While humans worry about the impending threats of COVID-19 and monkeypox, seals in the northeastern United States might have a different virus to worry about: bird flu. The marine mammals have come down this summer with a new strain of H5N1, which is believed to have spilled over to them from birds.
The disease has led to a population-scale outbreak that has led to the biggest mortality event in mammals caused by the new bird flu virus, indicating that even marine life can be affected by diseases from land animals. Researchers at the Cummings School of Veterinary Medicine at Tufts University report on the outbreak in a new preprint.
Though scientists hoped that the H5N1 outbreak from this past spring would mimic the December 2014 outbreak that nearly disappeared within six months, this latest spread raged on over the summer. This outbreak, according to a Nature article published in August 2022, has spanned the U.S., resulting in almost 400,000 dead wild birds and causing massive damage to domestic poultry farming.
As outbreaks have continued to escalate over the past year, concerns have been raised over the potential impact on birds migrating south for winter. However, one of the greatest concerns regarding the most recent outbreak is the spillover of the bird flu to marine mammals. The first wave of H5N1 infections peaked in March 2022 mainly impacted raptors; the second wave began in June in gulls and marked the spillover into marine mammalian life, specifically seals. The preprint hypothesizes that the infections in seals may have been associated with ecological interactions between seals and birds. The bird flu may also have spread to seals from dead birds, bird feces, or seal-to-seal infections.
While mammals have usually been considered dead-end hosts that do not further spread infection, the preprint reports explained, it is currently unclear if the marine mammal spillover will also be a dead-end transmission event based on the wider extent of new infections. The spread of H5N1 via wild birds and now seals cannot be controlled because they are highly mobile populations, resulting in the future potential for new strains of the virus to emerge that can threaten other mammalian life, including humans. With the potential threat of zoonotic spillover, where disease spreads from wild animals to human beings, the scientific community remains on alert regarding new viruses that are challenging to both predict and control.
AMA Update covers a range of health care topics affecting the lives of physicians, residents, medical students and patients. From private practice and health system leaders to scientists and public health officials, hear from the experts inmedicineon COVID-19, monkeypox, medical education, advocacy issues, burnout, vaccines and more.
Featured topic and speakers
In todays AMA Update, AMA Vice President of Science, Medicine and Public Health Andrea Garcia, JD, MPH, discusses preparing for flu season, changes to CDC's TPOXX guidance, as well as the latest data and findings from new physician burnout research study published in Mayo Clinic Proceedings. AMA Chief Experience Officer Todd Unger hosts.
Read more about the AMA, Mayo Clinic, and Stanford Medicine research findings on physician burnout.
Learn how the AMA is #FightingForDocs and access resources from the AMA Recovery Plan for Americas Physicians.
Visit AMA's monkeypox resource center.
Learn more at the AMA COVID-19 resource center.
Unger: Hello and welcome to the AMA Update video and podcast, an ongoing series covering a range of health care topics affecting the lives of physicians and patients. Today, we have our weekly look at the headlines with the AMA's Vice President of Science, Medicine and Public Health, Andrea Garcia, in Chicago. I'm Todd Unger, AMA's chief experience officer also in Chicago. Welcome back, Andrea.
Garcia: Thanks. It's good to be here.
Unger: Well, let's start off by talking about Omicron boosters. They've been out now for about two weeks. I got mine. Any data on how the response has been at this point?
Garcia: Well, we know the Biden administration bought 171 million doses of the new bivalent vaccines. And that millions of those doses have been shipped and arrived within the last two weeks in pharmacies, nursing homes and in clinics across the country. But federal data on how many shots of the updated booster doses have been administered is not yet available.
According to The New York Times, early numbers from some states and several cities showed what health officials are describing as a robust early response. So if you look at California, they've administered about 397,000 doses. In Texas, about 116,000 people got the new booster in a few days. And clinicians in Illinois had administered at least 137,900 shots.
I think, with that being said, others have called this rollout muted as the new shots have been barely noticed by some people. So we still have our work cut out for us.
Unger: Well, let's unmute that. Why don't you remind folks why it is so important to get the booster right now?
Garcia: So these updated COVID boosters can both help restore protection that has waned since previous vaccination and provide broader protection against the new variants. The U.S. COVID-19 vaccines authorized in the U.S. continue to reduce the risk of severe disease, hospitalization and death. And now that much of the population has stopped masking and quarantining, these boosters are our best defense against COVID-19 and the variants that are currently circulating in our communities.
Although people may be getting weary of getting shots, the administration has indicated that they expect COVID-19 shots will be administered annually, similar to a flu shot. And they're urging everyone 12 and older to receive the updated booster as soon as they are able to.
