Dr. Ruth's COVID news & more newsletter, 11/3/24

Here's the 11/3/24 edition of Dr Ruth Ann Crystal's always helpful COVID news & more newsletter:

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"Wastewater levels of COVID are LOW as of October 29, 2024 per the CDC’s website, but WastewaterSCAN reports MEDIUM levels as of November 2nd, across the west, midwest and northeast. According to WastewaterSCAN, the highest levels of SARS-2 in wastewater is in Lewiston, ME at 2703 PMMoV, followed by Snohomish, WA at 1285 PMMoV and Dover, NH at 825 PMMoV. Most places in the Bay Area are low, although Santa Cruz county had a peak a few days ago.

"According to JP Weiland, this week or next week should be the nadir of COVID infections and he expects the winter wave to start off slowly and then accelerate starting in mid-to-late November and into the winter holidays. Emergency room visits for COVID have been decreasing, but are starting to plateau. Currently, per JP Weiland there are about 220,000 new COVID infections per day in the United States and 1 in every 151 people is currently infected in America. Michael Hoerger’s numbers are a bit higher and he predicts that about 1 in every 123 people is actively infectious now. 

Variants 

"XEC has become dominant in many places around the world and it is increasing in the United States. Last week, XEC represented 17% of American COVID cases, but KP.3.1.1 was still the most common variant here at 57%. US variant proportion data is only being reported every 2 weeks now. In places where XEC is most prevalent, its growth appears to have slowed to about 20% per week according to JP Weiland and Mike Honey. So, it may not cause as large a wave as some other variants have in the past. The latest COVID vaccines protect against XEC and against KP.3.1.1, so now would be a great time to be vaccinated in order to have good protection over Thanksgiving, Christmas and New Years holidays.

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SARS-CoV-2 and the Brain 

"A new study in mice shows that SARS-CoV-2 infects neurons in the ventral tegmental area (VTA) of the brain which affects its ability to make the neurotransmitter serotonin, an important regulator of mood and behavior. SARS-CoV-2 also caused neuronal damage via the buildup of the tau protein which became excessively phosphorylated by an enzyme called GSK3β. Normally, tau stabilizes microtubules in neuron cells, but if it becomes phosphorylated, it can form “tau tangles” which are seen in neurologic diseases such as Alzheimer’s disease. The loss of serotonin-producing neurons in the VTA by SARS-CoV-2 may partially explain long term neuropsychiatric effects in people who have had a COVID infection. 

"The brain-vascular-immune interface plays a significant role in brain function and neurological diseases. When blood vessels do not function correctly, they can allow toxic proteins from the blood to leak into the brain via disruptions in the blood-brain barrier (BBB). For example, fibrin is a protein that is normally found in the blood. If fibrin leaks into the brain, it can activate immune responses and promote neuroinflammation and neurodegeneration in the brain. Genetic and pharmacological studies have shown that targeting fibrin can protect against neuroinflammation and neurodegeneration in animal models of multiple sclerosis, Alzheimer's disease, and COVID-19. The brain-vascular-immune interface, together with genetic susceptibility, affect neuroinflammation in Long COVID and in neurodegenerative diseases.

Figure 1: Integration of vascular risk factors with genetic susceptibility in neurological diseases

From: https://www.cell.com/cell/fulltext/S0092-8674(24)01037-7

Immunity to COVID 

"A new preprint from Harvard shows that by December 2023, 99.4% of  Americans had been infected at least once by COVID and 99.9% of people had been exposed to the SARS-CoV-2 virus through infection or vaccination. Despite the high level of cumulative exposure to SARS-CoV-2, only 53.6% of the population was protected from infection and 82.6% were protected from severe disease when the JN.1 variant arrived in the winter of 2023. As the SARS-CoV-2 virus evolves and immunity from vaccination and infection wanes, effective protection against COVID-19 decreases over time with ongoing risks for reinfection, hospitalizations, and Long COVID.  

COVID Tests

"Rapid antigen COVID tests require people to swab their nose for a sample. Charlie McCone wrote a Twitter post about studies showing that a rapid antigen COVID test may give a false positive if one uses a throat swab instead of, or in addition to, the nasal swab. This is due to a difference in acid levels in the throat versus the nose. 

COVID Testing With Cough Audio Analysis

"Using a multilayer deep learning artificial intelligence model, the Cough2COVID-19 framework is able to analyze cough sounds to diagnose a COVID infection. The AI-driven approach has high accuracy, with 98% specificity, 97% sensitivity and an AUC of 0.981. The Cough2COVID-19 framework incorporates the “CoughFeatureRanker” algorithm to identify key features in audio to best detect COVID.

