Most Wuhan COVID Survivors Still Have Health Issues

By Ernie Mundell
HealthDay Reporter

MONDAY, Jan. 11, 2021 (HealthDay News) — Concerns about “long-haul” symptoms in COVID-19 survivors may be reignited by a new study: It finds that 3 out of 4 patients from Wuhan, China — where the pandemic originated — were still suffering at least one lingering health problem six months later.

The study from China involved more than 1,700 patients first diagnosed with the virus in Wuhan between January and May, and then followed to June and September.

Researchers report that 76% of these patients had at least one symptom six months after symptoms began.

The most common symptoms were fatigue or muscle weakness (63%) along with trouble sleeping (26%) and anxiety or depression (23%).

“Because COVID-19 is such a new disease, we are only beginning to understand some of its long-term effects on patients’ health,” said researcher Dr. Bin Cao, from the National Center for Respiratory Medicine at the China-Japan Friendship Hospital and Capital Medical University, both in Beijing. His team published the findings in The Lancet journal Jan. 8.

“Our analysis indicates that most patients continue to live with at least some of the effects of the virus after leaving the hospital, and highlights a need for post-discharge care, particularly for those who experience severe infections,” Cao said in a journal news release. “Our work also underscores the importance of conducting longer follow-up studies in larger populations in order to understand the full spectrum of effects that COVID-19 can have on people.”

People who had been severely ill with COVID-19 more often had impaired lung function, as well as abnormalities seen in chest X-rays, which could indicate organ damage, six months after symptoms began, the Chinese researchers said.

Kidneys were also often affected. Based on lab tests, about 13% of patients who’d had normal kidney function while they’d been hospitalized showed reduced kidney function after they’d recovered from COVID-19, the researchers said.

One U.S. expert said post-COVID-19 “recovery” remains an ongoing, unfolding story.

“‘Long COVID’ is an evolving syndrome. Although the constellation of earlier associated symptoms is fairly well described, little is known about long-term outcomes,” said Dr. Thomas Gut, associate chair of medicine at Staten Island University Hospital in New York City. And he’s seen similar issues among patients at his hospital.

Continued

“As noted in this study, the vast majority of patients seen at our Post-COVID Recovery Center are for complaints of fatigue or brain fog, which both have overlap features with the complaints seen in this study,” Gut said.

“Many of our patients report either new onset symptoms since COVID, or significantly worsened symptoms,” he noted. “Most of our patients are seeing gradual improvement in symptoms as time passes, but some are still experiencing lingering effects nearly a year after infection. For many patients, there is little clear explanation for their persistent symptoms even after extensive testing and even less clear treatment options at this point.”

Another expert believes health care centers need to be prepared for a wave of long COVID patients.

“There will be a wave of patients with long COVID entering our medical systems that will require continuing care and rehabilitation,” said Dr. Robert Glatter, an emergency physician at Lenox Hill Hospital in New York City. “We must not only plan for this, by developing centers of excellence, but allocate the necessary federal funds for research and care of these patients.”

Beyond the physical issues experienced post-COVID, there’s a “psychological toll on recovery, which directly impacts how people are able to resume their lives,” Glatter added. “Having appropriate resources in place is essential for aiding recovery in the painful and long months after acute infection.”

The Wuhan study also tried to track survivors’ longer-term immunity against COVID-19. It found that levels of neutralizing antibodies against the new coronavirus fell by more than half (52.5%) after six months in 94 patients whose immune response was tested at the peak of the infection.

That finding increased concern about the possibility of survivors being reinfected by the virus. “At this time, the duration of immunity after COVID-19 infection is unclear,” Glatter said.

However, he pointed to another study released Thursday in the journal Science that “indicates that natural immunity to COVID-19 may last up to eight months, making the potential for reinfection less likely. It’s a complex response involving antibodies, memory B-cells, and different types of T-cells.” But all of this means vaccination is still imperative, even for people who already had COVID-19, Glatter said.

“We still don’t know the full picture of longer-term immunity, making vaccination an essential part of the public health approach to this pandemic,” he said. “The vaccine is safe and effective and represents the most effective way to reach herd immunity.”

Herd immunity occurs when enough people (about 70%) in a population have gained immunity against a virus, effectively stopping its further spread.

More information

For more on COVID-19, see the U.S. Centers for Disease Control and Prevention.