Unger: And get your flu shot at the same time in time to prepare for the fall right now. How are the COVID numbers looking this week?
Garcia: Overall, it's good news. We're seeing cases continuing to fall in nearly every state. If you look at The New York Times, less than 62,000 COVID cases are being reported daily. That's the lowest level since early May. And it's almost a 30% decrease than from two weeks ago.
Many areas are showing significant declines. And over a dozen states and territories have seen cases go down by 40% or more since the start of September.
Unger: And how about on the hospitalization and on deaths?
Garcia: There's been a sustained improvement in hospitalizations. We're looking at about less than 33,000 people in U.S. hospitals with COVID every day. That's down about 12% over the past two weeks.
And the average daily deaths due to COVID is around 426. That's a 13% decrease from two weeks ago. And while we know the number of deaths is unacceptable, this number is much lower than a year ago at this time when Delta was causing around 2,000 deaths per day.
Unger: Well, I want to take a little time and discuss a piece of news that came out last week that relates to physicians. And we know physicians have been taking care of this nation, its patients for the past two and a half years. And that has taken a toll on them.
This new study shows some interesting numbers about burnout that, I guess, people wouldn't be surprised to hear. Tell us more about that.
Garcia: Yeah, so those findings were really pretty dramatic. And it's a new study conducted by researchers from the AMA, the Mayo Clinic, Stanford University School of Medicine and the University of Colorado School of Medicine. And it found that the physician burnout rate spiked during the first two years of the pandemic, hitting an all-time high.
That data was gathered from a survey of nearly 2,500 U.S. physicians. It found the overall physician burnout rate was almost 63% in 2021. If we compare that to the number in prior years, it was 38.2% in 2020, 43.9% in 2017 and 54.4% in 2014. So these trends were consistent across nearly all specialties. And that spike came just after a six-year period of a decline in burnout.
Unger: And that's really important when you think about that trend. A lot of work by the AMA and partners out there to shine a spotlight on physician burnout and really address some of the systemic factors that are really at the root cause. But then something like the pandemic comes in and we see this really dramatic increase. What else did the survey have to tell us?
Garcia: The survey also looked at personal fulfillment scores, which also fell, with only 57.5% of physicians indicating that they would choose to become a doctor again. And that dropped from more than 72% in 2020. In a statement, AMA President Dr. Jack Resneck said that the worst days of the COVID-19 pandemic are hopefully behind us. And there is an urgent need to attend to physicians who put everything into our nation's COVID-19 response, too often, at the expense of their own well-being.
Unger: And that really is at the foundation of the AMA's Recovery Plan for America's Physicians. It's recognizing that after two and a half years of serving this nation's patients, it's time to take care of our physicians and the key issues that are affecting them and driving these record levels of burnout. Turning now to other diseases that continue to make headlines, the CDC has issued new guidance on a monkeypox treatment. What do we need to know about that, Andrea?
Garcia: Yeah, so CDC, last week, issued new guidance on TPOXX, which is the antiviral that is being made available through an expanded access investigational new drug protocol to treat monkeypox. And the agency is recommending that this treatment be limited to people at high risk for severe disease. This CDC decision is a result of recent data from the FDA, which suggests that broad use of TPOXX could promote resistance and render those antivirals ineffective for some patients.
According to the CDC's recommendation, TPOXX should be reserved for people with severely weakened immune systems. So think of those with HIV that is not controlled, people with leukemia, lymphoma or those who've had solid organ transplants, as well as people who are pregnant or breastfeeding, children under age eight. And people within that is vulnerable to injury.
Unger: Well, for the last several weeks, we've been talking about the monkeypox numbers. I think the story there was still more cases than we hope. But, hopefully, the rate of the outbreak seem to be declining. Is that still where we are?
Garcia: Yeah, so the CDC is indicating there are about 24,000 reported cases of monkeypox in the U.S. since the outbreak began. That rate of new cases has been declining for weeks and is showing signs of plateauing. I think it's unfortunate that last week, we saw the first death due to monkeypox, which was a case in LA County.
We know that deaths from monkeypox are rare. But they can occur among vulnerable groups, such as babies, pregnant women and those with weakened immune systems, like we just talked about. The patient who died was severely immunocompromised and had been hospitalized prior to death.
Unger: Well, we're also on the verge of entering flu season. It's going to be a little bit different this year. Many people back to work, out on public transportation, maybe not wearing a mask. What do people need to be thinking about when it comes to the flu? And what we can expect this season?
Garcia: Yeah, I mean, I think the concern here is we may be more susceptible to the flu virus than in past years and that's for a number of reasons. Flu activity tends to ramp up starting in October, though we know according to New York Times and other data that the virus has already been circulating this month in Texas, New Mexico, Delaware and Georgia. We know the Southern Hemisphere, which is finishing up its flu season, has seen a lot of flu this year. And that's typically an indicator of what we can expect for our flu season.
