Additional hours added to Easthampton COVID-19 testing site – WWLP.com

Additional hours added to Easthampton COVID-19 testing site – WWLP.com

COVID-19 Pandemic Dramatically Increased Childcare Stress Among Health Care Workers – Pharmacy Times

COVID-19 Pandemic Dramatically Increased Childcare Stress Among Health Care Workers – Pharmacy Times

August 2, 2022

Researchers found high levels of childcare stress among female and racial minority health care workers, supporting new programs and wellbeing initiatives.

A September 2021 poll revealed that 1 in 5 health care workers (HCWs) quit their job since March 2020. Pre-existing disparities and issues in the health care workforce and within the current childcare system were exacerbated because of the COVID-19 pandemic, according to the poll.

Researchers found that childcare stress (CCS) was associated with anxiety, depression, burnout (occupational stress), intent to reduce (ITR), and intent to leave (ITL) for HCWs, which were experienced at disproportionate levels across different subgroups.

The source of the study, called Coping with COVID, is a 14-item survey looking at several demographic items, such as race, ethnicity, gender, years in practice, outpatient vs inpatient practice environment, and work role between April-December 2020.

Although many questions were asked for HCWs to self-evaluate, the only item that was used to analyze CCS was the statement, due toCOVID-19, I am experiencing concerns about childcare.

A total of 58,408 participants answered this question using a scale between 1 and 4. A participant experienced CCS if they answered 3 or 4 on the scale. If the answer was 1, there was no CCS, and if they responded 4, they experienced a high degree of CCS.

The findings highlighted that racial and ethnic minority groups experienced CCS 40%-50% more than white respondents. Women also had 22% greater odds of reporting CCS than men; however, burnout was significant among all high CCS respondents. Although all workers with CCS were 80% more likely to have burnout than their low CCS counterparts, women reported burnout with 50% greater odds than men.

Other models further revealed that ITR for HCWs was higher in women than men, but any worker experiencing CCS was 91% more likely to report ITR. Additionally, logistical regressions for all workers noted similar ITL in both men and women.

All participants with CCS were more than 100% more likely to be anxious or depressed. Similar to the ITR and ITL findings, women were more likely to experience these symptoms.

The researchers noted a significant study limitation around the findings being based on self-reported answers. Other limitations include an unequivocal ratio of responders, a chaotic and unusual situation due to the pandemic, and confounding associations between CCS and whether it influenced burnout, or whether burnout influenced facets, such as ITL and ITR.

CCS was ultimately more prevalent in women HCWs, racial and ethnic minority groups, and people who have been in practice for more than 5 years. Researchers propose collecting more data on racial equity and increasing accessible childcare for HCW well-being. With an intentional approach, the health care workplace should address these childcare concerns.

Reference

Elizabeth M. Harry, MD,; Lindsey E. Carlasare, MBA; Christine A. Sinsky, MD; et al. Childcare Stress, Burnout, and Intent to Reduce Hours or Leave the Job During the COVID-19 Pandemic Among US Health Care Workers. JAMA Netw Open. 2022;5(7):e2221776. doi:10.1001. Accessed July 19, 2022.


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COVID-19 Pandemic Dramatically Increased Childcare Stress Among Health Care Workers - Pharmacy Times
COVID-19 mRNA vaccine effectiveness against hospitalisation and death in veterans according to frailty status during the SARS-CoV-2 delta (B.1.617.2)…
Biden tests positive for Covid-19 again  in a case of ‘Paxlovid rebound’ – STAT

Biden tests positive for Covid-19 again in a case of ‘Paxlovid rebound’ – STAT

July 31, 2022

President Biden tested positive for the coronavirus again Saturday, the White House said, an example of Covid-19 rebound that can occur after people take the oral antiviral Paxlovid.

Biden is not experiencing any symptoms but is isolating again, according to his physician, Kevin OConnor. Biden, who is vaccinated and has received two boosters, is not starting any Covid treatments at this time.

Biden, 79, first tested positive on July 21, and after a mild case, tested negative this past Tuesday. He tested negative each day the rest of the week the White House said he had upped his testing frequency following his infection but tested positive again Saturday morning.

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This in fact represents rebound positivity, OConnor wrote in a memo Saturday.

Such rebound cases following treatment with Pfizers five-day oral antiviral have stumped physicians as theyve tried to understand how frequently its occurring and whats allowing the virus to come back a second time.

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While some rebound cases are asymptomatic like Bidens thus far other people see their symptoms return.

Rebound cases have raised such questions as whether Paxlovid should be prescribed for longer courses and for which patients it should be recommended.

Pfizers clinical trials showed rebound in 1% to 2% of patients, but in both patients who took Paxlovid and those who received placebo. But there have been enough anecdotes about Paxlovid rebound that many infectious disease physicians believe the rate could be higher. Anthony Fauci also had a rebound case after taking Paxlovid.

