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San Marino torna alla normalità e reintegra tutti i sanitari sospesi perché non vaccinati. L’Italia quando lo farà?

Come nota SanmarinoTV, ormai siamo al ritorno alla normalità per la sanità sammarinese, dopo il covid-19. Dal  primo ottobre scade infatti il decreto 111 del 222 che prevedeva solo un reintegro temporanei dei sanitari e il governo della piccola repubblica ha deciso di non prorogarlo. Tornerebbe in vigore quindi in vigore il DL 72 di aprile che obbligava alla vaccinazione, ma che verrà subito abrogato. Il risultato sarà quindi un repulisti completo della normativa speciale emessa per i sanitari durante il covid e il ritorno alle condizioni pre-pandemiche .Restano invece invariate le misure igieniche e di controllo della diffusione del virus, come le mascherine, per accedere a ospedale, ambulatori medici, centri per la salute e farmacie. Una misura non particolarmente utile, ma comunque tollerabile dal punto di vista della fastidiosità.

Quindi, fra abrogazioni e scadenze naturali, la Repubblica del Titano, che non a caso ha la parola Libertas nel proprio emblema, ha deciso di tornare alla normalità, come ormai buona parte del mondo Solo in Italia per il personale non solo sanitario, ma perfino amministrativo impiegato in sanità, permane l’obbligo vaccinale pena sospensione. Una decisione che rischia di aggravare le mancanze del sistema sanitario nazionale quando si avvicina la normale stagione influenzale che comunque porterà molti italiani ad avere necessità dei servizi sanitari pubblici. Una decisione francamente inspiegabile, come molte altre.


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https://scenarieconomici.it/san-marino-torna-alla-normalita-e-reintegra-tutti-i-sanitari-sospesi-perche-non-vaccinati-litalia-quando-lo-fara/




Si ribalta bus che porta i positivi al test covid in quarantena: boom di proteste

Un autobus a Guizhou, che svolgeva il compito di trasportare le persone coinvolte nell’epidemia, ha subito un grave incidente stradale, provocando decine di morti. L’incidente ha suscitato l’opinione pubblica contraria all’isolamento forzato e alla chiusura della città: “Siamo tutti in quel pullman”! è diventato il grido di battaglia sui social e sul web dei cittadini indignati per quanto è successo e per gli effetti delle politiche covid zero applicate dal governo di Pechino. 

Alle 2:40 del 18 settembre, un autobus che trasportava 47 persone nella provincia di Guizhou, nella Cina sudoccidentale si è ribaltato  Finora, 27 persone sono morte nell’incidente e 20 sono state inviate in ospedale per cure. Secondo il rapporto “Guiyang Daily”, il veicolo era un veicolo di isolamento e trasferimento per le persone coinvolte nell’epidemia a Guiyang.

Le foto divulgate su Internet cinese mostrano come l’autista dell’autobus indossava una grande tuta protettiva bianca secondo quanto previsto  dalle normative, che probabilmente  ha influito sulla concentrazione e sulla visione dell’autista e che potrebbe aver contribuito all’incidente.

 Sui social media cinesi sono apparsi brevemente alcuni articoli che denunciavano le quarantene forzate e la chiusura delle città da parte delle autorità, ma sono stati immediatamente cancellati. L’utente Weibo @ Rui Ruidou ha pubblicato: “Perché pensi di non essere tu la prossima volta su quell’autobus la mattina presto?” Il post ha immediatamente attirato molti commenti e rilanci, prima di diventare invisibile. Ci sono anche i netizen Weibo che hanno detto: “Chi ha detto che non eravamo sull’autobus la mattina presto, ci siamo tutti”, “E non puoi evitare di andarci “, “Questo non è più un granello di sabbia di i tempi, questo è il martello dei tempi”.

Ormai sempre più voci, anche autorevoli, iniziano ad opporsi alla politica dei lockdown di massa e dei test generalizzati covid, con successiva segregazione dei positivi in centri talvolta anche lontani dalla città. un tipo di opposizione raro in Cina, ma l’esasperazione popolare è ormai alle stelle.


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https://scenarieconomici.it/si-ribalta-bus-che-porta-i-positivi-al-test-covid-in-quarantena-boom-di-proteste/




Biden calls pandemic “over” despite pathetic booster rates and new variants

US President Joe Biden speaks at the Detroit Auto Show, in Detroit on September 14, 2022.
Enlarge / US President Joe Biden speaks at the Detroit Auto Show, in Detroit on September 14, 2022.