And this year could be worse because of COVID restrictions. As you mentioned, people aren't wearing masks like they were before. And those measures we take to protect us from COVID also prevent the spread of flu.
So we could be seeing people travel more than they did over the past two years. And people's immune system, they haven't been exposed to the flu virus in a while. So that can make them more susceptible as well.
Unger: Well, I know of one really effective way to help protect yourself and your families this fall and winter. I'll bet you're going to tell me what that is.
Garcia: Yeah and much of this is the same as the advice we always give, which is get your flu shot. Even in years when the vaccine does not match well against the circulating strain, it's still important. It protects people against serious illness and complications. It's our best defense.
This year, you can get your flu shot and COVID booster at the same time. And many experts are still recommending wearing a mask when you're in a crowded indoor space. And, of course, wash your hands regularly.
I think people may want to stock up on at-home COVID tests. We know that flu and COVID symptoms can be similar. It will be important to determine which you have if you become sick so you can follow that recommended isolation guidance. And you also may be eligible for treatments, like Paxlovid for COVID or Tamiflu for influenza. I think the bottom line message, regardless of what you have here, is get vaccinated and stay home if you're sick.
Unger: Well, just in closing, just want to highlight some important news on the advocacy front, including some big news from areas of the AMA's Recovery Plan for America's Physicians that we mentioned earlier in the segment. What news do we have there?
Garcia: For one, last week, a group of 375 employers and health groups, including AMA, Amazon, the American Nurses Association, Google and Walmart, sent a letter to the Senate, urging lawmakers to continue COVID-19 era telehealth flexibilities for another two years. And there was also some movement on a bill to streamline prior authorization requirements. The measure will now move to the Senate for a vote. And health care advocates are hoping it will pass by the end of the year.
Unger: So that's great news. Two very important pillars of the recovery plan that you just talked there about supporting telehealth and, of course, prior authorization. We'll hear more about that when we talk to Jason Marino, the AMA's director of Congressional affairs, next week. We'll be back soon with another AMA Update. And you can find all our videos and podcasts at ama-assn.org/podcasts. Thanks for joining us today and please take care.
Disclaimer: The viewpoints expressed in this video are those of the participants and/or do not necessarily reflect the views and policies of the AMA.
An outbreak of flu is feared by top health experts to happen in the UK this Winter. Drawing from a sharp wave of cases in Australia during their winter, a record 35 million people are currently eligible to have a flu jab, reports The Express.
Professor Robert Booy, an infectious diseases expert at Sydney University, said many viruses had made a comeback during Australias winter, from June to August. He warned: You can be quite sure the UK is going to get at least a moderate, and potentially a severe respiratory viral season.
It will be dominated by flu and Covid but also include other viruses. You need to be preparing now.
There were almost no UK flu cases in the last two years, as Covid measures including lockdowns subdued other viruses. However, that means immunity is likely to be low, leaving people more vulnerable and the NHS struggling even more than it already is.
Read more: Covid Winter booster: Who is eligible as autumn jab programme rolls out and how to book
More than 223,000 flu cases were reported in Australia this year. They included 295 deaths and 1,763 hospital admissions. In 2021, only 512 cases were recorded. There were no deaths.
Prof Booy said: Flu came early this year, which was unusual, and it peaked quickly, then went away fast. Whereas previously it had been spread over three months, this time it was more like six to eight weeks. That was because we think a lot of viruses came back this year.
All these viruses were spreading like crazy and competing with each other, so the combination of all of them led to a bad respiratory season.
Prof Booy said immunity had fallen, particularly among children aged one to three never exposed to flu. The elderly also face increased risk through not being around the virus for a couple of years.
Prof Booy said: We dont have optimal rates of immunisation in young children or the elderly. We could do better, in the UK and here.
Flu jabs are being offered to a record number of people in the UK this year, including over-50s, healthcare staff, carers and mothers-to-be. There are fears even a moderate wave of respiratory infections could hit the struggling NHS.
The service did not have its usual summer respite and there has been record pressure on ambulances and A&E departments in recent months. Prof Booy said Australia experienced real pressure on its health system, prompting many regions to offer free flu jabs to all ages.
Read more: Cambs couple 'reluctant' to return to KFC after finding 'bloody chicken' in bargain bucket
He said vulnerable people should take simple, common sense measures, such as wearing a mask, keeping their distance, cutting the number of social guests and moving events outside. Gary McLean, a molecular immunology professor at London Metropolitan University, said there was no better time to have the annual flu jab and the Covid booster.