One theory for whats allowing rebound is that the drug wipes out most of the virus before the body has a chance to recognize whats happening and build up its full immune arsenal. If there are little pockets that manage to survive the treatment, they can start replicating again once the course of Paxlovid is finished. Other experts have wondered if it has something to do with the Omicron variant specifically. (The trials took place when the Delta variant was dominant.)

Research to determine the cause is ongoing.


Read the original: Biden tests positive for Covid-19 again in a case of 'Paxlovid rebound' - STAT
How the Covid-19 Pandemic Changed Americans Health for the Worse – The Wall Street Journal

How the Covid-19 Pandemic Changed Americans Health for the Worse – The Wall Street Journal

July 31, 2022

The ripple effects of the Covid-19 pandemics influence on nearly every aspect of health in America are becoming clear.

Covid-19 has killed more than one million people in the U.S., a toll mounting by some 350 people a day. A range of other chronic diseases and acute threats to health also worsened during the pandemic, data show, as people missed screenings, abandoned routines and experienced loss and isolation.


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How the Covid-19 Pandemic Changed Americans Health for the Worse - The Wall Street Journal
Lambeth seminar explores ‘Models of Partnership’ in the wake of COVID-19 – Episcopal News Service

Lambeth seminar explores ‘Models of Partnership’ in the wake of COVID-19 – Episcopal News Service

July 31, 2022

Texas Bishop Andy Doyle, left, Bishop Christopher Chessun of the Diocese of Southwark in the Church of England, and Bishop Pradeep Samantaroy of the Diocese of Amritsar in the Church of North India, right, spoke during a seminar on Models of Partnership co-chaired by the Rev. Stephanie Spellers, canon to the presiding bishop for evangelism, reconciliation and creation care, at the microphone, on July 30. Photo: Lynette Wilson/Episcopal News Service

[Episcopal News Service Canterbury, England] The COVID-19 pandemic has cast a light on well-entrenched global inequality and inequity, a fact that will likely re-shape and challenge the way churches engage in 21st-century partnerships.

That reality came into focus for Bishop Pradeep Samantaroy, of the Diocese of Amritsar in the Church of North India, during the start of the COVID-19 pandemic, when the world went into lockdown. As he began to get to know his own neighbors in his immediate community, he was reminded that God entrusts us to love our neighbors.

Extending the love thy neighbor sentiment into partnership relationships can lead to discovering your neighbor in unexpected places, Samantaroy said.

He was one of three Anglican and Episcopal bishops to talk about partnerships during a July 30 seminar at the Lambeth Conference on Models of Partnership, which explored the promise of mutual, interdependent church and diocesan partnerships across the globe. The other bishops were Texas Bishop Andy Doyle and Southwark Bishop Christopher Chessun, of the Church of England.

The Lambeth seminars focus on building relationships across the Anglican Communion, highlighting a variety of voices and offering an opportunity to learn about ministry in context while discussing issues impacting church life and the world today. The seminars will take place on designated days throughout the conference. In addition to Models of Partnership, topics discussed on July 30 included, Thy Kingdom Come: Life-changing Prayer for Evangelism, Leading with Integrity with Those of Other Faiths and Missional Formation with Young People.

In the wake of the COVID-19 pandemic, the poor have become poorer and the most vulnerable and desperate have suffered disproportionately, said the Rev. Stephanie Spellers, canon to the presiding bishop for evangelism, reconciliation and creation care. Spellers co-chaired and moderated the Models of Partnership seminar alongside Archbishop Nick Drayson, primate of the Anglican Church of South America and bishop of Northern Argentina.

Weve known these inequities and inequalities were part of our common life, but COVID-19 has shed light on the pain all around. Lives on the line, for all to see, Spellers said. Now more than ever, she added, its important to ask, How do we walk together, partner together, pursue the will and kingdom of God together?

It was an important topic before, she said, and one that feels more urgent now that we are here together. [There is] much that separates us: geography, economics, theology, ideology. Those differences can keep us apart, keep us from making common cause in the gospel. Pray they do not.

One way to approach partnership across differences is through the heart, as Samantaroy explained.

Partnership is a matter of heart. We are human beings and have minds and sometimes we are swayed away by our thinking and forget that in heart we feel something different. The language of heart is huge, he said.

If you approach partnership through the heart, partnership has no boundaries.

In England, the approach has always been to care for those in your immediate parish community, said Chessun, who has been the bishop of Southwark since 2011. But when he arrived in the community, it was pretty siloed.

He recommended speaking well of one another and modeling that behavior in all structures and relationships. Embracing diversity isnt always easy. Good disagreement is a result of understanding [and] presuming the good faith of the other person even when they dont presume yours.

Doyle looks at partnership as an invitation to be holy and as a form of living out the mission that is given to us as a form of Gods love into the world. And by no means is that going to be we are aspiring to holiness, he said. And given all this, this life I believe is lived out in kinship.

