Tag: SARS-CoV-2

Summer ’24 COVID wave

(COVID Photo by Martin Sanchez on Unsplash)

It’s become more difficult to keep track of COVID-19 cases here in the United States, as less data is being collected and shared with the public.

We do know that this summer’s wave has been substantial, mostly due to the Omicron subvariants known as FLiRT. While death rates have been lower than in previous waves, they have still been ranging in the 400s-700s per week this summer, which is upsetting. These figures may also be lower than the actual count because reporting is less robust than it was under the public health emergency protocols.

Last week, the US Food and Drug Administration approved the Pfizer and Moderna vaccines based on the KP.2 variant, one of the FLiRT family. Doses are already available from some pharmacies and are recommended for everyone ages 6 months and older. While some people will choose to wait until later in the fall to have the strongest protection possible going into the expected winter wave, I will be getting mine in mid-September so that my immunity will be strong when I go to North Adams for the annual Boiler House Poets Collective residency at MASS MoCA (Massachusetts Museum of Contemporary Arts). It looks as though the vaccine will be a good match for the strains that will likely be dominant in the coming months.

The FDA is also expected to approve the Novavax vaccine in the coming weeks. It is a more traditional protein-based vaccine rather than an mRNA one. Some people prefer it because it can cause fewer side effects.

Many people are choosing to ignore any news about COVID and vaccines but it is still a serious problem, here in the US and around the world. This is a reminder that some people are still getting very sick and dying from the SARS-CoV-2 virus. Updated vaccines are known to reduce the risk of hospitalization and death, so please get one if they are available to you. (Contact your health care provider for any special recommendations that may apply.)

Other measures can also help reduce your chances of getting COVID. Wearing a high quality mask, especially in crowded, indoor areas, dramatically decreases the rate of infection. Increasing indoor ventilation and air filtration and holding events outdoors are helpful in preventing the spread of COVID and other viruses. If you are sick, stay home and take precautions against spreading your illness to others in your household. Get adequate rest and nutrition to keep your immune system strong.

COVID-19 has not settled into a pattern like we see with flu and is still much more serious in terms of hospitalizations and deaths. It also impacts more systems in the body and can cause symptoms over a longer period of time, such as we see in cases of long COVID. Some people are willing to risk their own health but please remember that you are also putting your family and vulnerable community members at risk if you spread the illness to them.

Wishing everyone good health in the coming months.

losing Joan

(Photo by July on Unsplash)

I got news yesterday of the death of a college friend.

Joan and I met in Ron Perera‘s first-year music theory class. Like me, Joan was a western Massachusetts native and a Catholic with close ties to her family. She was a talented violinist. I remember her giving a demonstration to our theory class, showing us all the techniques used to create different sonorities for us to use in our compositions.

For junior year, Joan went to the University of Michigan and decided to transfer there to finish her education. However, “once a Smithie, always a Smithie,” Joan remained a member of the Smith College class of ’82.

Joan went on to a successful career playing in orchestras, concluding with a long tenure with the Kennedy Center Opera Orchestra in Washington, DC. Her performance schedule kept her busy but, two years ago, she was able to attend our 40th reunion in Northampton, visiting family in the area which hadn’t been possible during the height of the pandemic. While we had been keeping in touch over the years, it was the first time in decades that we had seen each other and it was great. We started speculating where we would each be living post-retirement when our 45th reunion rolled around.

Right after reunion, Joan developed COVID. Fortunately, she wasn’t very sick but she was bummed about missing some of her opera performances.

It was a shock when she was diagnosed with acute lymphoma that fall. She immediately began chemotherapy. Due to the intensity of the treatment and her weakened immune system, she had to stay at home, where her husband Paul was her loving and capable caregiver.

In summer of last year, Joan was able to resume performing while her treatment migrated to a maintenance regimen. This January, she was posting about the orchestra.

And, sometime since, her remission ended and the cancer came back with a vengeance.

I didn’t know.

