Tag: infection

COVID into the fifth year

Four years ago, here in the US, things were pretty much shut down due to the COVID-19 pandemic. B was working from home. I was the household’s designated shopper and would go, masked, to the grocery store every other week to stock up, although I’d sometimes have to visit more than one store because supply was a problem. We managed to keep ourselves safe, although we were horrified at the death toll in the US and around the world and at the people who became very ill. Over time, we also saw that some people had lasting damage to their lungs or other organs and others had symptoms that debilitated them for months.

Now, things are much better, due to vaccines and other precautions that have cut down on serious illnesses, although the US has slipped on vaccination, even as the virus has mutated in ways that make SARS-CoV-2 more infectious and immune-evasive. There are still way too many people getting sick and suffering long-term damage or death. While there are studies and some treatments on-going, there are still a lot of people suffering from long COVID.

We finally had our first case of COVID in our house last November, when B contracted it at a rare, in-person event for work. He isolated in part of our house and daughter T and I remained infection-free.

I don’t know how much longer we will be able to manage that status.

I was disappointed when the Centers for Disease Control and Prevention changed their guidance about isolating when infected with COVID. The new recommendations are for respiratory viruses in general and say that people can resume normal activities when their symptoms are improving and they have been without fever for 24 hours without being on fever-reducing medication. People are supposed to use masking, distancing, and other strategies to protect others from infection for five days afterward.

While I appreciate CDC’s reasoning, which is based on statistics, I don’t find it personally useful. It is typical that a person with COVID is infectious for ten days. It’s entirely possible to be fever-free and have improving symptoms and still be infectious. I’m afraid that most people won’t hear or won’t follow through on the part of the recommendation for masking and taking precautions to avoid exposing others after they leave isolation. This is especially troubling to me because so many people are not current on their vaccinations and/or are vulnerable due to age or health conditions. It’s great that the immunity level in the population halved the rate of serious illness and death, but that’s cold comfort if you expose a loved one, neighbor, co-worker, etc. and they become seriously I’ll or die.

If/when I contract COVID, I will isolate and mask until I test negative and am reasonably sure I can’t transmit the virus to anyone else. I want to protect my family and my community, especially our elders and those with medical issues, from contracting a virus that could cause them severe symptoms.

Please remember, when you see someone wearing a mask in public, to be kind and understanding. It’s entirely possible that they are trying to protect your health, not just their own.

(COVID Photo by Martin Sanchez on Unsplash)

another COVID-19 risk

I had saved this article on a research study that showed that SARS-CoV-2, the virus that causes COVID-19, can directly infect coronary arteries, which may help to explain the increased risk of heart attack and stroke among people who have contracted it.

It came to mind now because we received news that a friend’s family member with COVID has suffered a heart attack.

While it’s not known if infection and inflammation of the coronary arteries caused this particular person’s heart attack, it is a stark reminder that COVID can cause serious health complications. Way too many people are still getting sick and dying from it.

While there are no iron-clad ways to avoid infection, preventative measures like vaccines, avoiding crowds, and masking in indoor public spaces reduce your chances of infection and its follow-on risks.

Even if you don’t care about your personal risk of infection, remember that you could pass the infection on to someone who may be more vulnerable than you due to their age or underlying health condition. I know this has been a powerful motivating factor for me.

Please do what is right for you to protect yourself and others to the greatest extent possible.
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a belated Thanksgiving

Because spouse B had contracted COVID and needed to isolate at home and daughter T and I were masking around each other in case one of us was infected, we didn’t celebrate Thanksgiving last Thursday – or, I should say, we celebrated with a nice, but not fancy, dinner of roast pork with roasted vegetables with T and I eating in the dining room and B at the kitchen table where we could talk to each other at a safe distance. Instead of the traditional pie, we had (the also-traditional) Aunt Gert’s Indian pudding for dessert.

That Thursday was Day 12 of B’s COVID experience and the first day he had tested negative. On average, Omicron infections last for eight days, so B was on the long side of the spectrum but someone has to be to balance out those who have a short infectious phase. Because he needed to have two negative tests 48 hours apart for us to be unmasked around each other, he decided that our fancier Thanksgiving dinner should be on Sunday.

While, for many years, I did the bulk of the cooking at our house, I don’t especially enjoy it. B, on the other hand, likes cooking and baking, so he chose the menu and made the meal. We enjoyed a delicious dinner of individual beef Wellington with roasted Brussels sprouts with bacon and a Braeburn and Cortland apple pie for dessert.

