Deuce Adam

09/04/2020

//Lessons from 2009 flu epidemic
The textbook vaccine model goes out the window when novel viruses emerge.

Some lessons can be drawn from the 2009 H1N1 flu epidemic, which killed an estimated 500,000 people around the world. In the U.S, President Barack Obama declared the spread a national emergency.

A vaccine was developed as early as the fall of 2009. However, only 16 million doses were initially available. The CDC was required to make some difficult decisions about allocation. Some states requested 10 times the amount they were allocated.

In the end, the CDC allocated the vaccine strictly in proportion to a state’s population – that is, on a per capita basis. States then allocated them, often with priority to infants and the elderly, along with people at high risk.

This priority – to protect the most frail – has been public policy since at least the 1957-1958 influenza pandemic.

Later studies, however, have shown that a better way to protect older people was to control spread among the young, which often has meant vaccinating school-age children early.

One of the lessons from these past pandemics is that vaccinating the likely asymptomatic spreaders early can avert multiple infections with others.

[You need to understand the coronavirus pandemic, and we can help. Read The Conversation’s newsletter.]//

A team of experts argues that after taking care of essential workers, COVID-19 vaccinations should be given to the greatest transmitters of the virus, who are mostly the young.

09/04/2020

//Steroids aren’t risk-free, however. They can have side effects, and they could do more harm than good in patients with milder cases of COVID-19.

I am a pulmonologist and critical care physician and co-author of one of three new studies that analyzed data from clinical trials involving the effect of steroids on thousands of critically and severely ill COVID-19 patients. Here’s what people need to understand about steroids as a treatment for COVID-19.

Who benefits from taking steroids?
It’s important to understand that steroids can benefit the sickest patients hospitalized with COVID-19, but they’re not a treatment for relatively mild cases.

With COVID-19 and other infectious diseases, there are two key components: the infection itself and the body’s response to that infection.

In the sickest patients, the body’s immune system response is so robust it can injure organs. So, calming the immune response may be important. But someone who is less severely ill may need the body’s immune response to prevent the infection from getting worse. You wouldn’t want to interfere with the immune response unless it was harming the patient.//

Three new studies show corticosteroids can reduce deaths in critically ill COVID-19 patients. But what about other patients?

09/03/2020

Close the lid.

09/02/2020

//What is herd immunity?
Epidemiologists define the herd immunity threshold for a given virus as the percentage of the population that must be immune to ensure that its introduction will not cause an outbreak. If enough people are immune, an infected person will likely come into contact only with people who are already immune rather than spreading the virus to someone who is susceptible.

Herd immunity is usually discussed in the context of vaccination. For example, if 90% of the population (the herd) has received a chickenpox vaccine, the remaining 10% (often including people who cannot become vaccinated, like babies and the immunocompromised) will be protected from the introduction of a single person with chickenpox.//

Without a vaccine, the cost of reaching herd immunity during a pandemic is counted in lives lost, and it won't quickly stop the virus's spread.

08/31/2020

//Nearly a year before the novel coronavirus emerged, Dr. Leonardo Trasande published “Sicker, Fatter, Poorer,” a book about connections between environmental pollutants and many of the most common chronic illnesses. The book describes decades of scientific research showing how endocrine-disrupting chemicals, present in our daily lives and now found in nearly all people, interfere with natural hormones in our bodies. The title sums up the consequences: Chemicals in the environment are making people sicker, fatter and poorer.

As we learn more about the novel coronavirus and COVID-19, research is revealing ugly realities about social and environmental effects on health – including how the same chronic illnesses associated with exposure to endocrine-disrupting compounds also increase your risk of developing severe COVID-19.

In the U.S. and abroad, the chronic disease epidemic that was already underway at the start of 2020 meant the population entered into the coronavirus pandemic in a state of reduced health. Evidence is now emerging for the role that environmental quality plays in people’s susceptibility to COVID-19 and their risk of dying from it.

Why endocrine disruptors are a problem
Endocrine-disrupting compounds, or EDCs, are a broad group of chemicals that can interfere with natural hormones in people’s bodies in ways that harm human health. They include perfluoroalkyl and polyfluoroalkyl substances, better known as PFAS, flame retardants, plasticizers, pesticides, antimicrobial products and fragrances, among others.

