treated for mental health issues in the two years prior to the covid infection. Looking at the patients who had had covid, 39 percent were more likely to be diagnosed with depression while 35 percent were more likely to be diagnosed with anxiety one year after recovery from covid. On the flip side, people previously diagnosed with depression or anxiety seem to be at greater risk for developing long covid. Depression and anxiety are very common in today's America, but seem a bit more common in people who develop long covid. 

The article I was reading actually had a section with the title, "Why are people with long covid experiencing mental health issues?" My immediate thought was, "Well, duh!" The article did note that just having covid can be depressing and cause anxiety, but only after discussing how inflammation and immune response affect the brain as well as the rest of the body. It can develop into a vicious cycle. As for how people suffering from long covid should seek help, the article suggested support groups or doctors who specialize in treating long covid patients. This generated another "Well, duh" response here.

Global covid deaths dropped nine percent last week, but cases stayed the same. Same old, same old?

The Road goes ever on and on ... Day (379) (879)

Much of this morning's coronavirus news was yesterday's CDC announcement of relaxed covid guidelines. There is still much to learn about the Federal Bureau of Investigation's search of the home of the most recent ex-president; latest word is that they were looking for nuclear documents. Segue to midday today and Salman Rushdie was stabbed in the neck as he prepared to give a talk. As I type, he's been taken to a hospital, his condition unknown. The person who did the stabbing is in custody. The fatwa ordering his death for blasphemy was issued in 1989.

On to the coronavirus. One expert noted that the most notable change in the CDC guidance is what is not there. There is no guidance on how any surges should be handled or at what point should mitigation measures such as masks be reinstated. As noted yesterday, some guidance did not change. A person who tests positive should still isolate for five days, stopping when symptoms have improved and any fever has been gone for two days. After re-emerging, the person should spend five more days wearing a properly fitting mask. People living in counties with high levels of covid transmission should wear masks in public indoor settings. 

In terms of long covid, I read a source noting that some people had significant health issues for years after infection with SARS-1. It's not clear if we will ever know the full extent of the long covid some SARS-2 patients are facing.

Moderna hopes, within the next five years, to develop a single annual dose to cover coronavirus, influenza, and another common respiratory virus. The company is also studying personalized cancer vaccines and a monkeypox vaccine.

There could be hundreds or even thousands of polio cases in New York given the quantity of viral material found in wastewater in and outside New York City. Many polio cases are asymptomatic or only mildly symptomatic and are easy to miss. Canada meanwhile will start wastewater testing "as soon as possible."

Finally, some scientists are calling the Langya henipavirus a mere tip of the iceberg when it comes to zoonotic diseases passed from animals to humans. There is no evidence yet that Lanya is spreading human-to-human, something I hope continues. Seventy percent of emerging infectious diseases worldwide are thought to be animal-to-human transmission. A virologist at the University of Hong Kong says that continued study "is important so that we are not taken unawares by the next pandemic, when--not if--it comes."

"When" it comes ... I hope it's not already here.

The Road goes ever on and on ... Day 378 (878)

I was about to write something about the dearth of coronavirus news, followed by the two things I had found. Then, BAM! The CDC has issued new guidance on living with the coronavirus. As with almost everything about the pandemic, there are differing opinions on that guidance. Here goes.

Some things did not change. People showing symptoms and their close contacts should test for covid. Those who test positive should stay home for five days then stay masked for five more during which they can go out into the world. People living in counties with high covid levels should wear masks indoors. 

What's new? For one, social distancing is no longer necessary. It seems that enough people have enough immunity from whatever source that proximity no longer matters. Contact tracing is needed only for hospitals and certain high-risk group-living situations such as nursing homes or prisons. (Does anyone else see the humor in putting those two places together?) The use of regular covid testing is no longer needed except in those high-risk group-living settings. People who have been exposed but are not infected no longer need to be quarantined. People with moderate symptoms such as shortness of breath and those who have been hospitalized should stay home for 10 days rather than five. Immunocompromised people should talk with their doctor about coming out of quarantine after the infection. Finally, people with rebound cases should start over with isolation but also see their doctor. 

As to the differing opinions, an infectious disease specialist at the University of California in San Francisco says that the guidelines align with what people have been doing. They simply "reflect prevailing attitudes toward the pandemic." A Harvard epidemiologist says the new guidelines "...start giving people tools they can use to do something or not. Because otherwise, people will just will [sic] not take you seriously."