He added: We look to the southern hemisphere to predict what the northern hemisphere influenza season might be and what dominant strains of the virus are circulating. With the predicted rise in Covid cases also occurring, we are likely in for a bad winter in terms of respiratory virus infections.
Professor of medicine Paul Hunter, of the University of East Anglia, warned there may be a big peak in infections and many people getting quite sick. The health protection expert added: Many people may not have had flu for five years. Taking up the flu jab if offered is the best thing you can do to protect yourself this winter from this infection.
Read more:
Alexandre Le Vert, CEO and co-founder of Osivax, discusses the companys breakthrough vaccine technology, oligoDOM, and how its driving the development of new influenza and SARS-CoV-2 vaccines that attack T-cells, providing a long-lasting effect.
Currently, available vaccines for influenza and COVID-19 require yearly administration due to their makeup, as they target the outer layer of the virus. Le Vert says Osivaxs technology differs, however, as it attacks the virus T-cells, making the vaccine more effective in the long term, and that clinical trials have shown promise.
Osivax is a European-based biotech company that develops vaccines against infectious diseases. What makes us special is that we have this technology platform that allows us to target the internal parts of a virus. Therefore, were focusing our vaccines on non-mutating parts, Le Vert says.
As a virus mutates, the outer layers change more quickly than the inner layers. Attacking the non-mutating parts or the inner layers can create a more effective vaccine that will be sustainable through several viral mutations.
The technology
When exposed to a virus, ones immune system develops antibodies in response to foreign antigens, with or without a vaccine. However, a vaccine trains the immune system to recognise that familiar virus and kill it more rapidly.
Sometimes the difference between life and death is your immune system being ready within two days versus within five days. Thats really what a vaccine does: it helps your immune system be ready to fight the virus within one or two days versus five, six, or seven days without a vaccine, Le Vert states.
When training the immune system, the science becomes complicated, as different aspects of the system play different roles.
One arm of the immune system triggers antibodies, and the other triggers T-cells. Antibodies cover the pathogen of the virus and neutralise it. Theyll prevent the virus from entering the cells because they will be covered with antibodies, and the receptors will be unable to reach the cell.
On this front, the antibody works very well. But the antibody wont be able to access the internal parts of the virus, Le Vert states.
Another arm of the immune system is called the T-cell response, which destroys the cells that have been infected by the virus.
The virus has to enter into a cell to hack the cell and make the cell produce new viruses. The beauty of that T-cell response is that you can actually access the internal parts of the virus, Le Vert states.
Osivaxs technology, oligoDOM, trains the T-cell immune response to recognise the nucleoprotein.
When the virus infects a cell, it will take that cell and make it produce all the parts of the virus including the nucleoprotein. Then the virus reassembles and kind of merges out. But when a cell produces those viral particles or antigens, it will be marked with traces of each of these particles on its surface, Le Vert states.
This is how the cell, which has been infected, exposes all the parts of the virus. Thats where you can act and target these internal parts of the virus, but you have got to be very fast, very strong, because you cant wait too long after the cell has been infected. Otherwise, it will start producing all these replicate viruses.
The nucleoprotein is exposed at the cells surface and a robust T-cell response at that time can get rid of the virus. The virus cant divide and so disappears.
The company is using its oligoDOM technology to create influenza and COVID-19 vaccines which it hopes will provide long-term protection against the viruses.
Influenza
The influenza virus mutates quickly and, over the past decade, has shifted to where the vaccines available are less effective than they previously were.
The CDC analyses the effectiveness of flu vaccines yearly and has done so since the 2003/2004 flu season. Just eight years ago, the efficacy of flu vaccines was 52%. Analysis from the 2021-2022 flu season shows a vaccine effectiveness of 35%.
Everyone understands this is related to how fast the virus can mutate. So, we decided to use our approach to target an internal, non-mutating part of the virus, the nucleoprotein, and to develop a broad-spectrum vaccine against that using oligoDOM, Le Vert states.
Osivaxs influenza vaccine is in phase 2A studies. Over 800 subjects have been recruited for four clinical trials, with 72 to 300 subjects in the various trials.
We observed efficacy in our clinical trial in decreasing the confirmed symptomatic influenza by a matter of 78%. We dont have an internal comparison in this clinical trial, but the effectiveness of the current vaccines is much lower, Le Vert states.
We dont know what it will do in a head-to-head comparison because we havent done that, but were very enthusiastic about those results. Its unprecedented, according to us. And its the second time we see such a level of protection with our vaccine in our hands.
In 2019/2020, the company published an observed efficacy of 75%. Then in 2021/2022, it saw a 78% reduction in confirmed influenza symptoms.
