Fluvid

ACE-2-like enzymatic activity is associated with immunoglobulin in COVID-19 patients | mBio We provide what we believe to be the first description of angiotensin-converting enzyme 2 (ACE2)-like enzymatic activity associated with immunoglobulin in COVID-19 patients. COVID-19 includes many puzzling clinical features that have unclear pathogenesis, ...

Impact of Pre-Existing Chronic Viral Infection and Reactivation on the Development of Long COVID The presence and reactivation of chronic viral infections such as Epstein-Barr virus (EBV), cytomegalovirus (CMV) and human immunodeficiency virus (HIV) have been proposed as potential contributors to Long COVID (LC), but studies in well-characterized ...

Find me in the food court

Apple Maps The Mall at Green Hills

RAID: Call of the Arbiter | Limited Series | Official Trailer #2 The time is almost nigh. Answer the call of destiny, and stand against the darkness threatening Teleria.RAID: Call of the Arbiter premieres May 18 on YouTube...

MODERNA BIVALENT VACCINE PRODUCED STRONG NEUTRALIZING ANTIBODIES AGAINST BA.4 & BA.5

From their press release:
“In today's data, mRNA-1273.214 boosted neutralizing titers against BA.4/BA.5 by 5.4-fold (95% CI: 5.0, 5.9) above baseline in all participants regardless of prior infection, and by 6.3-fold (95% CI: 5.7, 6.9) in the subset of seronegative participants. Neutralizing titers against BA.4/BA.5 were approximately 3-fold lower than previously reported neutralizing titers against BA.1. One month after an mRNA-1273.214 booster, neutralizing geometric mean titers (GMT) against BA.4/BA.5 were 941 (95% CI: 826, 1071) in all participants, and 727 (95% CI: 633, 836) in seronegative participants. For context, prior studies of a third dose of the prototype booster induced neutralizing GMT against BA.1 of 629 (95% CI: 526, 751) and against Delta of 828 (95% CI: 738, 928)[1]. A third dose of the prototype booster was shown to be effective against Delta and BA.1 infection and hospitalization in observational studies [2],[3].”

“Today's data add to results shared earlier this month from the Company's ongoing Phase 2/3 study in approximately 800 participants. Previous results showed a 50 µg booster dose of mRNA-1273.214 met all pre-specified primary endpoints, including superiority in neutralizing antibody GMT against Omicron (BA.1) when compared to a 50 µg booster dose of the prototype booster (mRNA-1273). The bivalent booster was generally well tolerated, with a reactogenicity and safety profile that was consistent with the prototype booster. Moderna believes these data collectively support updating the composition of the Company's booster to bivalent (Omicron) mRNA-1273.214 for the fall.

The Company has already shared these data with regulators and is submitting a manuscript for peer reviewed publication.”

https://investors.modernatx.com/news/news-details/2022/Moderna-Announces-Bivalent-Booster-mRNA-1273.214-Demonstrates-Potent-Neutralizing-Antibody-Response-Against-Omicron-Subvariants-BA.4-And-BA.5/default.aspx

https://www.reuters.com/business/healthcare-pharmaceuticals/moderna-booster-candidate-produces-strong-antibodies-against-omicron-subvariants-2022-06-22/

Moderna booster candidate shows strong response against Omicron subvariants Moderna Inc said on Wednesday that an updated version of its COVID-19 vaccine designed to target the Omicron variant also generated a strong immune response against the fast-spreading Omicron subvariants BA.4 and BA.5, which have gained a foothold in the U.S. in recent weeks.

Finally we are seeing a new decline in this Omicron strain. Our clinic had been getting killed

Summary

India has seen more Covid cases in the last seven days than any other country in the world
A ferocious second wave of infections has taken the official death toll past the 200,000 mark - experts believe the actual number may be even higher
People have died waiting for beds, as oxygen supplies run low and hospitals crumble under the strain of new patients
From today all adults over the age of 18 can sign up for Covid vaccines in India - only 1.6% of the population is fully vaccinated so far
US President Joe Biden says he intends to send vaccines to India

This catchy thread is spreading across social media. Originally, someone answered it from a (flawed) governmental perspective (and by government I'm assuming CDC, but even this wasn't clear). Nonetheless, I thought it might be useful to answer from an accurate epidemiological perspective...