“The pandemic is over,” President Joe Biden said matter-of-factly in a 60 Minutes interview that aired Sunday night. The impromptu comment immediately drew headlines, as well as criticism from health experts. It also likely raised the anxiety levels of administration officials, who have been striving to promote booster uptake this fall. Some officials described the president’s comment as surprising.

“We still have a problem with COVID. We’re still doing a lot of work on it,” Biden immediately noted in the interview. “But the pandemic is over. If you notice, no one’s wearing masks,” he said, referencing the crowds at the auto show in Detroit, where he made the comments. “Everybody seems to be in pretty good shape. And, so I think it’s changing and I think this is a perfect example of it.”

Though many in the public health community will argue that the pandemic is objectively not over, the president’s remarks reflect the country’s relationship status with the pandemic, which is a resounding: “It’s complicated.”

Not over

By the data, we’re very much still in a pandemic. That’s not to say there isn’t cause for optimism—cases are on the decline, deaths and hospitalizations are down, vaccines are widely available in the US, the latest booster doses match the currently circulating strain of SARS-CoV-2 (for now). But reported cases are still high, with an average of over 61,000 new cases per day. And that’s just the cases that get reported. With most people relying on home-based testing, the true number of cases is likely to be several multiples of that figure. Even just based on the reported cases, the transmission rates are calculated as being high in 94 percent of US counties, according the Centers for Disease Control and Prevention.

While the rates of hospitalization and death are far lower than they have been, there are still 31,000 Americans hospitalized each day. And the current average of daily deaths is 464. Though some people may argue that some of those deaths are with COVID-19, rather than from COVID-19, the distinction may not be as meaningful as they think, given that COVID-19 is and has always been most dangerous to those with underlying health conditions. As top infectious disease expert Anthony Fauci recently noted in an interview with NPR:

“What’s the difference with someone who has mild congestive heart failure, goes into the hospital and gets COVID, and then dies from profound congestive heart failure?” he asked. “Is that with COVID or because of COVID? COVID certainly contributed to it.”

“The worst time to stop”

Though the current plateau of around 400 deaths per day feels relatively low—It’s dwarfed by a peak in February amid the omicron wave, which hit over 2,600 per day—it’s still a massive disease burden. If we continue seeing this relatively low 400-per-day rate, that would annualize to 146,000 deaths per year. Such a figure would likely keep COVID-19 in the top five causes of death in the US, potentially beating out Alzheimer’s disease, which killed 134,000 people in 2020. In reality, COVID-19 ranked as the third leading cause of death in 2020, killing over 350,000. And for anyone making the argument that COVID-19 is now just as dangerous as the flu: even in the worst flu season in recent years, the 2017-2018 season, flu deaths topped out at about 52,000. And, the flu isn’t associated with long-term disease like COVID-19.

Of course, this is only what’s going on in the US with the pandemic, which is by definition global. But, the current trends in the US mirror those seen globally, with cases, hospitalizations, and deaths relatively lower but still high. Global deaths are averaging over 1,600 per day.

In a press briefing last week, World Health Organization Director-General Tedros Adhanom Ghebreyesus gave remarks noting the positive trends but directly contradicting Biden’s suggestion that the global health emergency is over.

“We have never been in a better position to end the pandemic. We are not there yet, but the end is in sight,” Tedros said. “A marathon runner does not stop when the finish line comes into view. She runs harder, with all the energy she has left. So must we. … Now is the worst time to stop running. Now is the time to run harder and make sure we cross the line and reap the rewards of all our hard work.”

https://arstechnica.com/?p=1882677




Moderna-backed mouse study offers first head-to-head BA.5, BA.1 booster data

A pharmacist prepares to administer COVID-19 vaccine booster shots during an event hosted by the Chicago Department of Public Health at the Southwest Senior Center on September 9 in Chicago. The recently authorized booster vaccine protects against the original SARS-CoV-2 virus and the more recent omicron variants, BA.4 and BA.5.
Enlarge / A pharmacist prepares to administer COVID-19 vaccine booster shots during an event hosted by the Chicago Department of Public Health at the Southwest Senior Center on September 9 in Chicago. The recently authorized booster vaccine protects against the original SARS-CoV-2 virus and the more recent omicron variants, BA.4 and BA.5.

In mice, the BA.5-targeting bivalent booster now rolling out nationwide did an equally good job at thwarting the BA.5 omicron subvariant as the bivalent booster targeting its predecessor, BA.1, which US regulators passed on.

