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Omicron anecdata?


Not_a_Number

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You can look up individual meds here on the ASHP tracker: https://www.ashp.org/drug-shortages/current-shortages?loginreturnUrl=SSOCheckOnly

We lost a ton of manufacturing capacity on sterile injectables when Puerto Rico was hit by a hurricane a few years ago.  The market never fully recovered from that. The particular Pfizer facility that was hit in NC this week was previously owned by Hikma. It essentially took over a portion of market share, and didn't expand the number of manufacturers. Because reimbursement rates are particularly low on these generic sterile meds, most manufacturers don't find it cost effective to start up new production lines.  

Thankfully most of the damage was done to the warehouse side of the Pfizer facility and not to the manufacturing lines.  It could have been worse.  That particular facility specializes in anesthesia, anti-infectives, neuromuscular and therapeutics.

 

 

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Also, if we could please get some methotrexate injectables back into stock it has been nearly a full f-ing year since we have had a normal supply... that would be nice, thank you.  This telling the world it's going to be available in a couple of months and then changing the guideline is for the birds and I wish they would just stop lying about it.

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Had kind of funny interaction this week with someone coming up to me (a local I kind of know), "oh you're still wearing a mask, we should all be wearing masks, the covid numbers are really high, people don't realise . . .'  and then she went off.

I didn't even have time to open my mouth! The funny thing was that she wasn't wearing a mask. 

Australia reports the covid deaths on a Friday - definitely lower this week, under 100; it had been over 200 a few weeks back. 

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36 minutes ago, bookbard said:

I didn't even have time to open my mouth! The funny thing was that she wasn't wearing a mask. 

Were you outside?

We were at a conference this weekend (health-related), and a woman in the elevator who was also attending thanked us for wearing masks because she has only one lung. She didn't have hers on, lol! But I did see her later wearing it intermittently. I think she felt the social pressure not to mask like everyone else and/or was a bit absent-minded. 

There were more people masked at the conference than I expected, and quite a lot of people masked outside on the street (city environment). The air quality was fluctuating that weekend, so it might've been wildfire air as much as Covid, but people in our part of our state aren't masking for either one. 

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8 minutes ago, kbutton said:

Were you outside?

 

No, indoors. But no one at all wears masks anymore. Apparently a new Australian study came out showing that covid would drop by 25% if masking was instituted again. No one will act on it though.

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Study on superspreader event at Qingkou night market. Analysis suggests that aerosols were infectious up to one hour and 39 minutes after the index case left the open air market. Looking up pictures of the market though, the dining area where it is thought many of the transmissions occurred, is not an area I would have considered open air enough to remove my mask. Still, not great news as we have become very relaxed about outdoors. Analysis of a super-transmission of SARS-CoV-2 omicron variant BA.5.2 in the outdoor night market

The index case transmitted to 131 other individuals!

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20 hours ago, KSera said:

Study on superspreader event at Qingkou night market. Analysis suggests that aerosols were infectious up to one hour and 39 minutes after the index case left the open air market. Looking up pictures of the market though, the dining area where it is thought many of the transmissions occurred, is not an area I would have considered open air enough to remove my mask. Still, not great news as we have become very relaxed about outdoors. Analysis of a super-transmission of SARS-CoV-2 omicron variant BA.5.2 in the outdoor night market

The index case transmitted to 131 other individuals!

Honestly when I read stuff like this i question how I’ve not had Covid even with our masking. I really think we must have got false negatives on tests or something,

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People’s CDC COVID-19 Weather Report: July 25, 2023 (substack.com)

Wastewater levels continue to increase in the Northeast and Southern regions of the United States with a slight decrease in the Midwest and Western regions of the United States, and the national average increasing for a fourth week straight. This ongoing summer surge suggests that we must remain vigilant, protect ourselves and each other. We provide these urgent recommendations not to alarm, but out of concern for this community, your family, friends, and colleagues. This ongoing summer surge reminds us to remain vigilant to protect ourselves and each other. We are in this together.