Pediatrics

"A cohort study published in JAMA looked at 172,136 children and young adults and found that elevated BMI significantly increased the risk of post-acute sequelae of SARS-CoV-2 (PASC, or Long COVID) in a dose-dependent manner. Children and teens with obesity had a 25.4% increased risk of Long COVID, while those with severe obesity had a 42.1% increased risk compared to peers at a healthy weight. “In this cohort study, elevated BMI was associated with a significantly increased PASC risk in a dose-dependent manner, highlighting the need for targeted care to prevent chronic conditions in at-risk children and young adults.” 

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Vaccines

"Southwest District Health is a regional health department serving people in six counties in Idaho. Marking a first in the nation, the health department’s board decided to ban Southwest District Health from giving COVID vaccines despite expert testimony on the vaccine's necessity. The decision sparked concern about its impact on vulnerable populations including the homeless and the uninsured. Although policymakers in Texas prohibited health departments from promoting COVID vaccines and Florida’s surgeon general opposed medical consensus by advising against them, government bodies nationwide have not taken steps to completely block vaccine access until now.

Antiviral treatments

"Shionogi announced this week that their Phase 3 trial, called SCORPIO-PEP, showed that their oral drug Ensitrelvir prevented symptomatic COVID infection in people exposed to infected family members. The study involved about 2,400 participants and found that Ensitrelvir was safe and effective, making it a potential new option for preventing COVID-19 after exposure. Ensitrelvir is available in Japan and in Singapore.

"A retrospective cohort study of 7,290 high risk adult patients from Dubai during the Omicron wave shows that nirmatrelvir plus ritonavir (Paxlovid) given during acute COVID infection significantly reduced hospitalization rates by 61% and Long COVID symptoms by 58% in adult outpatients as compared to untreated patients. High risk individuals included people age ≥ 65 years, those with obesity (≥ 25 kg/m2), diabetes, cardiovascular disease or hypertension, chronic lung disease, immunocompromising conditions, chronic kidney disease, pregnant individuals, those with sickle cell anemia, neurodevelopmental disorders, and individuals dependent on medical-related technology such as tracheostomy. Early Paxlovid antiviral treatment was effective to mitigate severe COVID disease and prolonged Long COVID symptoms with the Omicron variant in high risk adults.

Fig. 1: COVID related hospitalizations by day 28

From: https://www.nature.com/articles/s41598-024-76472-0/figures/1

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Long COVID

"A new article looks at three systematic reviews which show that exercise therapy for Long COVID patients experiencing post-exertional malaise (PEM) is not safe. Even exercise programs that involve gradually increasing activity levels can be harmful for these patients and causing them long term damage. 

"Graphic designer Jane Vangool made these great Long COVID graphics that can be downloaded here.

H5N1

"H5N1 has been detected in pigs on a backyard farm in Oregon for the first time. This is dangerous because pigs are susceptible to both human influenza viruses and the H5N1 bird flu virus, meaning that the viruses could “mix” genetically to form a type of flu virus that could infect humans more readily. 

Other news

"Tauopathies are neurodegenerative diseases characterized by the buildup of tau protein in conditions like Pick’s disease and Alzheimer’s disease. In a study using a transgenic zebrafish model, researchers screened over 1,400 drugs and found that carbonic anhydrase (CA) inhibitors reduced tau toxicity. CRISPR experiments confirming similar effects. Glaucoma drug and CA inhibitor methazolamide improved outcomes in mouse models, suggesting that CA inhibitors could be promising treatments for tauopathies like Alzheimer’s in the future.

"Nature magazine had a special collection of 12 papers this week on the Human Tumor Atlas Network (HTAN) that analyzed hundreds of thousands of human and animal cells. They made detailed 3D maps and cell atlases that reveal how cancer develops and evolves, offering insights into early diagnosis and treatment strategies. These studies, including the use of CRISPR and molecular clocks, showed that cancer can arise from a mix of cell types, challenging the belief that it starts from a single cell. Understanding the diverse cell interactions within tumors could lead to more effective treatments and preventive measures.

"Dr. Eric Topol tweeted this week about "An unanticipated discovery: the brain suppresses the immune response by producing autoimmune "guardian peptides" that block neuroinflammation, which may be especially important in neurodegenerative diseases." Delivering guardian peptides in extracellular vesicles can stop neuroinflammation and may lead to antigen-specific therapy against brain inflammation in the future. 

"In addition to weight loss, treatment for diabetes, and the reduction of cardiovascular disease, GLP-1 drug semaglutide has been found to have yet another medical benefit- helping with osteoarthritis of the knees. Semaglutide (Ozempic) causes people to lose weight which helps relieve knee pain by putting less pressure on the joints, but it turns out that Semaglutide also has anti-inflammatory properties which also helps arthritic knee pain.

Credit: Dr. P. Marazzi/Science Photo Library

"Please remember to vote by this Tuesday.

