Omicron anecdata?

[Spryte]

@Harriet Vane Ugh, I’m so sorry. I hope you feel better soon, and wish we could send you soup!

One supplement that I take daily, and have heard that others feel is beneficial if one has Covid and for a period afterwards: Boluoke. My doc insists on it. You can buy it on Amazon, or from Researched Nutritionals, probably some other places as well. I have “sludgy blood” (a tendency to clot), and this helps. I double up when sick. Something like that might help prevent clot issues later. Nattokinase may have a similar action.

ETA: it’s expensive. You could probably find a different brand of lumbrokinase, this is just the one I trust, and have taken for the last ten years or so with good results.

Edited February 26 by Spryte

[kbutton]

https://tactnowinfo.substack.com/p/airborne-assault-of-measles-and-covid?fbclid=IwAR0Fr1Bcd1TkugiHloR0j0qKSzuEsl4mvo8o_Wn9gZFhSf-mYJl4qDop3x4_aem_AaOyS85gX23Tp2W3a-zOYyF-UhU-8UAstW0o0wlHEC-c-lOmd4fVeUXg0v9T1Np9luI

[historically accurate]

Today is the first day everyone is testing negative. Now I just have to not be brewing up some covid germs. 

DH still coughing pretty hard, and middle DD (tested positive until today) is still pretty emotional/tired/worn out. 

Everyone started feeling ok on about Saturday. 

[wathe]

4 hours ago, Harriet Vane said:

Yep.

I have Covid.

So far mild. So far dh and foster teen are not sick. 

I have berberine and NAC. I bought them last year before traveling because I had read some things suggesting they might help. But I am worried that my super-vague research of last year might have turned up snake oil and pixie dust. 

Whaddya think? Are those good anti-covid measures? Or not?

No quite snake oil, for NAC at least -- it's a drug with legitimate non-covid indications.  

Based on my quick search, the evidence to support NAC and berberine efficacy for covid seems very poor, and seems to gloss over risk.

 I, personally, wouldn't bother with them.  I am an EBM person though; I am generally skeptical of supplements and alt-med.

[Jaybee]

More on measles: https://www.medpagetoday.com/opinion/parasites-and-plagues/108905?xid=nl_mpt_DHE_2024-02-26&eun=g1838208d0r&utm_source=Sailthru&utm_medium=email&utm_campaign=Daily Headlines Evening 2024-02-26&utm_term=NL_Daily_DHE_dual-gmail-definition

 

[Amoret]

On the Swedish response (A profile of Anders Tegnell, Former Swedish State Epidemiologist)

Further commentary on measles (lines after the quote are from here)

The decline of measles antibody titers in previously vaccinated adults: a cross-sectional analysis

The seropositivity rate was 32.7% by ELISA and 75.3% by CLIA, and a strong positive correlation was found between the tests. Multivariate analyses revealed that age and time since the last dose were independently associated with positivity. Despite being a single-center evaluation, our results suggest that measles seropositivity may be lower than expected in adequately immunized adults. Seropositivity was higher among older individuals and those with a shorter time since the last MMR vaccine dose.

If you have not had your MMR boosted it might be a good time to consider it. You can get your titers checked but it is highly likely they have all but disappeared if you are my age.

[prairiewindmomma]

Has anyone posted this study yet on thyroid dysfunction after covid? https://pubmed.ncbi.nlm.nih.gov/38407979/

[Corraleno]

8 hours ago, Harriet Vane said:

I have berberine and NAC. I bought them last year before traveling because I had read some things suggesting they might help. But I am worried that my super-vague research of last year might have turned up snake oil and pixie dust. 
Whaddya think? Are those good anti-covid measures? Or not?

There's decent, but not extensive, research in favor of both, and they are very well tolerated with few side effects at the doses normally taken, so IMO they won't hurt and may very well help. Personally, I take both. (If you take berberine, the dihydroberberine form is 5x more bioavailable, although it is also more expensive.)

Unfortunately, most of the RTCs on NAC have been done on hospitalized patients, and results were mixed, with some studies showing improvement and others finding no significant difference in mortality, ICU stay, and intubation rates. But I'm not sure how relevant studies on severely ill ICU patients are in assessing the effect of NAC in mild to moderate cases, especially as there is good data on it's effect on mild to moderate cases of flu, for example.