That kinship comes partly through the idea of welcoming the stranger.

I dont make the kinship Kinship is given as a gift of God who is Trinity, he said. And Gods perfect love in the spirit is pouring out to all people in creation and that this kind of heavy theology, gives us an understanding that there are no limits to the vision of Jesus in the world.


Excerpt from: Lambeth seminar explores 'Models of Partnership' in the wake of COVID-19 - Episcopal News Service
Covid-19, Gender And Immune Response: What’s The Relationship? – Forbes

Covid-19, Gender And Immune Response: What’s The Relationship? – Forbes

July 31, 2022

This is the first installment in a two part series which analyzes biological sex differences in immune responses to SARS-CoV-2 infection. This article focuses primarily on Covid-19 related viral entry as well as innate and adaptive immune responses Covid-19 and their correlation to epidemiological evidence. Part two will highlight the role of sex hormones in SARS-CoV-2 immune responses, examine sex differences in response to several vaccines, and consider their possible therapeutic implications.

Paper cut out illustration of a man and woman facing each other

Men and women experience Covid-19 differently. Epidemiological studies show that, while males and females have similar infection rates, males are more likely to experience severe Covid-19 and die from SAR-CoV-2 infection. Women tend to have better prognoses; pregnant females are the exception, as they have an increased risk of severe illness, hospitalization, intensive care unit (ICU) admission, mortality and preterm delivery. After excluding societal and behavioral factors, a question remains: what are the biological mechanisms driving these observed differences? Ho et al. attempt to answer this question in their review, The Immune Response to Covid-19: Does sex matter? They consider several biological mechanisms in their work. This article will specifically examine differences in three stages of SARS-CoV-2 immune response: viral entry, activation of host innate immunity, and activation of adaptive immunity.

Sex Differences in SARS-CoV-2 Immune Response

Immune interaction to SARS-CoV-2 entails viral entry, then recognition of the virus and activation of host innate immunity, followed by activation of adaptive immunity. Ho et al. found several potential mechanisms in these three stages which may explain the stronger immune responses seen in females.

Viral Entry

In viral entry, SARS-CoV-2 attaches to and enters the host cell by binding to the angiotensin-converting enzyme 2 (ACE2) receptors in upper respiratory tract cells. ACE2 receptors usually decrease inflammation, but the binding alters this function. As a result, ACE2 receptors critically influence SARS-CoV-2 entry to cells and can worsen SARS-CoV-2-caused tissue damage through inflammation.

Ho et al. explain some known sex differences in ACE2 levels which could contribue to in the worse clinical outcomes seen in men. Some studies show that men express higher levels of ACE2, a factor which might increase vulnerability to infection. Males and females have similar soluble ACE2 (sACE2) levels up until 12 years old; after, male sACE2 levels exceed levels found in females. One paper demonstrated that females required a lower dose of ACE inhibitors to achieve optimal therapeutic effect. These data demonstrate potential in targeting ACE2 for Covid-19 treatments and for study on SARS-CoV-2 viral susceptibility, but Ho et al. note that more research is needed to further understand this relationship.

Innate Immunity

Sex differences were also found when comparing innate immune responses. The initial innate immune response involves viral detection, interferon (IFN) production and inflammasome activation. Innate immune responses are considered crucial to determining disease outcome.

Ho et al. found that females exhibit stronger innate immune responses than their male counterparts. This is seen in sex-specific expression of toll-like receptor 7 (TLR7). Toll-like receptor 7 is important for detecting single RNA viruses such as SARS-CoV-2. It is believed that the more toll-like receptor 7 is expressed, the quicker Covid-19 can be recognized and cleared from the system. Toll-like receptor 7 expression can be upregulated by female sex steroid estrogen. It is also thought to escape X chromosome inactivation in some cells; by evading inactivation, toll-like receptor 7 is therefore expressed more highly in females, who have two copies of the X chromosome.

Interferon (IFN) production involves the creation of proteins called cytokines which aid viral suppression after viral recognition. Chemokines, such as interferons, are a subclass of cytokines which encourage immune cells to move towards a target. Important to note are plasmacytoid dendritic cells (pDCs), immune cells which secrete interferons in response to viral infection.

Women have higher plasma concentrations of IFN and can produce more IFN from plasmacytoid dendritic cells (pDCs) than men due to estrogen. They express greater INF regulatory 5 (IFN5), a significant transcription factor in IFN signaling, in their plasmacytoid dendritic cells than males as well. In contrast, one study found that autoantibodies inhibited type I IFN signaling in older males with severe Covid-19.

The last consideration of innate immunity revolves around pro-inflammatory cytokines. Clinical studies associate increased inflammatory cytokine levels with severe Covid-19 pathology. In some cases, elevated cytokine levels lead to a cytokine storm: the flooding of cytokines in the bloodstream that damages tissues and organs.