"If I get vaccinated":
1. Can I stop wearing the mask?
Epidemiologist: Yes, once everyone’s vaccinated or we reach herd immunity

2. Can they reopen restaurants, pubs, bars etc and everyone work normally?
Epidemiologist: Yes, once everyone’s vaccinated or we reach herd immunity

3. Will I be resistant to covid?
Epidemiologist: Yes

4. At least I won't be contagious to others anymore
Epidemiologist: Correct, it stops ~60-70% transmission by reducing viral load

5. If I am vaccinated, can I stop social distancing?
Epidemiologist: Yes, if you’re with other vaccinated people

6. If I am vaccinated, can I stop disinfecting my hands? Epidemiologist: Yes, but we probably should keep washing hands regardless. It's a good habit to get into.

7. If I vaccinate myself and my grandparents, can we hug each other?
Epidemiologist: HELL YES

8. Will cinemas, theatres and stadiums operate as per normal thanks to vaccines?
Epidemiologist: Yes, thanks to vaccines or herd immunity

9. What is the benefit of the vaccine?
Epidemiologist (which agrees to the original “government response”): The virus won't kill you

10. Are you sure it won't kill me?
Epidemiologist: Yes

11. If statistically the virus won't kill me anyway (99.7% survival rate) ... Why would I get vaccinated?
Epidemiologist: This is purposefully misleading. Not everyone has a 99% survival rate; and even if you do survive, the long term effects are damaging.

12. So if I get vaccinated, I can protect 100% of people I come in contact with?
Epidemiologist: Not 100%. But, your viral load will be significantly reduced and it's much less likely that you'll spread COVID19 with the vaccine than without the vaccine.

13. Can you guarantee that I won’t experience adverse affects from taking the vaccine or die from the vaccine itself?
Epidemiologist: (first off it’s adverse EFFECTS) but, no we can’t protect you from rare, temporary adverse effects of the vaccine. But you won’t die from the vaccine itself (there haven't been any documented cases where this has happened yet and 231 million doses have been distributed worldwide)

14. Since you’re encouraging every American to get vaccinated then when people experience severe adverse reactions, long term effects (still unknown) or die from the vaccine will they or their families be compensated?
Epidemiologist: Maybe, we do have a vaccine injury program in the United States

15. How long does the vaccine last?
Epidemiologist: So far, 9 months (but that’s because we have 9 months of data from natural infections, we are at the mercy of time, this is likely much longer). But the vaccine won't last long if the virus continues to mutate (and we need new vaccine formulas).

So to summarize, the Covid19 vaccine...
Does give immunity.
Does eliminate the virus.
Does prevent death.
Does not guarantee you won’t get it. (This is true, there is a small chance you may still get it, but it will certainly be more mild)
Does stop you passing it on (about 70% of the time)
Does eliminate the need for travel bans (eventually).
Does eliminate the need for business closures (eventually).
Does eliminate the need for lockdowns (eventually).
Does eliminate the need for masking (eventually).

Love, YLE

Here are some data sources that people are looking for:
Transmission (although there have been other studies to come out since this post, like the J&J trial): https://yourlocalepidemiologist.substack.com/p/vaccine-and-transmission-an-update
99% survival rate: https://yourlocalepidemiologist.substack.com/p/but-99-of-people-dont-die
Vaccine and deaths: https://yourlocalepidemiologist.substack.com/p/deaths-and-the-vaccine

Deaths and the vaccine… It’s extremely important that epidemiologists (and for those trying to understand epidemiology) understand the difference between correlation and causation. When I teach this topic to my graduate students, I start with a classic example…When ice cream sale go up, drownings increase. Does ice cre...