Some of the studies on NAC:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10390689/
"Recent clinical studies suggest that oxidative stress is one of the key players in the pathogenesis of coronavirus disease 2019 (COVID-19), and N-acetylcysteine (NAC), a potent antioxidant, has been shown to improve clinical outcomes in COVID-19 patients. ...
Pooled analysis showed that NAC was associated with lower mortality in patients with COVID-19 compared with the placebo group [RR, 0.65; (95% CI: 0.56 to 0.75); p < 0.0001]. Similarly, C-reactive protein (CRP) [SMD, −0.32; (95% CI: −56 to −0.09); p = 0.0070] and D-dimer [SMD, −0.35, (95% CI: −0.59 to −0.10; p = 0.0062] levels were significantly decreased, and the oxygenation marker, PaO₂/FiO₂ ratio, was increased in the NAC-treated group compared with the placebo group [SMD, 0.76; (95% CI: 0.48 to 1.03); p < 0.0001].
....
NAC has been widely available, inexpensive, safe, and routinely used in clinical practice for many years. NAC administered orally or intravenously can suppress SARS-CoV-2 replication and improve outcomes when used immediately after the onset of signs and symptoms of COVID-19 [35,61]. Recommendations are that oral administration of NAC, as a prophylactic measure, can prevent a mild form of COVID-19 and that IV administration in the hospital can prevent severe morbidity, ICU admission, and mortality."

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9651994/

"The potential mechanisms of NAC's beneficial actions have been investigated in several in vitro and in vivo studies. Treatment with this drug has shown a positive impact on health outcomes in patients with respiratory conditions such as community-acquired pneumonia, COPD, ARDS and, more recently, its potential suppressive action on the progression of COVID-19 makes it a very promising therapy against COVID-19. It is hypothesized that the mechanism of action of NAC may consisted of blocking the viral infection and the consequent cytokine storm. Although the level of evidence is limited and data from controlled clinical trials is needed, the information currently available supports the use of NAC in symptomatic patients with COVID-19 at a minimum dose of 1200 mg per day. In patients with severe disease and respiratory compromise, the use of intravenous NAC at a dose of 100 mg/kg for a minimum of three days may be indicated."

The lack of RCTs on the effect of NAC in non-hospitalized patients is really unfortunate, but there is research on its efficacy against other respiratory illness. For example:

https://pubmed.ncbi.nlm.nih.gov/9230243/
"NAC treatment was well tolerated and resulted in a significant decrease in the frequency of influenza-like episodes, severity, and length of time confined to bed. Both local and systemic symptoms were sharply and significantly reduced in the NAC group. Frequency of seroconversion towards A/H1N1 Singapore 6/86 influenza virus was similar in the two groups, but only 25% of virus-infected subjects under NAC treatment developed a symptomatic form, versus 79% in the placebo group. ... N-acetylcysteine did not prevent A/H1N1 virus influenza infection but significantly reduced the incidence of clinically apparent disease."

There is even less data on berberine and covid, but this article explains in detail the mechanisms and pathways by which it may be effective:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9526677/
"BBR has potent anti-inflammatory, antioxidant, and antiviral effects. Therefore, it can be used as a possible anti-SARS-CoV-2 agent. BBR inhibits the proliferation of SARS-CoV-2 and attenuates the associated inflammatory disorders linked by the activation of inflammatory signaling pathways. BBR has the ability to inhibit the release of pro-inflammatory cytokines through the inhibition of NF-κB and p38MAPK signaling pathways, which are highly activated during SARS-CoV-2 infection."

This paper summarizes a bunch of mostly in vitro and in vivo (rodent) studies:
https://www.imrpress.com/journal/FBL/27/5/10.31083/j.fbl2705166/htm
"[T]reating SARS-CoV-2-infected Calu-3 cells with an immunotherapeutic berberine nanomedicine molecule named NIT-X (20 and 40 μg/mL) successfully inhibited SARS-CoV-2 replication and suppressed ACE2 and transmembrane serine protease 2 (TMPSS2) gene expression, the latter of which promotes SARS-CoV-2 infection and spread throughout the host via facilitating spike protein fusion with the host cellular-membrane. Further analysis from another in vitro investigation found that berberine (4.7–150 μM) suppressed SARS-CoV-2 viral replication process in African green monkey Vero E6 kidney cells via reducing infectious viral titer, indicating reduced production of infectious viral particles [79]. ... The same study also reported promising antiviral effects for berberine against SARS-CoV-2 in human nasal epithelial cells, which are believed to be more representative of the natural target cells (i.e., host cells). In particular, berberine was found to be effective at inhibiting SARS-CoV-2 RNA levels in the supernatant of the human nasal epithelial cell line with an EC50 value of 10.7 μM, suggesting its potency at low concentrations.
....
[B]erberine may help dampen cytokine storm, restore Th1/Th2 balance, and enhance cell-mediated immunity, [as well as] modulating the levels of various other inflammatory mediators implicated in respiratory infections. Moreover, evidence from in silico and in vitro studies suggests berberine as a promising candidate for exerting inhibitory effects on three main SARS-CoV-2 targets, namely Mpro, ACE2 receptor, and S protein. As it stands, there is ample evidence supporting the role berberine may play in alleviating immune dysregulations and excessive inflammation in COVID-19."

[Ausmumof3]

Anyone following the cholera cruise story?