That’s according to a pre-print study—which hasn’t been peer-reviewed or formally published—authored by researchers at Moderna and Washington University School of Medicine.

Although the study is still a preprint and only involved mice, it provides some of the first head-to-head data comparing the two omicron-targeting booster options considered for this fall—one of which is currently going into arms across the US. And the findings may raise questions about the US booster strategy.

Booster decisions

Over the summer, the US Food and Drug Administration—under advisement of its independent expert committee—decided to pass on authorizing the omicron BA.1-targeting bivalent COVID-19 booster. The formula was the farthest along in the development of an omicron-targeting booster and had human clinical data at a time when regulators were scrambling to make decisions and begin dose manufacturing at scale for the nationwide booster campaign this fall.

But even in the summer, BA.1 was already long gone. BA.1 was the first version of omicron that swept across the US, causing a towering wave of infection in January and February this year.

But, by June, when the FDA was making decisions, BA.1 was no longer circulating, and two omicron subvariants, BA.2 and BA.2.12.1, had already swept through. BA.5 and BA.4 were on the rise. The FDA, with the majority of its advisors, wanted to target the leading edge of SARS-CoV-2’s evolution, so it set its crosshairs on BA.4 and BA.5, which share the same spike protein. And BA.5 currently accounts for an estimated 87.5 percent of US infections

The sticking point was that there was no human clinical data on a BA.4/5-targeting booster when the FDA authorized the shots at the end of August—and even now as the doses are being administered. While preliminary mouse data suggested a BA.4/5-targeting booster could boost antibodies against BA.4/5, there wasn’t clear data comparing how the BA.4/5-targeting bivalent booster fared compared to the more developed BA.1-targeting booster. The FDA expected the BA.4/5-targeting booster would be better at protecting against BA.5 than the BA.1-targeting booster—but they didn’t have clear evidence for that. Some experts, including one of the FDA advisors, were critical of the decision to move forward without a clinical trial or data indicating that the BA.4/5 booster would be better than the BA.1 booster.

New mouse data

That’s where the new mouse data comes in. In experiments with mice vaccinated with the original COVID-19 vaccines, researchers compared different boosters given seven months after the initial series. The booster options included the original vaccine, the BA.1-targeting bivalent vaccine, and the BA.4/5-targeting bivalent vaccine. There was also an unboosted control group and a sham booster group, which got an injection of a buffer solution.

The two bivalent vaccines increased mouse neutralizing antibodies against BA.1 and BA.5 significantly more than a third shot of the original vaccine. But, both BA.1- and BA.4/5-targeting formulas generated fairly similar levels of neutralizing antibodies against both omicron subvariants.

A month after the booster, researchers challenged the mice with an intranasal BA.5 exposure. Again, both bivalent boosters offered better protection against infection and lung inflammation than a boost with the original vaccine. But among the two bivalent boosters, there wasn’t a clear winner.

The authors note in the conclusion:

Our experiments show that two bivalent mRNA vaccines including components against BA.1 or BA.4/5 had relatively equivalent protective effects against BA.5 in the lungs. Although there is a trend towards lower levels of BA.5 RNA after boosting with [the BA.4/5-targeting bivalent booster] compared to [the BA.1-targeting bivalent booster], our studies were not powered sufficiently to establish this increased protection, and larger cohorts would be needed to reach this conclusion.

Lingering uncertainty

Overall, the authors conclude that the data support the decision to roll out both bivalent vaccines. Though the FDA passed on the BA.1-targeting booster, other countries, including the UK, have begun rolling it out.

The authors also note that the study has many limitations, including being in mice, which are notoriously not equivalent to humans. The study also didn’t look at how long the protection seen in the mice lasted or how other components of their immune responses, such as cross-reactive T cell responses, were influenced by the boosters.

But for now, the jury is still out on whether the BA.4/5-targeting booster will outcompete the BA.1-targeting booster and whether the FDA was wise to pass on authorizing the BA.1-targeting booster earlier this summer.

https://arstechnica.com/?p=1881544




With BA.5 boosters, Biden officials herald the start of annual COVID shots

With BA.5 boosters, Biden officials herald the start of annual COVID shots

The updated COVID-19 boosters targeting the BA.4/5 subvariants now rolling out nationwide are meant to head off a surge of the disease this fall and winter—but they are also meant to signal a shift in the nation’s pandemic response, which is moving out of an emergency phase to a place with routine, potentially annual vaccinations against a virus that is clearly not going away.

