Here's the latest edition of
Dr Ruth Ann Crystal's fact-filled newsletter, COVID news & more, for October 13, 2024:
"Here in the United States, wastewater levels of SARS-CoV-2 are finally LOW
on a national level. In fact, according to JP Weiland, we are at a
level lower than we saw in Fall 2023 and 2022. COVID transmission has
decreased significantly in many places. There are approximately 310,000 new infections per day and only 1 in every 108 people
is currently infected which is significantly better than the almost 1
million daily infections that we saw during the summer wave.
"Montana and Oregon still have VERY HIGH levels of the SARS-CoV-2 virus in their wastewater, followed by HIGH levels (Level 8) in Arizona, Minnesota, New Hampshire, Vermont, Washington and Wyoming and HIGH levels (Level 7) in Arkansas, Delaware, Idaho, Maine, Massachusetts, Michigan, Oklahoma and West Virginia.
"In the United Kingdom, COVID hospitalizations have increased significantly in England, where they are also starting to see rises in Influenza and RSV.
Variants
"KP.3.1.1 represents 57% of current COVID cases. The new recombinant variant XEC
has been doubling over the last three weeks from 2.3% to 5.3% to 10.7%
in the United States. XEC is able to escape our immunity better than
KP.3.1.1, but it appears that the new fall vaccines should protect us against severe disease. XEC is expected to peak around the end of November, but it is not expected to cause a very large impact on winter surge numbers according to JP Weiland.
Vaccines
"In
the United States, the fall mRNA vaccines are based on the KP.2 variant
of SARS-CoV-2. However, many places in Europe will offer mRNA COVID
vaccines against the JN.1 variant this winter. A new study from Germany
shows that the JN.1 mRNA COVID vaccines provide neutralization against KP.3.1.1 and XEC and should protect against hospitalization and severe COVID disease with the current SARS-2 variants. The JN.1 Novavax vaccine was also approved by the European Union for people age 12 and older.
"In a randomized trial, adults in Japan with 3 prior mRNA vaccinations against SARS-CoV-2 were given either a new self-amplifying mRNA vaccine called ARCT-154 or the Pfizer mRNA vaccine. ARCT-154
produced a stronger and longer-lasting immune response compared to the
standard Pfizer mRNA vaccine with protection lasting at least 12 months.
This suggests that using self-amplifying mRNA vaccines for annual
boosters may provide better protection, as long new variants do not
change significantly over the year.
COVID, Oral Health and Social Determinants of Health
"In
Indiana, 209 people who were COVID positive answered a survey about
oral health months after their COVID infection. Self-reported gum
disease was associated with lower socioeconomic status, more severe
COVID infection, as well as ongoing problems with taste and smell. The
study suggests that poor oral health may increase the risk of severe COVID outcomes, especially for lower-income groups.
Pediatrics
"A study from Weill Cornell shows that children with Long COVID have 152% higher odds of being seen in the emergency department.
Long COVID kids were most often seen for chest pain, fluid imbalances,
and generalized pain. The authors emphasize "the importance of improved
guidance [for emergency department staff] for managing Long COVID
symptoms in children."
Antiviral treatments
"Nanobodies are made by camels. A group from Beijing, China made a trivalent nanobody called B11-E8-F3
which is composed of three nanobodies joined in a trivalent form that
neutralizes SARS-1 and 14 different SARS-CoV-2 variants. Animal studies
show therapeutic promise.
Testing
"This week, the FDA approved the first over-the-counter (OTC) rapid-antigen COVID-19/Flu & and B combination test
(Healgen Rapid Check COVID-19/Flu A&B Antigen Test) outside of
emergency use. Before now, other over-the-counter combination COVID and
Flu A and B tests have been available under emergency use authorization
only. It is important to remember that people often get symptoms with
COVID several days before they test positive on home rapid antigen
tests. So, it is important to mask and retest after 48 hours x 2 to be
sure that they do not have a COVID infection. One negative COVID test
does not mean that you do not have COVID if you have symptoms and repeat
tests are necessary to rule out a COVID infection.
Long COVID (LC)
This week’s Long COVID research summary:
"This has been a chock-full week of Long COVID news. We are learning that COVID can cause inflammation in the brainstem-
which is a vital center for many bodily functions. Three years after
COVID infection, people are at 2 to 4x increased risk for heart attack, strokes
and other major adverse cardiac events (MACE). Other viruses like the
flu do not cause such long term damage. Something in the blood of people
with Long COVID and ME/CFS is toxic, causing muscle damage and degradation of mitochondria. Amyloid the in microclots from people with Long COVID makes them impossible to break down. Three genes
have been found to be associated with Long COVID. Twenty-one percent of
people who have had a COVID infection are later found to have prolonged
COVID antigens in the blood (viral persistence), and in people with Long COVID, this number is double.