image.png.6ed2dadfa6b39bf31637d882366fb852.png

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On 7/24/2023 at 4:06 PM, Ausmumof3 said:

Honestly when I read stuff like this i question how I’ve not had Covid even with our masking. I really think we must have got false negatives on tests or something,

Genes and luck

https://www.nature.com/articles/d41586-023-02318-w

PDF link https://www.nature.com/articles/d41586-023-02318-w.pdf?pdf=button sticky

“The authors found a link between asymptomatic infection and an HLAmutation carried by about 10% of the study’s population. People with the mutated gene were twice as likely to remain asymptomatic as were people without it; people with two copies of the gene were eight times as likely. “We were pretty stunned by the magnitude of the effect,” Hollenbach says.

Researchers conducted the main analyses on participants who self-identified as white, because they did not have enough people from other ethnic and racial groups to analyse, they write. The authors also found evidence for the link in Black individuals, but the result is less clear in Asian and Hispanic people, they say.”

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Sex-specific differences in myocardial injury incidence after COVID-19 mRNA-1273 Booster Vaccination
Brief Title: Myocardial Injury after COVID-19 mRNA-1273 Booster Vaccination

https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/ejhf.2978?download=true
page 2

“Conclusion: mRNA-1273 vaccine-associated myocardial injury was more common than previously thought, being mild and transient, and more frequent in women versus men. The possible protective role of IFN-λ1(IL-29) and GM-CSF warrant further studies”

Page 18

“In conclusion, using active surveillance, mRNA-1273 vaccine-associated mild transient myocardial injury was found to be much more common than previously thought. It occurred in one out of 35 persons, was mild and transient, and more frequent in women versus men. Neither anti-IL-1RA, nor pre-existing vaccine/infection-induced immunity or systemic inflammation seemed to be dominant mechanisms of myocardial injury. No participant developed MACE within 30-days.”

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Is it time to be worried about Covid-19 again? (msn.com)

 

This week in outbreaks: July 28 edition - by Caitlin Rivers (substack.com)

I’m still seeing signs of a summer Covid-19 wave. Wastewater concentration is up again this week, now in all four regions of the country. The Northeast and Southern regions continue to be most affected, following by the West and Midwest.

https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F4616cae1-b55c-4106-9362-0596dc2aa942_2190x704.png

 

 

Compared to previous summers, wastewater concentration is almost exactly tied with this point during the 2021-2022 season, which is the year we had a summer Delta wave.

This year, the variant mix is predominantly XBB sublineages, which are the same Omicron variants that have been circulating for a while now. The fall booster is formulated to cover the XBB.1.5 variant, so I’m hopeful that it’s a good match.

Hospitalization indicators are increasing as well. The number of people admitted to the hospital with Covid-19 rose for the first time in months last week, and the proportion of emergency department visits that are diagnosed as COVID-19 is also increasing. Test positivity is now at 7.6%, up from a recent low of 4.1%.

 

As I’ve been saying for the last few weeks, I do think this is the beginning of a summer wave. Looking ahead, the next Covid-19 booster is expected to become available in mid to late September.

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The Savage Utopian: A Sarcastic Weekly News Round-Up (substack.com)

We’re definitely heading into a Covid wave. Wastewater surveillance has shown infections almost doubling over the last month. This wave follows the one that’s ripping through Japan. We’re hearing that they’ve seen their most deaths this summer since WWII. Public health officials have no information for us about new variants or how deadly this new one might be. At any rate, we can expect this wave to lead to even more Long Covid than we have now. That means more brain damage, more heart disease, more strokes and seizures.

We know the drill...

Those of us who care about public wealth will top off our air purifier coverage and check our filters. We’ll keep masking and avoiding crowded indoor spaces as much as possible. Everyone else will talk about living their lives while touting their immunity and blaming their Long Covid on allergies.