[kbutton]

49 minutes ago, Ausmumof3 said:

Anyone following the cholera cruise story?

Say what?!? Yikes!

[mommyoffive]

https://thosenerdygirls.substack.com/p/is-measles-making-a-comeback?utm_source=post-email-title&publication_id=366170&post_id=142037118&utm_campaign=email-post-title&isFreemail=true&r=q2z70&open=false&utm_medium=email

[mommyoffive]

https://yourlocalepidemiologist.substack.com/p/floridas-recommendations-give-room?utm_source=post-email-title&publication_id=281219&post_id=142043389&utm_campaign=email-post-title&isFreemail=true&r=q2z70&open=false&utm_medium=email

[mommyoffive]

Back to Covid

https://longcovidweekly.substack.com/p/long-covid-weekly-82-nih-flagship?utm_source=post-email-title&publication_id=999185&post_id=142053564&utm_campaign=email-post-title&isFreemail=true&r=q2z70&open=false&utm_medium=email

[Ausmumof3]

On 2/27/2024 at 2:19 PM, kbutton said:

Say what?!? Yikes!

Latest report today is it wasn’t confirmed to be cholera after all so that’s a plus. 
 

Who knew that a cruise full of gastro that wasn’t cholera in 2024 was going to feel like a positive thing?!

 

[Mom_to3]

22 hours ago, Ausmumof3 said:

Latest report today is it wasn’t confirmed to be cholera after all so that’s a plus. 
 

Who knew that a cruise full of gastro that wasn’t cholera in 2024 was going to feel like a positive thing?!

 

Not sure if I should laugh or cry at this post...So true.

[mommyoffive]

https://yourlocalepidemiologist.substack.com/p/acip-cliff-notes-feb-28?utm_source=post-email-title&publication_id=281219&post_id=142140786&utm_campaign=email-post-title&isFreemail=true&r=q2z70&triedRedirect=true&utm_medium=email

Bottom line up front (BLUF)

 

CDC says those over 65 should get a second Covid-19 vaccine this spring. (I’m not convinced that all people over 65 need it, though.)

[mommyoffive]

https://erictopol.substack.com/p/long-covid-and-cognitive-deficits?utm_source=post-email-title&publication_id=587835&post_id=142147403&utm_campaign=email-post-title&isFreemail=true&r=q2z70&triedRedirect=true&utm_medium=email

[mommyoffive]

https://peoplescdc.substack.com/p/take-action-for-covid-isolation-guidelines?utm_source=post-email-title&publication_id=1004289&post_id=142158774&utm_campaign=email-post-title&isFreemail=true&r=q2z70&triedRedirect=true&utm_medium=email

[KSera]

1 hour ago, mommyoffive said:

https://erictopol.substack.com/p/long-covid-and-cognitive-deficits?utm_source=post-email-title&publication_id=587835&post_id=142147403&utm_campaign=email-post-title&isFreemail=true&r=q2z70&triedRedirect=true&utm_medium=email

Interesting studies. They point this out in the discussion, but my first thought as soon as I read the study design is that it wasn’t going to be able to even capture some of the people most affected, because they weren’t going to have the executive function or energy to take surveys. For the people I know with long Covid, for most of them this would definitely drop off their small list of things they have enough spoons to accomplish in a day. If they even remember it at all  

Another thing that stood out to me, was that the difference existed even for those who had symptom resolution. This is not new news, but it’s further evidence that Covid is affecting the brain. I continue to see things with teachers complaining about the pandemic learning loss in their students, and now that we’re four years in, people need to start considering that these are Covid effects, not just the effects of a period of online schooling several years ago. 

[Mom_to3]

3 hours ago, KSera said:

Interesting studies. They point this out in the discussion, but my first thought as soon as I read the study design is that it wasn’t going to be able to even capture some of the people most affected, because they weren’t going to have the executive function or energy to take surveys. For the people I know with long Covid, for most of them this would definitely drop off their small list of things they have enough spoons to accomplish in a day. If they even remember it at all  

Another thing that stood out to me, was that the difference existed even for those who had symptom resolution. This is not new news, but it’s further evidence that Covid is affecting the brain. I continue to see things with teachers complaining about the pandemic learning loss in their students, and now that we’re four years in, people need to start considering that these are Covid effects, not just the effects of a period of online schooling several years ago. 

There could be biases in both directions - those with some concerns about long covid would be more likely to take the test than those who recovered after a few days of a "cold". And of course those most severely affected can't even manage to do this. These studies are a very strong indication that this will be quite devastating at the population level (and, in my eyes, even at the individual level. If after a decade of "minor" infections you lose 10IQ points - that is pretty significant and certainly a plausible extrapolation. And likely quite a bit worse than the effects of lead poisening. https://www.medicalnewstoday.com/articles/nearly-half-of-the-us-population-exposed-to-dangerously-high-lead-levels#:~:text=Deficits greatest for those born in 1966–1970&text=The researchers report two main,IQ points per U.S. adult. Alarm bells should be ringing...but instead our CDC announced the oldest can take a second shot because it reduced death and hospitalizations. What if we want help preventing long covid in the young and middle aged??