SOURCES: Thomas Gut, DO, associate chair, medicine, Staten Island University Hospital, New York City; Robert Glatter, MD, emergency physician, Lenox Hill Hospital, New York City; The Lancet, news release, Jan. 8, 2021

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Herd Immunity

What it Means for Disease

Since the start of the pandemic, we have all heard the term “herd immunity” more times than we can count. But some are not exactly sure what it means. Does it mean the disease goes away forever? Are we all safe? The list of questions goes on and on.

There are many answers to those questions, but starting with the basics; Photo herd immunity simply means that the majority of the population is immune to a disease. So no, this does not mean that the disease is going away, it just means that it is going to be difficult to transmit between people because most are immune to it. The tricky part though, is that different diseases require different levels of herd immunity to slow transmission. The more infectious (or more likely to spread) a disease is, the higher the percentage of herd immunity is. For example, measles is a highly infectious disease which means that approximately 95% of the population needs to be immune to it. This is why almost all public schools require a measles vaccine before you can attend.

Though this all may seem fairly straight forward, it is also crucial to consider the scale of the community. Let’s say that 2 years from now, 80% of the population of the United States has either had the COVID-19 vaccine or the disease itself. Regardless, 80% of the population has acquired immunity one way or another. This means that as a whole, the country has reached herd immunity. But there could still be small outbreaks here and there. This is because even though 80% of all people have received the vaccine, there still may be much smaller communities (such as counties, towns, and school districts) that have a small vaccine adherence rate. Maybe even as low as 0-10%. This similar scenario is why we are also starting to see increases in measles outbreaks every year. Even though the majority of the country has been vaccinated against it, due to personal or religious beliefs, there are small communities that do not have a high vaccination rate which makes it very easy for diseases to re-emerge and spread through a community like measles.

This same scenario described above about measles can also be applied to COVID-19. So to answer a question posed in the beginning, no, the disease itself will most likely not go away, but through vaccines and herd immunity at each community level; we can eventually put an end to all of this. Whether you decide to get the new vaccine or not once it is available to you, it is important to do your research. Get information from credible and reputable sources such as the CDC, direct publications from pharmaceutical companies, and highly respected medical professionals like Dr. Anthony Fauci; and then make the best decision for yourself and those around you.

As you are reading this article, someone out there is getting a COVID-19 vaccine. And although you are not going to wake up to a world tomorrow where there is no pandemic; you are going to wake up to a world that is literally one day closer to the end of the pandemic. We have reached the beginning of the end. As always, stay safe and be well.

Study Confirms It’s Possible to Catch COVID Twice

August 24, 2020 — Researchers in Hong Kong say they’ve confirmed that a person can be infected with COVID-19 twice.There have been sporadic accounts on social media sites of people who say they’ve gotten COVID twice. But scientists have been skeptical about that possibility, saying there’s no evidence it happens.The new proof comes from a 33-year-old man in Hong Kong who first caught COVID-19 in March. He was tested for the coronavirus after he developed a cough, sore throat, fever, and a headache for 3 days. He stayed in the hospital until he twice tested negative for the virus in mid-April.

On Aug. 15, the man returned to Hong Kong from a recent trip to Spain and the U.K., areas that have recently seen a resurgence of COVID-19 cases. At the airport, he was screened for COVID-19 using a test that checks saliva for the virus. He tested positive, but this time, had no symptoms. He was taken to the hospital for monitoring. His viral load — the amount of virus he had in his body — went down over time, suggesting that his immune system was taking care of the intrusion on its own.

The special thing about his case is that each time he was hospitalized, doctors sequenced the genome of the virus that infected him. It was slightly different from one infection to the next, suggesting that the virus had mutated — or changed — in the 4 months between his infections. It also proves that it’s possible for this coronavirus to infect the same person twice.

Experts with the World Health Organization responded to the case at a news briefing Monday.

“What we are learning about infection is that people do develop an immune response. What is not completely clear yet is how strong that immune response is and for how long that immune response lasts,” said Maria Van Kerkhove, PhD, an infectious disease epidemiologist with the World Health Organization in Geneva, Switzerland.

A study on the man’s case is being prepared for publication in the journal Clinical Infectious Diseases. Experts say the finding shouldn’t cause alarm, but it does have important implications for the development of herd immunity and efforts to come up with vaccines and treatments.

