4 The Record: The state of COVID-19 today
Updated: 11:30 AM EST Feb 25, 2024
WELCOME TO. FOR THE RECORD, IM KRISTEN POWERS THIS MORNING. WERE LOOKING AT COVID 19 TODAY. SINCE THE PANDEMIC HIT, WEVE LEARNED A LOT MORE ABOUT THE DISEASE AND THERE HAVE BEEN ADVANCEMENTS IN PREVENTION AND TREATMENT. NOW, WHILE IT MAY NOT BE TOP OF MIND ANYMORE, COVID IS STILL A REALITY AND IMPACTING MANY PEOPLE. JAN THREE OF 2020. THE FIRST CONFIRMED CASE OF COVID 19 IN THE U.S. LESS. THAN TWO MONTHS LATER, IN MARCH, THE FIRST IN ALLEGHENY COUNTY. NOW, IN EARLY 2024, VACCINATION AND TREATMENTS ARE SAVING COUNTLESS LIVES. ITS BECOME SO MUCH MORE MANAGEABLE. VACCINES, ANTIVIRALS, WASTEWATER MONITORING, HOME TESTS AND WEVE GOT THIS ABILITY NOW TO DECOUPLE THOSE CASES FROM SEVERE DISEASE AND HOSPITALIZATIONS. WERE SPEAKING WITH AN INFECTIOUS DISEASE PHYSICIAN ABOUT THE CURRENT STATE OF COVID 19 AND THE PROGRESS WEVE MADE SINCE THE PANDEMIC WAS DECLARED. PLUS, WERE LEARNING ABOUT THE STUDY THAT UPMC MAGEE-WOMENS HOSPITAL IS TAKING PART IN LOOKING AT IMMUNE RESPONSE TO THE VACCINE IN PREGNANT WOMEN AND THEIR BABIES. A COMMON THEME THAT YOU HEAR FROM THE WOMEN THAT ARE ROLLING THESE STUDIES WHEN THEYRE PREGNANT IS, I WANT TO TRY AND HELP OTHER WOMEN. AND FOR SOME, THE HEALTH IMPACTS CONTINUE EVEN AFTER THEY FINALLY TEST NEGATIVE. BEING HERE, IM FEELING OKAY, BUT I KNOW ILL PAY FOR IT TOMORROW AND PROBABLY THE NEXT DAY. ANYTIME I DO ANYTHING PRETTY LARGE, IM IM DOWN FOR THE COUNT FOR ABOUT TWO DAYS. AFTERWARD, WE SIT DOWN WITH A LOCAL WOMAN DEALING WITH LONG COVID. WERE FINDING OUT HOW THIS IMPACTS HER DAY TO DAY LIFE, TO GET AN UNDERSTANDING OF WHERE WE STAND WITH COVID 19 TODAY, WE SPEAK WITH DOCTOR AMESH ADALJA. HES AN INFECTIOUS DISEASE PHYSICIAN AND PRACTICES AT JOHNS HOPKINS. DOCTOR ADALJA IS ALSO A CLINICAL PROFESSOR AT THE UNIVERSITY OF PITTSBURGH. CAN YOU EXPLAIN YOUR VIEW ON THE CURRENT STATE OF THE VIRUS. YES. SO RIGHT NOW WERE IN A KIND OF ENDEMIC PHASE WHERE THIS HAS BECOME ONE OF THE NORMAL RESPIRATORY VIRUSES THAT WERE GOING TO DEAL WITH YEAR IN AND YEAR OUT. THERES GOING TO BE UPS, THERES GOING TO BE DOWNS. THERES GOING TO ALWAYS BE NEW VARIANTS. BUT THE IMPORTANT POINT TO REMEMBER ABOUT COVID IS WEVE GOT SO MANY MORE TOOLS TO DEAL WITH IT NOW IN 2024 THAN WE EVER HAD THAT ITS BECOME SO MUCH MORE MANAGEABLE. THE VACCINES, ANTIVIRALS, WASTEWATER MONITORING, HOME TESTS AND WEVE GOT THIS ABILITY NOW TO DECOUPLE THOSE CASES FROM SEVERE DISEASE AND HOSPITALIZATIONS. WE SEE THESE CASES GO UP, BUT WE DONT SEE IT TRANSLATE INTO HOSPITALS IN CRISIS LIKE HAPPENED IN 2020 2021. AND THATS A LOT OF PROGRESS FOR A DISEASE THAT WAS NEW TO HUMANITY IN 2019. TO WHAT EXTENT DO YOU EXPECT COVID TO SURGE AGAIN OVER THE NEXT FEW MONTHS? ITS. REALLY BEING DICTATED BY THE EVOLUTION IN TERMS OF DO NEW VARIANTS APPEAR THAT ARE ABLE TO GET AROUND SOME OF THE IMMUNITY AND CAUSE CASES TO RISE? THATS LIKELY TO HAPPEN FOR PROBABLY THE NEXT COUPLE OF YEARS UNTIL IT SETTLES DOWN. AND THEN WE KIND OF GET A NORMAL SEASONAL CADENCE TO IT. SO I DO THINK WERE GOING TO SEE UPS AND DOWNS. WE WE TEND TO SEE RISES IN COVID WHEN IT GETS VERY COLD, WHEN PEOPLE ARE INDOORS, JUST LIKE WITH OTHER RESPIRATORY VIRUSES. BUT WE ALSO SEE RISES IN COVID WHEN IT GETS HOT, ESPECIALLY IN THE SOUTHERN PARTS OF THE UNITED STATES WHEN PEOPLE GO INSIDE TO AVOID THE HEAT AND BE IN AIR CONDITIONING, THAT ALSO DRIVES CASES. SO WERE NOT QUITE AT THE ABILITY TO PREDICT IT WITH THE SAME SEASONALITY THAT WE CAN. FOR EXAMPLE, WITH INFLUENZA OR RSV, ARE THERE ANY NOTABLE MEDICAL DEVELOPMENTS WHEN IT COMES TO TREATING COVID OR THE SPREAD THAT YOU CAN SHARE WITH US TODAY? THE BIGGEST TOOL THAT WE HAVE IS THE VACCINE. AND HIGH RISK PEOPLE ARE STILL UNDER VACCINATED. IF YOU LOOK, FOR EXAMPLE, AT THE RATES OF VACCINATION IN NURSING HOMES, ITS REALLY SUBOPTIMAL. SO THATS A PREVENTABLE. THOSE ARE PREVENTABLE CASES, PREVENTABLE HOSPITALIZATIONS AND PREVENTABLE DEATHS. THE SAME IS TRUE FOR THE ANTIVIRAL PAXLOVID THAT ITS WOEFULLY UNDER PRESCRIBED. WE KNOW THAT THATS SOMETHING THAT CAN KEEP HIGH RISK PEOPLE OUT OF THE HOSPITAL. YET MANY DOCTORS DONT PRESCRIBE IT. MANY PATIENTS DONT KNOW ABOUT IT. THATS THOSE ARE GREAT TOOLS THAT WE HAVE THAT WERE NOT USING. THERE ARE GOING TO BE NEWER GENERATION ANTIVIRALS, NEWER GENERATION VACCINES. THERES A LOT MORE, UH, NUANCES IN HOW TO TREAT IT. WERE STARTING TO UNRAVEL SOME OF THE MYSTERIES OF LONG COVID. THATS ALL COMING, BUT WE STILL NEED TO USE THE TOOLS THAT WE HAVE NOW TO GET THOSE 1500 OR SO DEATHS THAT OCCUR EVERY WEEK FROM COVID DOWN LOWER. HOW DO WE DO THAT? HOW DO WE GET THOSE TOOLS TO BE MORE WIDELY USED, MORE WIDELY KNOWN ABOUT? WE HAVE TO DO TARGETED MESSAGING. WE HAVE TO TELL PEOPLE THAT THEY ARE HIGH RISK, THAT THEY HAVE A CONDITION. THEY