[kbutton]

10 hours ago, mommyoffive said:

https://yourlocalepidemiologist.substack.com/p/acip-cliff-notes-feb-28?utm_source=post-email-title&publication_id=281219&post_id=142140786&utm_campaign=email-post-title&isFreemail=true&r=q2z70&triedRedirect=true&utm_medium=email

Bottom line up front (BLUF)

 

CDC says those over 65 should get a second Covid-19 vaccine this spring. (I’m not convinced that all people over 65 need it, though.)

I wish she’d acknowledge that there are probably strategic ways to use that second shot eligibility. One of my kids gets a second shot for being high risk. We give it to him 2-3 weeks before things like a camp/conference for people with his illness. He still masks, but it’s hard to sleep in one, and he has no choice but to eat in a group. (Anecdata: the conference dropped masking/testing/vaccine requirements, and the teen track of the conference almost had a super spreader event—my freshly vaxed kid didn’t get it even though he’d been swimming in a small hotel pool and eating with kids who did.)

A summer vaccination lets him delay his winter vaccination until closer to actual peak infection time, and this year, it gave time for us to find him Novavax.

The over 65 crowd could be using this for their cruising and such.

[KSera]

49 minutes ago, kbutton said:

A summer vaccination lets him delay his winter vaccination until closer to actual peak infection time, and this year, it gave time for us to find him Novavax.

How have you been spacing his? I think spacing is part of what makes this so tricky. There tends to be a wave that begins in late August or September and then a bigger one around and right after the holidays. For elderly family members, I’m trying to figure out when is best for them to do the spring one in order to be protected by a later one for those fall and winter waves as well.
 

[kbutton]

2 minutes ago, KSera said:

How have you been spacing his? I think spacing is part of what makes this so tricky. There tends to be a wave that begins in late August or September and then a bigger one around and right after the holidays. For elderly family members, I’m trying to figure out when is best for them to do the spring one in order to be protected by a later one for those fall and winter waves as well.
 

Conference or camp opportunities tend to be July or August, and we back up 2-3 weeks to do the shot. Then we do the “regular” one for him around mid-December. The rest of us get the yearly shot in the fall when it comes out. The only time we’ve had COVID, it was late October.

[Amoret]

More on Covid Cognitive Deficits (by Ziyad Al-Aly; from The Conversation)

So many warnings and such widespread complacency. I can't imagine a way in which this ends well.

Edited February 29 by Amoret

[KSera]

37 minutes ago, Amoret said:

More on Covid Cognitive Deficits (by Ziyad Al-Aly; from The Conversation)

I was going to share this one as well. If people are going to read  one piece this week on cognitive harm from Covid, I would recommend this one. For those who don’t know Ziyad Al-Aly, he’s one of the top long Covid experts in the US. He’s a physician scientist and testified as one of four members on the expert panel last month at the congressional hearing on Long Covid. (I give that background because I know that when there are random pieces linked to a substack or The Conversation or wherever, I always want to know whether it’s someone who’s really qualified and trustworthy to be speaking on the topic.)

[mommyoffive]

4 hours ago, kbutton said:

I wish she’d acknowledge that there are probably strategic ways to use that second shot eligibility. One of my kids gets a second shot for being high risk. We give it to him 2-3 weeks before things like a camp/conference for people with his illness. He still masks, but it’s hard to sleep in one, and he has no choice but to eat in a group. (Anecdata: the conference dropped masking/testing/vaccine requirements, and the teen track of the conference almost had a super spreader event—my freshly vaxed kid didn’t get it even though he’d been swimming in a small hotel pool and eating with kids who did.)

A summer vaccination lets him delay his winter vaccination until closer to actual peak infection time, and this year, it gave time for us to find him Novavax.

The over 65 crowd could be using this for their cruising and such.

Can non high risk people get a second shot?  I know most of the stuff I see doesn't support a reason to do it, but I don't know if that is really because it doesn't help 

[KSera]

Just now, mommyoffive said:

Can non high risk people get a second shot?  I know most of the stuff I see doesn't support a reason to do it, but I don't know if that is really because it doesn't help 

I think it’s going to be place dependent. I think the bigger issues is if insurance will cover it. I’m hearing of people going in and asking for one and getting it no questions asked. There seems to be much less gate keeping now. But I don’t yet know if it’s actually a good idea or not. We have to make a decision for our high risk person.  

