Category Archives: @Coronavirus, @COVID-19

Vaccines Show Greater than Ninety Percent Efficacy

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“It’s not vaccines that save people; it’s vaccinations that will actually save people.” Edward Kelly, director of the WHO’s work on service delivery and safety

Biotechnology firm Moderna announced this week that preliminary results from large scale trials indicated that its coronavirus vaccine candidate demonstrated nearly 95 percent efficacy at preventing the illness.  This news comes on the heals of Pfizer’s announcement last week of it coronavirus vaccine candidate showed 95 percent efficacy (94 percent for adults over 65 years).

Efficacy refers to the performance of a treatment under ideal and controlled circumstances, and effectiveness is performance under real-world conditions. Clinical trials take place in a controlled environment to test if a vaccine is safe and if it works.

The efficacy rate means that COVID-19 symptoms were prevented for more than 90 percent for Pfizer’s coronavirus candidate and near 95 percent for Moderna’s candidate of participants who received the vaccine.

Pfizer plans to seek emergency use authorization for the vaccine, the company said.  This leave Pfizer’s vaccine on track to go into distribution by the end of the year if health regulators at the FDA permit.

Public health officials warn that the development of an effective COVID-19 vaccine represents the beginning of the challenge to vaccinate the world. “It’s not vaccines that save people; it’s vaccinations that will actually save people,” Edward Kelly, director of the WHO’s work on service delivery and safety, said.

A few of the significant challenges to vaccinate the world relate to vaccine supply, storage and distribution.  For example, Pfizer’s experimental vaccine requires ultracold storage conditions of about minus-70 degrees Celsius to ensure it remains effective.  While, Moderna’s vaccine can be kept at refrigerator temperatures for a month and frozen at minus-20 degrees Celsius for up to six months.

Additionally, there appears to be a steady reluctance among Americans and people across the globe to take the vaccine.  Convincing Americans that coronavirus vaccines are safe and effective will be another challenge thanks to the politicization of the vaccine development process by both sides of the aisle.

The U.S. Food and Drug Administration (FDA) will ultimately decide whether to authorize vaccines from Pfizer, Moderna and other candidates currently in large scale trials based on safety and effectiveness results that have been carefully reviewed by both government and independent health experts.

Health care workers should be given the highest priority to receive the vaccine and given to workers in essential industries, people with certain medical conditions, and people age 65 and older.

Bottom line, no vaccine is 100% effective, and whatever protection vaccines may provide, people should continue to wear masks, maintain social distancing, wash hands frequently, not touch their face and avoid crowded indoor gatherings until public health officials determine and the infection numbers demonstrate that the virus is under control.

References:

  1. https://www.washingtonpost.com/world/2020/11/16/who-vaccine-moderna-pfizer/
  2. https://www.wsj.com/articles/pfizers-covid-19-vaccine-95-effective-in-final-results-company-to-seek-approval-within-days-11605699996
  3. https://time.com/5907908/biden-administration-covid-19/?utm_source=twitter&utm_medium=social&utm_campaign=editorial&utm_term=health_covid-19&linkId=104044772

Measuring Oxygen Levels at Home

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With a pulse oximeter, you can monitor your oxygen levels and have a better measure for whether you need to contact your healthcare provider.

Some COVID-19 patients have dangerously low levels of oxygen, which is being called “silent hypoxia.”

When your body doesn’t have enough oxygen, you could get hypoxemia (low oxygen in your blood) which may lead to hypoxia (low oxygen in your tissues) when your blood doesn’t carry enough oxygen to your tissues to meet your body’s needs. These are dangerous conditions. Without oxygen, your brain, liver, and other organs can be damaged just minutes after symptoms start.

Many doctors are recommending that individuals testing positive for COVID-19 monitor their oxygen levels at home with a pulse oximeter. Pulse oximeters are devices you place on your fingertip to measure the amount of oxygen in your blood. These devices use small beams of light that pass through your finger to measure how much oxygen your blood is carrying and your pulse.