One of the sources I check regularly and with whom I generally agree, Eric Topol, responds, "This revision does not go anywhere near enough to correct the problems of flawed recommendations and lack of evidence."

If you've been reading this blog consistently, you know where I fall on the issue. Your mileage may vary, and that's okay as long as you let other people know where you fall. 

The Road goes ever on and on ... Day 377 (877)

Let's do a roll call of diseases about which to worry. There's covid followed by monkeypox followed by polio followed by Langya. Huh, you ask? What is this new disease of concern? Langya virus was first detected in China in 2018 but was only formally identified last week. There have been no deaths so far and, for now, no evidence of person-to-person transmission. The human cases have been zoonotic or tied to exposure to an animal carrier. Langya was found in one-fourth of 268 shrews caught in Taiwan as well as in two percent of domestic goats and five percent of dogs. Langya is a henipavirus, a category of RNA viruses that also includes Hendra virus and Nipah virus, both of which have been associated with high fatality rates. Fortunately, cases of these are very rare. Climate change and the destruction of nature have greatly increased the risk of zoonotic spillover of viruses from animals to humans. Want to know what to look for in Langya? Symptoms include fever, fatigue, cough, loss of appetite, and muscle aches. 

Also in China, covid cases have been reported in Tibet and Hainan, both tourist hubs. There are no Shanghai-style lockdowns in Tibet yet, just mass testing in Lhasa and Shigatse, the gateway to the Everest region. 

A recent survey of 1,580 adults demonstrates how too many (in my humble opinion) people think we're over and done with the coronavirus. The survey was done while Omicron was surging. Some 54 percent of respondents said they personally knew at least one person who had died of covid while 31 percent know someone who experienced long covid. More than half know someone who had a breakthrough infection, getting covid even though vaccinated. And 53 percent say they think it is likely that someone vaccinated but not boosted will catch covid in the next three months. That's all well and good, but 54 percent of respondents say that they rarely or never wear a mask indoors around people not in their household, more than double the percent found in January. In January, 16 percent of respondents said that they had returned to their "normal, pre-COVID-19 life." That has gone up to 41 percent now.

The Road goes ever on and on ... Day 376 (876)

One of many arguments in favor of vaccinating children: A study using a large medical-claims database suggests that children ages 0 to 17 with confirmed covid develop several conditions more often than do uninfected control subjects. Those conditions include acute pulmonary embolism, myocarditis and cardiomyopathy, venous thromboembolic events, acute and unspecified renal failure, and Type I diabetes. None of those sound particularly good to me and demonstrate the wide range of organs being affected by the virus. Children with covid had low rates of several other conditions compared to controls. These conditions include respiratory, mental health, neurological, muscle, and sleeping disorders. The standard used for the various conditions was "new, recurring, or ongoing health problems that occurred 4 or more weeks after infection with SARS-CoV-2." The statistical models used controlled for possible co-variants such as age, race, gender, and so on. 

On the adult side, it appears that persistent loss of smell after covid may predict cognitive impairment in older adults. In fact, loss of smell seems to be more strongly associated with cognitive impairment than the severity of the initial infection. Says a spokesperson for the Alzheimer's Association, "We're learning more every day about the link between COVID-19 and the brain. Loss of smell is often a signal of an inflammatory response in the brain. We know inflammation is part of the neurodegenerative process in diseases such as Alzheimer's." In other words, we still don't really know the big picture of covid's effect on the body and the brain. Also on the adult side, a yet-to-be reviewed study suggests that at least 43 percent of long covid sufferers may have chronic fatigue syndrome. 

I wonder sometimes if it's keeping this blog that makes me so obsessive about not putting myself in situations in which I could possibly get infected. Looking at more information each day than I write about here has shown me much more than I otherwise would know about the different ways the coronavirus can hurt me. It's certainly shown me the range of things we do not yet know about the long-term effects of the coronavirus, and that's frightening. Someone in a quilt group told me last week that they had had covid and it really was not a big deal. I just noted that each case was different and I did not want to find out how mild my own case of covid might or might not be. 

More evidence of polio is appearing in wastewater testing in New York. The State Health Commissioner said they were "... treating the single case of polio as just the tip of the iceberg of much greater potential spread. As we learn more, what we do know is clear; the danger of polio is present in New York today." If it's not covid, it's polio or monkeypox; Mother Nature must be really pissed at us over climate change. 

The Road goes ever on and on ... Days 373-375 (873-875)

I do have covid notes from today and just read some info on a new variant of concern, Omicron BA.4.6. I have unpacked but still have load(s) of laundry to work through. I'll write something for real tomorrow.