Theres still a lot of work to be done, but we see this as a big hope for the future prevention of all these mutating strains of influenza. Itd be amazing if we could anticipate the mutations of influenza, and we wouldnt have to react every year with nine months delay, Le Vert states.
In addition to Influenza, La Vert says Osivax is testing its technology to be used against current and potentially future strains of COVID.
SARS-CoV-2
When COVID initially hit, there was a scramble within the vaccine community to cultivate an effective vaccine to help stop or lessen the detrimental effects of the virus.
In 2020, when we saw the COVID-19 wave arriving, we thought of how we could help. Even though we were hoping to get antibody vaccines, at least for the first strains, we thought itd be important to have the same approach as with our flu vaccine. What if mutation starts to appear, which is just the typical way of life, and what if mutations help the virus evade vaccine effectiveness? It would be useful to have a vaccine to anticipate these mutations, Le Vert says.
The company uses the same approach for the COVID-19 vaccine as influenza, but to train the immune system to recognise the nucleocapsid a protein that forms complexes with the positive-sense RNA genome of coronaviruses.
One difference between the current COVID vaccines, the mRNA or the Novavax subunit vaccine, is that theyre targeting the outer membrane of the COVID-19 virus the spike protein.
One can argue that mRNAs and even the Novavax vaccines also trigger T-cells, but not against the nucleocapsid. Were targeting specifically the nucleocapsid with T-cells that are going to be effective, Le Vert says.
The vaccine candidate is in the preclinical phase today, but has shown promising results in animal trials. The company is looking to begin human trials next year.
If we manage to have protection against one strain, it should protect against all the other variants, and then potentially beyond COVID-19, in other coronaviruses. Also, the mutation rate of the nucleocapsid is just orders of magnitudes below the one with the spike. So, the level of mutations you get with a spike in one year is what you would get in a nucleocapsid in probably many years, Le Vert states.
Vaccine developers have done an amazing job with COVID-19, but now were seeing that these vaccines have their limitations. Why on earth do we need to change the vaccines every year? Its not the case with measles or polio; with these child infectious diseases. It just takes a lot of work and a lot of good science, but were ready for that.
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Strokes, seizures, memory and movement disorders among problems that develop in first year after infection
A comprehensive analysis of federal data by researchers at Washington University School of Medicine in St. Louis shows people who have had COVID-19 are at an elevated risk of developing neurological conditions within the first year after infection. Movement disorders, memory problems, strokes and seizures are among the complications.
If youve had COVID-19, it may still be messing with your brain. Those who have been infected with the virus are at increased risk of developing a range of neurological conditions in the first year after the infection, new research shows. Such complications include strokes, cognitive and memory problems, depression, anxiety and migraine headaches, according to a comprehensive analysis of federal health data by researchers at Washington University School of Medicine in St. Louis and the Veterans Affairs St. Louis Health Care system.
Additionally, the post-COVID brain is associated with movement disorders, from tremors and involuntary muscle contractions to epileptic seizures, hearing and vision abnormalities, and balance and coordination difficulties as well as other symptoms similar to what is experienced with Parkinsons disease.
The findings are published Sept. 22 in Nature Medicine.
Our study provides a comprehensive assessment of the long-term neurologic consequences of COVID-19, said senior author Ziyad Al-Aly, MD, a clinical epidemiologist at Washington University. Past studies have examined a narrower set of neurological outcomes, mostly in hospitalized patients. We evaluated 44 brain and other neurologic disorders among both nonhospitalized and hospitalized patients, including those admitted to the intensive care unit. The results show the devastating long-term effects of COVID-19. These are part and parcel of long COVID. The virus is not always as benign as some people think it is.
Overall, COVID-19 has contributed to more than 40 million new cases of neurological disorders worldwide, Al-Aly said.
Other than having a COVID infection, specific risk factors for long-term neurological problems are scarce. Were seeing brain problems in previously healthy individuals and those who have had mild infections, Al-Aly said. It doesnt matter if you are young or old, female or male, or what your race is. It doesnt matter if you smoked or not, or if you had other unhealthy habits or conditions.
Few people in the study were vaccinated for COVID-19 because the vaccines were not yet widely available during the time span of the study, from March 2020 through early January 2021. The data also predates delta, omicron and other COVID variants.
A previous study in Nature Medicine led by Al-Aly found that vaccines slightly reduce by about 20% the risk of long-term brain problems. It is definitely important to get vaccinated but also important to understand that they do not offer complete protection against these long-term neurologic disorders, Al-Aly said.
The researchers analyzed about 14 million de-identified medical records in a database maintained by the U.S. Department of Veterans Affairs, the nations largest integrated health-care system. Patients included all ages, races and sexes.