NEED TO KNOW THAT THESE TOOLS ARE GOING TO BENEFIT THEM INDIVIDUALLY, THAT THESE ARE GOING TO MAKE IT EASIER FOR THEM TO NAVIGATE A WORLD IN WHICH COVID 19 IS EVER PRESENT. AND THEN WE ALSO HAVE TO EDUCATE PEOPLE, RIDERS BECAUSE, FOR EXAMPLE, PAXLOVID DOCTORS ARENT EVEN OFFERING IT. MANY TIMES WHEN THEY SHOULD BE OFFERED. SO DOCTORS HAVE TO KNOW THAT THIS TOOL IS REALLY, REALLY GOOD. AND THERES A LOT OF MISCONCEPTIONS ABOUT PAXLOVID, ABOUT PAXLOVID, REBOUND, ABOUT THIS PATIENT LOOKS TOO GOOD TO NEED PAXLOVID. THOSE ARE ALL THINGS WE HAVE TO REALLY DISPEL. BECAUSE WHEN YOU THINK ABOUT A PILL THAT CAN PREVENT 90% OF PEOPLE TO TAKE IT, EVEN IF THEYRE UNVACCINATED FROM NEEDING HOSPITALIZATION, THATS REALLY A MIRACLE PILL. YOU TALKED ABOUT THE HOSPITALIZATIONS, THE DEATHS. WE SAW THIS VERY EARLY ON WITH COVID. WHATS THE STATE RIGHT NOW? IS THIS STILL HAPPENING IN 2024? YES, WE ARE STILL SEEING NATIONALLY ABOUT 1500 DEATHS PER WEEK. THATS SOMETHING THAT IS REALLY JUST COMPLETELY PREVENTABLE BECAUSE IF THESE PEOPLE WERE FULLY VACCINATED, IF THEY WERE GETTING DRUGS LIKE PAXLOVID OR THE OTHER ANTIVIRAL MOLNUPIRAVIR, YOU COULD REALLY SEE THAT THOSE HOSPITALIZATIONS AND DEATH NUMBERS DROP SIGNIFICANTLY. COVID NOW IS AN EMINENTLY MANAGEABLE DISEASE. WE HAVE MORE TOOLS FOR IT THAN ANY OTHER RESPIRATORY VIRUS, BUT WERE STILL SEEING THIS TOLL OF HOSPITALIZATIONS AND DEATHS. AND ITS ESPECIALLY IN HIGH RISK, OLDER PEOPLE THAT ARE JUST NOT USING THOSE TOOLS. SO THIS IS KIND OF THE FRUSTRATING POINT THAT WEVE SEEN SCIENCE AND MEDICINE DELIVER SUCH GREAT ADVANCES IN A SPAN OF LESS THAN FOUR YEARS, BUT WERE STILL KIND OF PLAGUED WITH COVID 19, CAUSING DISRUPTIONS TO PEOPLES LIVES. WHAT DO YOU CONSIDER THE BIGGEST LESSON LEARNED FROM THIS? THE BIGGEST LESSON IS THAT IF YOURE NOT PROACTIVE WITH A NOVEL INFECTIOUS DISEASE THATS SPREADING EFFICIENTLY FROM PERSON TO PERSON, YOURE GOING TO END UP WITH A PANDEMIC. SO YOU HAVE TO REMEMBER THAT THIS JUMPED INTO HUMANS PROBABLY IN 2019. IN THE FALL OF 2019, IN THE UNITED STATES, FOR EXAMPLE, WE DIDNT START TAKING ACTION UNTIL MID-MARCH. SO WHEN YOU DO THAT, YOU HAVE A WHOLE POPULATION INFECTED. YOU HAVE REALLY SHODDY ABILITY TO TEST PEOPLE BECAUSE YOU WERENT PROACTIVE, YOU WERENT PLANNING, YOURE TRYING TO SCRAMBLE TO GET TESTS OUT AND THEN YOU HAVE HOSPITALS OVERRUN, LIKE WHAT HAPPENED IN NEW YORK CITY. SO THE BIG LESSON HERE IS THAT WE HAVE TO BE PROACTIVE AND WE HAVE TO PUSH GOVERNMENT TO ACTUALLY TAKE PANDEMIC PREPAREDNESS SERIOUSLY. IT SHOULD BE THOUGHT OF LIKE NATIONAL DEFENSE. WE HAVE 1.1 MILLION PEOPLE DEAD IN THE UNITED STATES. MANY OF THOSE DEATHS ARE PREVENTABLE. IF WE WOULD HAVE TAKEN THE CORRECT ACTION. AND I THINK THATS WHAT THE MESSAGE NEEDS TO BE TO POLICYMAKERS. WHAT IS YOUR PANDEMIC PLAN? THIS NEEDS TO BE SOMETHING THAT VOTERS TALK TO THEIR POLITICIANS ABOUT AT EVERY LEVEL, FROM CITY COUNCIL, ALL THE WAY UP TO THE PRESIDENCY. DO YOU EXPECT A PANDEMIC OF A NOVEL INFECTIOUS DISEASE SIMILAR OF THIS MAGNITUDE TO EVER HAPPEN AGAIN IN OUR LIFETIMES? I DO, I THINK THAT PANDEMICS CAN HAPPEN ANY TIME. THERE ARE MANY VIRUSES OUT THERE THAT HAVE THAT CAPACITY TO CAUSE PANDEMICS. FOR EXAMPLE, BIRD FLU, OTHER CORONAVIRUSES. SO THIS IS SOMETHING THAT WE CANT THINK THAT THIS JUST HAPPENED, AND WERE NOT GOING TO GET ANOTHER PANDEMIC FOR 100 YEARS. A NEW PANDEMIC COULD BE STARTING NOW. SO ITS VERY IMPORTANT THAT PEOPLE THINK ABOUT WHAT IS THE GOVERNMENT DOING TO GET HOSPITALS READY TO GET THEIR PUBLIC HEALTH. THE PUBLIC HEALTH AGENCIES READY? IS THIS SOMETHING THAT PEOPLE ARE PRIORITIZING AND I THINK THAT THEYRE NOT. THIS IS SOMETHING THAT PEOPLE BECOME VERY COMPLACENT. THEY GET THROUGH THESE CYCLES OF PANIC AND NEGLECT, BOOM AND BUST WHERE THEYRE WORRIED ABOUT SOMETHING. AND THEN ITS OUT OF THE HEADLINES. SO THEY DONT THEY THINK THAT THIS IS NOT A PROBLEM ANYMORE. WEVE SEEN IT HAPPEN TIME AND TIME AGAIN WHEN IT COMES TO INFECTIOUS DISEASE EMERGENCIES. SO I DO THINK THAT WE HAVE TO BE MUCH, MUCH MORE PROACTIVE AND FUNCTIONING. BUT THIS IS GOING TO BE A LONG TERME RESEARCH PROJECT BEFORE WE COMPLETELY UNRAVEL IT. WHATS THE TOP THING YOU WANT PEOPLE TO KNOW ABOUT COVID NOW? MOVING FORWARD? THE TOP THING IS THAT WE SHOULD NOT HAVE LET THIS HAPPEN THE WAY IT DID, THAT THERE WERE SO MANY WARNING SIGNS, SO MANY OPPORTUNITIES TO INTERVENE. THE UNITED STATES DIDNT HAVE TO HAVE THIS TRAJECTORY IF WE WERE PROACTIVE, IF WE HAD POLICYMAKERS THAT TOOK THIS THREAT SERIOUSLY, WE COULD HAVE HAD AN EXPERIENCE LIKE TAIWAN OR LIKE SOUTH KOREA. AND I THINK YOU HAVE TO THINK THIS IS NOT GOING TO BE THE ONLY TIME WE FACE THIS. IF WE DONT ACT PROACTIVELY, IF WE DONT TAKE THE THREAT OF INFECTIOUS DISEASE SERIOUSLY, THIS IS WHAT YOU GET. LIVES DISRUPTED, LIVES ERASED, ECONOMIES CRUSHED, CHILDRENS LEARNING