In a White House press briefing Tuesday, top infectious disease expert Anthony Fauci along with other Biden administration officials, repeatedly pushed the idea that this new phase will see COVID-19 vaccinations follow the footsteps of seasonal flu vaccines.

“It is becoming increasingly clear that—looking forward with the COVID-19 pandemic, in the absence of a dramatically different variant—we likely are moving towards a path with a vaccination cadence similar to that of the annual influenza vaccine, with annual, updated COVID-19 shots matched to the currently circulating strains for most of the population,” Fauci said.

He stressed that some people might need more frequent vaccinations, such as the elderly and those with compromised immune systems. But for younger, generally healthy Americans, annual shots appear to be the way forward. This follows efforts from the Food and Drug Administration, which has long aimed at coupling COVID boosters with flu shots this fall.

Curveballs

There is a significant caveat to this strategy, however. The annual booster plan is barring an “out-of-left-field” variant.

“It is a possibility we’re going to get some crazy curveball,” Fauci said. “We plan for what we think is the median, the most likely scenario. But we’re always watching for that unusual event, and if that happens, we will address it, and we will adjust to it, and we’ll account for it,” he said. “But I think the most likely scenario is we’re going to see ongoing evolution off of BA.5,” which is the currently dominant variant in the US and targeted by the new bivalent booster doses.

White House COVID-19 Response Coordinator Ashish Jha echoed the points while also touting the utility of annual boosters that can be bundled with seasonal flu shots.”Barring those variant curveballs, for a large majority of Americans, we are moving to a point where a single annual COVID shot should provide a high degree of protection against serious illness all year,” Jha said. “That’s an important milestone.”

In advocating for Americans to get both shots this fall, he added: “I really believe this is why God gave us two arms—one for the flu shot and the other one for the COVID shot.”

While the annual booster strategy is neat and tidy, the data backing up the strategy is still sketchy. The seasonality of SARS-CoV-2 and durability of future vaccines remain unclear. It’s unknown if most Americans will need yearly shots going forward, despite the message from the White House on Tuesday. And long term, Jha and Fauci noted that a vaccine that could provide broader protection for longer is the ideal.

“We want to get a pan-coronavirus type of a vaccine with either a different platform or a better immunogen to do that, hopefully even with mucosally administrated,” Fauci said. “But that’s the long game.”

Uptake

For now, the administration is banking on the idea that SARS-CoV-2 will continue to evolve along the lines of the current lineage, BA.5, which would require only modest annual vaccine updates, similar to what is done with the flu vaccines. The administration also hopes that tying the COVID boosters to seasonal flu shots will boost uptake and acceptance.

In the press briefing, Rochelle Walensky, director of the Centers for Disease Control and Prevention, noted that scientists were projecting the impact of COVID boosters based on how many Americans typically get annual flu vaccines.

“Modeling projections show that an uptake of updated COVID-19 vaccine doses similar to an annual flu vaccine coverage early this fall could prevent as many as 100,000 hospitalizations, 9,000 deaths and save billions of dollars in direct medical cost,” Walenksy said.

But getting a similar number of Americans to get a COVID-19 booster as a flu vaccine may be a stretch. The percentage of Americans who get a seasonal flu shot has ranged from about 42 percent to 52 percent in recent years. So far, 67.5 percent of the US population has gotten their full primary series. But only half of those fully vaccinated have received a single booster. In other words, only about 33 percent of the US population is boosted. And only 34 percent of people age 50 and over who have gotten a first booster, and are eligible for a second, have gotten one.

https://arstechnica.com/?p=1878688




COVID coalition over, Moderna sues Pfizer and BioNTech over vaccines

Moderna states that it doesn't want to halt production or distribution of Pfizer/BioNTech's vaccine, but it does want to be paid a license for its claimed patents.
Enlarge / Moderna states that it doesn’t want to halt production or distribution of Pfizer/BioNTech’s vaccine, but it does want to be paid a license for its claimed patents.
Getty Images

Now that the vaccine race is over and shots are broadly available, Moderna has filed suit against Pfizer and BioNTech, claiming they infringed on Moderna’s mRNA patents from 2010-2016.