Normal oxygen level

A normal oxygen level measured by a pulse oximeter is around 97%. Medical experts start to worry oxygen level drops under 90% because this can affect the amount of oxygen going to your brain and other vital organs. Levels below 80% are considered dangerous and increase the risk of organ damage.

Usually, people with low oxygen levels appear uncomfortable, sometimes even to the point of appearing to be gasping for air. Although, doctors do not clearly understand why some COVID-19 patients have such low levels of oxygen without appearing uncomfortable.

Doctors are divided on whether home monitoring of oxygen levels with a pulse oximeter. In an opinion piece for The New York Times, one ER doctor recommended home oxygen monitoring for patients with COVID-19 because they “believed that information about oxygen levels may help some people seek care earlier if their oxygen level begins to drop”.

Benefits of using a pulse oximeter

Checking oxygen levels at home is beneficial for those diagnosed with COVID-19 or with symptoms that are highly suggestive of infection.

Monitoring your oxygen levels can provide reassurance. If you notice your oxygen levels dropping, you can reach out for medical help.

“The key to taking care of yourself at home with COVID-19 is to carefully monitor your symptoms, especially coughing, wheezing, shortness of breath, and fever, and to inform your healthcare provider about any worsening symptoms. “Paying attention to how you’re feeling is your best guide,” Michael S. Lipnick, M.D., assistant professor of anesthesia and critical care at the University of California, San Francisco, says.

COVID-19 is a viral respiratory illness. Most cases of COVID-19 are relatively mild and can be treated at home. Its symptoms are fever, dry cough, and, sometimes, shortness of breath. These range from mild to severe, and the most serious cases can be fatal, particularly in people who are older or have underlying medical conditions.

References:

  1. https://www.webmd.com/asthma/guide/hypoxia-hypoxemia#2
  2. https://blogs.webmd.com/webmd-doctors/20200428/what-is-a-pulse-oximeter-and-can-it-help-against-covid19
  3. https://www.consumerreports.org/medical-symptoms/covid-19-pulse-oximeters-oxygen-levels-faq/

COVID-19 Risk Assessment Planning Tool

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The risk assessment planning tool is designed to tell you how likely you are to encounter a coronavirus-infected person at an event.

The COVID-19 Event Risk Assessment Planning Tool, conceived by Joshua Weitz, a quantitative biologist, and built by a team of researchers at Georgia Institute of Technology (Georgia Tech), offers a risk level forecast for every county in the United States. The risk level is the estimated chance (0-100%) that at least 1 COVID-19 positive individual will be present at an event in a county, given the size of the event.

The tool assumes that the actual number of coronavirus cases is up to 10 times higher than what’s in the official reports, because not all cases will be caught by tests.

The map is updated daily with the latest information on how many cases have been tallied in every county across the U.S. The COVID-19 Risk Assessment Planning Tool went live in July, and the tool’s creators reported that 2 million people had visited the site by September.

The hope is that people would use the COVID-19 Risk Assessment Planning Tool to help them make decisions about how many local friends and family to invite to their celebrations, and whether traveling to different parts of the country is worth the risk, according to Clio Andris, Assistant Professor of City and Regional Planning and Interactive Computing, at Georgia Tech.

References:

  1. https://www.latimes.com/science/story/2020-11-11/covid-19-risk-thanksgiving-2020-what-to-expect
  2. https://covid19risk.biosci.gatech.edu

U.S. in a “Bad Position”

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White House coronavirus advisor Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, said that the United States is in a “bad position” as coronavirus cases and hospitalizations surge in many parts of the nation. “When you look at the country and the heat map color, when you see red dots, which indicate that that part of the county, the city … is having an uptick in cases … all of that puts us in a precarious situation.”

References:

  1. https://www.cnbc.com/2020/10/28/coronavirus-dr-fauci-says-us-is-in-a-bad-position-as-daily-cases-hit-record-highs.html?__source=iosappshare%7Ccom.microsoft.msedge.EMMXShareExtension

Regeneron’s REGN-COV2 Antibody Cocktail

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Regeneron Pharmaceuticals REGN-COV2 Antibody Cocktail Reduced Viral Levels and Improved Symptoms in Non-Hospitalized COVID-19 Patients

Regeneron’s neutralizing antibody cocktail is still being studied in clinical trials as a treatment for non-hospitalized patients with milder and more moderate forms of the disease.

