Amid rising Covid cases, Delhi could also see an outbreak of swine flu and other viral illnesses, according to health experts. They have also advised people to follow the mask mandate and adhere to social distancing norms.
As per the experts, Delhi had also reported a spike in the cases of Swine flu during August 2021.
Dr Manoj Goel, director, Pulmonology,
SymptomsSwine Flu is generally caused by the influenza virus, which resides in pigs. The symptoms of swine flu are fever, sore throat, running nose, nose block. Basically, the upper respiratory system gets affected due to the virus.
Dr Vishakh Varma, senior consultant and HoD, Critical Care Medicine at Aakash Healthcare, said since the symptoms of swine flu are quite similar to the common cold, people often don't take it seriously in the initial stages until it becomes critical.
"A swine flu patient usually goes through burning / sore throat, nose and abdominal pain and cough. There is an additional symptom of shortness of breath," he added.
He stressed that it's imperative to maintain good hydration, hand hygiene, cough hygiene (cough and sneezing in disposable tissue), and suitable disposal of this infected waste material.
Covid vs swine fluExplaining the difference between the two infections, Dr Manoj Goel said, "In Covid, the problem of respiratory distress arises in the second week and in the first week, patients have symptoms like fever, cough, etc but in the case of swine flu, shortness of breath, respiratory distress will start right from the first week."
He asserted that masking up and following social distancing norms will help guard one against swine flu.
His colleague, Dr Vikas Maurya, director and HOD, Pulmonology, Fortis Hospital Shalimar Bagh, also added that swine flu cases are increasing and those patients are also requiring hospitalisation.
This, he said, comes amid a slight increase in number of COVID-19 patients needing hospitalisation.
Get JabbedVarma recommended that people should get themselves vaccinated with a quadriplegic flu vaccine shot before the peak of the season and for health care / high-risk cases.
"Our hospital has encountered a case of swine flu, where the patient had a fever, cough and cold for three days. He even developed breathing difficulties a couple of hours before getting admitted to the hospital. The patient is also a diabetic and on maintenance dialysis due to his CKD," he said.
Dr Jugal Kishore, head of community medicine, Safdarjung Hospital, said, "In August-September, we see a spike in cases and every two-three years, there is a cycle when such spikes happen.
"The reasons might be decline in immunity or some new variant emerging. Although there is vaccination, but no one goes for it. People should get vaccinated. This swine flu season could continue till November-December," he said.
He advised that people should get vaccinated in April and May.
With PTI Inputs
The Portland Water District is about to begin testing the citys wastewater for the presence of monkeypox, influenza A and a common respiratory virus known as RSV.
The testing is part of a national effort to monitor the spread of infectious diseases in the same way wastewater treatment plants around Maine and the country are are now testing for the COVID-19 virus.
The East End Wastewater Treatment Plant in Portland will collect three samples each week and ship them to Verily Life Sciences lab, the district said in a statement. Testing will start next week. Results from Portland will be posted at wastewaterscan.org along with results from other communities around the country.
Results from this project will help Maine CDC better understand the burden of these viruses in our community, Maine Center for Disease Control and Prevention Director Dr. Nirav Shah said in a statement.
Because it is part of a national testing effort, there will be no cost to the Portland Water District, the district said. The project is funded through a philanthropic effort and spearheaded by Stanford University, Emory University and San Francisco-based Verily Life Sciences.
Maine has recorded three confirmed cases of monkeypox, while nationally there have been 12,689 cases. Monkeypox is spread through sexual or other close physical contact. So far, most cases have occurred between men who have sex with men, and sex is the largest risk factor, according to recent studies.
Monkeypox symptoms include pimple-like rashes, fever, chills, swollen lymph nodes, fatigue, headache and respiratory problems. It is rarely fatal. The virus is of unknown origin, and was first detected in humans in 1970. The current global outbreak of monkeypox began in May.
Influenza A is one of the common strains of flu that causes seasonal flu outbreaks, and can cause pandemics. RSV is a common respiratory virus that often occurs in children.
Wastewater testing has become a common technique for monitoring the spread of the virus that causes COVID-19, and scientists are now expanding its use to other viruses. It is considered an accurate way to monitor outbreaks in real time and can provide an early warning when infectious diseases are present and increasing in a community.
People infected with viruses can shed virus into the wastewater thats flushed into the sewer system through toilets, showers and sinks. Testing samples of wastewater at the public treatment plans can reveal if a virus is present in the community and how prevalent it is.