[kbutton]

1 hour ago, mommyoffive said:

Can non high risk people get a second shot?  I know most of the stuff I see doesn't support a reason to do it, but I don't know if that is really because it doesn't help 

I go back and forth on how high risk is high risk? I have risk factors. In my son’s case, a pulmonologist said it was reasonable to have get the extra shot. 

[Mom_to3]

11 hours ago, kbutton said:

I go back and forth on how high risk is high risk? I have risk factors. In my son’s case, a pulmonologist said it was reasonable to have get the extra shot. 

As I understand the rules (I actually went back to the CDC page), high risk) does not count, unless you are moderately to severely immunocompromised? Yet at the same time, we know that vaccines don't protect more than a few months at most, and with covid circulating year round, it is a very uncomfortable place to be. DId anybody see the tape of the meeting? I would be tempted to take a look at the evidence presented.

And Eric Feigl Ding reports that there is an embargo on a CDC message - presumably to lower the isolation guideline for respiratory viruse/covids. For release at 1pm EST on a Friday afternoon (as usual when they try to relax protections), and a couple of days after the latest vaccine recommendation (to prevent protest by the elderly, who count at the polls).

 

Edited March 1 by Mom_to3

[Amoret]

IQ decline & Global cognitive deficits, Covid still isn’t the Flu, “Natural immunity” sucks and more  (The Covid-Is-Not-Over Newsletter)

Many of the studies/posts that he links have already been mentioned here this week, but there are a few others in case anyone is interested.

[Amoret]

11 hours ago, Mom_to3 said:

For release at 1pm EST on a Friday afternoon

Looks like they made it official

From Eric Feigl Ding:

According to sources, the data analysis is mainly based on change in COVID levels after a certain state announced & enacted a similar controversial isolation relaxation policy — on Jan 9th 2024!!! It’s a brand new policy after the Nov-Dec 2023 wave had already peaked! The peak is visible in the @BiobotAnalytics & CDC’s very own NWSS data. Thus using state data (see other major flaws above) for analyzing a policy enacted after the national wave has already peaked and hoping to find a signal above the noise of the immediate post-holiday season is ludicrous—especially with such short term data!!! Not finding any signal would be the expected default — which is what this kinda shoddy analysis is pre-destined to do! Again, what the holy hell @CDCgov.

 

Edited March 1 by Amoret

[KSera]

9 minutes ago, Amoret said:

Again, what the holy hell @CDCgov.

💯 

So disheartened today 😰. They’re stressing that they’re just bringing it in line with flu and RSV, since most people no longer know which one they have, as if it’s actually just fine and dandy for people to be walking around spreading flu and RSV to other people. Of course people will tout the new “you don’t have to isolate” guidance while completely ignoring the fact that the same guidance they say they’re following says they’re supposed to be wearing a well fitting mask the entire time, using good ventilation, and avoiding at risk people. That last part continues to burn me because it’s patently ridiculous unless they expect high-risk people to just not be in public. Nobody knows who’s high-risk so if they’re going out in public, they’re going to be around high-risk people unless those high-risk people just stay home from now on. but as long as everybody’s able to get to work, we know that’s what counts, right? Never mind that the number who are out of work due to disability continues to climb. And will do so even more as people are pushed to go back to work not just after five days but after a single day while ill. 
 

[KSera]

“While still posing a significant health threat to those at higher risk, COVID-19 health impacts are now increasingly similar to other respiratory viruses, like flu, which are also important causes of illness and death, especially for people at higher risk,” according to the CDC. “As a result, this the right time to issue unified Respiratory Virus Guidance, rather than additional guidance for each specific virus.”
 

This just isn’t true! They patently ignore the wide range of post acute sequelae caused by Covid. The continued focus on death and hospitalization (which still are significantly higher than for flu) is a constant diversion from the reality of what is happening—that people’s bodies are being made increasingly compromised and put at risk by each of these infections. Some will be disabled by it, some will have heart attacks and strokes because of it, others will lose time off the end of their lives because of it and still others will have early onset dementia because of it. We don’t even have any idea what other things, but those are all things we already know. But it would be an economic disaster for the government to acknowledge all of that, so we go back to the same policy of “don’t look up.”

[Acadie]

CDC, the White House and my Congressional reps must love hearing from me. 

Anyone want to join my grassroots lobbying group? 

Five Million Furious Mamas

Pick just one weekday that works for you to call the above and share your thoughts on current Covid policy until CDC gets serious about protecting our children's long term health.

How long would it take with a million calls a day? And weekends off!

[Harriet Vane]

3 hours ago, KSera said:

“While still posing a significant health threat to those at higher risk, COVID-19 health impacts are now increasingly similar to other respiratory viruses, like flu, which are also important causes of illness and death, especially for people at higher risk,” according to the CDC. “As a result, this the right time to issue unified Respiratory Virus Guidance, rather than additional guidance for each specific virus.”
 

