Coronavirus COVID-19 - Global Health Pandemic #109

Stunned

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MimosaMornings

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<modsnip>


We need multiple approaches to reduce transmission. It’s going bonkers right now, and this is not a sustainable way to coexist with this virus. I’m not saying that people need to have mask mandates forever, but when transmission rates are this high, it is a good idea to think about masking, to think about testing more often, paying attention to who is up-to-date on their vaccines and making sure that our approaches are complementing each other. We still have huge issues with access to Paxlovid, access to tests, access to everything.”
 
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BetteDavisEyes

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Around a third of people with Covid will experience a rebound of their symptoms, regardless of whether they’ve been treated with the antiviral Paxlovid, according to a study posted online Tuesday.

The preprint study — meaning it hasn’t been published in a peer-reviewed journal — found that 27% of people with Covid saw a rebound in their symptoms after they had initially improved.

“It happens all the time. People who are untreated with Covid who then feel better can get symptoms afterward,” said study co-author Dr. Davey Smith, chief of infectious diseases and global public health at the University of California, San Diego School of Medicine. Still, Smith noted that the 27% finding was higher than what he’d expected based on anecdotal evidence...
 

ilovewings

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Around a third of people with Covid will experience a rebound of their symptoms, regardless of whether they’ve been treated with the antiviral Paxlovid, according to a study posted online Tuesday.

The preprint study — meaning it hasn’t been published in a peer-reviewed journal — found that 27% of people with Covid saw a rebound in their symptoms after they had initially improved.

“It happens all the time. People who are untreated with Covid who then feel better can get symptoms afterward,” said study co-author Dr. Davey Smith, chief of infectious diseases and global public health at the University of California, San Diego School of Medicine. Still, Smith noted that the 27% finding was higher than what he’d expected based on anecdotal evidence...

Around a third of people with Covid will experience a rebound of their symptoms, regardless of whether they’ve been treated with the antiviral Paxlovid, according to a study posted online Tuesday.

The preprint study — meaning it hasn’t been published in a peer-reviewed journal — found that 27% of people with Covid saw a rebound in their symptoms after they had initially improved.

“It happens all the time. People who are untreated with Covid who then feel better can get symptoms afterward,” said study co-author Dr. Davey Smith, chief of infectious diseases and global public health at the University of California, San Diego School of Medicine. Still, Smith noted that the 27% finding was higher than what he’d expected based on anecdotal evidence...

I am not surprised that people who are untreated would get a return of symptoms - I am however (as are probably many people), surprised that after treatment with an anti-viral, in this case Paxlovid, some people experience what is termed "rebound". Trying to think of why that may happen--- I think I heard somewhere (can't recall where or who may have said it), that perhaps some people have a large viral load that simply is not completely terminated by Paxlovid- and so they get what looks like rebound, but may be that the initial bout of Covid was not completely wiped out with Paxlovid. The important thing as pointed out in the article is that Paxlovid , along with vaccines, has really helped save lives and decrease the need for hospitalization.
 

Sundog

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I am not surprised that people who are untreated would get a return of symptoms - I am however (as are probably many people), surprised that after treatment with an anti-viral, in this case Paxlovid, some people experience what is termed "rebound". Trying to think of why that may happen--- I think I heard somewhere (can't recall where or who may have said it), that perhaps some people have a large viral load that simply is not completely terminated by Paxlovid- and so they get what looks like rebound, but may be that the initial bout of Covid was not completely wiped out with Paxlovid. The important thing as pointed out in the article is that Paxlovid , along with vaccines, has really helped save lives and decrease the need for hospitalization.

Many antiviral meds just suppress the virus, they don't eradicate it. So when you stop taking the antiviral medication, then the supressed virus starts to replicate again.

There is ongoing discussion as to whether or not the course of Paxlovid treatment should be longer than 5 days.
 

ilovewings

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Many antiviral meds just suppress the virus, they don't eradicate it. So when you stop taking the antiviral medication, then the supressed virus starts to replicate again.

There is ongoing discussion as to whether or not the course of Paxlovid treatment should be longer than 5 days.

Since not everyone who takes Paxlovid gets rebound, could it be that the rebound would be dependent on the viral load the person is experiencing so they might not feel it necessary to lengthen the course of treatment with Pavlovid.
 

BetteDavisEyes

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Many antiviral meds just suppress the virus, they don't eradicate it. So when you stop taking the antiviral medication, then the supressed virus starts to replicate again.