Scott Firmin, director of Wastewater Services at the Portland Water District, said in an interview that the East End plant was invited by Verily to participate in the project because it met qualifications that include serving more than 50,000 customers. The East End treatment plant serves about 65,000 people, Firmin said. Its unclear how many other Maine treatment plants might be eligible to be part of the testing, as East End is one of the largest treatment plants in Maine.
Firmin said testing for infectious diseases is an exciting opportunity to expand the role of wastewater treatment systems to further serve public health.
We are starting to build these databases that we can pull information from and make it available so that public health officials better understand the presence of viruses within our communities, he said.
Firmin emphasized that the Sebago Lake water that the district treats and supplies for drinking and other uses is safe. The testing is done on wastewater leaving the home that ends up at the treatment plant, which sits neat to Portlands East End Beach and discharges into Casco Bay.
Wastewater testing for monkeypox conducted by the same group has begun in California, Georgia, Michigan and other states, and aims to ramp up to about 300 testing locations in the United States, according to Kaiser Health News.
Dozens of cities and towns throughout Maine have tested for the presence of COVID-19 in their wastewater, including Portland, Westbrook, Augusta, Bangor, Lewiston-Auburn, Yarmouth and many others.
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Theres good news for humans in the ongoing struggle against COVID variantsBad Ned is almost dead.
That scenario didnt play out, which is good news for humanity. But although Bad Ned is mostly dead, there are two new COVID subvariants that experts say could pose problems this fall.
Trouble brewing in the Midwest?
Last week, a new subvariant called BA.4.6dubbed Aeterna by health care experts on Twittercompromised 5.1% of sequenced COVID infections in the U.S., up from 4.6% the week prior. Its been steadily rising, albeit slowly, since late May, when it comprised one-tenth of 1% of infections, according to data released Tuesday from the U.S. Centers for Disease Control and Prevention.
The variant is more prevalent in certain areas of the country, like the Midwest. Last week it comprised nearly 13% of cases in Nebraska, Kansas, Iowa, and Missouri, putting it in the number two spot behind BA.5, which comprised more than 80% of cases in that region and nearly 89% of cases nationally.
But as with Bad Ned, next to nothing is known about Aeterna except for its potential to outcompete BA.5. The rising subvariants ability to push back on the dominant global subvariant demonstrates that greater transmissibility is likely, Dr. John Swartzberg, a professor at the Division of Infectious Diseases and Vaccinology at the University of California Berkeleys School of Public Health, told Fortune.
With the exceptions of BA.5 and Aeterna, all other variants are declining in the U.S., Swartzberg pointed outincluding BA.4, a close relative of BA.5 that was expected to be more competitive. That subvariant comprised only 5.3% of U.S. infections last week, and peaked in mid-July around 13%.
Indias problem today, Americas problem tomorrow?
Another potential threat: Omicron subvariant BA.2.7.5dubbed Centaurus on Twitter this summer by experts. Both it and BA.4.6 could pose problems this fall, Dr. Bruce Y. Lee, a professor of health policy and management at the City University of New York School of Public Health, told Fortune.
The number of cases of Centaurus in the U.S. is so small that the CDC doesnt reportit. But the subvariant comprises nearly 40% of cases in India, where it has outcompeted BA.5 and is second only to stealth Omicron BA.2, according to Our World in Data, a nonprofit international data repository affiliated with the University of Oxford in the United Kingdom.
Centaurus has also shown an ability to compete with Aeterna in Australia, where the two are hovering around 2% of cases, experts pointed out this week, citing data from GISAID, an international research organization that tracks changes in COVID and the flu virus. The same scenario could play out in the U.S.only time will tell.
The waxing and waning of subvariants is a cycle thats certain to repeat until vaccine technology catches up, Lee said, though the players frequently change.
You know as a fact youre going to have continued variants emergethats what this virus does, Lee said. It makes a lot of mistakes when it reproduces genetic material. Thats why it was at risk of creating a pandemic in the first place.
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A peregrine falcon that had found its home in Leicester has died amid bird flu fears. The bird of prey was one of several that had settled at Leicester Cathedral in 2017.
A webcam previously set up as part of a local conservation project follows the lives of the Leicester peregrines with viewers regularly updated on the latest news through an accompanying blog. But in an update on Monday, August 15, Leicester Peregrines announced the female adult had died after looking unwell for several days.
The falcon's death follows Leicester City Council's announcement of the closure of Abbey Park's animal enclosure after the Avian Influenza virus was detected in the city. The Leicester Peregrines Project said in a statement that bird flue was the "probable" cause.