This just isn’t true! They patently ignore the wide range of post acute sequelae caused by Covid. The continued focus on death and hospitalization (which still are significantly higher than for flu) is a constant diversion from the reality of what is happening—that people’s bodies are being made increasingly compromised and put at risk by each of these infections. Some will be disabled by it, some will have heart attacks and strokes because of it, others will lose time off the end of their lives because of it and still others will have early onset dementia because of it. We don’t even have any idea what other things, but those are all things we already know. But it would be an economic disaster for the government to acknowledge all of that, so we go back to the same policy of “don’t look up.”

I have been in an utter daze of disbelief over this.

I've been sick with covid all week. Really, hideously ill. I spent days rotating between bed and the chair next to the bed (though I did also enjoy two stints outside on the back deck wrapped in blankets). I do weight training and other exercise all the time. There is a pretty wooded lane outside my house--normally I whip off four times down and back without much thought. Yesterday and today I slow-walked down the lane ONCE and was winded and exhausted and took a nap. I am more myself today but weak as a baby and still have symptoms (sore throat and ears and lots of rhinitis).

I cannot understand at all why the guidance has changed. The infectiousness and duration of illness have NOT changed, right? 

And isn't the CDC supposed to set guidance based on SCIENCE? Since when do scientists decide best practices based on what people feel like doing?!?!?

I'm ranting, but I'm also seriously asking--is there something I am missing? Why on earth does this change make sense? Can someone play devil's advocate here and help me understand?

[KSera]

55 minutes ago, Harriet Vane said:

I'm ranting, but I'm also seriously asking--is there something I am missing? Why on earth does this change make sense? Can someone play devil's advocate here and help me understand?

You're not missing anything. I can play devil's advocate based on what they say are the reasons, and it's not that I don't think there's any truth behind those reasons playing a part, but I don't think it's the whole story (they're leaving out the economic reasons, which I believe are huge). The CDC's job is to set public health policy. They're saying, since people aren't testing to know what they have, and covid, flu and RSV present similarly in the acute stage, the guidelines will be simpler to just make them the same for all. (This begs the question to me, why not make the guildelines for flu and RSV closer to match covid guidelines instead then--this would clearly be  more in the interest of public health.) They're also saying that hospitalization and death occurred mostly in unvaccinated people last year, with the implication, that if people don't want to be hospitalized or die of it, they have the option to vaccinate. It appears that vaccination decreases the risk of long covid, but they are leaning awfully hard into that decrease. The rate of infections is so high that it is still a tremendous number of people being disabled by long covid every year, and each infection adds to the risk. Most people getting long covid were vaccinated (because most people were vaccinated). It's still an unacceptably high risk.

But you're right, it's not in the interest of public health at all. This is part of the same advice, but you know it's not going to be emphasized or required most places: "C.D.C. urged those who end isolation to limit close contact with others, wear well-fitted masks, improve indoor air quality and practice good hygiene, like washing hands and covering coughs and sneezes, for five days." (and look, now suddenly we have the mask from days 6-10 (since most people are still contagious on those days) down to just mask through day 5, which is bad enough in itself).

Quote

“Our goal here is to continue to protect those at risk for severe illness, while also reassuring folks that these recommendations are simple, clear, easy to understand and can be followed,” --Dr. Mandy Cohen, CDC Director

Bullocks. There is clearly no goal of protecting those at risk for severe illness (long covid itself is a severe illness and everyone is at risk of it).

[Harriet Vane]

35 minutes ago, KSera said:

You're not missing anything. I can play devil's advocate based on what they say are the reasons, and it's not that I don't think there's any truth behind those reasons playing a part, but I don't think it's the whole story (they're leaving out the economic reasons, which I believe are huge). The CDC's job is to set public health policy. They're saying, since people aren't testing to know what they have, and covid, flu and RSV present similarly in the acute stage, the guidelines will be simpler to just make them the same for all. (This begs the question to me, why not make the guildelines for flu and RSV closer to match covid guidelines instead then--this would clearly be more in the interest of public health.) They're also saying that hospitalization and death occurred mostly in unvaccinated people last year, with the implication, that if people don't want to be hospitalized or die of it, they have the option to vaccinate. It appears that vaccination decreases the risk of long covid, but they are leaning awfully hard into that decrease. The rate of infections is so high that it is still a tremendous number of people being disabled by long covid every year, and each infection adds to the risk. Most people getting long covid were vaccinated (because most people were vaccinated). It's still an unacceptably high risk.

But you're right, it's not in the interest of public health at all. This is part of the same advice, but you know it's not going to be emphasized or required most places: "C.D.C. urged those who end isolation to limit close contact with others, wear well-fitted masks, improve indoor air quality and practice good hygiene, like washing hands and covering coughs and sneezes, for five days." (and look, now suddenly we have the mask from days 6-10 (since most people are still contagious on those days) down to just mask through day 5, which is bad enough in itself).