These chemicals are pervasive in modern life. They are found in a wide range of consumer goods, food packaging, personal care products, cosmetics, industrial processes and agricultural settings. EDCs then make their way into our air, water, soil and food.//

Endocrine-disrupting compounds are pervasive in modern life, from food packaging to shampoo. Research is connecting their effects on humans to risk of severe illness or death from the coronavirus.

08/28/2020

//The first conversation, in late March, was about whether to let Frank go or to try some experimental drugs and treatments for COVID-19. The second call was just a few days later. Hospital visits were banned, so Leslie couldn’t be with her husband or discuss his wishes with the medical team in person. So she used stories to try to describe Frank’s zest for life.

“Frank used to joke that he wanted to be frozen, like Ted Williams, until they could figure out what was wrong with him if he died,” said Leslie Cutitta. It wasn’t a serious end-of-life discussion, but Cutitta knew her husband would want every possible lifesaving measure deployed.//

Doctors are diagnosing a new stage of COVID-19 recovery: patients who take much longer than usual to regain consciousness after coming off a ventilator. And a growing number of doctors are worried …

08/28/2020

//This “emergency use authorization” triggered an outcry from scientists and doctors, who said the decision was not supported by adequate clinical evidence and criticized the FDA for what many perceived as bowing to political pressure.

With all the news swirling around convalescent plasma this week, we thought we’d break it down for you.

1. Convalescent plasma contains antibodies against disease. Donations are being promoted as a potential COVID-19 treatment.

“Convalescent” refers to recovery from a disease. And plasma is the yellowish, liquid part of blood in which blood cells are suspended.

When someone is infected with a virus, the body generates antibodies to fight off the viral particles. Enter COVID-19. If an individual who has recovered from this virus donates their plasma, scientists can isolate the antibodies from the plasma and give it to patients who are still in the early stages of their COVID-19 infection. This infusion, in theory, should help people fight off the virus while their own body catches up and makes its own supply of antibodies.

It’s not a new concept. An infusion of antibodies via plasma has been used as a treatment for other types of diseases, such as rabies.//

President Donald Trump touted the Food and Drug Administration’s approval of this unproven COVID-19 treatment for emergency use. That set off reactions ranging from excitement and optimism to scien…

08/28/2020

//If enough of the U.S. population gets vaccinated — more than the 45% who did last flu season — it could help head off a nightmare scenario in the coming winter of hospitals stuffed with both COVID-19 patients and those suffering from severe effects of influenza.

Aside from the potential burden on hospitals, there’s the possibility people could get both viruses — and “no one knows what happens if you get influenza and COVID [simultaneously] because it’s never happened before,” Dr. Rachel Levine, Pennsylvania’s secretary of health, told reporters this month.//

A robust sign-up for flu shots could help head off a nightmare scenario in the coming winter of hospitals stuffed with both COVID-19 patients and those suffering from severe effects of influenza. P…

08/27/2020

The fascinating new research proves that music heals and suggests that in future, music could be prescribed to help us focus, feel happier, relax and overcome sadness.

08/26/2020

//But in a paper published in the New England Journal of Medicine, researchers found that antibody levels decline in individuals who have recovered from COVID-19, dropping by half every 36 days. Does that mean people who have recovered from COVID-19 have lost their immunity?

I am a geneticist interested in innate immune response – the part of the immune system that we have at birth – and how the innate immune cells “educate” antibody-producing cells about a pathogen and how to identify and destroy it. As I’ll explain, antibodies are important for immunity, but they aren’t the only factor that counts.//

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If antibody levels drop dramatically after an infection, what does that mean for immunity? An expert explains how B and T cells contribute to immunity and why antibodies don't tell the full story.

08/26/2020

//The findings reflect a generalized sense of hopelessness as the severity of the global crisis set in. Most adults have been moored at home in a forced stasis, many in relative isolation. The unemployment rate hit its highest rate since the Great Depression of the 1930s. Thousands of families across California and tens of thousands across the U.S. have lost people to the virus. There is no clear indication when — or even if — life will return to normal.//

In a series of July U.S. Census Bureau surveys, nearly half of California adult respondents reported levels of anxiety and gloom typically associated with diagnoses of generalized anxiety disorder …

08/26/2020

Buckle up: Here's what dealing with colds, influenza and the coronavirus all at the same time could be like this fall and winter.