In this regard, males typically have higher levels of innate proinflammatory cytokines such as interleukin 8 (IL-8) and 18 (IL-18) than their female counterparts. They also have higher serum levels of IL-8, IL-18 and chemokine ligand 5 (CCL5). A significant correlation exists between high IL-8 levels and reduction in antiviral white blood cells. In comparison, research suggests the lower levels of cytokine levelsinterleukin 6 (IL-6) especiallyseen in women with Covid-19 are associated with better clinical outcomes; this is unusual, as women typically have stronger cytokine responses than men.

Adaptive Immunity

Adaptive immunity is a specialized mechanism which deploys immune cells (lymphocytes) and antibodies to target and destroy pathogens directly. Ho et al. observed sex differences in antibody production, T cell responses and the epigenetic status of immune cells.

Generally, females show higher antibody-mediated immune responses to viral infection and vaccination. This positive effect could be tempered by the greater autoreactivity also noted in this sex. Elevated humoral responses in women could be influenced by several estrogen-mediated mechanisms, including but not limited to germinal center formation, selection against autoreactive B cells, and epigenetic accessibility of B-cell specific loci.

Sex-different T cell interactions seem to impact Covid-19 recovery. Men with Covid-19 have weaker T cell activation during early disease than women; in comparison, elderly women with early Covid-19 have more robust T-cell activation. Weak T cell activation, in conjunction with lower lymphocyte count, higher neutrophil-to-lymphocyte ratio, and greater serum C-reactive protein (CRP) concentrations, could explain the poorer outcomes seen in males with Covid-19. Ho et al. state more research is necessary to understand sex differences in the role of T cells in acute infection, lung injury, and vaccine targets.

Another divergence seen in adaptive immunity is in the epigenetic status of immune cellsin other words, physical changes in immune cell DNA structure which do not impact its genetic sequence. One example of this is aging. Between ages 62 to 64 years, males undergo changes in epigenetic landscape which majorly impact the immune system. There is increased expression of innate proinflammatory genes and decreased expression of adaptive immune system genes. In addition, B cell levels and nave T cell levels decline faster in older men than in their female counterparts. Women exhibit similar epigenetic changes approximately five to six years later than men. A possible biological mechanism is the overexpression of immune genes on the X chromosome of T cells. This overexpression seems to correlate with incomplete X inactivationas similarly seen in toll-like receptor 7 expressionand epigenetic modifications.

Conclusions

Current knowledge of immunity suggests that strong innate immune responses likely contribute to the lower disease severity and mortality outcomes associated with females. Elevated levels of toll-like receptor 7 and IFN, along with decreased levels of interleukin 6, may correlate to better prognoses in women. On the other hand, the worse clinical outcomes observed in men could be explained by their higher levels of ACE2 and epigenetic changes in their immune cells, These mechanisms leave important clues to understanding the relationship between biological sex and immune responses to SARS-CoV-2 infection, but these associations are not linear. More research is needed to further our understanding.


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Reporting of Positive Home COVID-19 Tests May Depend on Where You Live – Livermore Independent

Reporting of Positive Home COVID-19 Tests May Depend on Where You Live – Livermore Independent

July 31, 2022

Two lines appear on your at-home COVID-19 test, indicating you've tested positive. Now what?

The answer can vary by county. Public health officials at the state and local level have advised that those who test positive stay home for at least five days if they have symptoms.

After five days, a negative test and improved symptoms are generally the ticket out of isolation. People are also not encouraged to seek additional PCR testing after the initial positive antigen test, which is sufficient on its own to seek treatment such as antiviral medication.

Across the Bay Area and Central Coast, only Marin and Sonoma counties encourage residents to report their at-home test results. Those who report a positive test will subsequently receive isolation and treatment guidelines and resources.

The other nine counties in the region either do not accept results from at-home tests or only request them in the context of an outbreak at a workplace, office, or school. Those seeking to report an outbreak can do so via the School and Shared Portal for Outbreak Tracking, which is run out of the California Department of Public Health.

The increase in easily available at-home tests has lessened the testing burden on local public health agencies and larger multi-county health care providers, but officials have noted that fewer and fewer test results are being recorded at testing sites run by local governments or health care providers, both of which do report their positive COVID tests to the CDPH.

As a result, health officials have said in recent months, the true number of active COVID cases at any one time is likely higher than the figures that are tracked and publicly available.

"The testing in the community is now people testing at home, the antigen tests," San Mateo County Health Chief Louise Rogers told the county's Board of Supervisors Tuesday. "Which is great that it's so accessible, but we don't receive those results."

Health officials have pivoted away from tracking raw COVID case numbers as an indicator of local virus transmission, focusing instead on hospitalizations, intensive care unit admissions and the amount of virus present in local wastewater systems. In any case, those who test positive are encouraged to contact their health care provider for further instruction on treatment, isolation and contact tracing.