COVID and the Brainstem
"The
brainstem is responsible for many of the body’s most vital functions
including breathing, consciousness, blood pressure, heart rate, and
sleep. People hospitalized for SARS-CoV-2 infection often have prolonged
fatigue, breathlessness, and chest pain. A group from the UK looked at
the brainstem of people who had been hospitalized for COVID using a very
high resolution MRI (7T). At an average of 6.5 months after
hospitalization, researchers found microstructural
abnormalities in the medulla, pons and midbrain regions in the
brainstem that were associated with neuroinflammation.
Specifically, there was increased susceptibility in the inferior
medullary reticular formation and the raphe pallidus and obscurus.
Prolonged respiratory symptoms after severe COVID may be related to
brainstem inflammatory injury. “Damage to the brainstem could also be
responsible for symptoms of long Covid, such as breathlessness and
fatigue.”
"According to dysautonomia expert neurologist Dr. Blitshteyn, neuroinflammation in the dorsal medulla of the brainstem may be a cause for POTS (Postural Orthostatic Tachycardia Syndrome).
Referenced: 3/2021 Journal of Neurology: Is postural orthostatic tachycardia syndrome (POTS) a central nervous system disorder? https://buff.ly/3Y5Y2RD
Increased risk of heart attack, strokes, blood clots three years after COVID infection
"You
may have heard of someone with a heart attack in their 30s or 40s.
Surprisingly, it could be due to a COVID infection that they had a few
years ago. New data from the UK Biobank shows that up to three years after a COVID infection people have a 2-fold increased risk of major adverse cardiac events (MACE), including heart attack, stroke and all-cause mortality.
People hospitalized for severe COVID had even higher risks (3.9-fold
increased risk) for MACE. Being hospitalized with COVID increased
people’s risk of MACE (including heart attack and stroke) at least as
much or more than if they had pre-existing cardiovascular disease or
diabetes. Any COVID infection is a risk factor for the heart and for
stroke for at least three years.
"The study also showed that people with non-O
blood types (i.e. blood type A, B, or AB) had an elevated risk of blood
clots up to three years after acute COVID infection compared
to those with type O blood. COVID infection, along with severity of
COVID infection and genetic factors such as blood type, affect long-term
cardiovascular risks.
"This new study is consistent with work from Dr. Ziyad Al-Aly who published in 2023 that COVID infection led to increased risks of heart attack, stroke and blood clots up to two years after infection.
"SARS-CoV-2
is unique in that it can increase risk (2x to 4x increased risk) for
heart attack, stroke and blood clots for at least three years after
infection. And, risks do not appear to diminish over time. We do not see
this with the flu. We do not see this with other common respiratory
infections. Why would that be?
"We know that the SARS-CoV-2 virus,
or parts of the virus, can remain in the body in the bone marrow, in the
gut, and even in the plaque of arteries that feed the heart. We call
this viral persistence. In addition, we have learned that the COVID
virus causes inflammation in the special cells, called endothelial
cells, that line blood vessels throughout the body. SARS-CoV-2 has also
been shown to cause unusual microclots in Long COVID that cannot be
broken down by the body like normal clots can. COVID is not only a
respiratory infection- it is a vascular disease that can affect the
entire body for at least three years after infection.
Fibrinaloid Microclots
"About
20 different proteins in the body have the potential to misfold into
beta-sheet clumps called amyloid that are difficult to break down once
they are deposited in tissues. What diseases are affected by abnormal
amyloid proteins? The amyloid protein Tau is found in the brains of
people with Alzheimer’s disease. The amyloid form of α-synuclein is
found to make abnormal clumps called Lewy bodies in the brains of people
with Parkinson’s disease. IAPP amyloid deposits are found in people
with Type II diabetes. Now we know that COVID infection can lead to
abnormal amyloid protein clumps within blood clots making them resistant
to being broken down and allowing them to clog small arteries and
veins.
"A new paper from Drs Kell and Pretorius shows that microclots found in people with Long COVID
are very unusual in that they do not contain typical clotting proteins
like α-2-macroglobulin, fibronectin, and transthyretin. Instead, these
atypical "fibrinaloid" microclots contain adiponectin, periostin, and
von Willebrand factor proteins that tend to misfold to form amyloid
structures in βeta-sheets. For this reason, these fibrinaloid microclots
are resistant to proteolysis.
Figure 18
Long COVID, ME/CFS and Skeletal Muscle
"Rob Wust’s lab has previously shown that exercise can actually cause muscle necrosis and amyloid clumps to be deposited in the skeletal muscles of people with Long COVID.
This is thought to be a part of what may be causing post-exertional
malaise (PEM) that follows 1 to 2 days after exercise in people with
Long COVID. PEM is a hallmark symptom of Myalgic
Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). About 50% or more
of people with Long COVID have ME/CFS.