Bullocks. There is clearly no goal of protecting those at risk for severe illness (long covid itself is a severe illness and everyone is at risk of it).

I do really appreciate your explaining their reasoning. 

(And I appreciate your validation.)

 

[Amoret]

2 hours ago, KSera said:

Bullocks. There is clearly no goal of protecting those at risk for severe illness (long covid itself is a severe illness and everyone is at risk of it).

Yet, just this week, she was lamenting the politicization and divisiveness in public health and said, without irony, “Folks forget we are the Centers for Disease Control and Prevention,” she emphasized. “We need a country that is healthy and that lifelong health begins early in life.”

We know what needs to be done, yet it remains just words. Action seems impossibly far off...

Public health doesn’t meet people where they are at; it enables them to move freely by altering their environment to facilitate risk-reducing behaviors, such as staying home from work when sick without fear of lost income. It’s not about individual risk tolerance, but about government making use of population-level tools—such as infrastructural investments in clean air and water—to lower the level of risk to which individuals are exposed by living in society. To do this effectively, public health prioritizes protections for those whose freedom is most obstructed by the current state of affairs: those who are immunocompromised, elderly, or incarcerated; migrant agricultural workers; people of color; and others especially exposed to harm. Public health should do this not simply out of altruism but because it recognizes that allowing harm to fall on vulnerable groups will ultimately return as multiplying harm for society. Public health thus requires seeing the world “from below,” rather than through the eyes of bankers, economists, or opinion writers at national newspapers. (From here)

[Mom_to3]

Yes - I am devastated. I knew it was coming, but still (I had hoped/expected that  there would be a public comment period beforehand). I looked at the website, and it appears that the at risk categories "for respiratory illnesses" have changed - "just" older, younger, immunocompromised and pregnant people, or those with disabilities. https://www.cdc.gov/respiratory-viruses/risk-factors/index.html 

As recently, this was the list for covid https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html

Again, I ask, what am I missing? This will make it virtually impossible to negotiate any kind of accommodations from work, friends, businesses, doctors...

Also, while the recent paper showed good short-term protection from covid from hospitalization for the recent booster, we did recently have a study that showed that protection from hospitalization the bivalent shot was quite poor just a few months out. Of course, as others have said, the continued focus on just hospitalization/death is very misguided.

Plus, to change guidance in part because people don't have at-home tests for other respiratory illnesses - they DO exist in other countries (and some, like Lucira right at home, though they are very expensive here). What we should have done if we wanted to make guidance more uniform across diseases is to invest in rapid (and cheap!) at home tests for multiple diseases, so that you can stay home and keep others safe while you are infectious - whether it is covid or flu or RSV.

Another part that is neglected in this change in guidance is that if/when covid mutates into an (even more) virulent form that evades vaccination/prior immunity (even more), this relaxed guidance will be disastrous.

So many flaws with this. Of course, Ashish Jha is fully on board with this. Is he hoping to lead the CDC in the future?

 

 

[kbutton]

This was shared in a Covid group on FB:

[kbutton]

Study about infants isolated during Covid and the development of allergic disease. It looks at the gut flora.

Isolation was associated with more beneficial bacteria and less allergic disease. 

https://onlinelibrary.wiley.com/doi/10.1111/all.16069?fbclid=IwAR2mOSn5zqyDSqUpSc7endy0aX3pIISaJz8m-nedXivuxo1-pRJrJC7MrCM_aem_AYRTizbGMeKxsTwwH_dt4ycpvfEOLJPFoWfZgBd-UKjeZPpuFHrqjuagLNc_MkH-RZ8

[Amoret]

16 hours ago, KSera said:

“Our goal here is to continue to protect those at risk for severe illness, while also reassuring folks that these recommendations are simple, clear, easy to understand and can be followed,” --Dr. Mandy Cohen, CDC Director

I came across some commentary on this quote:

The language from C.D.C. Shortens Isolation Period for People With Covid NYT is amazingly corrupt, even for CDC:

Cohen:

Our goal here is to continue[0] to protect those at risk[1] for severe illness[2], while also reassuring folks that these recommendations are simple, clear, easy to understand and can be followed[3]

[0] Lol.

[1] Translation: The goal of public health is no longer preventing infection (or allowing the “at risk” access to shared air, either).

[2] “Severe” is doing a of work there; even “mild” cases of Covid cause cumulative respiratory and vascular damage

[3] Test, stay home for 10 days, mask up with an N95, avoid 3Cs spaces are all “simple, clear, easy to understand and can be followed.” CDC is making a virtue of its bungled messaging for the last three years. (Of course, the ultimate solution is clean indoor air, but since CDC, to this day, resists the implications that #CovidIsAirborne, that’s cannot be on their agenda.)