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Just as your numbers are increasing, ours are decreasing, although we still had over 100 deaths from Covid last week. Every state had lower numbers than last week except Victoria, who has changed what it is doing so it's hard to know what's going on there. But they had highest deaths (nearly the biggest state, behind NSW). I do wonder about Queensland's accuracy - it has a bigger population than South Australia, who recorded 30 deaths, and yet it recorded no deaths. They have always been a bit funny about Covid recording so I am a bit suspicious. 

It seems nuts to me that the scientists aren't jumping up and down about stuff like this - I mean how dodgy and inconsistent the records have been over Covid. 

 

 

Edited by bookbard
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Planned a get together at an outdoor setting but weather messed things and we ended up indoors unmasked. I know I’m getting careless but it feels so hard to be the only ones doing this. Friends all seem to be fine 12 months post-COVID. As far as anyone’s saying anyway. 
 

It does look like US numbers are on the way back up again fairly steadily now.

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On 7/29/2023 at 8:22 AM, bookbard said:

Just as your numbers are increasing, ours are decreasing, although we still had over 100 deaths from Covid last week. Every state had lower numbers than last week except Victoria, who has changed what it is doing so it's hard to know what's going on there. But they had highest deaths (nearly the biggest state, behind NSW). I do wonder about Queensland's accuracy - it has a bigger population than South Australia, who recorded 30 deaths, and yet it recorded no deaths. They have always been a bit funny about Covid recording so I am a bit suspicious. 

It seems nuts to me that the scientists aren't jumping up and down about stuff like this - I mean how dodgy and inconsistent the records have been over Covid. 

 

 

I think the 30 here are a backlog as they are only reporting deaths spasmodically now. 

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59 minutes ago, Ausmumof3 said:

Planned a get together at an outdoor setting but weather messed things and we ended up indoors unmasked. I know I’m getting careless but it feels so hard to be the only ones doing this. Friends all seem to be fine 12 months post-COVID. As far as anyone’s saying anyway. 

Had that exact situation a month ago, and ended up with 3 of us sick (with a cold, not Covid). It was a real pain as we had to cancel a few things. I felt annoyed that things were changed without letting us know in advance (in this case, someone was invited who was obviously unwell). But people don't think about it - for example, asking for a lift someplace while they're sick, but they don't tell you they're sick until 5mins into the trip and they start coughing. 

Statistically, though, it's a low time now so you should be fine. I've noticed far fewer people sick now than a month ago. Of course term 3 has just begun so in a few weeks all the school bugs will be raring to go.

1 hour ago, Ausmumof3 said:

I think the 30 here are a backlog as they are only reporting deaths spasmodically now. 

Ah that makes sense, I thought that was a big number for a small state. I guess the reverse happened for Qld, reported no deaths and may have a catch-up in a month or so. 

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12 hours ago, Ausmumof3 said:

Planned a get together at an outdoor setting but weather messed things and we ended up indoors unmasked. I know I’m getting careless but it feels so hard to be the only ones doing this. Friends all seem to be fine 12 months post-COVID. As far as anyone’s saying anyway. 
 

It does look like US numbers are on the way back up again fairly steadily now.

We had an almost identical situation a month ago. We didn't have masks because there was no rain in the forecast. We stood away from all the humans and left early. 

What kills me is that in this same group there was a Covid outbreak in December and one person was ICU level sick and had to have major heart surgery and is still not recovered and everyone is sad but not willing to take precautions. I do not get it.

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People’s CDC COVID-19 Weather Report: July 31, 2023 (substack.com)

Despite the reduced data reporting from the US federal government since the end of the public health emergency this May, numerous mainstream media sources are now reporting increases in COVID cases and hospitalizations, highlighting a summer wave. Who could have predicted that COVID is not a fall/winter seasonal disease? 🤔 (Hint: The pandemic isn’t over, and COVID is spreading in every season under a “vaxxed and relaxed” public health approach.)