A vaccine can protect but cannot treat an already infected person. In contrast, laboratory-made antibodies (Y-shaped proteins that can help fight a foreign substance) can do both – protect and treat.

Regeneron is developing monoclonal antibodies for prevention and therapy of COVID-19. According to information on the company’s website, these antibodies would be injected into an infected individual; the antibodies would recognize and inactivate the coronavirus. Such a therapy would bridge the lag until the patient’s immune system was able to produce enough of its own antibodies; some patients with weak immune system may never produce antibodies to fight the virus.

“Regeneron’s antibody cocktail REGN-COV2 has shown efficacy by reducing viral load and associated symptoms in infected COVID-19 patients,” said George D. Yancopoulos, M.D., Ph.D., President and Chief Scientific Officer of Regeneron.”

The greatest treatment benefit was in “patients who had not mounted their own effective immune response”, suggesting that REGN-COV2 could provide a therapeutic substitute for the naturally-occurring immune response.

Regeneron confirmed it provided a single, 8-gram dose of its REGN-COV2 treatment for use by the president, who was diagnosis with coronavirus.

Regeneron’s antibody cocktail is experimental and has not received emergency use approval from the FDA, but it was provided in response to a compassionate use request.

CNBC reported that a “limited number of patients” had also received the drug on that basis after speaking with Regeneron’s chief scientific officer, Dr. George Yancopoulos.

Last week, Regeneron said its REGN-COV2 treatment improved symptoms and reduced viral loads in non-hospitalized patients who have mild to moderate Covid-19. That was based on results for the first 275 trial patients. At the time, the company indicated it plans to “rapidly” discuss the early results with regulatory agencies, including the FDA.

Monoclonal antibodies are viewed by experts have viewed as a promising potential Covid-19 treatment.

Regeneron’s REGN-COV2 is an experimental shot of lab-generated antibodies that mimics how the body would mount a reaction to a foreign invader. The goal is to boost the immune system’s defenses, rather than to wait on human biology to do its job.

References:

  1. https://www.finanzen.net/nachricht/aktien/regeneron-s-regn-cov2-antibody-cocktail-reduced-viral-levels-and-improved-symptoms-in-non-hospitalized-covid-19-patients-9344010
  2. https://patch.com/us/across-america/human-antibody-has-potential-work-prevention-therapy-coronavirus
  3. https://www.finanzen.net/nachricht/aktien/regeneron-s-regn-cov2-antibody-cocktail-reduced-viral-levels-and-improved-symptoms-in-non-hospitalized-covid-19-patients-9344010
  4. https://www.regeneron.com/antibodies

Experimental Monoclonal Antibody Treatment Lowers COVID-19 Hospitalizations

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Eli Lilly reports a reduced rate of hospitalization for coronavirus patients using its neutralizing antibody treatment

Eli Lilly said its experimental monoclonal antibody treatment (LY-CoV555) has helped patients rid their systems of the coronavirus sooner, potentially preventing them from hospitalization. The monoclonal antibody was identified from a blood sample taken from one of the first U.S. patients who recovered from Covid-19.

Eli Lilly said it tested three different doses of LY-CoV555 against a placebo in a trial enrolling roughly 450 patients. The middle dose of 2,800 mg met the trial’s target of significantly reducing the presence of SARS-CoV-2 after 11 days.

“The results reinforce our conviction that neutralizing antibodies can help in the fight against COVID-19.” Dr. Daniel Skovronsky, Lilly’s chief scientific officer and president of Lilly Research Laboratories.

Most study hospitalizations occurred in patients with underlying risk factors (age or BMI), suggesting a more pronounced treatment effect for patients in these higher-risk groups. Ongoing studies will seek to confirm this finding. Across all treatment groups (including placebo), no patients progressed to mechanical ventilation or died. Exploratory analyses indicated a more rapid improvement in symptoms for patients treated with LY-CoV555 versus placebo, supporting the hospitalization effect.