Early this month, I had emailed her some new photos of my granddaughters and Joan sent a reply about how beautiful they are. Sending photos had been something I had done during her home-bound period and continued to do from time to time. I am grateful that I was unknowingly able to add a moment of love and beauty to her final weeks.

Hearing the news of Joan’s death from our Smith friends was a shock and brought waves of tears. It’s also brought to mind this recent Washington Post article, raising the disturbing prospect that SARS-CoV -2 infection may play a role in the development of cancer, particularly rare or unusual ones. It will take years of research to determine whether or not this is the case but the mystery of it all is disquieting.

The final commendation at Joan’s funeral will begin, “May the angels lead you into Paradise.” May there be a beautiful violin waiting for you there, Joan.

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)

JN.1

It’s been four years since the first cases of COVID-19 were confirmed in the US but it’s still a major health issue. While vaccines, treatments, and preventative measures have made the current situation less severe than the initial onslaught of SARS-CoV-2, people are still getting sick, with some needing to be hospitalized and some, unfortunately, succumbing to the disease, including the person I referenced in this post. In the week of Dec. 31, 2023-January 6, 2024, COVID caused 4% of all deaths in the United States.

The virus continues to mutate. The current strain that is dominant in the United States and globally is JN.1, which is related to the BA.2.86 variant of Omicron. The good news is that the most recent vaccine, which is based on the related XBB lineage, is a good match for JN.1, so the vaccine significantly reduces the risk of severe symptoms, hospitalization, and death while offering some protection against infection. The bad news is that, in the United States, only about 8% of children and 19% of adults are estimated to have received the newest vaccine, contributing to a surge of cases, amplified by holiday travel and gatherings.

More good vaccine news. This large study from Sweden concludes that vaccination reduces the risk of developing long COVID and that additional vaccine doses reduce risk even more. As someone who has particular concerns about long COVID, I appreciate that these studies are continuing to increase our understanding.

Another recent study shows that the Omicron variants don’t cause peak viral loads until day 3-4, much later than the earlier strains of the virus. The practical implication of this is that at-home COVID tests may not pick up a positive reading until several days into the illness, during which time the person could be infecting others. It also has implications for prescribing anti-virals, which need to begin within the first five days of symptoms to be effective. For me, this is a reminder to mask around other people whenever I have symptoms, as an early negative test might not be accurate.

A study published just a few days ago seems to put some science behind what we have all experienced, that SARS-CoV-2 doesn’t have a “season” in the way that some other viruses, like influenza, do. Changes in temperature and humidity don’t appear to have significant influence in transmission. This seems to go along with what we have experienced in the United States, with major waves happening in different seasons of the year. We’ve had waves in the heat of summer as well as the cold of winter. This suggests that our current winter wave is due more to low vaccination rates and holiday travel and gatherings than to the fact that it is winter. It also highlights the importance of increasing ventilation and using masks in crowded indoor spaces, as both summer heat and winter cold tend to drive people to gather indoors.

Four years in, I’ve written a lot of COVID-19 posts. From my days as part of the Pfizer/BioNTech vaccine trials through the present, I’ve always tried to give the most updated information and public health guidance available. It’s frustrating that there is less information from the Centers for Disease Control and Prevention than when the state of emergency was still in effect but some useful recent data can be found here. A lot of the information in this post came to my attention through this post from Dr. Katelyn Jetelina, writing as “Your Local Epidemiologist” and this post from Those Nerdy Girls.

Through all these challenges, especially when spouse B had the first case of COVID in our house in November, I’ve managed to avoid infection, unless I had a totally asymptomatic case at some point. I use my research to make decisions about vaccination, masking, crowd avoidance, etc. that are right for me and my family. I don’t think that advocating for health measures ought to be seen as controversial or political. There are, though, forces in the US that have warped disease prevention into a political test. It’s very sad that Republicans are more likely to die from COVID than non-Republicans. Please, don’t put your health and the health of your family and neighbors at risk over politics. COVID-19 is still out there. Take care of your health and your loved ones.
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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.