While we are glad for the recognition that COVID isn’t over, watch out for inaccurate or incomplete reporting, such as:

Wastewater:

 

Along with the noted increases in COVID cases and hospitalizations, wastewater levels are now increasing in all regions. National wastewater levels have increased about 2-fold since June 21, 2023 (165 copies/mL to 326 copies/mL on July 26, 2023). Notably, the data we reported last week that showed a slight recent decrease in the West and Midwest have been updated on Biobot, which now shows a fairly steady rise across all regions since mid-June.

 

image.png.72856ad22e490869054cd1cc89d78cc0.png

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So the usual 'Friday figures' for Australia are once again hard to find - a lot of states not reporting on time. From what I can see, numbers are very low, only 34 deaths for the whole week and Victoria not reporting a single death. I assume there will be adjustments later.

Another local story - woman just got Covid for the 3rd time. She caught it doing a course for work where the instructor was coughing and spluttering the whole time. Again, I'm dumbfounded - firstly at the instructor for happily spreading Covid to a whole group, and secondly for the participants for not masking up for the 3 days of the course, with an obviously sick instructor!

 

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Both DS 24 and my sister have Covid currently. DS is asymptomatic, sister is very sick, but not as bad as last time (when she ended up in the hospital with neurological issues/brain damage). She is obviously worried, and her kids who have tested negative so far are supposed to start school on Thursday. She's trying to keep them from getting it. 

DS got it while on a trip to CT, the same dang way he caught it last time! He got home late Thursday night, went to bed pretty much right after getting home. On Friday he came out to grab a drink/food then went back to his room, and got a text from a friend he was with in the cabin in CT who had just tested positive. DS tested and was positive. Thankfully had mostly been in his room since he got home. No symptoms other than his normal nasal congestion he's had all summer from allergies. When he takes his allergy medicine he is absolutely fine. 

Meanwhile, the rest of the family got a cold while he was gone, not Covid, that is lingering and will not fully go away. Both DDs are still stuffy. And yup, I've tested everyone, it's not Covid. 

Basically, several of us had symptoms, but not Covid, while he was gone and continue to have them, and he has no symptoms, and has Covid. My sister has symptoms (lots and lots of congestion, exhaustion,etc) and has Covid. Sister also started Paxlovid yesterday, which normally wouldn't be a great plan given she's under 50 so no known benefit, but since she is high risk (asthma) AND ended up with neurological symptoms and some permanent neuro damage last time she had Covid it was decided it was worth trying. 

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10 minutes ago, ktgrok said:

Sister also started Paxlovid yesterday, which normally wouldn't be a great plan given she's under 50 so no known benefit, but since she is high risk (asthma) AND ended up with neurological symptoms and some permanent neuro damage last time she had Covid it was decided it was worth trying. 

Do I remember correctly that metformin has been shown to reduce long Covid also? Is that something she could safely take?

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10 minutes ago, Mom_to3 said:

Yes, correct, by 40%. But the study focused on overweight people.

Was it in people already on metformmin? Edit- never mind, found the study and sent it to my sister. Thank you!!! 

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People’s CDC COVID-19 Weather Report: August 7, 2023 (substack.com)

 

Wastewater levels continue to increase in all four regions of the United States, and the national average continues to increase as well. Although some public health departments are warning their communities, not every government agency across the country is similarly sharing this important information. It is important that we hold them accountable, especially when the risk of an infection is increasing. 

image.png.e4f298e34daa2ed756a5eba56a5fd668.png

 

 

The current variant landscape remains a mix of nearly equally dominant strains since the last variant update we gave on July 22, 2023 (CDC now updates every 2 weeks). EG.5 nicknamed “Eris,” a descendant of XBB, is growing in proportion and has become the dominant strain at 17.3% and XBB.1.16 is now the second most dominant strain, representing 15.6% of infections. Due to local health departments being no longer obligated to share data as a result of the end of the public health emergency, the CDC has limited its regional-level reporting of variant proportions through its Nowcast estimates, currently available for only three out of ten regions.