READ MORE: Pets Corner forced to shut to limit bird flu spread after virus detected in two of the city's parks
The statement, shared by Leicestershire and Rutland Ornithological Society, which runs the project alongside the city council and the cathedral, said: "Regular viewers of the Leicester Peregrines webcam and blog may have noticed a lack of updates in recent days. We had become concerned about the health of the adult female who was spending more time in the box and didn't appear to be feeding particularly well, despite the opportunities.
"She was becoming lethargic and very sleepy. Whilst initially this was considered to be due to the extreme temperatures we have been having, her posture was beginning to look strange and unnatural.
"Unfortunately, she fell from the platform in the early hours of August 15. Her body has been found and will be collected by Defra to determine the cause.
"We are aware that there is an outbreak of Avian Influenza in the city, and it is very probable that this will be identified as the cause. This is yet another dramatic twist in the history of the Leicester Peregrines, but it is only through the monitoring of sites like ours that show how precarious the life of a Peregrine is.
"Our fingers are crossed that both the male and juvenile TJC will remain healthy."
Four new eggs were hatched at the Leicester Cathedral earlier this year, much to the delight of regular webcam viewers.
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People struggling to afford to heat their homes are going to be more vulnerable to the flu virus this winter, vaccines minister Maggie Throup has admitted.
The minister who has outlined plans for over 50s and the clinically vulnerable to get a further Covid booster this autumn said there was concern about a spike in flu deaths.
Asking about fears more people could die if they could not afford to keep the heating on, Throup told LBC: Well, that is a concern, its something that weve taken into consideration when we looked at our vaccination programmes.
The Tory minister added: Youre right, people who perhaps dont heat their homes as much will be more vulnerable. And thats why, as I say, were putting that ring of protection around the most vulnerable with our vaccine programme.
Throup said that the flu and the Covid job would be given together, where possible, so people can have both jabs at one go. She said the government was providing as much protection as we can.
The Tory MP, a back of Rishi Sunak for the leadership,also told ITVs Good Morning Britain that the government had already offered lots of help with the cost of living crisis.
Asked if Sunak should make his plan for additional direct support more clear, Throup said: I think its quite right that we wait until we know who is our new leader ... and then they will take on a lot of advice.
The National Energy Action charity predictsthat 8.2 million UK households one in three will be in fuel poverty when the price cap rises in October. Campoaigners have warned that thousands could die from cold-related illnesses.
Labour leader Sir KeirStarmerdefended his plan to freeze energy prices this winter on Tuesday, saying the zombie government are producing absolutely no plan.
Starmer dismissed claimed that the 29bn Labour plan which involves an expanded windfall tax on the oil and gas giants is poorly targeted.
This assumption that most people can afford these massive hikes in their energy bills is completely wrong, Sir Keir said. I think the government in making that argument is completely out of touch.
Sunak has suggested he is considering further payments of around 5bn for the most vulnerable if he wins the Tory leadership contest. But Truss has yet to commit to any further handouts.
Truss was said to be considering whether the existing 400 government discount on energy bills this autumn aimed at helping all households in the UK could be better targeted. But a Truss campaign spokesperson said she would go ahead with the universal 400 payment.
A group of 70 charities have signed an open letter to Sunak and Liz Truss warning that families on benefits face a 1,600 shortfall over the coming months, despite receiving 1,200 in the last government support package.
In the letter, co-ordinated by theJosephRowntreeFoundation (JRF), they warn soaring energy bills mean many are already facing in a choice between skipping meals or not heating their homes properly.
One of Leicester's beloved family attractions has been forced to shut temporarily, after bird flu was detected in the area. Leicester City Council announced the closure of Pets' Corner, in Abbey Park.
The animal park was closed to the public on Monday to limit the spread of the virus after it was detected in deceased wild fowl in Abbey Park and Watermead Park. The council said the decision was made to reduce to the number of people accessing the area.
Any clothing, footwear and equipment used while in the area is urged to be thoroughly cleaned and disinfected to avoid any possible contamination. Posters have been put up in parks and open spaces across the city, informing locals of the outbreak.
READ MORE: Residents kicking up a stink as Leicester smells like vomit or old milk
Anyone who has spotted dead birds in the city's parks and waterways have been asked to contact the Department for Environment, Food and Rural Affairs (DEFRA). Members of the public are being reminded not to touch any sick or deceased birds, swans, ducks, geese, gulls or birds of prey - as well as wild bird feathers.
Councillor Piara Singh Clair, deputy city mayor said: With avian flu now present in Leicester, were asking members of the public to be extra vigilant. People can help by reporting any sightings of dead birds, and by making sure that they comply with DEFRAs regulations, if they keep birds at home.