“These interim data from the BLAZE-1 trial suggest that LY-CoV555, an antibody specifically directed against SARS-CoV-2, has a direct antiviral effect and may reduce COVID-related hospitalizations,” said  Dr. Daniel Skovronsky, Lilly’s chief scientific officer and president of Lilly Research Laboratories. “The results reinforce our conviction that neutralizing antibodies can help in the fight against COVID-19,” Skovronsky said in a statement.

References:

  1. https://www.cnbc.com/2020/09/16/coronavirus-eli-lilly-reports-a-reduced-rate-of-hospitalization-for-patients-using-its-antibody-treatment.html?__source=iosappshare%7Ccom.apple.UIKit.activity.Message
  2. https://investor.lilly.com/news-releases/news-release-details/lilly-announces-proof-concept-data-neutralizing-antibody-ly

C.D.C. Testing Guidelines for People Without Covid-19 Symptoms

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“It is critical that science, evidence and data continue to serve as the foundation of every C.D.C. recommendation.” Dr. Mary Pittman, president and chief executive of the nonprofit Public Health Institute

The Centers for Disease Control and Prevention reversed its earlier controversial recommendation suggesting people who have had close contact with a person infected with the coronavirus do not need to get tested if they have no symptoms.

The new guidance recommends that anyone exposed to an infected person for more than 15 minutes needs a test. The change comes after widespread criticism of the earlier guideline.

Those who have been within 6 feet of a person with the coronavirus for at least 15 minutes, and those without symptoms, “need a COVID-19 test”. The Centers for Disease Control and Prevention

The previous phrasing, which suggested asymptomatic people who have had close contact with an infected individual “do not necessarily need a test,” now clearly instructs them: “You need a test.”

Public health experts welcomed the change as consistent with research showing that people without symptoms can spread the virus to others.

Read more: https://www.nytimes.com/2020/09/18/world/covid-coronavirus.html

References:

  1. https://www.cdc.gov/coronavirus/2019-ncov/hcp/testing-overview.html
  2. https://www.miamiherald.com/news/coronavirus/article245840460.html#storylink=cpy

America’s Mental Health Epidemic

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“Be sure to give each other a lot of grace and be kind and forgiving to each other. We’re all experiencing heightened levels of uncertainty and anxiety right now. Giving an extra beat of patience to others is critical.” Dani Fallin, chair of the Department of Mental Health at the Johns Hopkins Bloomberg School of Public Health

The mental health impact of COVID-19 are real, widespread and growing exponentially. The immense stress and emotional trauma experienced by vulnerable individuals, families and households amid the pandemic has given rise to an unprecedented mental-health crisis. Additionally, there’s strong evidence showing that social isolation and distancing can increase symptoms of mental illnesses like depression and anxiety.

Data is staggering

The latest data reveals some of the most frightening and staggering spikes in anxiety, depression, substance use, drug overdose and suicide rates that behavioral-health experts have ever witnessed, according to Babette Hankey, president/CEO of Aspire Health Partners in Orlando.

A recent survey by the Centers for Disease Control and Prevention on adult mental health found that more than 40% of U.S. adults have reported at least one mental health issue during this pandemic, and more than 1 in 10 adults had seriously considered suicide. During this period, 7 out of 10 young adults (18-24 years old) reported experiencing symptoms of anxiety and depression and more than 25% have seriously considered suicide.

In the wake of the coronavirus COVID-19 outbreak, many people may feel anxiety or stress.

Everyone responses differently

Everyone reacts differently to stressful situations such as the seemingly enduring COVID-19 pandemic infectious disease outbreak. It is normal to experience a wide range of emotions. Yet, it’s important for people to take care of themselves physically, emotionally, and mentally.

According to the CDC study, the rate of substance abuse and/or suicidal thoughts among unpaid caregivers more than tripled between May and the end of June.

Older Americans appear to be more resilient to the strain of the pandemic compared to the young: The study found rates of anxiety, depression, substance abuse and suicidal thoughts were most prevalent among those aged 18 to 24, and the prevalence of these issues “decreased progressively with age.”

Black and Hispanic Americans tended to have higher rates of mental health issues tied to the pandemic than did whites, the study also found.