"Have a great rest of your weekend,

"Ruth Ann Crystal MD"

What Jew-Haters Are Capable Of

If you still need more proof that the lifelong goal of Hamas, Hezbollah, and the other Islamic terror organizations, as well as of the citizens, is to kill Jews and destroy Israel, read this:

IDF discovers Hamas underground weapons manufacturing facility in central Gaza; The terrorist-operated facility contained workshops and hundreds of supplies for producing rockets, shells and grenades, the IDF says

"The IDF has released video showing Israeli troops uncovering a Hamas underground weapons-manufacturing facility in central Gaza located beneath the local civilian population.

"The terrorist-operated facility contained workshops and hundreds of supplies for producing rockets, shells and grenades before it was destroyed by engineering troops, the IDF says. It was situated near the area of Zeitoun.

"The IDF says the facility also had diving equipment intended for Hamas to infiltrate Israeli territory by sea."

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When I read this, it reminded me of the underground facilities of the Nazis, who are admired by Hamas:

From 2014: Nazis’ vast, secret WMD facility uncovered in Austria

"A huge, secret, underground Nazi weapons factory, believed to have been built for the development and planned manufacture of nuclear weapons and other WMDs, has been uncovered in Austria."

 “The facility, like the Bergkristall factory, relied on slave labor from the nearby Mauthausen-Gusen concentration camp,” the Sunday Times said. “Up to 320,000 inmates are said to have died because of the brutal conditions in the subterranean labyrinth.”

The Worst Possible Choice for HHS Secretary

This headline from ABC News left me aghast, but I can see why an anti-vaxxer like Robert Kennedy Jr. would be so enthusiastic about Joseph Ladapo. RFK Jr. may have the Kennedy name, but he definitely lacks the Kennedy brains.

Choosing someone like Ladapo, who has been a disaster for Florida, would be an even greater danger nationally, and Trump has to say no to this horrendous idea.

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RFK Jr. recommends fellow vaccine skeptic, Florida's surgeon general, to Trump for HHS secretary; Kennedy has recommended Florida Surgeon General Joseph Ladapo for the position.

"Robert F. Kennedy Jr., who recently sparked controversy with claims that former President Donald Trump has promised him "control" of public health agencies if Trump regains the presidency, has been privately advising the Trump transition team on prospects for cabinet positions -- including recommending a fellow vaccine skeptic to lead the federal agency responsible for public health protection, according to sources.

"Kennedy, who has spent years fueling mistrust around safe vaccines, has recommended Florida Surgeon General Joseph Ladapo to Trump's transition team as a candidate for the position of United States Secretary of Health and Human Services, multiple sources told ABC News.

"Sources close to Trump's transition operation say the recommendation is being taken seriously and the team working on the transition is expected to vet Ladapo, who was appointed by Florida Gov. Ron DeSantis in 2022, for the position.

"Trump has echoed Kennedy's comments that he sees a prominent role for Kennedy in a potential administration.

"I said focus on health, focus -- you can do whatever you want," Trump said of Kennedy in a recent appearance on the Joe Rogan podcast, adding he was completely committed to bringing Kennedy into a potential new Trump administration when asked by the podcast host.

"In an interview earlier this week, the co-chair of Trump's transition team, Howard Lutnick, said he had spoken with Kennedy for more than two hours.

Kennedy told ABC News chief Washington correspondent Jonathan Karl that the discussions are in their preliminary stages, but confirmed that Ladapo is among those under consideration to become secretary of Health and Human Services if Trump should win the election.

"We are still talking to people and he is among the people we are talking to," Kennedy told Karl regarding Ladapo, who Kennedy said he recommended in part due to Ladapo's vaccine skepticism.

"He was willing to question some of the government orthodoxies to not close the schools, to not force people to wear masks, to look actually at the safety data from the vaccines, rather than just accept the words that vaccines are safe and effective," Kennedy said of Ladapo's response to the COVID-19 pandemic, as part of why he thinks Ladapo should be considered for the position.

"We are still fine-tuning our list," Kennedy told ABC News.

"Kennedy also made it clear that Trump has spoken to him about taking a lead role on the issue of public health.

"The president has asked me to clean corruption out of the agencies, to return them to doing the kind of gold-standard, evidence-based science that they were famous for when I was a kid, and to end the chronic disease epidemic. And he's asked that I get measurable results in reducing chronic disease in children within two years," Kennedy told Karl.

"In response to Kennedy's comments, the Trump campaign distanced themselves from any formal decision.

"No formal decisions about cabinet and personnel have been made, however, President Trump has said he will work alongside passionate voices like RFK Jr. to Make America Healthy Again by providing families with safe food and ending the chronic disease epidemic plaguing our children," Trump campaign press secretary Karoline Leavitt said in a statement. "Trump will also establish a special Presidential Commission of independent minds and will charge them with investigating what is causing the decades-long increase in chronic illnesses."