COMPLETELY DECIMATED. ALL OF THAT IS THE LONG TAIL. THE CASCADE OF THIS PANDEMIC. SO A PANDEMIC IN THE 2020S DOES HAVE THIS ABILITY TO REALLY TO HARM THE HUMAN SPECIES IN A WAY THAT, YOU KNOW, PEOPLE THOUGHT MAYBE IN 19 THAT WAS 1918, 1918, INFLUENZA COULD DO THAT. THATS NOT GOING TO HAPPEN IN 2020. BUT IT DID STILL AHEAD. WE FELT IT WAS SO IMPORTANT TO GET DATA SO THAT WE COULD HELP THE MOMS FEEL GOOD ABOUT TAKING THE VACCINE, BOTH FOR THEMSELVES AND THE BABIES. THE STUDY THAT UPMC MAGEE-WOMENS HOSPITAL IS INVOLVED IN LOOKING AT COVID VACCINES, PREGNANT WOMEN AND BABIES. WELCOME BACK MILLIONS OF AMERICANS ROLLED UP THEIR SLEEVES TO RECEIVE THE COVID 19 VACCINE, INCLUDING PREGNANT WOMEN. NOW, UPMC MAGEE-WOMENS HOSPITAL IS TAKING PART IN A STUDY TO SEE HOW THOSE SHOTS IMPACT MOMS AND THEIR BABIES. TODAY, DOCTOR BECKY, LETS FIRST START TALKING ABOUT THIS STUDY THAT MCGEE IS PARTICIPATING IN THE NIH SPONSORED STUDY. WHAT EXACTLY ARE YOU GUYS LOOKING AT AND WHAT DOES THIS STUDY INVOLVE? THANK YOU VERY MUCH. THE REASON FOR THIS STUDY WAS THAT, UM, IN THE EARLY DAYS OF THE PANDEMIC, UH, WE REALIZED THAT PREGNANT WOMEN, UNFORTUNATELY, WERE EXCLUDED FROM THE ORIGINAL CLINICAL TRIALS OF THE NOW VERY WELL KNOWN MRNA VACCINES. BECAUSE OF THAT, WE DECIDED TO DO WHATS CALLED AN OPPORTUNIST STUDY, WHICH MEANS KNOWING THAT NUMEROUS PREGNANT WOMEN WERE GOING TO BE OFFERED. AND THEN TAKING THE VACCINE IN THE FIRST YEAR OR TWO AFTER ITS RELEASE, WE OFFERED TO STUDY THEM IN AN OBSERVATIONAL WAY, WHICH MEANS THEY GET THE VACCINE ON THEIR OWN ACCORD, AND THEN WE FOLLOW THEM THROUGH THE REST OF THEIR PREGNANCY, THROUGH THEIR DELIVERY, AND THEN FOR A YEAR AFTER DELIVERY, AND THEN ALSO FOLLOW THE BABY ONCE THE BABY IS BORN. THE PURPOSE OF THAT IS TO STUDY THE SAFETY OF THE VACCINE. BUT MORE IMPORTANTLY, WHAT THIS RECENT PAPER SHOWED IS LOOKING AT THE IMMUNOLOGY OF THE VACCINE GENE AND HOW WELL THE VACCINE HAS PRODUCED ANTIBODIES. BUT REALLY IMPORTANTLY, HOW WELL THOSE ANTIBODIES TRANSFER INTO THE BABY THROUGH THE PLACENTA. AND HOW MUCH PROTECTION DO THOSE ANTIBODIES GIVE TO THE BABY IN THE FIRST SIX MONTHS OF LIFE, THAT WAS THE PRIMARY PURPOSE OF THIS STUDY. THAT BRINGS ME TO MY NEXT QUESTION. WHAT HAVE BEEN SOME OF THOSE MAJOR FINDINGS SO FAR? SO, SO FAR? SOME OF THE MAJOR FINDINGS ARE THAT, FIRST OF ALL, THE VACCINE AS AS HAS BEEN SHOWN BY OTHER PEOPLE, IS VERY SAFE. ITS ALSO VERY EFFECTIVE AT PRODUCING ANTIBODIES IN THE MOTHER THAT GIVE PROTECTION TO THE MOTHER. BUT THIS STUDY SPECIFICALLY SHOWED THAT WHEN MOMS GET THOSE VACCINES DURING PREGNANCY, AND ESPECIALLY WHEN WE GET THE BOOSTER DOSE, THE THE ANTIBODY LEVELS ARE VERY HIGH WHEN THE BABY IS BORN. AND THAT OFFERS PROTECTION THROUGH THE FIRST SIX MONTHS OF LIFE, WHICH IS A VERY IMPORTANT FINDING BECAUSE WHEN BABIES ARE FIRST BORN, THEY ARE SUSCEPTIBLE TO GETTING COVID, GETTING QUITE ILL, AND THEYRE NOT ELIGIBLE TO GET THEIR OWN VACCINE. FOR THE FIRST SIX MONTHS OF THEIR LIFE. SO THIS PROVIDES A NICE WINDOW OF PROTECTION UNTIL THE BABIES CAN GET THEIR OWN VACCINE. WHEN THEY HIT SIX MONTHS. IN GENERAL, WHAT IMPACT DID YOU SEE COVID HAVING ON MOMS AND BABIES AT MAGEE THAT MAKES RESEARCH LIKE THIS SO IMPORTANT? YEAH, WE UNFORTUNATELY SAW SOME OF THE IMPACT IN THE MOMS, PREDOMINATELY IN THE MOMS FOR THE FIRST COUPLE OF YEARS OF THIS OUTBREAK. THIS WAS PRIMARILY A PROBLEM IN MOMS. AND THEN AS THE OMICRON WAVE CAME ALONG, WE STARTED TO SEE ADVERSE OUTCOMES IN THE BABIES. THIS WAS NOT SURPRISING BECAUSE IT TURNS OUT THAT PREGNANT WOMEN ARE UNIQUELY, UNIQUELY SUSCEPTIBLE TO ADVERSE OUTCOMES FROM VARIOUS VIRAL INFECTIONS, ESPECIALLY VIRAL RESPIRATORY INFECTIONS LIKE INFLUENZA. UM, AND UNFORTUNATELY LIKE COVID. SO WE WERENT TERRIBLY SURPRISED BY WHAT WE SAW, BUT IT WAS STILL, UH, TROUBLING AND DISHEARTENING. AND THATS WHY WE FELT IT WAS SO IMPORTANT TO GET DATA SO THAT WE COULD HELP THE MOMS FEEL GOOD ABOUT TAKING THE VACCINE, BOTH FOR THEMSELVES AND THE BABIES, THEIR BABIES. BUT ALSO TO HELP OUR OBSTETRIC PROVIDERS FEEL CONFIDENT THAT THEY COULD RECOMMEND THIS VACCINE THAT WAS SAFE AND HIGHLY EFFECTIVE FOR BOTH MOMS AND BABIES. SO THERE WAS A LOT OF THINGS GOING ON. WHAT MORE DO YOU HOPE TO DISCOVER FROM THIS RESEARCH? WELL, THERE ARE ONGOING ANALYZES AROUND SOME OF THE LABORATORY METHODS AND EVEN THE IMPACT OF BREAST MILK. THE ANTIBODIES THAT CAN GET INTO THE BREAST MILK, UM, BUT REALLY IMPORTANTLY FROM THIS STUDY AND THIS, AS I TOUCHED ON EARLIER, THIS STUDY REALLY HIGHLIGHTS THE NEED TO DO THIS STUDY HIGHLIGHTS THE FACT THAT, UM, PREGNANT WOMEN ARE OFTEN EXCLUDED FROM CLINICAL TRIALS. AND THATS WHAT WE FACED AT THE FIRST YEAR OF COVID. AND WHEN WE LEARNED THAT THEY WERE NOT GOING TO BE INCLUDED IN THOSE TRIALS WHILE WE WERENT SURPRISED, WE REALLY TOOK THAT AS AN OPPORTUNITY TO