“This appears to be pretty clear-cut evidence of reinfection because of sequencing and isolation of two different viruses,” says Gregory Poland, MD, an expert on vaccine development and immunology at the Mayo Clinic in Rochester, MN. “The big unknown is how often is this happening,” he says. More studies are needed to learn whether this was a rare case or something that is happening often.

Past Experience Guides Present

Until we know more, Poland says the possibility of getting COVID-19 twice shouldn’t make anyone worry.

This also happens with other kinds of coronaviruses — the ones that cause common colds. Those coronaviruses change slightly each year as they circle the globe, which allows them to keep spreading and causing their more run-of-the-mill kind of misery.

It also happens with seasonal flu. It is the reason people have to get vaccinated against the flu year after year, and why the flu vaccine has to change slightly each year in an effort to keep up with the ever-evolving influenza virus.

“We’ve been making flu vaccines for 80 years, and there are clinical trials happening as we speak to find new and better influenza vaccines,” Poland says.

There has been other evidence the virus that causes COVID-19 can change this way, too. Researchers at Howard Hughes Medical Center, at Rockefeller University in New York, recently used a key piece of the SARS-CoV-2 virus — the genetic instructions for its spike protein — to repeatedly infect human cells. Scientists watched as each new generation of the virus went on to infect a new batch of cells. Over time, as it copied itself, some of the copies changed their genes to allow them to survive after scientists attacked them with neutralizing antibodies. Those antibodies are one of the main weapons used by the immune system to recognize and disable a virus.

Though that study is still a preprint, which means it hasn’t yet been reviewed by outside experts, the authors wrote that their findings suggest the virus can change in ways that help it evade our immune system. If true, they wrote in mid-July, it means reinfection is possible, especially in people who have a weak immune response to the virus the first time they encounter it.

Good News

That seems to be true in the case of the man from Hong Kong. When doctors tested his blood to look for antibodies to the virus, they didn’t find any. That could mean that he either had a weak immune response to the virus the first time around, or that the antibodies he made during his first infection diminished over time. But during his second infection, he quickly developed more antibodies, suggesting that the second infection acted a little bit like a booster to fire up his immune system. That’s probably the reason he didn’t have any symptoms the second time, too.

That’s good news, Poland says. It means our bodies can get better at fighting off the COVID-19 virus and that catching it once means the second time might not be so bad.But the fact that the virus can change quickly this way does have some impact on the effort to come up with a vaccine that works well.“I think a potential implication of this is that we will have to give booster doses. The question is how frequently,” Poland says. That will depend on how fast the virus is changing, and how often reinfection is happening in the real world.

“I’m a little surprised at 4½ months,” Poland says, referencing the time between the Hong Kong man’s infections. “I’m not surprised by, you know, I got infected last winter and I got infected again this winter,” he says.

It also suggests that immune-based therapies such as convalescent plasma and monoclonal antibodies may be of limited help over time, since the virus might be changing in ways that help it outsmart those treatments.

Convalescent plasma is essentially a concentrated dose of antibodies from people who have recovered from a COVID-19 infection. As the virus changes, the antibodies in that plasma may not work as well for future infections.

Drug companies have learned to harness the power of monoclonal antibodies as powerful treatments against cancer and other diseases. Monoclonal antibodies, which are mass-produced in a lab, mimic the body’s natural defenses against a pathogen. Just like the virus can become resistant to natural immunity, it can change in ways that help it outsmart lab-created treatments. Some drug companies that are developing monoclonal antibodies to fight COVID-19 have already prepared for that possibility by making antibody cocktails that are designed to disable the virus by locking onto it in different places, which may help prevent it from developing resistance to those therapies.

“We have a lot to learn,” Poland says. “Now that the proof of principle has been established, and I would say it has with this man, and with our knowledge of seasonal coronaviruses, we need to look more aggressively to define how often this occurs.”

Sources

Clinical Infectious Diseases, Aug. 24, 2020.

Gregory Poland, MD, consultant, Division of Pediatric Infectious Diseases; consultant, Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, MN.

Maria Van Kerkhove, PhD, infectious disease epidemiologist, World Health Organization, Geneva, Switzerland.

 

© 2020 WebMD, LLC. All rights reserved.