"Closing Pets Corner is a temporary measure, and we look forward to reopening our popular family attraction as soon as its safe to do so."
The attraction was last shut in November following fears of an outbreak. An Avian Influenza Prevention Zone (AIPZ) was enforced, meaning bird keepers had to adhere to strict restrictions from DEFRA to ensure birds were housed in an enclosed environment as well as keeping to biosecurity protocols to reduce the risk of disease transmission.
An AIPZ is currently in force across the country. Leicesters director of public health, Professor Ivan Browne added: Avian flu is primarily a disease affecting birds and the risk to the general publics health is very low.
"You do not need to stop enjoying Leicesters beautiful parks and green spaces, but if you see a dead or sick bird, please do not touch it or go near it but call the DEFRA helpline to report it as soon as possible.
"There is a very low food safety risk from avian flu and properly cooked poultry and poultry products, including eggs, are safe to eat."
Further information and advice from DEFRA is available at www.gov.uk/bird-flu. If you spot a dead or sick bird call the DEFRA helpline on 03459 33 55 77.
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2022-08-15 15:13
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Can monkeypox spread on the subway? Can it kill like COVID-19? Is it transmitted through sex?
Misconceptions, myths and a lack of public knowledge on the monkeypox virus are widespread. Despite 57 percent of adults recently polled by Morning Consult feeling confident in the Centers for Disease Control and Preventions ability to control the spread of monkeypox, many Americans are misinformed on how the virus spreads and how concerned they should be
Last month, the Annenberg Public Policy Center found that nearly half of 1,580 surveyed adults were not sure if monkeypox was less contagious than COVID-19. (It is much less contagious.) One-third of more than 4,000 adults polled by Morning Consult arent sure how monkeypox spreads. Two-thirds of those surveyed by Annenberg were unsure or didnt believe that there is a monkeypox vaccine (there is, its FDA-approved, and to be eligible for a vaccine right now in most areas, people must be in a high-risk group predominately queer men, or trans and nonbinary people, who have had multiple or anonymous sex partners in the last two weeks).
Monkeypox is a disease primarily transmitted through skin-to-skin contact that can infect anyone, but is currently affecting queer men the most.
Heres what experts have to say in response to common misconceptions and myths about the monkeypox virus.
The risk of getting infected through these situations is extremely low, said Stephen Abbott, medical director at Whitman-Walkers Max Robinson Center, a D.C.-based health care provider focused on serving LGBTQ+ people.
Abbott stressed that spread occurs through direct skin-to-skin transmission not skin-to-object, then someone else touching that object. The virus can spread by touching sex toys, sheets and other fabrics that have made contact with exposed lesions or skin rashes, per the CDC but the vast majority of cases are being reported by men who had sex or close intimate contact with another man prior to infection.
Places where a person could typically pick up a cold or flu virus are not considered primary points of transmission.
Theres really no evidence at this time to suggest people are being infected through casual contact through public transportation, and anything like that. The vast majority of the cases that have been identified from the outbreak so far had been through intimate contact or sexual activity, said Daniel Uslan, co-chief infection prevention officer at UCLA Health and clinical chief of infectious diseases.
These are also very low-risk situations, Uslan said, adding that he is not aware of recorded cases where handshaking is the suspected route of transmission.
But skin-to-skin contact with someone who has an open lesion can still occur if those lesions are on the hands, Abbott noted and some lesions are so small that patients dont notice them.
Some of the patients Ive seen when I do their skin exam, they havent even noticed that they have a lesion on their hand, he said. They might inadvertently shake someones hand and expose them unknowingly.
However, some of the fears surrounding the spread of monkeypox especially from low-risk encounters in public spaces seem to manifest from anti-LGBTQ+ sentiment, as gay and bisexual men are primarily contracting the virus right now, said Perry Halkitis, dean and professor of public health and health equity at Rutgers School of Public Health.
People will use any piece of information, if they are homophobic, to disadvantage and to stigmatize gay men, he said.
The virus can spread through any prolonged skin-to-skin contact with lesions or rash areas but transmission during sex, where plenty of skin-to-skin contact takes place, is still primarily how the virus is spreading right now.
You can have sex with somebody and have the flu, and they can get the flu. That doesnt make the flu an STI, Halkitis said. Oral, anal, or vaginal intercourse are not required for monkeypox transmission to occur, he added.
Technically, it is not [an STD or STI] because it is not solely spread through sexual contact. But the current outbreak appears to be spreading primarily through sexual contact, so it is associated with sex, but is not technically a sexually transmitted infection, Uslan said.