Moderna, a Massachusetts-based firm, filed suit against New York-based Pfizer and BioNTech in Düsseldorf, Germany, related to the firms’ joint Comirnaty vaccine and its similarities to Moderna’s Spikevax. Moderna claims in the suit that it doesn’t want to halt vaccine production. The suit also doesn’t seek damages for sales before March 8, 2022, sales in lower or middle-income AMC 92 nations, or sales where “the US Government would be responsible for any damages.”

In a statement announcing the suit, Moderna stated that it expected Pfizer and BioNTech to “respect its intellectual property rights” and “consider a commercially reasonable license” to sell vaccines outside those accepted conditions, but the firms failed to do so.

“Our mission to create a new generation of transformative medicines for patients by delivering on the promise of mRNA science cannot be achieved without a patent system that rewards and protects innovation,” Moderna’s Chief Legal Officer, Shannon Thyme Klinger, said in the statement. Moderna did not specify its claim for damages in the suit. A Pfizer spokesperson told The New York Times that the company was “surprised by the litigation.”

Moderna claims it started work on its “mRNA technology platform” in 2010, and patented it in 2015 and 2016. This work allowed for record-fast vaccine production, Moderna’s CEO Stéphane Bancel said in the statement.

Vaccines based on mRNA use a fatty nanoparticle wrapping to deliver a slice of genetic code—”messenger RNA—from viruses. In the case of SARS-CoV-2, the blueprint of the virus’ spike protein is conveyed. With that bit of code, the body can train the immune system to target the spike protein, creating potent antibodies to fight off an infection.

Moderna’s patent claims are tied to chemical modifications made to the mRNA in Pfizer and BioNTech’s vaccine, and the lipid (fatty) coating.

mRNA-based vaccines have proven effective against COVID-19 and could be the next leap forward for influenza and other vaccinations. Moderna demanding a license for all non-AMC-92, post-March-2022 mRNA vaccines could hamper that. The company has previously received criticism for dragging its feet on sharing its vaccine formula for global distribution and even won a “2020 Shkreli Award” for goosing the price of its vaccine after receiving $1 billion in government funding.

But pharmaceutical giants suing one another over lifesaving innovations isn’t uncommon. Nor are such lawsuits coming after public funding. While Moderna did, as The New York Times points out, accept $2.5 billion in taxpayer money to develop its vaccine, that’s separate from the patents underlying the delivery mechanisms, which Moderna claims go further back.

Medical journalist Matthew Herper says in STAT (paywall) that pharmaceutical patent litigation “proceeds at a glacial pace” and that mRNA’s development is inherently fraught. Moderna, Pfizer, and BioNTech are all being sued by a company across town from Moderna, Alnylam, over the fatty nanoparticle work. And the origins of mRNA delivery may go further back, still.

Derek Lowe notes in Science that there is “almost never an example of a breakthrough biopharma technology that does not end up setting off a flurry of patent lawsuits.” Moderna had to license an RNA modification, after initially claiming it had invented its own. Lowe also notes that Moderna is currently being sued by two other companies claiming that their own lipid nanoparticle patents were infringed.

While it may be business as usual for huge pharmaceutical companies, seeing the companies credited for beating back the tide of coronavirus fighting over licensing rights in court—however many carve-outs they promise—could be harmful to vaccination efforts and public perception of health care. And while the public investment in the vaccine race may not be directly related to this lawsuit, it doesn’t look great to be reminded of the gap between public health and the private companies that often benefit.

(Update 1:12 pm: Added link and context from Derek Lowe’s Science post, and quote from Pfizer spokesperson given to The New York Times.)

https://arstechnica.com/?p=1876381




CDC to regain control of US hospital data after Trump-era seizure, chaos

An older man in a business suit listens to a woman in a business suit.
Enlarge / Former president Donald Trump, right, listens to Deborah Birx, former coronavirus response coordinator, as she speaks during a news conference in the White House in Washington, DC, on Thursday, April 23, 2020.

This December, the US Centers for Disease Control and Prevention will finally regain control of national COVID-19 hospital data—which the agency abruptly lost early in the pandemic to an inexperienced private company with ties to then-President Donald Trump.

As SARS-CoV-2 raged in the summer of 2020, the Trump administration was busy sabotaging the once-premier public health agency. The administration’s meddling included stripping the CDC of its power to collect critical data on COVID-19 patients and pandemic resources in hospitals around the country.

According to multiple investigative reports at the time, then-White House Coronavirus Task Force Coordinator Deborah Birx was frustrated by the CDC’s slow and somewhat messy process of collecting and tidying the data submitted by thousands of hospitals. The data included stats on admissions, patient demographics, bed availability, ventilator use, discharges, and personal protective equipment (PPE) supplies.