"During the COVID-19 pandemic, Ladapo drew criticism for repeatedly questioning the effectiveness of vaccines, which were developed under the Trump administration. Under Ladapo, Florida defied guidelines from the CDC and the American Academy of Pediatrics regarding the COVID-19 vaccine.

"In October 2022, Ladapo recommended against men between the ages of 18 and 30 receiving the COVID-19 mRNA vaccines due to a "modestly increased" risk of cardiac-related deaths in an analysis posted online. The study was widely criticized by the medical and scientific community due to its poor methodology and because it never went through the rigorous standards of peer review.

"The U.S. Food and Drug Administration and the CDC subsequently sent a letter to Ladapo debunking his claims. The agencies wrote that cardiovascular experts found the risk of strokes and heart attacks was lower in people who were vaccinated against COVID-19, not higher.

"Earlier this week, Kennedy said that Trump had "promised" him "control of the public health agencies" should Trump win the election. The agencies Kennedy would reportedly oversee would include the Department of Health and Human Services and the Department of Agriculture.

"The key, which President Trump has promised me, is control of the public health agencies, which is HHS and its sub-agencies, CDC, FDA, NIH and a few others," Kennedy said. "And also the USDA, which is, you know, key to making America healthy, because we've got to get off of seed oils and we've got to get off of pesticides ... and we need to make that transition to regenerative."

Misplaced Outrage Over Masks

This headline is from the Daily Mail, November 1, 2024.  Instead of being outraged, wouldn't you think they'd be relieved that hospitals are trying to protect patients and visitors from COVID, flu, pneumonia, and every other virus that's going around? Wearing a mask won't kill you -- but catching a disease might.

I'll never understand such selfish people.

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Americans outraged as hospitals bring back COVID-era mask mandates for visitors and patients

"Americans are being left outraged as Covid era mask rules appear to be creeping back into daily life.

"This week, a hospital system in Monterey, California, which treats nearly 400,000 patients a year, reinstated its face mask mandate for visitors and patients.

"Meanwhile several counties in the Bay Area have also brought back mask rules in healthcare facilities.

"And this week, New York City's health department again began recommending people mask-up while using public transport.

"The new mandates in Monterey and New York prompted angry reactions from many residents, who demanded health officials 'move on' from the Covid era.

"One said online, 'tired of this', while another added, 'this is a joke right? Masks don't work', and a third said, 'You're still pushing this?'

"Another said: 'I think it's good for everybody to kind of go back to normal and move on.'

"The mandates come as the US heads into the annual flu season, which tends to start in October and peak through December and February. 

"Officials in California said they were ordering the mandates to reduce the spread of viruses in their hospital — which they said was especially important because of falling uptake of the Covid and flu vaccines.

"Official surveillance shows there is yet to be a surge in the flu, Covid or other respiratory viruses this year. Cases of pneumonia have picked up among children, however.

"The test positivity rate for flu peaked at eight percent on August 10, data shows, but in the latest week had fallen to 6.6 percent. 

"Revealing the mask mandate for the Community Hospital of the Monterey Peninsula, its infection specialist Dr Martha Blum said: 'Now is the time to really make these preparations and be reminded of what we can do to prevent things from really taking off at a sharp increase.

"'As we like to say, Noah built the ark before the flood.'

"Urging people to wear masks, New York City's Health Department said: 'Wearing a mask in crowded indoor settings can help protect you from viruses like Covid and the flu this season.

"'Masking up also protects others if you're sick.'

"Mask mandates became a staple in many Democrat states during the Covid pandemic as a way to stop the virus spreading.

"But studies have failed to show they reduced infections or deaths.

"A major review by the Cochrane Institute found they make 'little to no difference' to someone's risk of catching Covid.

"Previous studies have also suggested face masks do not work in the rain, and may not be necessary on public transport — because the repeat opening of train doors consistently changes the air in the carriage.

"At the same time, some experts have suggested that Covid measures like masking and social distancing may put people — especially children — more at risk of severe infections. 

"They say it robs children of exposure to diseases early in life, which means their immune system may not develop correctly.

"Some have reacted positively to the news, however, with one saying online: 'Immunocompromised here. It means a lot to us when people wear a mask.'

"A second said, 'thank you for this messaging!', and a third added, 'Wish this was normal. Let's take care of our health and each other please'.

"Flu surveillance by the CDC shows that the proportion of flu tests that detected the virus has remained level for the latest three weeks that data is available, at 0.6 percent.

"The CDC also publishes a map of the impact of flu by state, which currently shows almost every state has minimal activity of the virus. Only three — Indiana, Ohio and Virginia — have low activity."