COVID-positive people should also alert potential close contacts that they may have been exposed to the virus.

Full guidance from the CDPH about isolation after a positive COVID test can be found at bit.ly/3PwXfUg. In addition, specific COVID-positive guidance in a given county can be found via a county's public health department. Those living in Marin County can report their positive at-home COVID test at bit.ly/3RIxuSx. Sonoma County residents can do the same at bit.ly/3RN8jhA.


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Spread of COVID-19 appears to be slowing in San Diego County – The San Diego Union-Tribune

Spread of COVID-19 appears to be slowing in San Diego County – The San Diego Union-Tribune

July 31, 2022

Coronavirus activity in San Diego County continues to increase, but slowed significantly in the past week, providing a bit of positive news as doses of Novavax, the latest COVID-19 vaccine, begin to arrive.

The latest wastewater data shows that the amount of virus detected in effluent increased from 15.5 million to 19.8 million coronavirus copies per liter of sewage as of Tuesday, before falling to 18.1 million Wednesday. That figure represents a 17 percent increase over a week earlier, but is much less robust than the spike from 8.1 million to 15.5 million observed from July 13 to July 20.

Confirmed cases, though, have not tracked wastewater trends as closely as they have in the past. There were 1,678 positive test results communicated to the countys epidemiology department Wednesday, 329 fewer than the 2,007 cases reported one week earlier.

The previous pattern was for wastewater to increase first, followed by case rates, and to begin declining a bit before cases did.

Why that doesnt seem to be the case at the moment has not yet been fully explained, but Dr. Cameron Kaiser, deputy public health officer for the county health department, said the move to home testing certainly plays a role. County testing centers, he said, are performing about half as many tests as they did during the winter Omicron wave, and home tests generally dont get reported. It also may be that BA.5, the current dominant coronavirus subvariant, causes infected people to shed more virus than previous versions of the virus did, he said.

If theyre shedding more virus per case, then thats a potential explanation, and there is some anecdotal evidence to suggest that this might be true for the early Omicron variants like BA.2, Kaiser said. BA.5 is really too new for us to know how big an effect this is.

Thus far, BA.5 is not showing an ability to cause problems in hospitals as Omicron did.

There were 450 confirmed and suspected patients with positive COVID-19 tests in local non-military hospital beds Thursday, slightly lower than the 473 reported one week earlier.

Kaiser said that county monoclonal antibody clinics, which offer a treatment for those newly infected that can significantly decrease the odds of developing severe illness, have recently been quite busy. Such treatment, he said, is likely contributing to COVIDs lower hospital impact, which surpassed 1,200 occupied beds this past winter.

People are definitely getting sick enough to seek treatment, but thats keeping them out of the hospital, Kaiser said.

A loss of critical health care workers due to widespread transmission of the virus causing a wave of sick calls, as occurred with the Omicron wave in late December and early January, seems to have so far been avoided. Sharp HealthCare, the regions largest medical provider, indicated that callouts have held steady at about 500 per day out of its more than 20,000 employees.

A significant update to the vaccination arsenal is also starting to arrive.

It took about two weeks for the Novavax vaccine, approved by the U.S. Food and Drug Administration on July 13, to start showing up in vaccination clinics and medical provider pharmacies, but officials reported receiving shipments this week.

Virologist Shane Crotty at the La Jolla Institute for Immunology collaborated with the vaccines manufacturer to confirm its potency, publishing two recent papers that compared Novavax to mRNA vaccines already in wide circulation.

The data indicate that it, broadly speaking, works just as well as the mRNA vaccine, Crotty said in an interview earlier this month.

Unlike mRNA versions from Pfizer and Moderna, the Novavax product is more traditional, delivering coronavirus spike proteins grown in moth cells. These spikes are harvested and packaged into a vaccine with helper compounds made from chemicals found in tree bark that help activate an immune system response. By comparison, mRNA vaccines use snippets of genetic code to prod the bodys own cells to make coronavirus proteins that can train the immune system to recognize coronavirus.

This different route might help produce a response in those with weak immune systems who did not benefit from mRNA inoculation, he said.

If a person gets two shots of an mRNA vaccine, and they respond poorly, yes, I think it probably makes sense for them and their physicians to say, well, OK, lets try Novavax, Crotty said.

There is also some hope that those who have so far refused to get vaccinated might decide that the Novavax shot, because of its more traditional manufacturing method, is acceptable.

In San Diego County, which surpassed 3 million residents with at least one dose on July 14, about 340,000 eligible residents age 6 months and older remain unvaccinated. And an additional 350,000 got their first dose but not their second.

If concern over the manufacturing method is what led people to look for another option, then I have great hopes that Novavax can be that option, Kaiser said.

He pushed back against those who look at dramatically lower COVID-19 death rates and decline to move forward. Thus far, he said, there have been 35 COVID-related deaths in June and 31 in July, though the case review process often causes long delays before deaths are added to the official count.

