Originally Posted by Bwana:
Once again, don't come in this thread with some kind of political agenda, or you will be shown the door. If you want to go that route, there is a thread about this in DC.
Originally Posted by Dartgod:
People, there is a lot of good information in this thread, let's try to keep the petty bickering to a minimum.
We all have varying opinions about the impact of this, the numbers, etc. We will all never agree with each other. But we can all keep it civil.
Thanks!
Click here for the original OP:
Spoiler!
Apparently the CoronaVirus can survive on a inanimate objects, such as door knobs, for 9 days.
California coronavirus case could be first spread within U.S. community, CDC says
By SOUMYA KARLAMANGLA, JACLYN COSGROVE
FEB. 26, 2020 8:04 PM
The Centers for Disease Control and Prevention is investigating what could be the first case of novel coronavirus in the United States involving a patient in California who neither recently traveled out of the country nor was in contact with someone who did.
“At this time, the patient’s exposure is unknown. It’s possible this could be an instance of community spread of COVID-19, which would be the first time this has happened in the United States,” the CDC said in a statement. “Community spread means spread of an illness for which the source of infection is unknown. It’s also possible, however, that the patient may have been exposed to a returned traveler who was infected.”
The individual is a resident of Solano County and is receiving medical care in Sacramento County, according to the state Department of Public Health.
The CDC said the “case was detected through the U.S. public health system — picked up by astute clinicians.”
Officials at UC Davis Medical Center expanded on what the federal agency might have meant by that in an email sent Wednesday, as reported by the Davis Enterprise newspaper.
The patient arrived at UC Davis Medical Center from another hospital Feb. 19 and “had already been intubated, was on a ventilator, and given droplet protection orders because of an undiagnosed and suspected viral condition,” according to an email sent by UC Davis officials that was obtained by the Davis Enterprise.
The staff at UC Davis requested COVID-19 testing by the CDC, but because the patient didn’t fit the CDC’s existing criteria for the virus, a test wasn’t immediately administered, according to the email. The CDC then ordered the test Sunday, and results were announced Wednesday. Hospital administrators reportedly said in the email that despite these issues, there has been minimal exposure at the hospital because of safety protocols they have in place.
A UC Davis Health spokesperson declined Wednesday evening to share the email with The Times.
Since Feb. 2, more than 8,400 returning travelers from China have entered California, according to the state health department. They have been advised to self-quarantine for 14 days and limit interactions with others as much as possible, officials said.
“This is a new virus, and while we are still learning about it, there is a lot we already know,” Dr. Sonia Angell, director of the California Department of Public Health, said in a statement. “We have been anticipating the potential for such a case in the U.S., and given our close familial, social and business relationships with China, it is not unexpected that the first case in the U.S. would be in California.”
It is not clear how the person became infected, but public health workers could not identify any contacts with people who had traveled to China or other areas where the virus is widespread. That raises concern that the virus is spreading in the United States, creating a challenge for public health officials, experts say.
“It’s the first signal that we could be having silent transmission in the community,” said Lawrence Gostin, director of the World Health Organization Collaborating Center on National and Global Health Law. “It probably means there are many more cases out there, and it probably means this individual has infected others, and now it’s a race to try to find out who that person has infected.”
On Tuesday, the CDC offered its most serious warning to date that the United States should expect and prepare for the coronavirus to become a more widespread health issue.
“Ultimately, we expect we will see coronavirus spread in this country,” said Nancy Messonnier, director of the CDC’s National Center for Immunization and Respiratory Diseases. “It’s not so much a question of if, but a question of when.”
According to the CDC’s latest count Wednesday morning, 59 U.S. residents have tested positive for the new strain of coronavirus — 42 of whom are repatriated citizens from a Diamond Princess cruise. That number has grown by two since Messonnier’s last count Tuesday, although the CDC was not immediately available to offer details on the additional cases.
More than 82,000 cases of coronavirus have been reported globally, and more than 2,700 people have died, with the majority in mainland China, the epicenter of the outbreak.
But public health leaders have repeatedly reminded residents that the health risk from the novel coronavirus to the general public remains low.
“While COVID-19 has a high transmission rate, it has a low mortality rate,” the state Department of Public Health said in a statement Wednesday. “From the international data we have, of those who have tested positive for COVID-19, approximately 80% do not exhibit symptoms that would require hospitalization. There have been no confirmed deaths related to COVID-19 in the United States to date.”
CDC officials have also warned that although the virus is likely to spread in U.S. communities, the flu still poses a greater risk.
Gostin said the news of potential silent transmission does not eliminate the possibility of containing the virus in the U.S. and preventing an outbreak.
“There are few enough cases that we should at least try,” he said. “Most of us are not optimistic that that will be successful, but we’re still in the position to try.”
S
BY MICHAEL DAIGNAULT AND MONICA GANDHI SEPTEMBER 6, 2022 10:41 AM EDT
Michael Daignault, MD, is an emergency physician at Providence Saint Joseph Medical Center in Burbank, CA
Dr. Gandhi MD, MPH is Professor of Medicine; Associate Division Chief of the Division of HIV, Infectious Diseases, and Global Medicine; Director of the Ward 86 HIV Clinic at San Francisco General Hospital; and Director of the Center for AIDS Research at UCSF
The FDA and CDC both approved the updated bivalent COVID-19 vaccines last week. The promise of the mRNA vaccine technology platform was always that we could update them quickly. We may finally have achieved an advantage over SARS-COV-2 as the updated vaccine recipe matches the current dominant circulating BA.5 strain (and slow growing BA.4.6 strain) without another more transmissible variant of concern yet on the horizon.