US EXPERIENCE WITH PROTECTIVE EFFECT OF COVID VACCINATION: 88.7% EFFECTIVE, AND LESS SEVERE DISEASE POST VACCINATION

"Large Phase 3 clinical trials of the two FDA-authorized COVID-19 vaccines, mRNA-1273 (Moderna) and BNT162b2 (Pfizer/BioNTech), have demonstrated efficacies of 94.1% (n = 30,420, 95% CI: 89.3-96.😎 and 95% (n = 43,448, 95% CI: 90.3-97.6) in preventing symptomatic COVID-19, respectively. Given the ongoing vaccine rollout to healthcare personnel and residents of long-term care facilities, here we provide a preliminary assessment of real-world vaccination efficacy in 62,138 individuals from the Mayo Clinic and associated health system (Arizona, Florida, Minnesota, Wisconsin) between December 1st 2020 and February 8th 2021. Our retrospective analysis contrasts 31,069 individuals receiving at least one dose of either vaccine with 31,069 unvaccinated individuals who are propensity-matched based on demographics, location (zip code), and number of prior SARS-CoV-2 PCR tests. 8,041 individuals received two doses of a COVID-19 vaccine and were at risk for infection at least 36 days after their first dose. Administration of two COVID-19 vaccine doses was 88.7% effective in preventing SARS-CoV-2 infection (95% CI: 68.4-97.1%) with onset at least 36 days after the first dose. Furthermore, vaccinated patients who were subsequently diagnosed with COVID-19 had significantly lower 14-day hospital admission rates than propensity-matched unvaccinated COVID-19 patients (3.7% vs. 9.2%; Relative Risk: 0.4; p-value: 0.007). Building upon the previous randomized trials of these vaccines, this study demonstrates their real-world effectiveness in reducing the rates of SARS-CoV-2 infection and COVID-19 severity among individuals at highest risk for infection."

Acute COVID-19 is characterized by acutely elevated platelet reactivity state, in the pulmonary microcirculation, leading to platelet-derived mediator release and pathogenicity associated with such mediators, and the end result of a higher burden of platelet-rich microthrombi in pulmonary and systemic vasculature. This heightened platelet reactivity due to SARS- CoV-2 infection has been demonstrated in multiple studies thus far, and there are several more studies in the pipeline. Link | Link | Link | Link
In addition to platelet activation due to viral infection with SARS- CoV-2, the role of mast cell activation has been well described in similar viruses such as Dengue, another ssRNA. This mast cell activation in Dengue has been shown to result in platelet activation via serotonin release from mast cells infected by Dengue virus. Link
Platelets and mast cells both harbor Toll-Like Receptors, a member of which (TLR7) is used to detect ssRNA such as SARS and Dengue and Influenza. Viral detection via TLR7 allows both cell lines to act as an early defense mediator to initiate a cascade of inflammatory responses in lungs and systemically. Link
50% of total circulation platelets are produced in lung intravascular spaces. Pulmonary endothelial injury by SARS- CoV-2 leads to a uniquely intense degree of platelet activation, a phenomenon which is a hallmark of COVID-19 lung injury (more proof published soon on this). Link
It appears though (data coming soon) that recovered COVID-19 patients have recovered platelet reactivity back to baseline, as also evidenced by a reduction in the risk of thrombotic complication in long-haul and recovered COVID19 patients.
Long haul COVID-19 may, however, be a Mast Cell Activation Syndrome (MCAS) that lingers after platelet recovery.
Below is a list of symptoms and pathophysiologic explanation of such symptoms and findings in MCAS. Vast majority of these clinical findings, after speaking extensively with long-haul patients, appear to be unusually and eerily similar between MCAS and long-haul COVID-19, raising strong suspicion that long-haul COVID-19 is indeed a presentation of MCAS.
Mast cell activation leads to common clinical findings such as hives, rashes, lip and facial swelling, diarrhea, acid reflux, and nasal and throat irritation and congestion. Not all of these symptoms will be present in every case, and not all symptoms will present simultaneously. Symptoms are often unpredictable and occur at random times, in response to different endogenous or environmental triggers, in an exaggerated fashion in the context of a hyperreactive mast cell population.
Mast cells release serotonin and histamine and other important mediators; hence, the ubiquitous beneficial response reported from long-haul COVID-19 patients to H1 and H2 blockers. Additional therapies are available and should be explored under care of physicians experienced in evaluating and treating MCAS.
F. Jalali MD | Aug 2020

Mast Cell Activation has been implicated in relationship to:
Viral Myocarditis due to Mast Cell Activation: Link | Link Acute cardiac injury (Kounis syndrome): Link | Link Pulmonary Fibrosis: Link | Link | Link
Hyperadrenergic POTS | Dysautonomia: Link Exercise-induced Bronchoconstriction: Link
Telogen effluvium: Link Neuromodulation: Link
Altered Nociception: Link Neuropsychiatric Effects: Link Nighttime awakenings: Link Nocturnal increase in symptoms: Link Impaired glucose homeostasis: Link Impaired lipid homeostasis: Link Interstitial cystitis: Link
Magnesium deficiency: Link Dysfunctional uterine bleeding: Link Thyroid Hormone Disturbances: Link
F. Jalali MD | Aug 2020