One of the things for which we are most thankful is that B’s bout with COVID was relatively mild, even if his infectious period did hang on longer than expected. We are also thankful that T and I remained uninfected. The pool of people I know who have never had COVID has dwindled to just a few, so I know it’s likely we will contract it someday, but, for now, we are all happy to be able to spend time together at home unmasked in the same room, whether or not there is a fancy late-Thanksgiving meal on the table.

Photo by Pro Church Media on Unsplash

still positive

Spouse B is still testing positive for COVID on Day 11, although the line on the test kit is fainter so maybe he is getting closer to the two negative tests 48 hours apart to be ready to be unmasked together without worry.

Not sure yet what we will do about Thanksgiving. It will just be the three of us and we were planning to do something other than the traditional turkey dinner. Maybe we will just postpone until we can all eat together in the same room. T and I have been eating in the dining room while B sequesters himself in his office at mealtimes.

We all remain grateful that his symptoms were relatively mild and short-lived but we are anxious to actually spend time together again. We are also grateful that T and I aren’t infected but we want to make sure we remain cautious. B would feel so badly if his case spread to us because we got tired of following protocol. Given the length of time that has passed, we all realize T and I dodged catching it when he was infectious before and in the early hours of the symptomatic phase.

So, at least, three more days of masking in our future.

I might need to order some more KF94 masks…

(COVID Photo by Martin Sanchez on Unsplash)

out of luck

I’m sad to report that, despite our best efforts, we finally have a case of COVID-19 in the house.

My spouse B tested positive yesterday. We think he was exposed at an in-person work event on Wednesday.

We are taking precautions to isolate from each other but daughter T and I were both exposed to B before he developed symptoms when he was probably infectious, so it’s a waiting game at this point. We’ll be testing before going out in public and masking when we do to avoid infecting anyone else, in case we are pre-symptomatic.

So far, B has had fever and symptoms similar to a bad cold. Our primary care practice wants to hold off on prescribing Paxlovid but will if his condition worsens over the next couple of days.

I knew our luck would run out one day but I’m upset and worried to have COVID in the house. Because I’ve been reading about it and observing the twists and turns in its history since the beginning, I know that things sometimes go very badly, even in someone who is healthy and up-to-date on vaccines, so…

Photo by Martin Sanchez on Unsplash

COVID update – late summer 2023

There are many people here in the United States who are no longer taking COVID-19 seriously and a disturbing number who never did.

I am not one of them.

I’ve written dozens of posts over the past three and a half years about it, including about my family’s participation in the Pfizer/BioNTech Phase III clinical trial. I’ve tried to encourage people to take precautions to reduce their chances of infection and serious illness. In that vein, I offer this update.

There was a summer wave in the US with the most prevalent strain being Omicron XBB.1.5. On September 12, the Centers for Disease Control and Prevention Advisory Committee on Immunization Practices will meet to develop a recommendation for a newly formulated booster based on the XBB.1.5 variant. It’s anticipated that the recommendation will be that most people get this new booster, which is expected to be available by the end of September. I will get the booster as soon as I am able. To my knowledge, I’ve still not contracted COVID and would love to keep it that way. Even if the vaccine does not keep me from getting infected, it, along with taking an anti-viral such as Paxlovid, will likely keep me from being hospitalized.

Of course, SARS-CoV-2 continues to mutate. Even now, the variant mix has shifted in the US. EG.5 has become the highest in prevalence with FL.1.5.1 next in an array of variants currently circulating. (You can find current data in the US at the CDC site here.) It is expected that the new booster, though based on XBB.1.5, will still be effective against these other Omicron strains.

The unfortunate wild card at this point is another Omicron variant BA.2.86. The link is to a 8/22 post from epidemiologist Dr. Katelyn Jetelina, explaining why this variant may be more problematic than others, perhaps even warranting the World Health Organization to name it a variant of concern with the name “Pi.” BA.2.86 has over 30 mutations of the spike protein, which is part of the virus that our bodies learn to recognize via vaccines, infection, or both. The fear is that we could see another world-wide wave develop because BA.2.86 might be able to evade our defenses. Researchers are studying it to see if our current tests, vaccines, and treatments will work against it and how it might affect individuals and populations exposed to it. The current number of cases world-wide are thought to be small, but that has been the beginning status of any variant that has become dominant.

Part of the problem is that we don’t have as much data to work with. Most COVID cases aren’t reported to public health authorities anymore. Surveillance and genomic sequencing are lower. This results in less public awareness and information. Theoretically, we should be able to ramp up our system more quickly if a new wave occurs but I wish we had kept up our system in the first place in a proactive stance.