 

As an increased level of COVID infections persists, it is important to be aware of how best to detect an infection. Use PCR testing sites where available, and when using rapid antigen tests, we additionally recommend swabbing the throat and cheeks, as well as re-testing in the following days for more effective results. Retesting is especially important within the first few days of exposure, before symptoms arise. It is also important in asymptomatic cases, as recent studies have shown rapid antigen tests miss 90% of asymptomatic cases, especially when taken only once as opposed to serially over multiple days. We include a video on how to properly conduct a throat and cheek swab.

 

If you or someone you know develops COVID, treatment options are available that can reduce the risk of severe disease. Paxlovid as well as Lagevrio (molnupiravir) are both options that may help treat this infection and may also reduce the risk of Long COVID. Lagevrio is usually considered for those who cannot receive Paxlovid for medical reasons. See these links to studies on Paxlovid and Lagevrio and Long COVID prevention. We strongly recommend that you request one of these options after testing positive. If you are having trouble getting access due to potential eligibility recommendations, you can go here to find places that will “test to treat,” and if you face resistance from these healthcare providers, CVS pharmacies are much more willing to provide access to these invaluable treatment options through telehealth and after a positive COVID test. 

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So I tried to look at the usual Friday covid reports in Australia, but it's practically useless now. Victoria won't report, a lot are only reporting random stuff like 'averaged deaths' etc. Basically it's very difficult to see what is happening. I do think we're in the low part before the wave begins. 

Lots of news about 'Eris' in the media, but mostly downplaying it and pushing that it's been around for ages and it's fine. 

We are going on holidays in a few weeks so we are trying to lay low till then. Already told the family we won't be attending some big indoors dinner they're planning - we'll catch up with them outdoors instead. It's been lovely weather anyway. 

 

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11 minutes ago, Acadie said:

Looks like a steep rise in the Midwest. 

Interesing.  Our local (Midwestern) wastewater published yesterday looks more like June than Feb right now.  I guess we'll see.  Wish they'd get the new boosters out sooner rather than later.  We've been living pretty normally and I will continue to take precautions as appropriate, but can't go back to staying home.  Need to travel to drop off a kid at college (Midwest, but about 6 hours drive in a city)  in a couple weeks and it is what it is!

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On 8/7/2023 at 7:09 PM, Mom_to3 said:

Yes, correct, by 40%. But the study focused on overweight people.

Anyone remember the name of the otc supplement with a similar action to metformin?

On 8/8/2023 at 10:28 AM, mommyoffive said:

It is also important in asymptomatic cases, as recent studies have shown rapid antigen tests miss 90% of asymptomatic cases, especially when taken only once as opposed to serially over multiple days.

I wonder if asymptomatic cases are currently less likely to transmit than they used to be. Given that the rapid tests have been tightly correlated to contagiousness, that seems a plausible hypothesis to test. 

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22 hours ago, catz said:

Interesing.  Our local (Midwestern) wastewater published yesterday looks more like June than Feb right now.  I guess we'll see.  Wish they'd get the new boosters out sooner rather than later.  We've been living pretty normally and I will continue to take precautions as appropriate, but can't go back to staying home.  Need to travel to drop off a kid at college (Midwest, but about 6 hours drive in a city)  in a couple weeks and it is what it is!

I'm with you on wanting new boosters asap! How about we proactively set families up for a healthy start to the school year, instead of a couple months of viral chaos before boosters come out? 

Honestly hoping my family can find a way to get new primary series of Novovax. We've done a mix of Pfizer & Moderna so far and though I'm happy they were available earlier in the pandemic it's way past time for more durable vaccines. 

ETA: Regional trends obscure a lot of variability in specific locales, for sure. When I look at my state's wastewater I see a few places trending up quickly but more cities & towns trending the same. The data's often a week or more behind, just to make things even more confusing. I am hearing of more friends and family getting Covid now, though.  

Edited by Acadie
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