Of course, unemployment or the threat of it is a major source of anxiety for millions in 2020. So, efforts aimed at “strengthening economic supports to reduce financial strain” should be part of an effort to boost mental health, the researchers said.

According to the CDC, reactions during the outbreak can include:

  • Fear and worry about your health status and that of your loved ones who may have been exposed to COVID-19.
  • Increase levels of stress, anxiety, hopelessness and depression.
  • Changes in sleep or eating patterns.
  • Difficulty sleeping or concentrating.
  • Worsening of chronic health problems.
  • Increased use of alcohol, tobacco, or other drugs.

Learning to cope with anxiety and stress

Figuring out ways to cope with anxiety and stress can help you, your loved ones and your community. If stress begins to interfere with your daily life, reach out to your healthcare provider.

These numbers, although startling, are unsurprising to mental health experts given the emotionally taxing measures local and state governments have taken to reduce the spread of the virus: children and grandchildren have been separated from their parents and grandparents; students are prevented from attending school; and the sick and dying have been denied the embrace of loved ones.

During this unique moment in the nation’s history, American society and economy have slowed down, we’re experiencing unprecedented social unrest and political rancor, and, many have been left feeling powerless and uncertain about their physical health and financial wellbeing as well as that of their loved ones.

https://youtu.be/60kGONUJSRY

The importance of self-care during this challenging time.

“Seek out ways to have social and professional engagement while adhering to social distancing…can help people feel connected socially with their colleagues, family, and friends, and maintain a sense of belonging.” Dani Fallin, chair of the Department of Mental Health at the Johns Hopkins Bloomberg School of Public Health

  • Avoid excessive exposure to media coverage of COVID-19. Be aware and conscious of your news and media intake. The more time you spend consuming news about the pandemic, the more likely you are to feel anxious and concerned. That’s especially true at home, when you’re able to access news media 24/7.
  • Take care of your body. Take deep breaths, stretch or meditate. Eat healthy, well-balanced meals, exercise regularly, get plenty of sleep and avoid alcohol, smoking and drugs.
  • Make time to unwind and remind yourself that strong feelings will fade. Take breaks from watching, reading, or listening to news stories. It can be upsetting to hear about the crisis and see images repeatedly. Try to do some other activities you enjoy to return to your healthy life.
  • Learn a new hobby or skill like gardening, a foreign language or a musical instrument. Devote yourself to learning and growing everyday.
  • Connect with others. Share your concerns and how you are feeling with a friend or family member. Maintain healthy relationships.
  • Maintain a sense of hope that “this too shall pass” and maintain positive outlook and thinking. Have faith in your inherent resilience to persevere and overcome life’s extraordinary challenges brought on by the pandemic.

Take care of your mental health

Mental health is an important part of overall physical health and emotional wellbeing. It affects how we think, feel, and act. It may also affect how we handle stress, relate to others, and make choices during uncertain situations or an emergency.

Again, we stress to contact your healthcare provider if you think you have new or worsening mental health symptoms or stress (or anxiety) gets in the way of your daily activities for consecutive days.

References:

  1. https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/managing-stress-anxiety.html
  2. https://www.orlandosentinel.com/opinion/guest-commentary/os-op-coronavirus-mental-trauma-aspire-health-20200914-xw7kcjahvbfrlgcd2s4bmvbmzi-story.html
  3. https://www.webmd.com/lung/news/20200813/levels-of-anxiety-addiction-suicidal-thoughts-are-soaring-in-the-pandemic#1
  4. https://hub.jhu.edu/2020/04/06/dani-fallin-mental-health-challenges-coronavirus/

Family Gatherings and House Parties Account for Majority of COVID-19 Transmissions

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In Maryland’s Prince George’s County, family gatherings and house parties have accounted for sixty-seven percent (67%) of COVID-19 transmissions, according to county officials. County officials say that contact tracers have determined that 44 percent of people who contracted COVID-19 reportedly attended family gatherings and 23 percent reportedly attended a house party.

Maryland Governor confirms that the trend is the same across the state of Maryland, saying that the number one cause of virus transmission in the state is family gatherings, followed by house parties, and then outdoor events.