The switch

In July 2020, the Trump administration abruptly directed hospitals to stop reporting all that data to the CDC and instead submit it to a new database run by the Pittsburgh-based software company TeleTracking Technologies. The little-known company had won a $10.2 million, six-month contract with the federal government, despite having no previous experience with setting up such a data-collection system. Before the award, the company had won only small contracts with the Department of Veterans Affairs for software that tracked the status of patients. The $10.2 million pandemic-era grant was over twenty times larger than all of the company’s previous government grants combined.

The move quickly drew questions and concern from journalists and lawmakers. An investigation by NPR detailed irregularities in how TeleTracking won the contract. For instance, the Department of Health and Human Services initially said it was a no-bid contract—meaning that companies did not provide competing proposals to do the work—only to backpedal and say there was competition. The department clarified that the contract was won through a low-stakes competitive process called a “Broad Agency Announcement,” which is a process usually used for innovative research, not setting up a database.

Meanwhile, a spokesperson for TeleTracking co-CEO Michael Zamagias told NPR that the company won the contract after the HHS reached out to it directly over the phone. NPR also noted that Zamagias was a long-time Republican donor who was previously in the real-estate business. Notably, he had personal ties to a Manhattan-based real estate financing company, Cooper-Horowitz, which worked extensively with the Trump Organization. Neal Cooper, whose father was a partner in the company, was closely mentored by Zamagias. Cooper told NPR that “we did tons of business with [Trump], billions of dollars of business.”

End of an era

When officials for the Trump administration delivered the news to the CDC that TeleTracking was taking over, staffers immediately knew that the transfer would be a disaster, according to an investigative report by Science. One CDC staff member left the announcement meeting to sob. Others were outraged. “Birx has been on a monthslong rampage against our data,” one CDC employee texted to a colleague shortly after the meeting. “Good fucking luck getting the hospitals to clean up their data and update daily.”

The CDC staffers were right to be pessimistic. The transition to the new system was chaotic due to technical and administrative problems. Hospitals complained that they didn’t have enough time to prepare and that they faced frustrating technical problems requiring intensive resources at a time when they were overwhelmed with patients. The result was unreliable data amid a public health crisis.

“We went dark at the same time we were getting close to what our previous peak was,” Dave Dillon, vice president of media and public relations for the Missouri Hospital Association, told Healthcare IT News at the time. “Moving from a known platform that all of the individuals could easily manipulate… has harmed our ability to have that situational awareness.”

Nevertheless, TeleTracking’s contract has been continually renewed since then, and the company has earned more than $50 million. Now, that’s coming to an end. The latest contract expires on December 31 and will not be renewed. Hospitals will once again submit their data to the CDC starting in mid-December, according to a leaked email seen by Bloomberg News.

“This change is both a surprise and a disappointment for us,” Christopher Johnson​, TeleTracking’s president and co‑CEO, told Bloomberg. Johnson added that the company will work to make the transition smooth.

The move follows emphasis by current CDC Director Rochelle Walensky to modernize the CDC’s data collection. On August 1, the federal government issued a final rule that outlined new measures for the data collection system. Some hospitals have called the switch back “disruptive,” Bloomberg noted, but it generally appears to be a rare win for the CDC, which has faced extensive criticism amid the pandemic.

https://arstechnica.com/?p=1873850




How long will it take to understand long COVID?

How long will it take to understand long COVID?

Rachel Robles contracted COVID in March 2020. The 27-year-old data analyst has not gone a single day without symptoms since. Most doctors did not believe her when she described how she had gone from running the Brooklyn Half Marathon the previous year to enduring such crippling fatigue that her couch felt like quicksand. How she suddenly struggled to put numbers together, despite her technical training. How no matter how many breaths she took, she always felt starved for air.

Three months in, one doctor told her, “COVID doesn’t last for 90 days. You either get over it or you die.”

That dichotomy—in which the only possible outcomes of COVID are either complete recovery or death—has turned out to be anything but true. Between 8 million and 23 million Americans are still sick months or years after being infected. The perplexing array of symptoms known as long COVID has left an estimated 1 million of those people so disabled they are unable to work, and those numbers are likely to grow as the virus continues to evolve and spread. Some who escaped long COVID the first time are getting it after their second or third infection. “It is a huge public health crisis in the wake of acute COVID infection,” says Linda Geng, a physician and codirector of Stanford Health Care’s long COVID clinic.