They created a controlled data set of 154,000 people who had tested positive for COVID-19 sometime from March 1, 2020, through Jan. 15, 2021, and who had survived the first 30 days after infection. Statistical modeling was used to compare neurological outcomes in the COVID-19 data set with two other groups of people not infected with the virus: a control group of more than 5.6 million patients who did not have COVID-19 during the same time frame; and a control group of more than 5.8 million people from March 2018 to December 31, 2019, long before the virus infected and killed millions across the globe.
People who have had COVID-19 are at an elevated risk of developing neurological conditions within the first year after infection, according to a detailed analysis of federal data by researchers at Washington University School of Medicine in St. Louis. Movement disorders, memory problems, strokes and seizures are among the complications.
The researchers examined brain health over a year-long period. Neurological conditions occurred in 7% more people with COVID-19 compared with those who had not been infected with the virus. Extrapolating this percentage based on the number of COVID-19 cases in the U.S., that translates to roughly 6.6 million people who have suffered brain impairments associated with the virus.
Memory problems colloquially called brain fog are one of the most common brain-related, long-COVID symptoms. Compared with those in the control groups, people who contracted the virus were at a 77% increased risk of developing memory problems. These problems resolve in some people but persist in many others, Al-Aly said. At this point, the proportion of people who get better versus those with long-lasting problems is unknown.
Interestingly, the researchers noted an increased risk of Alzheimers disease among those infected with the virus. There were two more cases of Alzheimers per 1,000 people with COVID-19 compared with the control groups. Its unlikely that someone who has had COVID-19 will just get Alzheimers out of the blue, Al-Aly said. Alzheimers takes years to manifest. But what we suspect is happening is that people who have a predisposition to Alzheimers may be pushed over the edge by COVID, meaning theyre on a faster track to develop the disease. Its rare but concerning.
Also compared to the control groups, people who had the virus were 50% more likely to suffer from an ischemic stroke, which strikes when a blood clot or other obstruction blocks an arterys ability to supply blood and oxygen to the brain. Ischemic strokes account for the majority of all strokes, and can lead to difficulty speaking, cognitive confusion, vision problems, the loss of feeling on one side of the body, permanent brain damage, paralysis and death.
There have been several studies by other researchers that have shown, in mice and humans, that SARS-CoV-2 can attack the lining of the blood vessels and then then trigger a stroke or seizure, Al-Aly said. It helps explain how someone with no risk factors could suddenly have a stroke.
Overall, compared to the uninfected, people who had COVID-19 were 80% more likely to suffer from epilepsy or seizures, 43% more likely to develop mental health disorders such as anxiety or depression, 35% more likely to experience mild to severe headaches, and 42% more likely to encounter movement disorders. The latter includes involuntary muscle contractions, tremors and other Parkinsons-like symptoms.
COVID-19 sufferers were also 30% more likely to have eye problems such as blurred vision, dryness and retinal inflammation; and they were 22% more likely to develop hearing abnormalities such as tinnitus, or ringing in the ears.
Our study adds to this growing body of evidence by providing a comprehensive account of the neurologic consequences of COVID-19 one year after infection, Al-Aly said.
Long COVIDs effects on the brain and other systems emphasize the need for governments and health systems to develop policy, and public health and prevention strategies to manage the ongoing pandemic and devise plans for a post-COVID world, Al-Aly said. Given the colossal scale of the pandemic, meeting these challenges requires urgent and coordinated but, so far, absent global, national and regional response strategies, he said.
Ziyad Al-Aly, MD, has lead multiple studies on long COVID as a clinical epidemiologist at Washington University School of Medicine in St. Louis and the Veterans Affairs St. Louis Health Care system. His research has included the devastating effects of the virus on the heart, kidneys and mental health.
Xu E, Xie Y, Al-Aly Z. Long-term Neurologic Outcomes of COVID-19. Nature Medicine. Sept. 22, 2022. DOI: https://doi.org/10.1038/s41591-022-02001-z
This research was funded by the U.S. Department of Veterans Affairs; the American Society of Nephrology; and KidneyCure. The data that support the findings of this study are available from the U.S. Department of Veterans Affairs. VA data are made freely available to researchers behind the VA firewall with an approved VA study protocol.