Additionally, the Texas Medical Association released a chart breaking down the risk of contracting COVID-19 from certain activities ranging from grocery shopping, having parties at some else’s house and swimming in a public pool. Activities such as going to a hair salon or barbershop, traveling by plane, attending family gatherings like weddings and funerals, and going to a bar are considered moderate-high to high risk even for those wearing masks, maintaining six-feet of distance when out and washing hands thoroughly.

Texas Medical Association “Know Your Risk”

Currently, those at greatest risk of infection are individuals who have had prolonged, close contact with symptomatic or asymptomatic individuals infected with COVID-19 and those who live in or have recently been to areas with sustained transmission, according to Texas Medical Association and CDC. Keep in mind that many Americans have not been tested and studies suggest that people can be infected and not feel sick.

According to recent scientific findings, age is a strong risk factor for severe illness, complications, and death. Based on currently available information and clinical expertise, older adults and people of any age who have serious underlying medical conditions might be at higher risk for severe illness from COVID-19.

References:

  1. https://wjla.com/news/local/prince-georges-house-parties-family-gatherings-coronavirus
  2. https://www.tpr.org/post/know-your-risk-covid-19-chart-released-texas-medical-association
  3. https://www.texmed.org/uploadedFiles/Current/2016_Public_Health/Infectious_Diseases

COVID-19 Lung and Heart Damage

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“Your immune system in response to COVID-19 infection can become overzealous and go rogue – attacking and killing healthy cells in the body“.

COVID-19 patients suffer lung and heart damage, but there’s encouraging news for many “long-haulers” — COVID-19 patients who have continued showing symptoms for months after the initial infection — report neurological problems including confusion, difficulty concentrating, heart and lung issues, fatigue, insomnia, plus loss of taste and/or smell.

Cytokines are inflammatory immunologic protein

The immune system is there to help us fight infection, but sometimes it wreaks more havoc than the disease itself.

“There is evidence now that the virus can directly attack heart muscle cells, and there’s also evidence that the cytokine storm that the virus triggers in the body not only damages the lungs, but can damage the heart,” according to John Swartzberg, a clinical professor emeritus of infectious diseases and vaccinology in the the UC Berkeley-UCSF Joint Medical Program.

Inflammatory proteins, also known as cytokines, serve as molecular messengers between cells. Cytokines are proteins that are produced by cells and play a crucial role in the immune response. Cytokines interact with cells of the immune system in order to regulate the body’s response to disease and infection, as well as mediate normal cellular processes in the body.

If this immune response is too strong, a phenomenon known as “cytokine storm” can cause harm to the patient. It has been thought that a cytokine storm contributes to disease severity in patients with COVID-19.

“Cytokine storm”…your body may not know how to handle the presence of the coronavirus and overreact.” Reynold Panettieri, M.D., a lung specialist and vice chancellor for translational medicine and science at Rutgers University

With viral infections like COVID-19, our immune system can become overzealous and go rogue – attacking and killing everything in sight, including healthy cells in the body. When “cytokine storm” happens, it may kill severe COVID-19 patients.

“Cytokines are inflammatory immunologic proteins that are there to fight off infections and ward off cancers,” says Randy Cron, M.D., Ph.D, at the University of Alabama at Birmingham, “But when they are out of control, they can make you very ill.” 

While some research has found an elevated presence of cytokines in coronavirus patients, there isn’t enough data to say all rapidly-declining cases of COVID-19 are a result of a cytokine storm–the immune system gone rogue.

References:

  1. https://on.mktw.net/3lS0iYS
  2. https://medicalxpress.com/news/2020-09-covid-cytokine-storm.html?ocid=uxbndlbing.
  3. https://www.forbes.com/sites/claryestes/2020/04/16/what-is-the-cytokine-storm-and-why-is-it-so-deadly-for-covid-19-patients/#5eb2c364460f
  4. https://www.prevention.com/health/a32906012/cytokine-storm-coronavirus/
  5. https://www.health.com/condition/infectious-diseases/coronavirus/cytokine-storm