Though there is no longer debate that long COVID is a real phenomenon—both the Centers for Disease Control and Prevention and the World Health Organization have recognized its existence—the science is so new that many questions remain about how to define the condition, what causes it and how to effectively treat it. It has become clear, for example, that long COVID can assume a variety of different forms. “Not everyone has the same disease,” which means there are different causes, says Akiko Iwasaki, an immunologist at the Yale School of Medicine.

Scientists have proposed several different, yet interconnected, origin stories to explain these wide-ranging symptoms: The coronavirus could damage organs, spawn tiny blood clots, trigger autoimmunity, hide out in tissues or prompt new and ongoing symptoms in other, more subtle ways. To complicate matters further, these narratives are not mutually exclusive: Several could be occurring at the same time in a particular patient, or one could set off another in an unhappy sequence of events that keeps the patient in perpetual bad health. By teasing apart the theories one by one, researchers are gaining a greater understanding of this enigmatic illness and inching closer to therapies that don’t just mask symptoms but eliminate the root cause.

Produced by Hunni Media for Knowable Magazine

Listening to patients

Many of the earliest insights into long COVID have been gleaned from the experiences shared by patients. A survey by the Patient-Led Research Collaborative, a team of long COVID patients who are doing research into their condition, compiled a list of more than 200 different symptoms across 10 organ systems. These range from the most common complaints like fatigue, cognitive impairment, shortness of breath, irregular menstrual periods, headaches, heart palpitations, sleep problems, and anxiety and depression, to other afflictions like double vision, peeling skin, hair loss, tinnitus, tremors, food allergies, and sexual dysfunction. The constellation of reported symptoms can vary from person to person, even changing over the course of the condition.

Because there is no agreed-upon definition of long COVID, no simple diagnostic test, and no way to clearly distinguish one subtype from another, the various manifestations of this mysterious condition often get lumped under one big umbrella, confounding researchers. Yet emerging research is providing the first evidence for several promising hypotheses.

One theory blames the illness on lingering organ or tissue injury caused by the initial infection with SARS-CoV-2, the virus behind COVID-19. Though the coronavirus enters the body through the respiratory tract, it can travel through the bloodstream to infect the kidneys, heart, nervous system, and gut. In the process, it can set off waves of inflammation that reverberate throughout the body, causing collateral damage to multiple organs.

In one study, researchers at the University of Oxford compared brain scans of people before and after they got COVID and found that even mild cases can cause the brain to shrink by 0.2 to 2 percent more than in people who had not been infected. Because adults typically lose about 0.2 percent of their brain volume in regions related to memory every year, that translates to mental decline equivalent to 1 to 10 years of aging. It’s too soon to know if this effect is temporary or might set up people for age-related disorders later in life.

https://arstechnica.com/?p=1873313




Clamoroso! Il CDC: per il covid nessuna quarantena. Vaccinati trattati come i non vaccinati. Noi abbiamo Burioni

Per gli USA il Covid è veramente finito, e lo segnala questa notizia chiara e da fonte molto ufficiale: il CDC USA, cioè il Center for Desease Control. In questo chiaro comunicato si dice che, da ora in poi, se positivi, non ci sarà quarantena, il tutto indipendentemente dallo status vaccinale. Ormai è finita

Nessun sintomo? Nessun problema.
Vaccinati o non vaccinati? Stesse linee guida . Esposti? Non serve nemmeno la quarantena.
Studenti esposti? Possono rimanere in classe, senza nessun problema.

Se non siete diventati pazzi in questi due anni seguendo ordini sempre più assurdi, se siete fisicamente e psicologicamente vivi complimenti. A questo punto potremmo dire che siete stati gli eroi di questa faccenda.

Chi sono stati i cattivi? Quei medici e quelle autorità che hanno dato indicazioni sempre contradditorie, che hanno seminato terrore, che hanno applicato misure eccessivamente e ingiustificatamente restrittive. I virologi da TV e non da ospedale, che hanno campato sulla paura. Quelli che adesso dicono “Ah si ma l’aspirina sarebbe bastata a curare”, salvo voler  vaccinare anche il vostro gatto, se avessero potuto. Quelli che opprimevano con gli obblighi delle mascherine.

In America il CDC ha quindi chiuso il Covid, togliendogli praticamente ogni aura di sacralità e di terrore. Una malattia come un’altro. In Italia invece abbiamo Burioni…

Ora o sono impazziti al CDC, oppure in Italia qualcuno vuole continuare a fondare il proprio potere sulla paura.