Abbott agreed that, by definition, monkeypox is not an STI or STD. Josh Michaud, associate director of global health policy at the Kaiser Family Foundation, noted that the answer should ultimately not affect how the country responds to the virus and that labeling the virus as an STI may not be black or white.
What we know is that sexual behavior, or particularly men who have sex with men with multiple partners, has been the bulk of the cases so far of monkeypox. And therefore transmission is very much associated with sexual activity, Michaud said. I think people are sort of debating terminology here. And we dont necessarily need to classify it to be able to respond to it one way or the other.
The virus that causes chickenpox is unrelated to monkeypox, although their names are similar.
The viruses are in completely different families, said Michaud. In the case of the chickenpox virus, it doesnt provide any cross-protection against monkeypox.
Someone who got the smallpox vaccine as a kid would likely have some protection against current monkeypox transmission, experts say, since the viruses are in the same family. However, any immunity provided by a childhood smallpox shot may have waned.
Health departments are still suggesting that those folks get vaccinated, Abbott said, adding that immunity may have waned because smallpox was declared eradicated in 1980.
The passage of several decades since smallpox vaccinations were commonplace means that most young people have not received the same level of protection, Uslan noted.
Monkeypox is not as contagious, or as fatal, as COVID-19, which is highly transmissible through airborne and respiratory routes.
It is absolutely not as contagious as COVID, Uslan said. Monkeypox is not spreading through casual contact, and evidence so far shows that patients are not contagious with monkeypox until symptoms emerge as opposed to COVID-19, which asymptomatic people can spread.
Its also not nearly as fatal, Abbott said, and it wont leave you with a chronic infection. Its a rash that is very uncomfortable and painful. But most people will recover in two to four weeks.
While scarring can be one long-term side effect, after the lesions heal, there havent been reports of a long monkeypox syndrome similar to the long COVID that many Americans have experienced.
There is no evidence to suggest that getting COVID-19 increases a persons risk to contract monkeypox. While those who are immunocompromised are more susceptible to contract a variety of viruses, Halkitis noted, contracting COVID does not mean someone is more likely to get monkeypox.
With two different diseases, one doesnt create exposure to the other, Abbott said.
Children are still at minimal risk. While the virus could spread into their social networks at some point, the current focus to slow the spread of the virus is to vaccinate men who have sex with men.
I dont think parents should be terribly worried at this time, but this is something that people should be paying attention to, Uslan said. We have not seen a lot of cases in daycare settings for children at this point. So it doesnt seem to be a major concern.
While a few monkeypox cases have been seen in women and children, and the potential for greater spread cannot be ignored, the difference in risk right now is still massive, Michaud said.
A persons risk of getting infected with monkeypox is high right now if they are among high-risk groups like queer men who have recently had multiple sexual partners or anonymous sex, or arent using protection.
If were gonna get ahead of this and keep it from escalating, we need to be vaccinating those at highest risk gay and bisexual men and our networks, and trans folks as well, Abbott said, noting that social networks within these groups can be vectors for spread alongside sexual networks.
The highest-risk individuals in my view are young gay and bisexual men, born after 1972, who have no smallpox vaccination, and who are socializing in large groups with other gay men, Halkitis said.
Its safe to get the JYNNEOS shot even with eczema or similar skin conditions. However, ACAM2000, an FDA-licensed smallpox vaccine that may also be effective against monkeypox but is not being widely offered due to a long list of side effects and a more difficult injection procedure, can be harmful to those with eczema and those with other exfoliative skin conditions or dermatitis.
TPOXX, the antiviral and primary pain management treatment for monkeypox, is safe for those living with HIV, including those taking antiviral drugs to manage their HIV, experts said. There are also no interactions between the JYNNEOS vaccine and HIV medications, Halkitis said.
More studies on TPOXXs effectiveness are gearing up and are likely to start in the next few weeks, Uslan said, although it is already known that the treatment is safe and well-tolerated in healthy patients.
According to an analysis by the CDC of monkeypox cases from May through July, a substantial number of monkeypox cases have been reported among those with HIV.
Find more information on monkeypox symptoms, how the virus spreads, and what to do if you are sick from the CDCs website.
While many New Yorkers this summer have returned to activities and gatherings reminiscent of pre-pandemic times, COVID-19 is still sickening and killing far more residents than another virus - the flu - did before March 2020, according to state and federal health agencies.
About 10 to 20 New Yorkers are still dying daily from COVID-19, and thousands more are currently hospitalized with the disease, according to the most recent data from the state Department of Health (DOH) and the Centers for Disease Control (CDC).