SAY, WELL, WE STILL NEED TO HAVE THE DATA. SO THATS WHY WE SET THIS STUDY UP. SO ONE OF THE THINGS THAT I HOPE WOULD COME OUT OF THIS IS THAT FOR FUTURE PUBLIC HEALTH DISEASE OUTBREAKS SUCH AS COVID, AND WE KNOW WERE GOING TO HAVE ONES IN THE FUTURE. WEVE HAD THREE IN THE LAST 10 OR 12 YEARS, SO WE KNOW WERE GOING TO HAVE SOMETHING AGAIN IN THE FUTURE THAT IF THAT SHOULD HAPPEN, THEN WE HAVE AN ACTIVE THOUGHT PROCESS IN A WAY, AND A RECOGNITION THAT WE NEED TO INCLUDE PREGNANT WOMEN BOTH SAFELY AND ETHICALLY. FROM THE OUTSET OF THE OUTBREAK IN THE VACCINE, IN DEVELOPMENT STUDIES. SO THAT WE DONT HAVE THE SITUATION WHERE THE VACCINE IS NOW OUT AND BEING GIVEN TO PEOPLE, AND THERES REALLY NOT MUCH DATA, WHICH IS WHAT HAPPENED DURING COVID. WE HAD NO REASON TO BELIEVE IT WAS HARMFUL. AND BECAUSE OF THAT, WE RECOMMENDED THAT WOMEN GET IT. AND SOME WOMEN DIDNT GET IT AND THEY ENROLLED IN THE STUDY. AND NOW WE HAVE EVIDENCE TO THAT. BUT THE BIGGER POINT IS THAT IT WOULD BE MUCH MORE OPTIMAL, MUCH MORE IDEAL TO ENROLL THEM EARLY ON IN THE PHASE OF STUDYING THE VACCINE SO THAT WE HAVE GREAT DATA WHEN IT COMES OUT TO BE USED IN THE GENERAL POPULATION. WHAT DO YOU THINK THIS DOES FOR WOMEN WHO ARE INVOLVED IN THIS STUDY? IS IT ALMOST A PIECE OF MIND FOR THEM AS THEYRE GOING THROUGH THEIR PREGNANCY, KNOWING SOMETHING GOOD CAN COME OUT OF IT? YEAH, DEFINITELY. THERES A LOT OF WOMEN WHO HAVE ENROLLED IN STUDIES REALLY, BECAUSE FIRST OF ALL, THEY THINK ITS IMPORTANT. BUT A COMMON THEME THAT YOU HEAR FROM THE WOMEN THAT ARE ROLE IN THESE STUDIES WHEN THEYRE PREGNANT IS I WANT TO TRY AND HELP OTHER WOMEN. SO AND EVEN SINCE THIS ARTICLE HAS BEEN PUBLISHED, I HAVE HAD SOME PEOPLE REACH OUT TO ME AND SAY, IM SO GLAD I PARTICIPATED. THANK YOU. AND ITS SO NICE TO KNOW THAT MY PARTICIPATION LED TO THIS KNOWLEDGE THAT CAN BE USEFUL FOR OTHER WOMEN GOING FORWARD. SO THERES A LOT OF ALTRUISM IN THE WOMEN ENROLLED IN THESE STUDIES. WHAT IS YOUR ULTIMATE GOAL FROM THE FINDINGS AND WHAT WILL BE SHARED NOT ONLY THATS IMPORTANT FOR OUR COMMUNITY, BUT FOR THE NATION, FOR PREGNANT WOMEN TO KNOW THEYRE NOT FORGOTTEN, THAT WERE THINKING OF THEM. AT MAGEE, WE ALWAYS PUT THEM FIRST AND THAT WE ARE, YOU KNOW, COMMITTED TO DOING ETHICALLY RESPONSIBLE, SAFE STUDIES THAT ENABLE OUR DOCTORS AND OUR PROVIDERS. TO BE ABLE TO GIVE THEM SOUND MEDICAL ADVICE AND TO KEEP THEM SAFE FROM INFECTIOUS DISEASE OUTBREAKS LIKE THIS. THERE ARE NO NUMBER ONE PRIORITY. AND, UM, THE STUDY DEMONSTRATES ITS. SAFE. ITS EFFECTIVE FOR BOTH THEM AND THEIR BABIES. SUPER IMPORTANT. AND THAT THEME HAS BEEN SEEN OVER AND OVER AGAIN FOR VARIOUS INFECTIONS. SO ITS ITS KIND OF REPRODUCIBLE. SO, UM, NOT UNEXPECTED BUT STILL VERY NICE TO SEE. STILL AHEAD. IM NOT HERE TODAY SPEAKING FOR ME ALONE. IM SPEAKING FOR THOUSANDS UPON THOUSANDS OF PEOPLE. AND WERE STILL STUCK BACK IN 2020, IN THE PANDEMIC, THE WORLD HAS MOVED ON, BUT WE HAVENT. A LOCAL WOMAN STILL DEALING WITH COMPLICATIONS. MORE THAN THREE YEARS AFTER HAVING COVID. WELCOME BACK. AN ELEMENT OF COVID 19 IS STILL A BIT OF A MYSTERY WHEN IT COMES TO LONG COVID OR POST-COVID. THATS WHEN SOMEONE WHO GETS THE VIRUS EXPERIENCES LONG TERME EFFECTS AFTER THE DIAGNOSIS, I SPOKE WITH A LOCAL WOMAN WHO FIRST GOT COVID IN LATE 2020, AND TODAY HER STRUGGLES CONTINUE. WHEN DID YOU KNOW YOU HAD LONG COVID AND WHAT WERE THE SYMPTOMS OF THAT FOR YOU? LONG COVID I DIDNT KNOW QUITE WHEN IT ALL STARTED. UM, I WENT BACK TO WORKING AND I WOULD COME HOME EXHAUSTED. UM, PROBABLY ABOUT A WEEK AFTER I HAD COVID. UM, AND THE FATIGUE JUST KEPT GETTING WORSE AND WORSE. AND SO I TALKED TO MY BOSS AND I SAID, UM, YOU KNOW, IM JUST I HAVE NOTHING TO GIVE MY FAMILY WHEN I GET HOME. UM, I DONT KNOW WHAT WHATS GOING ON. SO I THINK I NEED TO TRY TO GET ANOTHER JOB WHERE I WORK FROM HOME. AND I DID GET A JOB WHERE I WORKED FROM HOME, AND I WENT FOR A PHYSICAL FOR THAT JOB. AND WHEN I WENT FOR THE PHYSICAL, THE NURSE TOLD ME, YOU HAVE EXTREMELY HIGH BLOOD PRESSURE, WHICH I HAD NEVER HAD IN MY LIFE. AND SHE SAID, YOU MIGHT WANT TO CHECK WITH YOUR PCP AND JUST FOLLOW UP. SO I DID START MY NEW JOB, AND WHEN I STARTED THAT NEW JOB, I REALIZED I WASNT RETAINING ANYTHING IN THE TRAINING. UM, I WOULD TAKE NOTES. I KEPT TRYING TO LEARN. I KEPT TRYING TO LISTEN. AND AFTER WORK I WOULD SIT AND READ MY NOTES, REREAD MY NOTES, AND THE NEXT MORNING I WOULD HAVE NO CLUE WHAT I READ OR WHAT I DID. THE DAY BEFORE. SO I DID FOLLOW UP WITH MY PCP, UM, WHICH STARTED A WHOLE SNOWBALL EFFECT. UM, I ENDED UP GETTING AN EKG. I WENT TO A HEART SPECIALIST WHO TOLD ME I AFTER I HAD A HEART CATHETERIZATION, THEY TOLD ME THAT, UM, I HAD CHRONIC FATIGUE. I HAD CHRONIC HEART FAILURE. I HAD PULMONARY HYPERTENSION. SO I WAS SEEING HEART SPECIALISTS, I WAS SEEING PULMONOLOGISTS. I WAS SEEING