Will COVID Sideline the College Football Season?

By Dennis Thompson
HealthDay Reporter

TUESDAY, Aug. 18, 2020 (HealthDay News) — The odds are not good for college football conferences that have decided to press forward with their fall season despite the coronavirus pandemic, experts say.

The Big 10 and PAC 12 have decided not to play sports in the fall, but the SEC, the Big 12 and the ACC say they will proceed with college football while still keeping players safe from the coronavirus.

“I do predict, because we’ve already been seeing it in those sports that have been very diligent, that there will be transmission and they will have to stop their games,” said Dr. Colleen Kraft, an NCAA medical adviser and a professor of infectious diseases with Emory University School of Medicine in Atlanta. She was one of several experts who recently briefed the media on navigating college sports during the pandemic.

Ultimately, the nationwide debate over college football is occurring because the United States has failed to tackle the COVID-19 pandemic in an effective manner, said Dr. Brian Hainline, senior vice president and chief medical officer of the NCAA.

“When we started talking about return to sport in April, we were envisioning there would be a continued downward trajectory of COVID-19 new infections and deaths, that there would be a national surveillance system, national testing and national contact tracing that would allow us to really navigate this pandemic,” Hainline said. “That hasn’t happened, and it’s made it very challenging to make decisions as we approach fall sport.”

About 1% to 2% of NCAA athletes are already testing positive for COVID-19, Hainline noted.

Despite this, and despite increasing COVID-19 infections and deaths, some conferences have decided to “sort of dip your toe in and see what happens,” Kraft said.

Colleges are taking steps to protect players, including having them practice in small units and experimenting with innovations such as internal face masks that are part of the football helmet, Hainline said.

The problem is that no matter how stringent your university’s COVID-19 policies, your players will be sharing the field with another team at game time, Hainline said.

Continued

“The greatest risk when it comes to football is when you have one team competing against another team and you have to be certain both teams have been following very strict standards, so you’re not taking one team that’s been a relatively secure bubble and all of a sudden expose it to another that’s not,” Hainline said.

Campuses a hotbed for COVID spread

Also, no matter how hard school officials work to make sports an infection-free environment, players will still be spending a lot of time off the field in situations where they face infection they can then spread to their teammates, said Dr. Carlos del Rio, an NCAA health adviser and executive associate dean of Emory University School of Medicine.

“We can do all the planning we want to have safe sports, but what happens outside of sports is really where the problem is,” del Rio said. “It’s the fraternity party. It’s the other things that can happen.”

This month already has produced a number of examples of college students thumbing their noses at COVID-19.

University of Alabama athletic director Greg Byrne tweeted a photo Sunday showing dozens of tightly packed people, most without masks, waiting to get into a popular bar.

“Who wants college sports this fall?? Obviously not these people!!” said Byrne, whose team is in the SEC.

ACC member University of Louisville kicked three soccer players off its team and suspended three others after they hosted a COVID-19 party, according to news reports. The men’s and women’s soccer teams, field hockey team and volleyball team had to cancel their workouts after 29 COVID cases were reported.

Meanwhile, an entire sorority house at Oklahoma State University is under quarantine and isolation after 23 members of Pi Beta Phi tested positive for COVID.

“I would encourage schools that there be significant education for those athletes about how to minimize their risk of getting infected,” del Rio said. “Their risk of getting infected is going to be in the community, because there’s so much transmission in the community.”

Athletes infected with COVID-19 face serious and potentially career-threatening illness, Kraft and del Rio said.

Continued

For example, they are at increased risk of myocarditis, an inflammation of the heart caused by a viral infection that can cause dangerous irregular heart rhythms.

“You can absolutely not train when you have a viral syndrome because there’s a risk of myocarditis. This has been around for a long time,” del Rio said.

Some warning-sign guidelines

The NCAA has set a five-item mandate under which schools must pull the plug on their athletic programs, Hainline said.

These include:

  • A lack of ability to isolate positive cases or quarantine high-risk cases of COVID-19 on campus.
  • Insufficient ability to test for COVID.
  • Campuswide or local community COVID rates that are deemed unsafe by local public health officials.
  • Inability to contact trace and prevent outbreaks.
  • A lack of capacity in local hospitals to deal with a surge in COVID cases.