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Clamoroso! Il CDC: per il covid nessuna quarantena. Vaccinati trattati come i non vaccinati. Noi abbiamo Burioni




CDC no longer gently recommends COVID precautions most weren’t following anyway

Huge facade for CDC headquarters against a beautiful sky.

The US Centers for Disease Control and Prevention updated its pandemic guidance today, offering slightly looser recommendations that likely won’t change much about how Americans handle the pandemic these days.

According to the updated guidance, people who are not up-to-date on their vaccinations—i.e., unvaccinated people or people who have not received the recommended number of boosters—no longer need to quarantine if they know they’ve been exposed to someone with COVID-19. Instead, if a not up-to-date person is exposed, the CDC now recommends they wear a mask for 10 days after the exposure and get tested for COVID-19 on day 5. Currently, roughly 68 percent of the US population is not up to date on their COVID-19 vaccination.

This guidance update essentially ends all COVID-19-related quarantine recommendations since the CDC had previously said that those who are up to date on their vaccines do not need to quarantine but only wear a mask for 10 days and test.

Although it’s unclear how many people were still quarantining, the end of COVID quarantining spurs one significant change, likely the most consequential of all the updates announced today: the end of the CDC’s recommendation for school “test-to-stay” policies. These were policies in which not up-to-date students could use negative test results to remain in school after an exposure. This was an alternative to requiring such students to quarantine. But, in the absence of any quarantine recommendation, the test-to-stay strategy is now unnecessary.

Otherwise, the updated guidance backs off suggestions for testing to screen people without symptoms or known exposures—such as requiring healthy people to test negative for events. “Screening testing might not be cost-effective in general community settings, especially if COVID-19 prevalence is low,” according to the guidance published today in the CDC’s Morbidity and Mortality Weekly Report. The CDC says screening might be most useful in high-risk congregate settings, such as long-term care facilities, correctional facilities, or homeless shelters.

The guidance also de-emphasizes physical distancing as a primary mitigation effort. Instead, the CDC now says that people should consider distancing “just one component of how to protect yourself and others.” People should consider factors such as COVID-19 Community Levels and ventilation when deciding if physical distancing is necessary, the agency said.

Living with it

The CDC’s looser guidance is the latest shift from public health messaging toward individuals’ choices. At the beginning of the pandemic, public health officials stressed the need for collective efforts to lower transmission in communities, protect the most vulnerable, and reduce the risk of creating new variants. But the current messaging stresses personal decision-making rather than community-wide effects.

“Persons can use information about the current level of COVID-19 impact on their community to decide which prevention behaviors to use and when (at all times or at specific times), based on their own risk for severe illness and that of members of their household, their risk tolerance, and setting-specific factors,” the new guidance states.

The CDC says it’s focusing on “sustainable measures.” the agency also says its guidance reflects that the vast majority of the population has some immunity against COVID-19—from vaccination or prior infection—which lowers the risk of severe disease and death.

“We’re in a stronger place today as a nation, with more tools—like vaccination, boosters, and treatments—to protect ourselves, and our communities, from severe illness from COVID-19,” Greta Massetti, lead author of the CDC’s guidance, said in a statement. “We also have a better understanding of how to protect people from being exposed to the virus, like wearing high-quality masks, testing, and improved ventilation. This guidance acknowledges that the pandemic is not over, but also helps us move to a point where COVID-19 no longer severely disrupts our daily lives.”

Currently, the CDC is reporting that 40 percent of US counties have high levels of COVID-19 Community Levels and should therefore require masking in public indoor settings. Nearly 94 percent of counties, meanwhile, have high COVID-19 transmission levels, according to the latest CDC data.

For those who get COVID-19 moving forward, the CDC still recommends isolation—guidance on this has not changed. People who test positive for COVID-19 should isolate for five or more days and wear a mask for 10 days. The CDC still does not suggest that people need to test negative before leaving their isolation. But, if they do want to use testing to end isolation or masking early, the CDC notes that people should use two consecutive negative tests 48 hours apart.

On Thursday, the Food and Drug Administration separately advised that at-home COVID-19 tests can yield false negatives. For those who do not have symptoms but have been exposed to COVID-19, the FDA now recommends people take three tests, each 48 hours apart, to confirm they are not infected.

https://arstechnica.com/?p=1873355