ALL KIND OF DOCTORS. AND THEN IT STARTED IN MY GUT, UM, TO THE POINT THAT I COULDNT KEEP ANYTHING DOWN. AND I WAS HAVING TROUBLE SWALLOWING. SO THEY DID A STOMACH WRAP ON ME. AND WITH THAT, UM, WITHIN A FEW WEEKS, YOURE TO START, YOU KNOW, YOU START ON LIQUIDS, THEN YOU GO TO SOLID FOODS AND ON AND ON. WELL, I WAS STUCK IN THE LIQUID PHASE, AND I COULDNT GET BEYOND IT. AND I WENT DOWN TO 73 POUNDS. AND AT WHAT POINT THEY PUT ME ON A FEEDING TUBE AND SO THATS, THATS HOW THIS ALL STARTED. AND I NEEDED TO QUIT MY JOB. AND THIS HAS IMPACTED YOUR LIFE IN SO MANY DIFFERENT WAYS. WHEN YOU HAD TO SWITCH YOUR LIFE LIKE THIS, ALL THESE NEW CHALLENGES, HOW DID YOU FEEL? IT SOUNDS QUITE FRUSTRATING. IT WAS. AND I, I HAD TO GRIEVE THE PERSON I WAS BECAUSE I WAS NO MORE THAT PERSON. UM, AND THERE ARE TIMES I HAVE GOOD SPELLS RIGHT NOW, BUT THERE ARE TIMES WHERE I STILL CANNOT GET OUT OF BED OR IM SO WEAK AND TIRED I CANT DO ANYTHING. I CANT DO HOUSE CHORES. UM, ON A GOOD DAY, I CAN LOAD THE DISHWASHER AND HAVE TO REST AND THEN UNLOAD IT AND REST. YOU CANT DO MANY THINGS AT ONCE. I HAVE TROUBLE WALKING. UM. I RUN OUT OF BREATH. UM, ITS JUST ITS IMPACTED MY WHOLE PERSON. AND I HAD TO GET TO KNOW THIS WHOLE PERSON THAT I AM NOW AND TRY TO DEAL WITH IT. AND THIS IS STILL IMPACTING YOU TODAY, ALTHOUGH, LIKE YOU SAID, THERES UPS AND DOWNS TODAY. WHAT ARE YOU FEELING EVEN JUST BEING HERE, BEING HERE IM FEELING OKAY, BUT I KNOW ILL PAY FOR IT TOMORROW AND PROBABLY THE NEXT DAY. ANYTIME I DO ANYTHING PRETTY LARGE, IM DOWN FOR THE COUNT FOR ABOUT TWO DAYS AFTERWARD AND ITS HARD TO PLAN ANYTHING SOCIALLY WITH FRIENDS OR FAMILY BECAUSE I JUST DONT KNOW HOW ILL BE THAT DAY OR THAT MINUTE. WHAT DO YOU THINK PEOPLE ARE UNDERSTANDING LONG COVID? IT SOUNDS LIKE ITS COST YOU YOUR JOB, COST YOU SOCIAL INTERACTION PENS. AND LIKE YOU SAID, KIND OF GRIEVING THE PERSON YOU WERE, RIGHT? HOW DO PEOPLE RESPOND TO THAT WHEN YOU SAY, YOU KNOW TODAY IS NOT A GOOD DAY FOR ME? UM, IM VERY BLESSED WITH MY HUSBAND AND MY MY CHILDREN. THEY UNDERSTAND AND MY FAMILY TRIES TO UNDERSTAND IT. AND I HAVE A FEW VERY GOOD FRIENDS THAT UNDERSTAND IT. UM, BUT I DONT THINK THE PUBLIC DOES IT ALL. AND IM NOT HERE TODAY SPEAKING FOR ME ALONE. IM SPEAKING FOR THOUSANDS UPON THOUSANDS OF PEOPLE, AND WERE STILL STUCK BACK IN 2020, IN THE PANDEMIC, THE WORLDS MOVED ON, BUT WE HAVENT. THERES A LOT OF SUPPORT GROUPS. I SAW ONLINE. RIGHT. WHAT IS THE SUPPORT THATS OUT THERE AND WHAT IS IT LIKE TO CONNECT WITH SOMEONE WHOS EXPERIENCING SIMILAR THINGS TO YOU? ARE THE SUPPORT THATS OUT THERE RIGHT NOW? UM, THAT I BELONG TO IS A LONG COVID SUPPORT GROUP ON FACEBOOK AND IT IS WONDERFUL. ITS ONE PLACE WHERE WE ALL KNOW HOW EACH OTHER FEELS. YOU KNOW, YOU TRY TO TELL YOUR PARTNER, YOU TRY TO TELL YOUR FAMILY, UM, AND THEY TRY TO UNDERSTAND AND, UM, BUT A LOT OF FAMILIES DONT. AND THEY, THEY THINK THEIR, THEIR LOVED ONE IS EITHER LAZY OR FAKING IT. AND THIS IS NOT I MEAN, THIS IS A REAL PROBLEM AND A REAL DISEASE. IN FACT, I CALL IT CHRONIC LONG COVID BECAUSE ITS BECOME CHRONIC. UM, BUT THE LONG COVID GROUP HAS BEEN THE BEST AND I RELY ON MY FAITH, UM, A LOT. IT GIVES ME STRENGTH EACH DAY TO CARRY ON AND I HAVE HOPE. I DO HAVE HOPE BECAUSE IF YOU DONT HAVE HOPE, YOU CANT. WHAT DO YOU DO? YOU KNOW, HOPE IS MY ONLY THING I GRASP ON TO EVERY MORNING WHEN I WAKE UP. WHAT WOULD BE YOUR MESSAGE TO PEOPLE WATCHING THIS? WHAT DO YOU WANT THEM TO KNOW ABOUT LONG COVID AND EVERYONE WHOS STILL EXPERIENCING SYMPTOMS? I THINK FIRST OF ALL, WE NEED MORE AND MORE RESEARCH DONE. WE NEED THE DOCTORS TO UNDERSTAND MORE. WE NEED, YOU KNOW, OUR PCPS TO UNDERSTAND MORE. UM, THEY TREAT YOU KNOW, MY HEART FAILURE. THEY TREAT MY LUNGS. BUT WHAT ABOUT THE REST OF IT? THATS GOING ON? I MEAN, COVID ATTACKED MY ENTIRE SYSTEM, AND I JUST WANT THE PUBLIC TO KNOW THAT, YOU KNOW, THERE ARE LOTS OF US STILL SUFFERING HERE, AND WE NEED WE DONT NEED RIDICULED. WE NEED SUPPORTED AND LIFTED UP. YOURE WATCHING FOR THE RECORD, WERE BACK RIGHT AFTER THIS. WELCOME BACK TO FOR THE RECORD, IF YOU HAVE A TOPIC YOUD LIKE US TO ADDRESS, WE WANT TO HEAR FROM YOU. SEND US AN EMAIL TO NEWS AT WTAE DOT COM. YOU CAN ALSO REWATCH THIS EPISODE OR ANY EPISODE WITH THE VERY LOCAL APP ON YOUR SMARTPHONE, TABLET OR SMART TV. THANKS SO MUCH FOR JOINING US. HAVE A GOO
4 The Record: The state of COVID-19 today
Updated: 11:30 AM EST Feb 25, 2024
The world shut down when the COVID-19 pandemic took over. In the years since a pandemic was declared, we've learned much more about the disease and developed preventative measures and treatments. 4 The Record takes a look at the progress made and the work still being done, plus what its like for people who suffer from long COVID complications.Watch this weeks full episode in the video player above.