There is ongoing discussion as to whether or not the course of Paxlovid treatment should be longer than 5 days.
Based on what I've read, it sounds like Paxlovid "masks" the virus. It helps resolve symptoms fairly quickly, so the patient feels better and believes that they're ready to return to normal life. Paxlovid seems like a placebo that simply makes Covid sufferers belive that they've licked Covid. If I were to get Covid - and I do everything possible to avoid that - I would prefer intravenous anti-body treatment. JMO

One of my brothers had Covid during the winter. He's 68 and retired but likes to have a part-time job so he can afford to play lots of golf. He started parking cars at a local hospital last fall and was originally assigned to the main entrance that had limited visitors due to Covid. Shortly after the first of the year, the valet service transferred him to the emergency entrance. He greeted patients with various illnesses and injuries, escorted them (usually in wheelchair) into the emergency reception area, then parked their vehicles. Troy Beaumont Hospital's ER has been packed to the gills since the pandemic began. Most incoming patients were accompanied by a family member who also could have been infected with Covid even if they were asymptomatic at the time.

Long story short, my brother contracted Covid in late January. He was sick for about 10 days but was given the "royal" treatment by Beaumont Hospital, receiving intravenous antibodies. He had been vaccinated but was told not to get boosters following the treatment. When my brother was given the all-clear to return to work, the valet service wanted to transfer him to another Beaumont location that was much farther from his home, so he decided to "retire" again. He hasn't had any recurrence of symptoms.
 
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Kingsley

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Have you all been watching Japan? It's been raging there.

I wonder if there is a holiday or social season/event that is related to the latest surge.

The last graph in the link was excellent, however, in showing the almost synchronous rise in the recovery line and drop in the mortality line. Sometimes a graph like that goes a long way to giving perspective. That is not to say in any way that the lives that were still lost are not significant.

JMO.
 

jjenny

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Based on what I've read, it sounds like Paxlovid "masks" the virus. It helps resolve symptoms fairly quickly, so the patient feels better and believes that they're ready to return to normal life. Paxlovid seems like a placebo that simply makes Covid sufferers belive that they've licked Covid. If I were to get Covid - and I do everything possible to avoid that - I would prefer intravenous anti-body treatment. JMO

One of my brothers had Covid during the winter. He's 68 and retired but likes to have a part-time job so he can afford to play lots of golf. He started parking cars at a local hospital last fall and was originally assigned to the main entrance that had limited visitors due to Covid. Shortly after the first of the year, the valet service transferred him to the emergency entrance. He greeted patients with various illnesses and injuries, escorted them (usually in wheelchair) into the emergency reception area, then parked their vehicles. Troy Beaumont Hospital's ER has been packed to the gills since the pandemic began. Most incoming patients were accompanied by a family member who also could have been infected with Covid even if they were asymptomatic at the time.

Long story short, my brother contracted Covid in late January. He was sick for about 10 days but was given the "royal" treatment by Beaumont Hospital, receiving intravenous antibodies. He had been vaccinated but was told not to get boosters following the treatment. When my brother was given the all-clear to return to work, the valet service wanted to transfer him to another Beaumont location that was much farther from his home, so he decided to "retire" again. He hasn't had any recurrence of symptoms.
If it were placebo it wouldn't lead to 90% reduction in risk of hospitalization or death. It clearly works, but 5 day dose might not be long enough for at least some of the patients.
 

Sundog

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Paxlovid as an antiviral blocks the virus from replicating, it blocks a certain enzyme that the virus needs to replicate. So when you stop taking Paxlovid, if you haven't cleared the virus, the virus that is left can replicate again.
 

Sundog

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Since not everyone who takes Paxlovid gets rebound, could it be that the rebound would be dependent on the viral load the person is experiencing should be longer than 5 days.

Seems that they don't know yet why the rebound happens. The article below discusses this and concludes that it is a mystery and needs to be studied. At this time, it sounds like the rebound cases have been mild, so there isn't the concern by the CDC to lengthen the course of treatment (i.e. a second round of Paxlovid). The main concern is that the person who is experiencing the rebound is contagious and is usually without symptoms.

 

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Seems that they don't know yet why the rebound happens. The article below discusses this and concludes that it is a mystery and needs to be studied. At this time, it sounds like the rebound cases have been mild, so there isn't the concern by the CDC to lengthen the course of treatment (i.e. a second round of Paxlovid). The main concern is that the person who is experiencing the rebound is contagious and is usually without symptoms.

Here's another article on the rebound issue:
Excerpts:

"Biden’s chief medical adviser, Dr. Anthony Fauci, also took Paxlovid when he contracted covid in June yet soon tested positive for the disease again. So he took a second round of the drug even though it isn’t approved for that....