Repost. Recommended immune strengthening items for Stage 2 of the virus

Zinc 50 mg a day
Vit C 1000 mg three times a day
Vit D3 5000 IU a day
Kefir milk. 4 oz three times a day
And New recommendation.
Famotodine (Pepcid) 40 mg a day

Comparisons of all case mortality per years

New question. Has there been anyone in any trials that received the mRNA vaccines AND the new adenovirus vaccines. Since they are using different methods of protection (or for that matter any other type of vaccine for COVID-19) should we not begin testing cross reactivity using two different methods of vaccinations? It COULD radically cut down the chance of mutational drift in theory. Using the same logic if using double coverage for some bacterial infections. Any feedback?

https://youtu.be/0gLmMPOHDwM

"Post-acute COVID-19 Syndrome": COVID "long-haulers" suffering symptoms months after initial diag… Doctors are still searching for answers to why a portion of people who were diagnosed with COVID-19 are still suffering symptoms months later. Anderson Coope...

The CDC ACIP (Advisory Committee on Immunization Practices) had an emergency meeting today.

The purpose of this meeting is to update everyone on the current affairs related to COVID19 vaccinations. There were a lot of big wigs in attendance: new CDC Director, FDA, NIH, DOD, HHS, CDC, AAP, ACOG, AMA, CSTE, AAP (just to name a few).

Here are your cliff notes…

AstraZeneca update…
• Enrollment ended in the US. 32,459 people enrolled. As of Jan 21, 26,327 trial participants have received their second dose. 57.8% have a comorbidity and 23.6% are 65+ years old. Trial participants are only getting the standard dose (not the half dose that some in the UK received)

COVID19 epidemiology among kids…
• Kids with the most severe COVID19 are in these groups (and in this order): Obesity; Asthma; Immunocompromised; Chronic lung disease; Cardiovascular disease; sickle cell disease; diabetes; cerebral palsy; down syndrome; hypertension, and renal disease.
• 1,659 cases of MIS-C in 47 states, leading to 26 deaths

Vaccines for children…
• Rationale for pediatric clinical trials: 1) Pediatric burden of disease is significant 2) Disproportionate burden among children in minority communities 3) Indirect effects to the child and society (school, development, etc.) 4) Continued burden if we wait for natural “herd” effects 5) Data suggests that vaccination prevents asymptomatic carriage, thus reversing pandemic more rapidly 6) Safety data are best collected in clinical trials
• Age de-escalation trials will be organized as the following: 6 to

ACIP January 27, 2021 Presentation Slides | Immunization Practices | CDC ACIP Presentation slides from January 27, 2021 meeting. Advisory Committee on Immunization Practices (ACIP).

Here is proof of antibody response. The one on the left was over 14 days after the second shot and is stronger then the one on the right which was 7 days after the first shot only. This would lead extra credence to the national discussion of maybe getting everyone one vaccine and just try to keep up manufacturing to give the second. Neither person had previously had Covid btw

As a very wise cardiologist friend of mine said... if you don’t believe in masks and social distancing, look at the numbers it has held flu to this year.

https://www.covenantmss.org/documents/mso/CHS-COVID19-Therapeutics-Policy-Final.pdf

www.covenantmss.org

https://youtu.be/rsWPgeoL-hg

Vaccine FAQ Hear Covenant Health's CMO Dr Craig Rhyne answer your questions about the covid vaccine.

Cases in the Lubbock area skyrocket

First of laboratory confirmed reinfections. (Tested true negative in between) because of different strains. Yes you can catch it twice.

In my opinion, the latest Remdesivir studies have not been as promising as we had hoped. It does shorten hospital stay length of time but not in the extremely sick second phase which is autoimflammatory in nature. In these cases, Steroids should be used as best measures.

Hydrochloroquine (plaquenil) was largely touted early in the discovery of COVID as it had had positive effects on SARS1. Unfortunately, the recent tests show it does significantly alter the course of the disease. I will add that I get alot of anecdotal messages from doctors who are on the frontlines that disagree. The early retracted studies in the Lancet, had made many investigators on the ground, not trust the studies but the data is piling up. In my mind, it doesnt make sense that it would not work on SARS2 but did on SARS1. But that is what science is, testing early hypothesis and then either verifying or refuting them based on further analysis. This process will take many years/decades so this could change in the future.

IL 6 Antagonist really have not shown much promise in early testing. No change in course of the disease.

A new drug Inhaled interferon beta may significantly decrease mortality by 40% in COVID patients. Scientist in early studies think this is because the COVID virus naturally depletes interferon which is responsible for viral cell death.