The world shut down when the COVID-19 pandemic took over. In the years since a pandemic was declared, we've learned much more about the disease and developed preventative measures and treatments.
4 The Record takes a look at the progress made and the work still being done, plus what its like for people who suffer from long COVID complications.
Watch this weeks full episode in the video player above.
More than half the world will be at a "high or very high risk" of measles outbreaks by the end of 2024, according to the World Health Organization (WHO).
Earlier this week, the global group warned that the viral infection which is also known as rubeola has been increasing across the globe due to a high amount of vaccinations missed amid the COVID-19 pandemic.
"What we are worried about is this year, 2024, we've got these big gaps in our immunization programs, and if we don't fill them really quickly with the vaccine, measles will just jump into that gap," Natasha Crowcroft, a Senior Technical Adviser on Measles and Rubella with the WHO, said during a press briefing in Geneva.
"We can see, from data that's produced with WHO data by the CDC, that more than half of all the countries in the world are going to be at high or very high risk of outbreaks by the end of this year," she added.
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Measles, according to the WHO, is a "highly contagious, serious airborne disease caused by a virus that can lead to severe complications and death."
While it is most common in children, it can affect anyone. Symptoms include a high fever, cough, runny nose and a rash all over the body.
Last year, more than 300,000 cases were reported worldwide, marking a 79% increase from 2022, Crowcroft said on behalf of the WHO.
Global vaccination rates, she added, have slipped to 83%. Figures for deaths have not yet been completed, Crowcroft revealed.
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This year, a total of 20 measles cases have been reported by 11 jurisdictions across the United States, according to data from the Centers for Disease Control and Prevention (CDC).
Arizona, California, Georgia, Maryland, Minnesota, Missouri, New Jersey, New York City, Ohio, Pennsylvania and Virginia have all had cases, the organization said.
Multiple large-scale studies have found that vaccines are safe. There is no scientific link between vaccines and autism, according to the Centers for Disease Control.
Researchers at the University of Oxford published new findings yesterday in Nature suggesting as many as 1 to 3 out of every 100 COVID-19 infections in the United Kingdom persist longer than 30 days, and patients with persistent infections are 55% more likely to report developing long COVID.
Persistent infections have long been a concern to COVID-19 researchers, because people with prolonged infections tend to display a high number of viral mutations, making them reservoirs of new variants.
Previously, this concern focused on immunocompromised patients, but the new study suggests these types of long infections may be more common than previously thought.
The study was based on 3,603 participants who provided two or more positive viral samples for genomic sequencing from November 2020 through August 2022 as part of the Office for National Statistics COVID Infection Survey (ONS-CIS). The two positive tests to define persistent infections had to be taken at least 26 days apart.
Of the participants, 381 had persistent infections, testing positive with the same virus for 30 days or longer, and 54 individuals had a persistent infection that lasted at least 2 months.
Of the persistent infections, 11 were caused by the Alpha variant, 106 Delta, 97 BA.1 and 167 BA.2the last two of which are Omicron subtypes. Of note, the authors said, was one persistent BA.1 infection that lasted for at least 133 days, during which time 33 unique mutations were documented.
In about 30% of the persistent infections, researchers noted rebounding viral dynamics in patient samples, showing high, low, then high again viral load dynamics.
"In the absence of genetic information, they could have been misidentified as reinfections, depending on the definition used," the authors wrote.
All study participants were asked about self-reported long COVID symptoms, or symptoms that lasted 3 months after initial infections. In the persistent infection group, 9% of respondents (32 of 356) self-reported long COVID at their first visit 12 weeks or longer since the start of infection, and 5.8% (19 of 326) reported long COVID at 26 weeks or longer, the authors said.
In the participants with non-persistent infections, only 5.4% (4,291 of 78,902) reported long COVID at their first visit 12 weeks or longer, and 4.1% (3,000 of 72,608) reported long COVID at 26 weeks or longer.
Although the link between viral persistence and long COVID may not be causal, these results suggest persistent infections could be contributing to the pathophysiology of Long COVID.
"Although the link between viral persistence and long COVID may not be causal, these results suggest persistent infections could be contributing to the pathophysiology of Long COVID," said co-author Katrina Lythgoe, PhD, in a University of Oxford press release. "Indeed, many other possible mechanisms have been suggested to contribute to Long COVID, including inflammation, organ damage, and micro thrombosis."
Welling up with emotion, the couple recounted how Matt went into cardiac arrest as his heart stopped during intubation.
Medical personnel took about an hour to revive him, in what felt like an eternity for the terrified couple.
Mr Semodio, an information technology support staff,sighed and said: I dont think there is just one adjective or correct adjective for how I felt. I was devastated, in denial and more scared than anything in my life. It was a mix of emotions that made up the most difficult time in my life.
His wife, who also works in IT,said: It was always panic mode for us.
As the boy was brought back from the brink, he was put on an extracorporeal membrane oxygenation (Ecmo), which pumps and oxygenates a patients blood outside the body, allowing the heart and lungs to rest.
The day after Matt was put on Ecmo, the couple said that doctors did several viral and bacterial tests, and found out that Matt had contracted Covid-19, which led to myocarditis.
Myocarditis is an inflammation of the heart muscle that reduces the hearts ability to pump blood, resulting in chest pain, shortness of breath, and rapid or irregular heart rhythms. Viral infections are one of the common causes.