Raynard Washington, health director of Mecklenburg County, N.C (Cohen emerged from NC, so I assume the “reporter” got the name from Cohen):

Having a streamlined, consolidated guidance[1] across the respiratory viral portfolio[2] will allow us to be able to do public health[3] on the ground at the state and federal level, to send a very clear message to people[4].

[1] “Streamlined” is an aesthetic judgment, not a medical, let alone a public policy judgment

[2] Portfolio? Are we rethinking everything in financial terms, now?

[3] Public health prevents infection. This policy does not.

[4] A clear message isn’t the same as this message.

And Washington:

It’s not like people have on a sign that says, ‘I’m immunocompromised,’

No, and better yet, we’re not going to lift a little finger to prevent them, are we? For example, Cohen could model public behavior that protects the immuno-compromised by wearing a mask. She doesn’t. Ergo, while claiming to protect “the vulnerable” in practice she is doing just the opposite.

 

Edited March 2 by Amoret

[prairiewindmomma]

19 hours ago, Harriet Vane said:

 

I'm ranting, but I'm also seriously asking--is there something I am missing? Why on earth does this change make sense? Can someone play devil's advocate here and help me understand?

Please note that I am playing devil’s advocate here and that I railed against the policy change when Oregon adopted this stance over a year ago.

Basically, wastewater is showing that there are waves of very high disease activity but hospitalization rates and deaths have remained low. Through that lens, the positive test shouldnt be the controlling factor as to when to stay home, rather a fever or other symptoms should be the controlling factor. If you know you are positive, you should mask if going out in public to limit spread. 
 

—-I can tell you that this is in part because schools and hospitals were not getting staffed due to waves of adults being ill. Now, they are staffed, but with masked people unlikely to spread (cough, cough) disease because they are afebrile. 
 

———-

What has largely happened is that people dont test anymore and any illness is assumed to be a cold or influenza. It’s the wild west🥺 which is why we are all still masking.

[Harriet Vane]

45 minutes ago, prairiewindmomma said:

Please note that I am playing devil’s advocate here and that I railed against the policy change when Oregon adopted this stance over a year ago.

Basically, wastewater is showing that there are waves of very high disease activity but hospitalization rates and deaths have remained low. Through that lens, the positive test shouldnt be the controlling factor as to when to stay home, rather a fever or other symptoms should be the controlling factor. If you know you are positive, you should mask if going out in public to limit spread. 
 

—-I can tell you that this is in part because schools and hospitals were not getting staffed due to waves of adults being ill. Now, they are staffed, but with masked people unlikely to spread (cough, cough) disease because they are afebrile. 
 

———-

What has largely happened is that people dont test anymore and any illness is assumed to be a cold or influenza. It’s the wild west🥺 which is why we are all still masking.

Yes, I have seen this rampant, everywhere. People don't test anymore and any illness is assumed to be something else. It defies all logic and common sense.

[KSera]

6 hours ago, prairiewindmomma said:

What has largely happened is that people dont test anymore and any illness is assumed to be a cold or influenza.

I can never understand why people think it’s okay to spread their cold or flu either, for that matter. I’m less concerned about cold or flu for my family, but I still sure don’t want it and it causes a lot of misery and life disruption while illness makes it’s way through a large family, which could take a month when people fall ill one by one. 

[mommyoffive]

https://caitlinrivers.substack.com/p/outbreak-outlook-national-march-4?utm_source=post-email-title&publication_id=1017072&post_id=142069291&utm_campaign=email-post-title&isFreemail=true&r=q2z70&triedRedirect=true&utm_medium=email

[mommyoffive]

https://yourlocalepidemiologist.substack.com/p/cdc-updates-isolation-guidance?utm_source=post-email-title&publication_id=281219&post_id=142188628&utm_campaign=email-post-title&isFreemail=true&r=q2z70&triedRedirect=true&utm_medium=email

[mommyoffive]

https://longcovidweekly.substack.com/p/long-covid-weekly-83-iron-issues?utm_source=post-email-title&publication_id=999185&post_id=142311311&utm_campaign=email-post-title&isFreemail=true&r=q2z70&triedRedirect=true&utm_medium=email

[Amoret]

1 hour ago, mommyoffive said:

https://yourlocalepidemiologist.substack.com/p/cdc-updates-isolation-guidance?utm_source=post-email-title&publication_id=281219&post_id=142188628&utm_campaign=email-post-title&isFreemail=true&r=q2z70&triedRedirect=true&utm_medium=email

The comments here (and for her earlier post from 2/15 urging readers to be patient and wait for clarification from the CDC) are overwhelmingly critical...

In other news:

White House lifting its COVID-19 testing rule for people around Biden, ending a pandemic vestige ("vestige"?!)

Edited March 5 by Amoret

[Mom_to3]

I came to post the report about the White house dropping the testing rule. It would be interesting to see what other precautions they still take (ventilation, far UV etc.), and I am sure he just received another booster...