We dont see months with more than 30 deaths very often with the flu, and certainly not in summertime, Kaiser said.

Novavax is approved only for those age 18 and older.


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Spread of COVID-19 appears to be slowing in San Diego County - The San Diego Union-Tribune
How long-term Covid-19 immunity paves the way for universal Covid-19 vaccines – Vox.com

How long-term Covid-19 immunity paves the way for universal Covid-19 vaccines – Vox.com

July 31, 2022

This week, the White House held a summit on the future of Covid-19 vaccines that brought together scientists and vaccine manufacturers to discuss new vaccine technologies. Officials said that new vaccines are an urgent priority as US Covid-19 cases and hospitalizations are rising once again, vaccination rates are hitting a plateau, Covid-19 funding is running low, and the virus itself is continuing to mutate.

But in recent months, scientists have also learned that the immune cells that provide lasting protection known as memory B cells and T cells can keep the worst effects of the most recent versions of the virus at bay, even if they were trained to corral older strains of SARS-CoV-2. Vaccine researchers are expanding their focus from antibodies to these memory immune cells as the new discoveries open a path toward universal coronavirus vaccines.

Universal vaccines, however, are still a long way off possibly years drawing on approaches never used before. Thats a scientific challenge, said Anthony Fauci, chief medical adviser to the president, during the summit.

The good news is that far fewer people are dying from the disease compared to the wave of cases this past winter spurred by the omicron variant of SARS-CoV-2, the virus that causes Covid-19. The first round of Covid-19 vaccines is still holding death rates down to around 360 per day, according to the Centers for Disease Control and Prevention. Still, health officials want to do better.

While the vaccines are terrific, hundreds of Americans, thousands of people around the world are still dying every day, Ashish Jha, the White House Covid-19 response coordinator, said Tuesday. Building a new generation of vaccines will make an enormous difference to bringing this pandemic to an end.

The National Institutes of Health is already funding several research teams developing Covid-19 vaccines that elicit protection against many different versions of the virus, shield against future changes to the virus before they arise, and protect against other coronaviruses.

From there, health officials are aiming not just to develop vaccines that provide more durable protection against a wider array of threats, but also rethinking the vaccination strategy overall. With a better understanding of long-term immunity, more robust vaccines, and a comprehensive public health approach, health officials say they have a better shot at restoring normalcy.

Much of the discussion around vaccines and immunity to Covid-19 centers on antibodies, proteins produced by the immune system that attach to the virus. And indeed, they are important.

Antibodies that prevent the virus from causing an infection in the first place are called neutralizing antibodies. A high concentration of antibodies in the body that blocks SARS-CoV-2 is a key indicator of good protection against reinfection. Antibodies can also serve as a way to mark intruders so that other immune system cells can dispose of them.

But making large quantities of antibodies takes a lot of resources from the body, so their production tapers off with time after an infection or a vaccination. Another concern is that antibodies are very particular about where they attach to the virus. If the virus has a mutation at that attachment site called an epitope antibodies have a harder time recognizing the pathogen. Thats why some antibody-based treatments for Covid-19 are a lot less effective at stopping the omicron subvariants.

Fortunately, the immune system has other tools in its chest. Inside bone marrow lie stem cells that differentiate to become B cells and T cells. Together, they form the core of the adaptive immune system, which creates a tailored response to threats. After a virus invades a cell, it hijacks its machinery to make copies of itself. White blood cells known as cytotoxic T cells, a.k.a. killer T cells, can identify the wayward cell and make it self-destruct. This mechanism doesnt prevent infections, but it stops them from growing out of control.

Another type of T cell, called a helper T cell, acts as an on switch for B cells, which are the cells that manufacture antibodies. After an infection is extinguished, some T cells and B cells turn into memory cells that stick around in parts of the body, ready to rev up if a virus dares to show up again.

So far, the adaptive immune system seems to hold up pretty well. The first round of Covid-19 vaccines was targeted against the earliest versions of the virus, so plenty of vaccinated people have had breakthrough infections, especially from the newer variants. But only a tiny fraction of those immunized have fallen severely ill or have died.

That likely means that their immune systems couldnt keep the virus out entirely, but their immune cells were able to spool up once an infection took root.

Someones neutralizing antibodies may not be up to the task, but if they have the T cell response, that may make all the difference with severe disease, said Stephen Jameson, a professor of microbiology and immunology at the University of Minnesota.

In just the past year, many studies have borne out the significance of memory B cells and T cells for long-term Covid-19 immunity and answered critical questions about whether they can respond to new variants.

Researchers have found that lower levels of memory B cells were associated with a greater risk of breakthrough infections from the delta variant. On the other hand, B cells induced by Covid-19 vaccines could reactivate months out from the initial vaccine doses to churn out antibodies.