Recalling the moment she heard the diagnosis, Ms Reyes said: We didnt know because everybody tested negative before we returned to Singapore.
She added that before this, Matt was a completely healthy boy with no heart conditions or lung problems.
Mr Semodio said that a decision was made not to have Matt vaccinated when Covid-19 vaccines were made available for children because it was not really required for him at his age, and they were worried about the side effects.
Hes very small-sized for a nine-year-old, so we were worried about how it might impact him. Hes often being treated as a six-year-old, in terms of dosage and everything else, because of his small frame, Mr Semodio said.
In addition to their worries about the myocarditis diagnosis and seeing their son hooked up to the Ecmo machine, the couple also learnt that Matt had suffered a mild stroke affecting his left side.
They were told that the Ecmo process had side effects, which included the formation of blood clots that reached his brain at some point during the 11 days that he was hooked up to the machine.
The boy was in the intensive care unit from Jan 5 to 24 before he was moved to a high-dependency ward, which offers closer monitoring than a general ward.
Mr Semodio recalled that when Matt woke up, he told the boy, "Hi, welcome back, before the two of them prayed. The family are Catholics and have been living in Singapore since 2006 as Ms Reyes is a permanent resident.
Ms Reyes said that her sons first words to them were: Hold my hand.
Even though their boy was out of intensive care, the couple remained very concerned because their sons heart was still not able to function normally.
If I see him just look a bit lethargic, I would get scared but then I would remind myself that the worst is over because his heart is beating on its own again, Mr Semodio said.
TODAY interviewed the couple a few weeks after Matts hospitalisation and they said that his recovery has been progressing. They can see a return of traces of their dinosaur- and anime-loving boy.
He can go to the toilet and do the exercises he picked up in physiotherapy. He also started slowly regaining his skills after the mild stroke, and is playing games on his laptop now, Mr Semodio said.
Despite the improvement, the couple still have moments of despair.
Its been mentally excruciating as a father to see my son like this. Even though he is getting better, its difficult to control the mind, Mr Semodio added.
Since Matt was discharged from the hospital on Feb 8, he has returned twice after vomiting blood, likely a side-effect of his medication.
I would be happy and then when something happens like this, I will get shaken easily. It is really difficult.
"Sometimes I would second-guess myself and get lost in my thoughts, and sometimes I would just stare at nothing, Mr Semodio added.
For her part, Ms Reyes said that she still feels "trauma" over the ordeal.
Every time we try to sleep, we dont know if Matt is going to feel better. I still cant sleep well and I have to check on him every once in a while, so the fear is still there.
On top of such anxiety, the couple have to confront the financial aspect of this ordeal, which has taken a toll on the two full-time working parents who have had to take unpaid leave to care for their son.
It did not help that they were only able to use MediSave and Mr Semodios insurance to pay for about S$143,950 of their sons estimated S$335,000 medical bill. They are still left to find about S$191,000 out of their own pocket.
The hospital has agreed in principle to their request to pay the bill in instalments, but it is still a really huge sum, Mr Semodio said.
That was why when their family friend initiated an online fundraiser through fundraising platform GiveAsia for the family, they could not be more grateful.
She talked to us and told us that she could do this for us and any form of help is good. Whatever comes in is good, and will help us to pay Matts bills moving forward, Mr Semodio said.
The fundraiser started on Jan 28 and as of Saturday (Feb 24), it has garnered about S$35,000 in donations.
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LAVAL A new Moderna plant in Laval will be able to supply COVID-19 vaccines for the fall 2025 vaccination campaign, the company said Friday during an official visit to mark the end of construction work at the messenger RNA production facility.
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The $250-million Laval plant should produce about 100 million doses of RNA vaccines annually, able to provide vaccines to all Canadians, said Modernas chief operating and quality officer, Jerh Collins.
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The factory will be able to do much more than produce vaccines against COVID-19, noted the minister of Innovation, Science and Industry, Franois-Philippe Champagne, at a news conference.
Moderna is not just about COVID-19. This is a range of vaccines that we will be able to produce at home. There are even vaccines potentially for cancer.
Quebecs economy minister, Pierre Fitzgibbon, emphasized the project makes it possible to reduce Canadas dependence on foreign vaccine production.
He said Modernas new project will serve as a calling card to attract other projects in the pharmaceutical sector to Quebec.
There are international pharmaceutical companies that are looking at what is happening, the talent that there is at McGill, that there is at Universit de Montral, among others. I think it will create quite significant momentum for life sciences.
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Today, a team of scientists from Trinity College Dublin and investigators from FutureNeuro announced a major discovery that has profound importance for our understanding of brain fog and cognitive decline seen in some patients with Long COVID.
In the months after the emergence of the novel coronavirus SARS-CoV2 in late 2019 a patient-reported syndrome termed Long-COVID began to come to the fore as an enduring manifestation of acute infection.
Long COVID has up to 200 reported symptoms to date, but in general patients report lingering symptoms such as fatigue, shortness of breath, problems with memory and thinking and joint/muscle pain. While the vast majority of people suffering from COVID-19 make a full recovery, any of these symptoms that linger for more than 12 weeks post infection can be considered Long COVID.
Long COVID has now become a major public health issue since the outbreak of the pandemic in 2020. While international incidence rates vary, it is estimated to affect up to 10% of patients infected with the SARS-CoV2 virus. Of these patients suffering from Long-COVID, just under 50% of them report some form of lingering neurological effect such as cognitive decline, fatigue and brain fog.
Now, the findings reported by the Trinity team in the top international journalNature Neuroscienceshowed that there was disruption to the integrity of the blood vessels in the brains of patients suffering from Long COVID and brain fog. This blood vessel "leakiness" was able to objectively distinguish those patients with brain fog and cognitive decline compared to patients suffering from Long-COVID but not with brain fog.
The team led by scientists at the Smurfit Institute of Genetics in Trinity's School of Genetics and Microbiology and neurologists in the School of Medicine have also uncovered a novel form of MRI scan that shows how Long-COVID can affect the human brain's delicate network of blood vessels.
For the first time, we have been able to show that leaky blood vessels in the human brain, in tandem with a hyperactive immune system may be the key drivers of brain fog associated with Long COVID. This is critically important, as understanding the underlying cause of these conditions will allow us to develop targeted therapies for patients in the future,"
Prof. Matthew Campbell, Professor in Genetics and Head of Genetics at Trinity, and Principal Investigator at FutureNeuro
This project was initiated by a rapid response grant funded by Science Foundation Ireland (SFI) at the height of the pandemic in 2020 and involved recruiting patients suffering from the effects of Long-COVID as well as patients who were hospitalised in St James' Hospital.
"Undertaking this complicated clinical research study at a time of national crisis and when our hospital system was under severe pressure is a testament to the skill and resource of our medical trainees and staff. The findings will now likely change the landscape of how we understand and treat post-viral neurological conditions. It also confirms that the neurological symptoms of Long Covid are measurable with real and demonstrable metabolic and vascular changes in the brain,"saidProf. Colin Doherty, Professor of Neurology and Head of the School of Medicine at Trinity, and Principal Investigator at FutureNeuro.
In recent years, it has become apparent that many neurological conditions such as Multiple sclerosis (MS) likely have a viral infection as the initiating event that triggers the pathology.However, proving that direct link has always been challenging.
Prof. Campbelladded:"Here, the team at Trinity was able to prove that every patient that developed Long-COVID had been diagnosed with SARS-CoV2 infection, because Ireland required every documented case to be diagnosed using the more accurate PCR-based methods. The concept that many other viral infections that lead to post-viral syndromes might drive blood vessel leakage in the brain is potentially game-changing and is under active investigation by the team."