About Washington University School of Medicine
WashU Medicine is a global leader in academic medicine, including biomedical research, patient care and educational programs with 2,700 faculty. Its National Institutes of Health (NIH) research funding portfolio is the fourth largest among U.S. medical schools, has grown 54% in the last five years, and, together with institutional investment, WashU Medicine commits well over $1 billion annually to basic and clinical research innovation and training. Its faculty practice is consistently within the top five in the country, with more than 1,790 faculty physicians practicing at over 60 locations and who are also the medical staffs of Barnes-Jewish and St. Louis Childrens hospitals of BJC HealthCare. WashU Medicine has a storied history in MD/PhD training, recently dedicated $100 million to scholarships and curriculum renewal for its medical students, and is home to top-notch training programs in every medical subspecialty as well as physical therapy, occupational therapy, and audiology and communications sciences.
Health care systems encourage everyone eligible to get a COVID-19 vaccination and booster. (Getty Images)
Vaccine boosters and breakthrough infections following vaccination both provide a substantial and potentially pandemic-breaking immunity against COVID-19, according to new laboratory research from Oregon Health & Science University.
The study, published Wednesday in the journal Med, is the latest in a series of OHSU discoveries using blood samples to characterize immune response to the SARS-CoV-2 virus.
As the number of omicron subvariant cases rise and as global vaccination and booster campaigns continue, an increasing proportion of the worlds population will acquire potent immune responses that may be protective against future SARS-CoV-2 variants, the researchers conclude.
The research measured a powerful immune response among samples from 99 OHSU employees who had blood drawn for the research. Notably, researchers measured an equally potent immune response to the virus with dramatic increases in magnitude, potency and breadth among people whose blood was drawn three months after a third vaccine booster dose and another group one month after a breakthrough infection.
In addition, the study found the immune response was just as powerful among people 65 and older.
Marcel Curlin, M.D. (OHSU)
Early in the pandemic, we had very high mortality in certain vulnerable groups, such as older adults in nursing homes, but that reality is slowly changing, said co-senior author Marcel Curlin, M.D., associate professor of medicine (infectious diseases) in the OHSU School of Medicine and medical director of OHSU Occupational Health. Our study bolsters the idea that vaccination is a pathway to a milder illness. Even if youre older, your chances of having a severe illness if youre re-infected down the line appears to be much lower than it was at the start of the pandemic.
Fikadu Tafesse, Ph.D. (OHSU)
Co-senior author Fikadu Tafesse, Ph.D., associate professor of molecular microbiology and immunology in the OHSU School of Medicine, said he would expect an even more robust immune response among people receiving the new bivalent vaccine booster targeting the BA.4 and BA.5 variants.
We anticipate that updated vaccine strategies with variant-specific regimens will significantly improve the breadth of the immune response and provide better protections against the SARS-CoV-2 variants, he said.
In contrast to the onset of the pandemic, the SARS-CoV-2 virus is no longer novel to the human immune system. Most people in the world have now been vaccinated, infected or both meaning the virus is running up against a much more effective immune response with each new infection.
Curlin said the new study most likely reflects the fact that the virus is evolving to become more transmissible but less harmful.
Evolutionary pressure is driving the virus to find more ways to infect people at the cost of pathogenicity, most likely, he said. Pathogenicity refers to the capacity to cause symptoms associated with the disease.
Funding for this study was supported by the M.J. Murdock Charitable Trust; the OHSU Foundation; the National Institutes of Health training grant T32HL083808; and a grant from the OHSU Innovates IDEA fund. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.
COVID-19 testing startup Curative is laying off 109 employees as it pivots its focus from COVID-19 testing to its health insurance plan, according to a Worker Adjustment and Retraining Notification notice.
The company is launching a health plan in the Austin, Texas, area and will offer $0 copays and $0 deductibles after conducting baseline health visits. Curative intends to roll out the plan in additional Texas counties and eventually other states, according to a press release.
The company is making additional adjustments taking place in staffing throughout the company based on the demand for our COVID-19 testing services and new hiring needs as we launch our new health plan in Texas, a spokesperson said.
The baseline health visit, which must be completed within 120 days, will assess preventive health needs and aim to improve the health literacy of members.
The plan will be available to employers with 51 or more employees.
Curatives new health plan represents its next phase of growth and is the primary focus of the company, according to the press release.
Health officials have noted since as early as April that COVID-19 testing demand has been decreasing.
Curative was founded in 2020 and provided 35 million COVID-19 tests and 2 million vaccines across more than 40 states during the coronavirus pandemic.
Surgeonfish school at Molokini. PC: Alan Friedlander.
With no boats around at one of the most popular snorkeling sites in Hawaii, Molokini thrived during the height of the COVID-19 pandemic. Thats what a small team of researchers discovered during a year-long study that started in April of 2020. Their findings will be presented during a free webinar set for 5:30 p.m. on Sept. 28.
Researchers involved in the study will share their findings which compare Molokini during the pandemic vs. past and present times. This presentation is part of Maui Nui Marine Resource Councils monthly Know Your Ocean Speaker Series, sponsored by the County of Maui. Registration is free but is required in advance of the webinar. Register here.