“If the local [hospital] infrastructure of a particular school is really imploding and can’t accept any new cases, you can’t go forward with fall sports,” Hainline said.

Del Rio noted that in Georgia, 98% of the hospital beds and 97% of the ICUs are now filled.

“My advice is that we hold off and control this virus,” del Rio said. “That would be my priority number one as a nation.”

Colleges that press ahead with fall football have one other hard decision — what to do with the fans.

Schools like Texas A&M University and Florida State University have announced that football attendance likely will be limited to a quarter to a half of their stadium’s capacity, Bloomberg News reported.

WebMD News from HealthDay

Sources

SOURCES: Colleen Kraft, M.D., professor, infectious diseases, Emory University School of Medicine, Atlanta; Brian Hainline, M.D., senior vice president and chief medical officer, NCAA; Carlos del Rio, M.D., executive associate dean, Emory University School of Medicine, Atlanta; media briefing, Infectious Disease Society of America/NCAA; Aug. 13, 2020

Copyright © 2013-2020 HealthDay. All rights reserved.

Coronavirus Daily Digest: May 29, 2020

The CDC presents expansive guidelines for reopening American offices. Infections and deaths are still rising in a dozen states. And for the first time ever, the Boston Marathon is canceled. Here’s the latest news on coronavirus:

  • Let’s talk reopening: The CDC has issued sweeping new guidelines on the safest ways to reopen offices. In New York City, Mayor Bill de Blasio expects up to 400,000 residents to head back to work in the first half of next month, as the city prepares to begin lifting some of its most stringent coronavirus restrictions. Illinois is joining many of its neighboring Midwest states in reopening some retail shops, restaurants, salons, and other businesses today, but Chicagoans will have to wait.
  • The panel assembled by President Donald Trump to confront the pandemic has been sharply curtailed while the White House looks ahead to reopening.
  • Requiring patients to visit a hospital, clinic, or medical office to get an abortion pill is needlessly risking their health during the COVID-19 pandemic, a group of physicians allege in a lawsuit that seeks to suspend the federal rule.
  • Organizers canceled the Boston Marathon for the first time in its history, ending a 124-year run that had persisted through two World Wars, a volcanic eruption and even another pandemic.
  • Even as the pace of new infections quickens — with nearly 700,000 new known cases reported in the last week after the pathogen found greater footholds in Latin America and the Gulf States — many countries are sputtering into reopenings at what experts fear may be the worst time. In South Korea, more than 500 schools closed again as the country moves to stamp out a resurgence of the coronavirus in the capital, Seoul, and its surrounding metropolitan area.
  • A New York Times reporter and photographer are driving more than 3,700 miles to document life as Europe reopens, where surreal moments now seem normal, and normality surreal.
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Corona-Virus through a Mother’s Eye’s

As a mother I have never been more surprised to find myself especially in such modern times dealing with a virus “The Corona-Virus” and all the pandemonium that came with it.

Starting with having to explain to my mother-n-law that she is not allowed to step-outside of her house. No walking to her favorite retailers or restaurants, no walking to Rite Aide to pick up her medications, and definitely no taking the local Bus to get groceries. If that wasn’t already allot for her to process I then proceeded to explain to her that she is not even aloud to have any contact from friends, neighbor’s but most importantly no visits from her loved ones, that was such a difficult conversation I can only imagine how sad and alone she must have felt especially by the sound of her voice.

I am not even sure what logistical nightmare’s that are about to complicate our lives, coordinating to ensure she has her medication’s and Groceries. I literally started to organize my thought’s with concerns to my mother-n-law when I received news that my son’s school board decided it would be best to close his school from March 16, 2020 until April 6,2020, unless when the board meets on March 25th to extend his school’s closure.

This is insane the effects this virus has brought with it, our local grocery store is closing early due to limited inventory, even our local Costco is being cleaned out, I saw several grown adults literally fighting over Toilet-Paper, Toilet-Paper. I am not impressed with how times like these when we should be working together to support one another we are allowing fear to dictate our lives.

We are teaching our youth in the midst of all this how to handle future problems may they be big or small, this is not the message I personally want my son to learn. I am instead going to use this Health crisis as a learning experience, and come up with tools to help in the event of future situations that may arise. We owe it to our children to equip them instead of allowing them to watch grown adults fighting over Toilet-Paper.