The state COVID-19 online tracker does not provide easily accessible daily, weekly or monthly death counts, only a total number of deaths by county, and other demographic data, since 2020. But according to the CDC, nearly 11,000 deaths in New York so far this year are listed as "involving COVID-19." More than 23,500 people died with a coronavirus diagnosis last year, according to federal data that breaks numbers out by New York City and outside the city.
The state's dashboard shows 2,538 New Yorkers were hospitalized with COVID-19 as of Monday.
Just 54 people were hospitalized with the flu during the week ending June 25, the most recent influenza report available from the state DOH.
In the Capital Region alone, there are nearly 100 patients hospitalized with COVID-19, state data shows.
"Doctors and scientists are working to estimate the mortality rate of COVID-19, but at present, it is thought to be substantially higher (possibly 10 times or more) than that of most strains of the flu," Albany County Health Commissioner Elizabeth Whalen said in an email.
"New Yorkers have worked hard to keep each other safe from COVID-19, and as we approach the fall, we must continue to use the tools at our disposal to prepare for any potential surges," Gov. Kathy Hochul said in a statement Tuesday. "Make sure you and your loved ones are up to date on the vaccine and booster doses. Get tested if you have symptoms, and if you do test positive, talk to your doctor about potential treatment."
Still, the virus is less lethal than it was at the start of the pandemic. At this point, most New Yorkers have some level of immunity -- either through vaccination or previous infection -- and there are several therapeutic treatments available in cases of severe infection, resulting in fewer deaths.
Close to 80 percent of all New Yorkers have completed a vaccine series, according to the CDC.
But since May, hospitalizations -- and deaths -- have plateaued at an elevated level that has some epidemiologists concerned.
"In addition, we still have a lot of COVID circulating in the community, and are currently at CDC designated 'medium' level classification," Whalen said. "In these circumstances, I would urge awareness to make best decisions on preventive actions."
Actual flu and COVID-19 levels are difficult to determine since milder cases of both illnesses are widely unreported.
Facilities are no longer federally required to report negative lab test results, so cases per 100,000 data is a more reliable metric to measure virus impact on a community than percent positivity, according to New York health officials.
COVID-19 cases are also greatly underreported due to the availability of at-home tests.
Hospitalization and death trends are the clearest indicators that COVID-19 is still a threat.
Nearly all who die of COVID-19 are elderly or have comorbidities, state and local health officials said. But while masking and social distancing appear to have dramatically curbed transmission of the flu, reducing flu-related deaths to historic lows, even in the winter, COVID-19 continues to multiply and mutate.
The latest omicron variant BA.5, which now represents more than 95 percent of the viruses in circulation, is also highly transmissible and has been bypassing vaccine immunity, according to health experts.
A new vaccine authorized in the United Kingdom targets two omicron variants and is expected to be authorized in the U.S. this fall.
County health officials continue to encourage community members to get booster shots as they become eligible and anticipate there will be further guidance from state and federal health agencies when the variant vaccines are approved.
Protection provided by the current vaccine against symptomatic infection and transmission is less than its effectiveness against severe disease, vaccine protection can diminish over time, and currently circulating variants are able to better evade the immune system," Saratoga County Health Commissioner Daniel Kuhles said via email. "For these reasons, it is important for individuals to stay up to date with their immunizations, especially as new vaccines become available.
Hospitalized adult COVID-19 patients before and after SARS-CoV-2 vaccine availability had significantly higher odds of venousbut not arterialthromboembolism than those hospitalized for influenza before the pandemic, finds a study published today in JAMA.
A team led by University of Pennsylvania researchers retrospectively studied rates of venous thromboembolism (blood clot in a vein) and arterial thromboembolism (blood clot in an artery) in 41,443 COVID-19 patients hospitalized before the vaccine rollout (April to November 2020), 44,194 COVID-19 patients admitted after vaccines became available (December 2020 to May 2021), and 8,269 patients hospitalized with the flu from October 2018 to April 2019.
Thromboembolism can cause blockage of a blood vessel and thus can be severe.
Death rates were collected through Aug 28, 2019, for flu patients and through Sep 28, 2021, for COVID-19 patients. Data were derived from the US Food and Drug Administration (FDA) Sentinel System. Average age of all patients was 72 years.
The absolute risk of venous thromboembolism by 90 days was 5.3% in flu patients, versus 9.5% in COVID-19 patients before vaccines (risk difference, 4.1 percentage points) and 10.9% after (risk difference, 5.5 percentage points).
Relative to flu patients, the risk of venous thromboembolism was significantly greater among COVID-19 patients both before (adjusted hazard ratio [aHR], 1.60) and after (aHR, 1.89) vaccine availabilitya 60% and 89% higher risk, respectively.