The Road goes ever on and on ... Day 372 (872)

A quick morning post before I work in a quick workout and assemble the rest of the non-cooler things we will be taking. I'll be able to check news if an intermittent cellular signal permits and will write a daily something to post when we get back on Monday. And if the cellular goddesses don't want to help out, I just won't write anything those days.

Something sobering from the CDC website: "Although rare, children with prior COVID-19 had higher rates of certain conditions a month or more after diagnosis than children without COVID-19." The conditions highlighted in the graphic were heart conditions, kidney failure, blood clots, and diabetes. To vaccinate one's kids or not vaccinate them? I wouldn't be reading the above to help make my decision. My kids would have been vaccinated as early as they could be. The report on which this was based can be read HERE. The report does list seven limitations of the study.

That does it for today. Now to see that The Professor puts work and grad students aside at least for a couple of days.

The Road goes ever on and on ... Day 371 (871)

The CDC is apparently about to relax some restrictions that may already be too loose in their current form. Do they think it's over? If they do, here are a few sobering observations: Half of all covid infections during the entire pandemic have taken place this year. If the current pace continues, over 80 percent of all the cases will ultimately happen in 2022. Some experts define endemicity as when each infected person infects no more than one other person. We aren't even close right now. Some epidemiologists cite an annualized death rate of 100,000 per year. This would make covid the most deadly infectious disease. One epidemiologist suggests that we may be back to covid's being an old person's disease given the difficulty older people have in building up and maintaining immunity. I wonder whether that would make many people take it less seriously than they do already. I mean, those old people are going to die soon anyway, right?

Current CDC guidelines say someone can leave isolation after five days if they have not had a fever for 24 hours and their symptoms are improving. They should wear a tight-fitting mask for the next five days and stay out of areas with high possibilities of transmission. The "however" is that a small study tested 17 patients on their sixth day. Twelve still had positive results on rapid antigen tests, and six of those had culturable virus, in other words, were still infectious. Two had symptoms that were improving, two had unchanged symptoms, and two had never had any symptoms. The results may not be generalizable because of the small sample size and the fact that most of the 17 people were young, vaccinated, and not hospitalized. Still, it's serious food for thought. 

The CDC is expected to ease quarantine restrictions for infected people, de-emphasize social distancing, and downplay regular screening testing in schools. The guidelines are just that; they are in no way legally binding. Call me overcautious or even paranoid, but in my humble opinion they're moving in the wrong direction.  

Monkeypox moment: It's being declared a public health emergency by the federal government. This will free up some emergency funding and give federal agencies the power to expedite vaccines and drugs and hire extra staff needed to help handle the increased work. It's probably a good thing this is happening now since many experts say we've passed the point at which monkeypox can be contained.

The Road goes ever on and on ... Day 370 (870)

Another slow day. After taking today's notes, I worked on my next quilt; I'm embarrassed to say I started this one 25 years ago and never finished it. I can't say I was a beginner at quilting when I made it, but I see in it things I do much differently now. I then made the crust dough for the blueberry pie I will make tomorrow to take along on our weekend escape. And once I write this, I will have plenty of time for something else. Perhaps the bag I'm knitting or the 2,000-piece jigsaw puzzle Son #1 gave me for my birthday. He wrapped the top of the box, so I'm doing it blind. The professor thinks that what we've done so far looks like curtains. I'm not sure what I think except that it's challengingly fun.

The CDC defines covid rebound (also known as Paxlovid rebound) as the return of symptoms or a "new positive viral test after having tested negative" occurring "2 to 8 days after initial recovery." Infectious disease docs evidently can attest that some respiratory diseases other than covid also can have a bimodal course. One problem in identifying covid rebound is that there are secondary bacterial infections that may be misidentified. Another problem is antigen testing. Such testing can't distinguish between viable or dead viruses. The first would be transmissible; the second, not.

New Zealand's borders are fully open for the first time since March 2020. Most visitors will still need to be fully vaccinated, but there are no longer any quarantine requirements. 

Up in the Great White North (also known as Canada), extortion cases rose nearly 300 percent in the last decade. More of those attempts are now online thanks to the increased internet activity of the pandemic. British Columbia is now vaccinating everyone ages six months or older. They're using the Moderna vaccine at one fourth the adult dosage with two shots given four weeks apart. 

Also in Canada, Alberta just had a bout of ... wait for it ... baseball-to-grapefruit-sized hail. I would not want to be outside or have left my car out in the open, but it would definitely rock to see such hail. I wonder how long it lasted before melting away. 