...Fauci said he took a second course of Paxlovid after testing positive for covid and feeling even sicker on the second go-around with the virus....

...Some medical experts wonder if tweaking the timing or duration of a course of Paxlovid might eliminate the rebound effect some patients experience. If people started taking Paxlovid on day 3 of symptoms, instead of right away, for example, their bodies’ defenses could kick in, bolstered by vaccines or previous infections, Nori said.

“Then we augment with the antiviral, and this rebound might be mitigated,” she said.

Many experts believe a five-day course is just too short, said Wachter, who wants more data. “You would think it wouldn’t be that hard to do a study on five days versus seven days versus 10 days,” he said.

According to Pfizer’s Longley: “There may be some patient populations who may benefit from longer durations of treatment or recurrent treatment, and we are considering additional studies to evaluate this in some populations.”
 

anneg

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Post–COVID-19 Symptoms and Conditions Among Children and Adolescents — United States, March 1, 2020–January 31, 2022​

Weekly / August 5, 2022 / 71(31);993–999

Summary​

What is already known about this topic?

Children and adolescents might be at risk for certain post-COVID symptoms and conditions.

What is added by this report?

Compared with patients aged 0–17 years without previous COVID-19, those with previous COVID-19 had higher rates of acute pulmonary embolism (adjusted hazard ratio = 2.01), myocarditis and cardiomyopathy (1.99), venous thromboembolic event (1.87), acute and unspecified renal failure (1.32), and type 1 diabetes (1.23), all of which were rare or uncommon in this study population.

What are the implications for public health practice?

COVID-19 prevention strategies, including vaccination for all eligible persons aged ≥6 months, are critical to preventing SARS-CoV-2 infection and subsequent illness, and reducing the public health impact of post-COVID symptoms and conditions among persons aged 0–17 years.
 

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<modsnip - polio thread is at New York polio case may be "tip of the iceberg," August 2022>
--------------------

Dr. Peter Hotez has a related article in Nature about anti-vaccine activism and childhood vaccinations.

In the time of the COVID-19 pandemic, anti-vaccine activism in the USA accelerated, amplified and formed an alliance with political groups and even extremists. An organized, well-funded and empowered anti-science movement now threatens to spill over and threaten all childhood immunizations in the USA and globally.
[...]

A central concern is whether anti-vaccine activism from the USA will detrimentally effect the world’s low- and middle-income countries (LMICs). For two decades, under the auspices of the ‘Global Goals’ (initially the ‘Millennium Development Goals’ followed by ‘Sustainable Development Goals’), tremendous strides have been made in reducing deaths and morbidity from measles, polio, pertussis and other dangerous illnesses that can be prevented by vaccination5. The fear is that globalizing anti-vaccine activism might reverse these trends. A successful vaccine ecosystem led by Gavi, the Vaccine Alliance, and its United Nations partners, the World Health Organization (WHO) and UNICEF, is under threat.
 
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ilovewings

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<modsnip>
--------------------

Dr. Peter Hotez has a related article in Nature about anti-vaccine activism and childhood vaccinations.

In the time of the COVID-19 pandemic, anti-vaccine activism in the USA accelerated, amplified and formed an alliance with political groups and even extremists. An organized, well-funded and empowered anti-science movement now threatens to spill over and threaten all childhood immunizations in the USA and globally.
[...]

A central concern is whether anti-vaccine activism from the USA will detrimentally effect the world’s low- and middle-income countries (LMICs). For two decades, under the auspices of the ‘Global Goals’ (initially the ‘Millennium Development Goals’ followed by ‘Sustainable Development Goals’), tremendous strides have been made in reducing deaths and morbidity from measles, polio, pertussis and other dangerous illnesses that can be prevented by vaccination5. The fear is that globalizing anti-vaccine activism might reverse these trends. A successful vaccine ecosystem led by Gavi, the Vaccine Alliance, and its United Nations partners, the World Health Organization (WHO) and UNICEF, is under threat.
Since the anti vaxxers have take such hold in this country, I have been afraid that too many parents are not going to get their children vaccinated and that if that happens we will thrown back into the dark ages-- It is very scary.
 
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BetteDavisEyes

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President Joe Biden tested negative for Covid Saturday but will continue to isolate until he tests negative a second time, his doctor said in a letter.

"The President continues to feel very well," White House physician Dr. Kevin O’Connor wrote, a week after Biden, 79, tested positive again in a "rebound" case. "This morning, his SARS-CoV-2 antigen testing was negative."

He will continue "his strict isolation measures pending a second negative test as previously described," O'Connor added...
 

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