Similarly, scientists found that T cells generated by vaccines were able to recognize SARS-CoV-2 variants like omicron months later. These data provide reasons for optimism, as most vaccine-elicited T cell responses remain capable of recognizing all known SARS-CoV-2 variants, scientists wrote in a March paper in the journal Cell.

Another study showed that Covid-19 vaccines generated strong T cell memory that protected against the virus even without neutralizing antibodies. I think the immunological memory which is induced by vaccines is pretty good and is actually sustained, said Marulasiddappa Suresh, a professor of immunology at the University of Wisconsin-Madison who co-authored the study, published in the Proceedings of the National Academy of Sciences in May.

Whether this protection will hold up over the course of years remains to be seen. Experiences with past coronaviruses like MERS showed that antibodies to the virus can last for four years. Covid-19, however, is spreading at much higher levels and mutating more than MERS did during its initial outbreak. Future protection against the disease hinges on the immune system as well as how much the virus itself will change, and scientists are closely watching both.

Most vaccines to date are designed to counter one or a handful of versions of a given virus. They present the immune system with a target that allows it to prepare its defenses should the actual virus ever invade.

In the case of Covid-19, most vaccines coach the immune system to target the spike protein of the SARS-CoV-2 virus, which it uses to start the infection process. This helps the immune system generate strong neutralizing antibodies. But the spike protein is one of the fastest mutating parts of the virus, making it a moving target.

The fact that B cells and T cells have managed to hold off newer variants hints that it may be possible to target the virus in other ways. Rather than just making neutralizing antibodies that attach to the spike, the adaptive immune system could also produce non-neutralizing antibodies that bind to other regions of the virus that mutate very little, if at all. While these antibodies may not block an infection from taking root, they may be able to provide more durable protection against severe illness that holds up against future SARS-CoV-2 variants.

Another approach is to present the immune system with a variety of different potential mutations of a virus, allowing white blood cells to prepare a response to a spectrum of threats and fill in the blanks.

Universal vaccines have not been deployed before, so researchers are in uncharted territory, and the shots likely wont be ready ahead of a potential fall spike in Covid-19 cases. But developing such a vaccine could eventually reduce the need for boosters and give health officials a head start on countering future outbreaks.

In the meantime, US health officials are planning to distribute vaccines reformulated to target newer Covid-19 variants by September, but its not clear yet what the optimal strategy will be to deploy them given the wide range of immune protection across the population. Between infections and vaccinations, the majority of people in the country have had some exposure to the virus, granting some degree of protection. And since the adaptive immune response to Covid-19 seems to be robust in most people, it may not be necessary for everyone to get an additional shot.

One option is to seek out those with weaker immune systems for boosters. Researchers have now developed a rapid test to measure T cell responses to Covid-19 that could identify people who are more vulnerable to reinfections or breakthrough infections.

Though vaccines are absorbing the most severe consequences from Covid-19, infections are still proving disruptive. Covid-19 outbreaks are contributing to staffing shortages at hospitals, schools, and airlines, leading to delays and cancellations. And the more the virus spreads, the more opportunities it has to mutate in dangerous ways. Stopping this threat requires limiting infections, which in turn still demands measures like social distancing and wearing face masks.

So as good as the next generation of vaccines may prove to be, they are only one element of a comprehensive public health strategy for containing a disease.


View original post here: How long-term Covid-19 immunity paves the way for universal Covid-19 vaccines - Vox.com
Theres no evidence the Pfizer COVID-19 vaccine is connected to the monkeypox outbreak – PolitiFact

Theres no evidence the Pfizer COVID-19 vaccine is connected to the monkeypox outbreak – PolitiFact

July 31, 2022

How are monkeypox cases, COVID-19 vaccines and shingles infections connected? They are not.

But if you believe claims circulating online, they are linked to a group of global elites who are using the coronavirus "as a tool to reorganize global societies and economies to their benefit at the expense of ordinary people, with the ultimate goal of a global totalitarian regime," according to the Anti-Defamation League.

Those claims are part of "The Great Reset" conspiracy theory, which PolitiFact has repeatedly debunked. Other news outlets have also dismissed the idea as unsubstantiated.

One article pushing the narrative that monkeypox is tied to this conspiracy theory appeared on The Expos, a U.K.-focused blog that has repeatedly spread misinformation about the pandemic and COVID-19 vaccine.

"Monkeypox is only circulating in countries where the Pfizer vaccine has been distributed and is being used to advance a Technocratic Great Reset," read a July 24 Expos headline.

The article claimed that the monkeypox outbreak is actually shingles cases caused by Pfizers COVID-19 vaccines.

"Were seeing the consequences of injecting millions of people with an experimental mRNA injection that causes untold damage to the immune system," the article said. "And public health authorities are now scrambling to cover up COVID-19 vaccine-induced shingles and using it as an opportunity to advance their technocratic agenda of implementing The Great Reset."