In both flu and COVID-19 patients, the risk of venous thromboembolism by 90 days was greater for patients admitted to an intensive care unit (ICU) or who needed mechanical ventilation or had a previous venous thromboembolism.
After adjustment, the risk of venous thromboembolism was significantly elevated in COVID-19 patients both before (aHR, 1.60) and after (aHR, 1.89) vaccine availability. The risks were similar for venous thromboembolism with an emergency department (ED) or hospital release diagnosis of deep vein thrombosis, pulmonary embolism (blood clot in the lungs), or venous thrombosis of medical devices, implants, or grafts in COVID-19 patients before (aHR, 1.57) and after (aHR, 1.84) the vaccine rollout.
Relative to flu patients with no previous venous clots, COVID-19 patients with no history of venous thromboembolism were at significantly higher risk for the clots both before (aHR, 1.77) and after (aHR, 2.09) vaccine availability.
Compared with flu patients with a history of venous clots, COVID-19 patients with previous venous clots were not at significantly higher risk for subsequent venous thromboembolism before vaccine availability (aHR, 1.22) but were after the rollout (aHR, 1.42). Relative to flu patients, 30-day all-cause death rates after an inpatient venous thromboembolism in COVID-19 patients were elevated both before (aHR, 2.96) and after (aHR, 3.80) the vaccine rollout.
In addition to male sex and older age, risk factors for venous thromboembolism in both vaccine periods included antiphospholipid antibody syndrome (clot-promoting disorder), cancer, chronic kidney disease, chronic obstructive pulmonary disease, heart failure, previous venous thromboembolism, inherited thrombophilia, obesity, pregnancy, thrombocytosis, and recent outpatient use of a blood thinner.
The absolute risk of arterial thromboembolism by 90 days, in contrast, was 14.4% in flu patients, compared with 15.8% in COVID-19 patients before vaccine availability (risk difference, 1.4%) and 16.3% in COVID-19 patients after the vaccine rollout (risk difference, 1.9%). Relative to flu patients, the risk of arterial thromboembolism wasn't significantly greater among COVID-19 patients before vaccine availability (aHR, 1.04) and after (aHR, 1.07).
The risk of arterial thromboembolism with an ED or hospital release diagnosis of heart attack, ischemic stroke, chest pain, transient ischemic attack (mini stroke), or peripheral artery disease in COVID-19 patients was comparable before (aHR, 1.02) and after (aHR, 1.03) the vaccine rollout.
Among patients with cardiovascular disease and relative to flu patients, the risk of arterial thromboembolism was significantly greater among COVID-19 patients before (aHR, 1.10) and after (aHR, 1.13). Relative to flu patients, COVID-19 patients who had arterial thrombosis were more likely to die before (aHR, 3.45) and after (aHR, 3.45) vaccine availability.
In all groups, the 90-day risk of arterial thromboembolism was significantly greater in older patients, men, and those who were admitted to an ICU, needed mechanical ventilation, or were previously diagnosed as having cardiovascular disease.
The researchers said that the elevated risk of venous thromboembolism in COVID-19 patients could be due to virus-induced inflammation and blood-clotting abnormalities.
"Alternatively, heightened awareness of thrombosis with COVID-19 might have led to a greater ascertainment of events in patients with COVID-19 after case series published early in the pandemic reported high rates of these complications," they wrote. "However, no association between COVID-19 and arterial thromboembolism was observed, which might be subject to similarly increased event ascertainment."
The increased risk of death among COVID-19 patients may have been due to higher rates of thromboses that contributed to organ failure or multisystem injury, the authors said. "However, data regarding the severity of the thrombotic events were not available in this study," they wrote. "Further research is needed to understand the mechanisms for this observation."
Collage of various newspaper headlines related to the previous year's influenza pandemic, Chicago, ... [+] Illinois, 1919. Headlines include 'Police Raid Saloons in War on Influenza,' 'Flu Curfew to Sound for City Saturday Night,' and 'Open-Face Sneezers to Be Arrested.' The image was originally published in 'A Report on an Epidemic of Influenza in the City of Chicago in the Fall of 1918' by the city's Department of Health. (Photo by Chicago History Museum/Getty Images)
With all the controversy about gain-of-function research and all the concerns about how dangerous it is, you might think that scientists have stopped doing that kind of work.
Well, no.
In the latest news, a team of scientists in Canada and the U.S. report that they have re-created the 1918 influenza virus and used it to infect macaques. Lets be clear here: the 1918 flu vanished from the Earth, long ago. Its simply not a threat, or it least it wasnt, until someone figured out a way to bring it back.