Molokini Marine Preserve is normally visited by approximately 1,000 tourists every day. During COVID-19 when tourism was switched off and there were no tour boats and no snorkelers at Molokini, researchers had a once-in-a-lifetime opportunity to understand how human activity affects how wildlife uses the reserve.
Many animals are afraid of humans, but since people visit Molokini every day, we didnt know how they would use the habitat if we were absent, said Kevin Weng, Associate Professor at the Virginia Institute of Marine Science. COVID caused a natural experiment that dramatically reduced human presence, allowing us to see wildlife in a more pristine system.
Tourism at Molokini provides benefits to the local economy and gives people an appreciation for what a healthy marine ecosystem looks like, said Alan Friedlander, Chief Scientist for the National Geographic Societys Pristine Seas program. What is needed is the right balance of tourism at Molokini so that both people and wildlife benefit from this exceptional place.
The study was made possible by more than 55 donors who collectively contributed cash, lodging, airfare, boat use and vehicles for the four researchers working on the project. In all, more than $3,500 was raised through a fundraising effort led by Maui Nui Marine Resource Council, as well as the value of the in-kind contributions.
Led by Maui resident Russell Sparks, Aquatic Biologist, Department of Land and Natural Resources, Division of Aquatic Resources on Maui, a small team of scientists with expertise in coral reef ecology and animal movement studies in the Hawaiian Islands studied the ecosystem at Molokini for a little over a full year. The study ran from a period of the COVID-19 pandemic shut down in April 2020, to a period of moderate activity resumption in November 2020 and into a full return of tourism in May of 2021.
The team included Alan Friedlander, Chief Scientist, Pristine Seas, National Geographic Society, and a researcher at the Hawaii Institute of Marine Biology. Friedlander has studied Molokini extensively for nearly two decades and is the co-author of five research publications on Molokini conducted in collaboration with the Maui Division of Aquatic Resources. Other members include Kevin Weng, Associate Professor at the Virginia Institute of Marine Science, Whitney Goodell, National Geographic Fellow and marine ecologist with the Fisheries Ecology Research Lab, University of Hawaii, and Laura Gajdzik, scientist at the Division of Aquatic Resources.
Maui Nui Marine Resource Council is humbled to have been involved in supporting this unique study, said Meredith Beeson, Project and Research Coordinator at MNMRC. Were excited at the chance to share the eye-opening findings with the public.
Nearly 43,000 CT residents got the new COVID-19 vaccine booster last week. The state is now on its second week of distributing the new bivalent boosters.
The U.S. Food and Drug Administration announced on Aug. 31 that the new COVID-19 vaccine booster would be rolled out to the public. States are expected to slowly start receiving the new booster.
Here are some answers to questions CT residents may have.
On Sept. 1, the Centers for Disease Control and Prevention recommended that people get the new booster if they are able and eligible.
Those eligible to receive the Pfizer-BioNTech vaccine are 12 and older. The Moderna vaccine is for people 18 and older.
Hartford HealthCare has an interactive tool on its website to determine ones eligibility.
In a few weeks, the CDC will also start recommending this new booster to younger age groups.
As the CDC sees spikes in different sub-variant cases, new boosters will be introduced to reduce or prevent illness from these new strains.
This CDC says the booster adds Omicron BA.4 and BA.5 spike protein components to the current vaccine composition in order to fight these new variants.
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The COVID-19 strands targeted for this booster have been described by doctors as more transmissible and immune-evading than others.
The Department of Public Health said the state ordered about 200,000 doses of the bivalent boosters.
The state is expected to receive more doses in the next couple of weeks.
According to a Sept. 15 press release from Gov. Ned Lamont, 43,618 residents received the booster in its first few days of availability.
The FDA and CDC recommend the booster for anyone who is eligible.
Chris Boyle, director of communications at the Department of Public Health, said that even though the state has fewer COVID cases than it did this time last year, residents should still consider getting the new booster.
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With the start of the new school year and the onset of the fall season when people begin spending more time indoors, there is no better time to receive this extra level of protection, which targets these variants and prevents transmission of this virus, Boyle said.
In the last week, 9.9% of all COVID tests reported to the state were positive, but that number is not necessarily a good measure of the current spread of the disease, as at-home test results are not routinely reported.
The state also reported 14 COVID-associated deaths in the last week as well as 74 new hospitalizations, bringing the statewide total to 400.
The COVID-19 vaccine is free. No one is required to show ID or have health insurance to get a booster.
Residents can contact their primary care doctor to get vaccinated or go to vaccines.gov to look for vaccination clinics.