However, we are concerned that the CDC may again be missing the boat with its recommendations on timing for when most American adults should receive this booster. Following its Advisory Committee on Immunization Practices (ACIP) meeting on September 1, the CDC stated that adults who completed their primary vaccine series are eligible for the updated booster if it’s been at least two months since their previous vaccine. They advised those who recently had an infection to wait 3 months before getting boosted.
However, such a short interval is not optimal if we are aiming for robust fall/winter-long protection and could also be counter-productive. The CDC should recommend a 6-month interval between a previous booster or infection and the new updated vaccine for healthy adults for two primary reasons: updated immunologic studies and recognition that millions of Americans had post-vaccination infection with Omicron variants this year and thereby have strong current protection against re-infection with BA.5.
Immunologic studies
We previously called on the CDC to extend the recommended interval between primary doses of both mRNA vaccines to 8 weeks primarily on the basis of immunologic studies demonstrating a higher antibody response, amplified T cells, and enriched memory B cells with a longer time period between doses.
Recent research studies during the Omicron variant era continue to demonstrate the benefit of an extended interval between doses in terms of increasing both neutralizing antibodies and memory B cells. A booster provides antibody protection for at least 6 months according to a recent study. Another study demonstrated that antibody levels stabilized 6-9 months post-vaccination for study participants both with and without previous infection.
Memory B cells were even more robust after vaccination–demonstrating maintained reactivity against all variants including Omicron for at least 9-10 months after the primary 2-dose series; with an additional positive response to a 3rd dose booster. An additional study showed that memory B cells continue to mature for approximately 6 months, after either vaccination or infection. B cell immunity—as well as T cell immunity to COVID vaccines–provided protection against severe illness and did not lead to high levels of hospitalization as BA.5 became dominant this summer.
One of the aims of the Omicron-specific vaccines is to increase antibodies and prevent even mild infections. The antibody level plateau at the 6 month mark would thus signal an ideal time to boost with a BA.4/5-focused vaccine since a low pre-boost antibody level actually correlated with a greater fold increase post-boosting. To put it another way—high levels of circulating antibodies from short interval boosting may limit the added protection of another booster. Another recent study by the NIH showed the same concern after a recent infection, but even more drastically: giving a booster 2 months after a recent infection actually abrogates effective B cell responses.
Millions infected by Omicron
A recent study in JAMA showed that 56% of people who were infected with the Omicron variant were unaware of the infection. And the actual number of daily infections this past summer vastly exceeds the official tabulation given the scale of unreported home rapid antigen testing. In addition, millions of Americans have received their third and fourth vaccine doses in the last few months.
The benefit of this degree of population immunity can be extrapolated from a recent study out of Portugal which shows, contrary to previous concerns for BA.5 re-infection, that a previous BA.1/2 infection provides upwards of 75.3% protection against re-infection with BA.5. This was consistent with a Qatar study showing 79.7% protection against re-infection.
All of this data means that there is a high amount of active population-level immunity to COVID-19 in the U.S. that is protective against severe disease. Our booster strategy should recognize this existing immunity and seek to build upon it in a manner that prolongs the protection of this shot throughout the winter. Short-interval repeat boosting or boosting too soon after a post-vaccination infection will limit the neutralizing antibody response and stunt the expansion of memory B cells.
After considerable expert input, the CDC formally updated its guidelines in February 2022 to recommend an extended dosing interval for the primary vaccine series, but significantly lagged behind their counterparts in Canada, Europe, and India to adopt this 8-week interval. Moreover, the extension of the vaccine interval was not advertised very widely. The CDC now has an opportunity to take these immunologic principles for the updated Omicron booster and make them work better.
The Canadian National Advisory Committee on Immunization, already ahead of the curve, formally recommended this past week that the updated bivalent vaccine be offered at an interval of 6 months after previous vaccination or infection.
In a recent survey by the CDC, 72% of those polled will “definitely” or “probably” get an updated booster. The interest in an updated booster is significant because only half of eligible Americans got the first recommended booster dose and only 34% of those 50+ got a second booster. That is why it is absolutely critical that we get the recommendations on timing right for this updated Omicron booster, the first update in the mRNA vaccines since their roll-out in January 2021. [Reply]
TL;DR The authors believe that it's more optimal to wait until 6 months after either your most recent booster or most recent infection before you get another booster. Seems reasonable. [Reply]
If I follow that articles line of thinking, I'll be due up again in December. I suppose if the reformulated shots show the ability to prevent infection, I might get one.
We'll probably be facing a different variant at that point anyway, and the shots will be no good at preventing infection but will hold up against severe disease.
Originally Posted by Hank Hill:
Anyone gotten the new bivalent shot yet? Any difference on side-effects?
No, and it's a little odd to me how little they've put into communicating about it. I have no issue doing it if it makes sense, but even my doctor's office is only sending out messages about flu shots. Kind of odd.
Meanwhile, I see news articles about how only 2% of people have done it and concluding that no one wants to get it. There's definitely a lot of truth to that, but the bigger story is just that there's been so little guidance on it. [Reply]
Originally Posted by MagicalFruit:
Any updated thoughts on this? Do we think anything good has really come from this pandemic? Any amazing medical advancements? Are we more prepared for a much more dangerous pandemic?
I am thinking that at this point we are less prepared, honestly.
Originally Posted by Hank Hill:
If I follow that articles line of thinking, I'll be due up again in December. I suppose if the reformulated shots show the ability to prevent infection, I might get one.
We'll probably be facing a different variant at that point anyway, and the shots will be no good at preventing infection but will hold up against severe disease.