The article was flagged as part of Facebooks efforts to combat false news and misinformation on its News Feed. (Read more about our partnership with Facebook.)

Available evidence directly refutes the articles claims.

COVID-19 vaccines are safe and effective

Pfizers mRNA vaccine, marketed as Comirnaty, in August 2021 became the first COVID-19 vaccine to achieve full approval from the U.S. Food and Drug Administration. Millions of people have received the two-dose Pfizer vaccine, which is a safe and effective way to prevent COVID-19.

A nurse gives a child, aged 5, the first dose of the Pfizer vaccine on Nov. 6, 2021. This was the first time children aged 5 to 11 across the United States had the opportunity to get immunized against COVID-19. (AP)

In the seven days after vaccination, it is common to experience mild side effects including fever, chills, fatigue or headaches, according to the Centers for Disease Control and Prevention. More severe side effects including severe allergic reactions or myocarditis and pericarditis (especially for males ages 12 to 39) are rare but can happen.

Some countries reporting monkeypox cases arent using the Pfizer vaccine

Pfizer told PolitiFact it had agreements to provide its vaccine to more than 140 countries.

As of July 28, cases of monkeypox have been reported in 77 countries, including 71 countries that have not historically reported monkeypox, the CDC reported.

A map on Pfizers website shows where it has shipped vaccines, and a map on the CDCs site also shows monkeypox cases around the world.

Comparing these maps shows that the articles claim that monkeypox is "only circulating" where the Pfizer vaccine was distributed is false.

Venezuela reported one case of monkeypox as of July 28, but Pfizers map does not show any shipments of COVID-19 vaccines. Venezuela has approved the use of Russian COVID-19 vaccines Sputnik V and Sputnik Light, Cubas Abdala and Soberana COVID-19 vaccines and the Sinopharm and Sinovac vaccines from China, according to the U.S. Embassy in Venezuela.

India reported four cases of monkeypox as of July 28. Pfizer has not sent COVID-19 vaccines to India, according to its map last updated July 3.

India is currently distributing four vaccines, per the BBC: the Oxford-AstraZeneca vaccine, Corbevax, Covaxin and Sputnik V.

Also, not all the countries that received Pfizer vaccines have reported monkeypox cases. As of July 28, for example, Indonesia has not reported any monkeypox cases, but Pfizer has shipped nearly 69 million doses of the COVID-19 vaccine there.

A medical worker shows vials of the Pfizer COVID-19 vaccine during a vaccination campaign at the Patriot Candrabhaga Stadium in Bekasi on the outskirts of Jakarta, Indonesia, on Feb. 8, 2022. (AP)

Monkeypox and shingles differ in many ways

The CDC tracks adverse events reported after COVID-19 vaccinations, and has not indicated that the vaccines cause shingles.

Nearly 10,000 cases of shingles have been reported to the CDC and FDAs Vaccine Adverse Event Reporting System after doses of the Pfizer vaccine. This does not mean the vaccines caused shingles.

VAERS is an open system, meaning anyone can submit a report to the database, "regardless of seriousness, and regardless of how likely the vaccine may have been to have caused the adverse event," per the CDC. On one occasion, a doctor said hed submitted a report that a flu vaccine had turned him into the Hulk; that report was accepted and remained in the database for some time, he said.

Pfizer said it has not seen data that suggests its COVID-19 vaccine causes shingles.

Monkeypox and shingles cause skin rashes, but they look different on the body.

Shingles causes a painful rash that typically "occurs in a single stripe around either the left or the right side of the body" or on one side of the face, according to the CDC. In contrast, monkeypox causes "a rash that can look like pimples or blisters that appears on the face, inside the mouth, and on other parts of the body, like the hands, feet, chest, genitals, or anus."

This image provided by the National Institute of Allergy and Infectious Diseases shows a colorized transmission electron micrograph of monkeypox particles (red) found within an infected cell (blue). (NIAID via AP)

The diseases are also caused by different viruses: Monkeypox is caused by an orthopoxvirus; shingles is caused by reactivation of the varicella zoster virus that also causes chickenpox.

Our ruling

A blog post claimed that monkeypox "is only circulating in countries where the Pfizer vaccine has been distributed and is being used to advance a Technocratic Great Reset."

"The Great Reset" is an unsubstantiated and widely debunked conspiracy theory. Monkeypox has been reported in countries that dont have Pfizers COVID-19 vaccine. And there are countries that received Pfizers vaccine that have not yet reported monkeypox cases.

We rate this claim False.

RELATED: Shingles-monkeypox claim misleads with false flu-COVID-19 theory

RELATED: No, the COVID-19 vaccines are not weapons of mass destruction

RELATED: Federal VAERS database is a critical tool for researchers, but a breeding ground for misinformation


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Theres no evidence the Pfizer COVID-19 vaccine is connected to the monkeypox outbreak - PolitiFact