"A new
eye-opening and somewhat terrifying report shows that adding the serum
from people with ME/CFS or Long COVID to normal skeletal muscle tissue
in a test tube leads to increased mitochondrial stress and a shift to glycolysis in the muscle cells within 48 hours. By 96 hours, exposure to ME/CFS
or Long COVID serum significantly impairs the skeletal muscle tissue's
ability to contract and causes the muscle cell mitochondria to
disintegrate. Mitochondria are usually the “powerhouses of the
cell” that make the energy needed for cells to function normally. More
studies are needed to discover what substance exactly is in the blood of
people with Long COVID and/or with ME/CFS that poisons the mitochondria
of muscle cells.
"People with ME/CFS and those with Long
COVID have often been gaslighted by medical professionals telling them
that their symptoms of exhaustion and post-exertional malaise are just
in their head. My own family member who has Long COVID and ME/CFS has
had this experience. PEM and exhaustion from Long COVID and ME/CFS are
very real as seen by these latest studies.
Genetic Risk for Long COVID
"In
a really interesting new large study, researchers from 23andMe used
Genome-Wide Association Studies (GWAS) across different ethnic groups
and found 3 genes that are linked to Long COVID.
The three loci HLA-DQA1–HLA-DQB, ABO, and BPTF–KPAN2–C17orf58 are
associated with immune and thrombo-inflammatory mechanisms in the body.
They summarized, “Our top finding links the HLA region, in particular
the HLA-DRB1*11:04 variant, to developing Long COVID.”
Viral persistence: SARS-CoV-2 Antigens in the Blood
"A
new RECOVER consortium study looked at SARS-CoV-2 antigens in the blood
of 706 people up to 14 months after a COVID infection to see if there
was a relationship with persistent virus in the blood and Long COVID.
SARS-CoV-2 antigens, of which the majority were the spike protein, were
found in 21% of samples overall. SARS-CoV-2 antigen found in the blood
was significantly associated with a higher risk of all Long COVID
symptoms, although cardiopulmonary, musculoskeletal, and neurologic
symptoms were seen most commonly. While 21%
of blood samples overall were found to be SARS-2 antigen positive,
people with Long COVID were twice as likely (43%) to have persistent
viral antigens in their blood and having persistent virus in the blood correlated with Long COVID symptoms.
Other Long COVID and ME/CFS news
"The CIBS Center will be sponsoring a free webinar Thursday October 17th on applying for SSDI or SSI Disability for people with Long COVID and other post-infectious diseases.
"The
Bateman Horne Center put out a new video featuring an endearing
character called Mito explaining post-exertional malaise and ME/CFS
entitled “Life with a Low Battery: Living with ME/CFS”.
Tom Kindlon posted an infographic from the Chronic’s Chronicles showing
what it is like to have a chronic illness like ME/CFS and Long COVID.
H5N1
"Six new human cases
of H5 Avian Flu were confirmed in California dairy workers since
October 3rd, bringing the total to 20 human cases of avian influenza
A(H5) virus infection in the United States since April 2024. “Ten of
these cases were associated with exposure to H5N1 bird flu-infected
poultry and nine were associated with exposure to sick or infected dairy
cows… All six California cases are reported to have experienced mild
symptoms, including eye redness or discharge (conjunctivitis), and none
were hospitalized.”
"This week, the USDA confirmed 3 more H5N1 infected dairy herds in California, bringing the state’s total to 99 herds. As Helen Branswell states, “That's 9% of the state's total herds, confirmed as infected over a period of only 6 weeks. Cumulative national total: 299 herds in 14 states.”
"In a zoo in Vietnam, the H5N1 bird flu virus killed 47 tigers, 3 lions and a panther.
Other news:
"A Marburg virus outbreak in two Rwandan hospitals
has infected 61 people and killed 14. An experimental Sabin vaccine has
been given to people exposed and there is no evidence of community
transmission. “The United States recently upgraded its travel advisory
for Rwanda, recommending against nonessential travel, and announced that
health screening for inbound travelers from Rwanda will begin on
October 14.”
"The Earth will have a new temporary ‘mini moon’.
"The mini moon is actually an asteroid about the size of a school bus
at 33 feet (10 meters). When it whizzes by Earth on Sunday, it will be
temporarily trapped by our planet’s gravity and orbit the globe — but
only for about two months."
"Blind fans
can now use a handheld device from Field of Vision to allow them to
“see” what is going on in a sports match via haptic feedback that they
can feel with their hands."
Have a great week,
Ruth Ann Crystal MD
"As long as these signals keep emerging from the public and private sectors’ Byzantine middle-management setups, woke has not peaked.
"Mike Shaw and everyone else still in touch with reality needs to increase the pressure till they win"