Why would anyone do this? Ill get to that, but first a little background.
The 1918 flu pandemic was the worst plague since the Black Death, which occured in the mid-14th century. During World War I, a new flu virus swept the planet, killing upwards of 50 million people. It probably infected a third of the entire world population at the time.
Since Covid-19 appeared, the 1918 flu pandemic has been cited often (sometimes called the Spanish flu), usually to compare or constrast it with Covid-19. Sure, Covid is bad, but at least its not as bad as what the world experienced in 1918.
About 20 years ago, a small team of researchers led by Jeffery Taubenberger and Ann Reid figured out how to sequence the genome of the 1918 flu. In a series of papers spread over six years, they described how they recovered pieces of the flu virus from human samples that had been frozen for nearly 100 years, including corpses buried in the permafrost of Siberia and Alaska. In 2005, they reported the complete sequence in the journal Nature. Their main discovery was that the 1918 flu had originally been a bird flu, which jumped into humans sometime before 1918. Taubenberger and others, including Adolfo Garcia-Sastre at Mt. Sinai School of Medicine, also re-constructed live viruses and tested them on mice, that same year. Not surprisingly, the mice died.
It didnt take long before gain-of-function researchers said hey, why dont we reconstruct the flu virus and see what happens in primates? The tools of modern genetics make it possible to reconstruct a virus from scratch, using just the sequence.
In 2007, only two years after the 1918 flu sequence was completely decoded, influenza researcher Yoshihiro Kawaoka at the University of Tokyo and the University of Wisconsin described, in a paper in Nature, how he and his colleagues used the sequence to create live, infectious 1918 flu viruses. To test them on more human-like subjects, they infected 7 macaques with them. Not surprisingly, the macaques got severely ill, and the scientists eventually euthanized all of them.
(Insiders may recognize Kawaokas name: he and Dutch scientist Ron Fouchier are widely known for their gain-of-function research that aimed to give deadly bird flu the ability to infect mammals. Ive called them out on this in the past, and Ive openly asked why NIH was funding this work.)
In the new paper, a team of researchers at the Public Health Agency of Canada, the University of Manitoba, and Oregon Health & Science University re-created the 1918 flu virus again, and infected 15 macaques. This time they used more realistic doses, and the macaques didnt get so sick, suffering only mild or moderate disease. Maybe macaques are not ideal for the development and testing of novel pandemic influenza-specific vaccines and therapies, they concluded.
So lets review: flu scientists have been using the sequence of a long-vanished, extremely deadly virus to reconstitute the virus and infect animals, and then observe how sick they get. (Kawaoka did it a second time, in a study published in 2019.)
Why do they do it? All of the papers give essentially the same reason: these experiments, they say, will help us develop animal models in which we can test vaccines. These same justifications have been used for decades, but flu vaccines havent improved one whit, as far as I can tell.
But hold on a minute! Even if you accept their argument that infecting macaques and other animals with influenza virus will help develop better vaccines, why use the 1918 influenza virus at all?
They dont answer that question, because there really is no good answer. The fact is that the experiments will be more relevant if they use currently circulating flu strainsbecause those are the strains that we need vaccines against.
I imagine that the scientists doing this work truly believe the arguments they make, about how their work will help design better vaccines and therapies. But theyve been making similar arguments for decades, and it just hasnt played out that way.
The 1918 flu disappeared long ago, and theres no way it could possibly re-appear naturally. Theres only one way that the 1918 flu becomes a threat to human health again: through a lab leak. Re-creating the virus in a lab makes that possible.
Were still trying to figure out if Covid-19 had a natural origin or whether it started as a lab leak. Even if it turns out to have a natural source, the intense discussions about the lab leak hypothesis have been useful, because they made it clear that lab leaks happen, and that they should be considered a genuine risk.
In recognition of this risk, scientists and non-scientists alike have called for a worldwide ban on gain-of-function research. That hasnt happened yet, although NIH has issued a carefully worded statement about the kinds of work that it supports.
Most of the recent controversy over gain-of-function research has focused on research that makes viruses more deadly. I hope its clear that re-creating a deadly virus from scratch is another form of gain-of-function research, one that carries equally great risks with little or no potential benefit. We should put a halt to both types of work.
Theres an easy way to eliminate the risk that a lab leak might release the 1918 influenza virus into the human population: stop re-creating the virus. The 1918 flu disappeared from the natural world long agoor to be more precise, it evolved into a much, much milder form of influenza. The deadly form that was recently re-created in several labs does not exist in nature today. Lets keep it that way.