I’m concerned about the attitude that equates COVID infection with other viruses. A study in the journal Nature Medicine shows increased risks for an array of medical conditions, including diabetes, pulmonary and cardiovascular problems, two years after COVID infection, even if the initial case was mild.

“A lot of people think, ‘I got covid, I got over it and I’m fine,’ and it’s a nothingburger for them. But that’s not everything,” said the study’s senior author, Ziyad Al-Aly, a clinical epidemiologist at Washington University School of Medicine in St. Louis. After a couple of years, “maybe you’ve forgotten about the SARS-CoV-2 infection … but covid did not forget about you. It’s still wreaking havoc in your body,” said Al-Aly, chief of research at the Veterans Affairs St. Louis Health Care System.

source: https://www.washingtonpost.com/health/2023/08/21/long-covid-lingering-effects-two-years-later/

The risk of long COVID is real. The article cited above, which is free to access, explains more about the attempts to do research and get care for people with long COVID. People need to realize that they might be someone who gets COVID and has a mild case without long-term repercussions or they might become seriously ill or they might have symptoms for months and years to come. They could also infect someone else who would face the same uncertainties.

I’m once again imploring people to take COVID seriously. Vaccinate, if it is recommended for you. (Being in the US, I’m most familiar with recommendations here but people should look to their own local health authorities and medical practitioners for guidance in their area.) Test and treat an infection. Stay home if you are sick and avoid infecting others. Avoid crowds indoors; wear a high-quality mask if you can’t. If infection rates are significant in your area, mask indoors when you are away from home. Increase ventilation and air filtration. Wash your hands. Get adequate rest and nutrition. Remember that everyone deserves respect, so never question someone else’s decision to mask; they could be immunocompromised, caring for a vulnerable person, etc. and need that protection.

Eventually, we may get to a place where COVID is endemic, like the flu, but we aren’t there yet. Be careful and be kind as we continue to face this still-formidable challenge.

still COVID

I’m sad to report that the total death toll in the United States from COVID-19 is now over 1.04 million with over 93 million confirmed cases. The actual case count is no doubt higher, as some states have stopped reporting and many cases that are detected by at-home testing are not reported to health agencies at all. New cases are still occurring at a rate of 93,000 a day with 457 deaths (7-day rolling average on August 22, 2022).

It’s still heart-breaking.

And still considered by most experts a pandemic, although perhaps heading in the direction of being considered endemic in the United States soon, as influenza is.

Most cases in the US now are Omicron variants BA.4 or BA.5. There is some hope that new boosters that contain components targeted at Omicron variants might give some additional protection going into the fall and winter, especially against hospitalizations and deaths, but we will have to see if a) people actually get vaccinated and b) the vaccines do boost protection for any length of time.

And/or c) a new strain could develop that evades all prior immunity, is even more wildly contagious, doesn’t respond to current treatments, and/or causes more severe illness.

At home, B, T, and I all still remain uninfected to the best of our knowledge. It’s possible that one or more of us have had an asymptomatic case but there is no real way to know. Any time that we have had symptoms, we have tested, as we have also for travel and after known exposures. We also have had extra tests as part of our participation in the Pfizer/BioNTech vaccine trials. T remains a participant in the third shot trial; B and I exited the trial in order to receive a fourth dose before travelling to the UK this spring. I believe that our vaccination status has helped us to avoid infection and plan to receive one of the new booster shots this fall, if I’m eligible for what will be my fifth dose. T may be eligible for a booster after she finishes with her trial participation this fall if those boosters are available to people under 50.

Broome County, New York, managed to have only a few weeks in the Centers for Disease Control category of low community risk for transmission before going back up to medium. I’ve gone back to masking with a KF94 while shopping or in other indoor public places. I’m making determinations on small gatherings on a case by case basis. Other than church services, I’m avoiding large gatherings.

Some people think I’m being overly cautious at this point but I am still trying to avoid infection, if I can. At the very least, if I do become infected, I will know that I was doing everything I could to keep myself healthy so that I don’t suffer guilt on top of COVID. I am well aware that, even with multiple vaccine doses, masking, avoiding crowds, etc., Omicron, especially BA.5, has been quite successful at evading immunity and protections. I know from what the public health experts are saying and also anecdotally among my friends. There are very few left who have managed to stay COVID-free in recent months.

A large part of my motivation to keep from getting infected is fear of long COVID. While SARS-CoV -2 is too new a virus for researchers to fully understand, it’s possible that I may have some genetic risk factors that could come into play regarding long COVID. None of this is helped by the fact that the underlying medical conditions I have are themselves not well understood.

So, I’ll keep on doing the best I can to stay as healthy as possible.

Wish me luck.

I’m going to need it.