The Road goes ever on and on ... Day 369 (869)

Yesterday, I suggested that I did not find a statement about POTUS feeling well as grammatically correct. Back in the day when they taught grammar in English classes, I learned that because "feel" is a verb,  "well" is an adverb modifying it. If you feel well, you're doing a good job feeling things such as shapes in a canvas bag. So saying that POTUS "continues to feel quite well," I have to ask just what is he feeling? When "good" is put after it, "good" remains an adjective. It modifies the person who feels good, not the verb. So in speaking of one's health, "feeling good" is the appropriate usage. I do hope POTUS continues to feel good. 

Monkeypox moment: California has joined New York City in declaring a monkeypox state of emergency. The federal government also now has a national monkeypox coordinator.

I read a troubling article on the rise of single-issue voters for whom the single issue is ending vaccine mandates and not just the ones for covid. It's not clear how this will affect the November elections. I worry when I read that a "longtime anti-vaccine advocate" comments, "So many people, but especially young parents, have come to this cause in the last year. It's been a huge gift to the movement." Several anti-vaccine activists are trying to take control of the board that oversees Sarasota. Florida's flagship public hospital. One of them posted on social media, "All 4 of us are devoted Christians, conservatives and patriots who deserve to make the [Sarasota Memorial Hospital] system stronger, more accountable, with greater transparency." How does accountability get measured. Will they account for the people who get infected by people who have not been vaccinated against measles? Measles is a nasty disease that people can die of. And when an unvaccinated person contracts the disease they are not vaccinated against, does an insurance company have to pay for their care? Lots of questions there.

Daily covid deaths are relatively low in Japan, Singapore, and South Korea. Besides high vaccine compliance, mask-wearing is viewed as a way to protect other people. Besides consistent mask-wearing, people in those cultures take sick leave as needed. How many people here in the US do that? I dislike seeing high school graduates who get attendance awards for never having missed even one day of school. How many days did they go to school perhaps not very symptomatic but still contagious?

WHO is urging countries with BA.4 and BA.5 surges to urge vaccine taking and reinstate mask-wearing. In Singapore, masks are required in indoor public spaces including libraries, markets, shopping centers, and schools. Masks are also required at weddings, though the bride and groom are allowed to switch to face shields during the ceremony. Otherwise, masks stay on except when a person is eating or drinking.

In Japan, masks are referred to as "face pants." People don't typically leave home without pants on, and masks are just as important. Japanese wear masks even outdoors. During this summer's heat waves, the government has had to tell people to remove masks to reduce the risk of heat stroke. Responsibility for the common good makes infection-control measures more than just a political issue.

Responsibility for the common good. Looking after other people. What concepts! I wish more people around here cared for others as much as for themselves. What a wonderful world this could be.

The Road goes ever on and on ... Day 368 (868)

Monkeypox moment: Local public health agencies, still recovering from handling covid, now have to handle monkeypox. It is going better in some places than in others. There is also concern over equitably distributing vaccines among richer and poorer nations.

Back to covid, China's factory activity shrank in July due to sporadic covid outbreaks. Factory output and new orders both fell, especially in energy-intensive industries such as petrol, cooking coal, and ferrous metals. Needless to say, there may be even more supply chain problems ahead. 

According to the White House physician, POTUS has had "no reemergence of symptoms and continues to feel quite well." I remember a lesson in high school English about the difference between feeling good and feeling well. If you had a similar lesson, you'll know why that statement bothers me.

A study done in the UK found that acute covid infection led to a six-fold increase in cardiovascular disease. Contributing to this were an 11-fold increase in pulmonary embolism, a six-fold increase in atrial arrhythmias, and a five-fold increase in venous thrombosis. Diagnosis of theses declined from four to 12 weeks after infection. From 12 to 52 weeks, things were back to normal. Starting with a pool of 13.4 million patients identified via over 1,300 family practices, the study involved 428,000 people who had had covid as well as a comparable number of patients who had not. 

As school years start, school mask mandates are coming back in places such as Louisville, Kentucky. In some other places, teachers are required to wear masks, but student mask use is up to parents. The District of Columbia is requiring students ages 12 and over to be vaccinated; this is one of the strictest such mandates in the nation. Some public school districts such as in New York City are strongly recommending that students be vaccinated but are not requiring it. 

I have decided to discontinue labels such as "pandemics." If a post has a topic considered at relative length, I'll use that as a label. Most posts will likely go label-less.