Dr Chris Greene, Postdoctoral research fellow and first author of the study, added:"Our findings have now set the stage for further studies examining the molecular events that lead to post-viral fatigue and brain fog. Without doubt, similar mechanisms are at play across many disparate types of viral infection and we are now tantalizingly close to understanding how and why they cause neurological dysfunction in patients."
The research was supported by Science Foundation Ireland, the European Research Council and FutureNeuro, the SFI Centre for rare and chronic neurological, neurodevelopmental and neuropsychiatricconditions.
Source:
Journal reference:
Greene, C., et al. (2024). Bloodbrain barrier disruption and sustained systemic inflammation in individuals with long COVID-associated cognitive impairment.Nature Neuroscience. doi.org/10.1038/s41593-024-01576-9.
HYDERABAD:If you are vaccinated against Covid-19 and feeling safe, think again you might be prone to clots that could result in a heart attack or a brain stroke.
Since the declaration of the Covid-19 pandemic by the World Health Organization (WHO) on March 11, 2020, more than 13.5 billion doses of Covid-19 vaccines have been administered worldwide.
As of November 2023, at least 70.5 percent of the worlds population had received at least one dose of a COVID-19 vaccine. This unparalleled scenario underscores the pressing need for comprehensive vaccine safety monitoring as very rare adverse events associated with Covid-19 vaccines may only come to light after administration to millions of individuals.
Also Read: 4th COVID-19 vaccine dose approval only matter of time: Australian PM
The study Covid-19 vaccines and adverse events of special interest: A multinational Global Vaccine Data Network (GVDN) cohort study of 99 million vaccinated individuals was published in the renowned scientific magazine Vaccine. However, the study done from December 2020 to August 2023 covered eight countries in North and South America, Europe, and Oceania not including India. The study is an eye-opener to those who advocate universal vaccination against the pandemic without knowing the consequences.
The total vaccinated population across all sites comprised 99,068,901 individuals. Most vaccine recipients were in the 2039 and 4059-year age groups. In total, 183,559,462 doses of BNT162b2, 36,178,442 doses of mRNA-1273, and 23,093,399 doses of ChAdOx1 were administered across all the sites in the study periods. The highest numbers of doses were administered in France (120,758,419), followed by Canada Ontario (32,159,817) and Australia Victoria (15,617,627).
Covid-19 vaccines
Multiple vaccines against Covid-19 represented multiple platform types such as inactivated, nucleic acid-based (mRNA), protein-based, and nonreplicating viral vector platforms.
The study focused on three vaccines that recorded the highest number of doses administered, Pfizer/BioNTech BNT162b2, Moderna mRNA-1273, and Oxford/Astra Zeneca/Serum Institute of India ChAdOx1 vaccines.
The cumulative number of doses of other vaccines administered across study sites was relatively low, with exceptions for the inactivated Sinopharm and Sinovac vaccines, the protein-based Novavax vaccine, and the adenovirus-vector Janssen/Johnson & Johnson and Gamaleya Research Institute/Sputnik vaccines.
The study identified post-vaccine risks in three main categories such as neurological. hematological and cardiological.
Neurological conditions in cases within 42 days after the first ChAdOx1 dose and first mRNA-1273 dose.
Hematologic conditions within 42 days after a first dose of ChAdOx1. Clots were identified (thrombocytopenia) after a first dose of ChAdOx1, BNT162b2, and mRNA-1273, as well as after a third dose of ChAdOx1.
Immune thrombocytopenia was also demonstrated after a first dose of ChAdOx1 and BNT162b2.
Cardiovascular conditions including heart attacks were consistently identified following a first, second, and third dose of mRNA vaccines (BNT162b2 and mRNA-1273). The highest impact was observed following a first and second dose of mRNA-1273.
Observed vs. expected analyses in a multi-country context offer a larger and more diverse dataset, enhanced generalizability, and improved statistical power over single-site or regional studies.
It also presents challenges related to data heterogeneity, population confounding factors, and variations in vaccination strategies and reporting systems.
The involvement of researchers and data sources from diverse regions of the world promotes inclusivity, reduces potential biases, and fosters collaboration in the pursuit of a shared public health goal.
While the study confirmed previously identified rare safety signals following Covid-19 vaccination and contributed evidence on several other important outcomes, further investigation is warranted to confirm associations and assess clinical significance.
This could be addressed by conducting association studies specific to individual outcomes by applying methodologies such as the self-controlled case series (SCCS) to validate the associations.
India has logged 110 new cases of Covid, while the number of active cases of the infection stood at 893, according to the Union Health Ministry data updated on Monday.
No new deaths have been reported in a span of 24 hours, the data updated at 8 am stated.
The number of daily cases had dropped to double-digits till December 5, 2023 but cases had begun to increase after emergence of a new variant and cold weather conditions.
After December 5, a maximum of 841 new cases were reported on December 31, 2023 which is 0.2 per cent of the peak cases reported in May 2021.
India has witnessed three waves of COVID-19 in the past with the peak incidence of daily new cases and deaths being reported during the Delta wave in April-June 2021.
At its peak, 4,14,188 new cases and 3,915 deaths were reported on May 7, 2021.
Since the pandemic began in early 2020, more than 4.5 crore people have been infected and over 5.3 lakh deaths recorded.
Study design and participants
This prospective cohort study was conducted in a suburban area of Japan, targeting residents and workers aged18years. Bizen City is a small city located in Okayama Prefecture, in western Japan. We recruited 1972 individuals who either held registered residency or were employed in organizations situated in Bizen City. Participation was entirely voluntary. Individuals indicated their interest in study participation by responding to city-wide public announcements, receiving informational leaflets, or after finding information at medical institutions. The recruitment phase spanned from May to June 2022, with data collection between June 3, 2022 and March 27, 2023. During the study period, Japan experienced two major epidemic waves dominated by the Omicron variant, from July to September 2022 and November 2022 to January 2023. Study participants were requested to undergo antibody level measurement approximately every 2months. Participants were notified about their next antibody measurement appointment via email or telephone, or by the designated contact person within their respective organizations. Participants made an appointment, had their antibody levels measured, and completed a questionnaire survey. Throughout the study, each individual had a maximum of five opportunities for antibody measurement and survey completion. Eligibility criteria included individuals who had received a minimum of three doses of COVID-19 vaccine. Those who never underwent any measurement or lacked information on age or sex were excluded. This study comprised 1763 participants, with a collective total of 7376 antibody measurements taken (ranging from one to five measurements per participant) (Fig.3).
Flowchart of participants.
During the study period, Japan's vaccination strategy was as follows. As of June 2022, initial vaccination and the third booster dose were recommended for all individuals aged12years. Additionally, a fourth booster dose was recommended for individuals aged60years or adults with underlying medical conditions. The required interval between additional doses was at least 5months. In late July 2022, eligibility for the fourth booster dose was expanded to include health care workers in elder care facilities. Starting from September 20, 2022, all individuals aged12years who had completed their initial vaccination series could receive Omicron-compatible vaccinations. From October onward, the interval for additional doses was adjusted to a minimum of 3months. This vaccination strategy was aimed to provide comprehensive coverage and adapt to the challenges posed by emerging variants, particularly the Omicron strain, while considering the vaccination needs of specific populations such as older adults and those with underlying health conditions24.
Information regarding COVID-19 vaccination among residents of Bizen City, including details such as the number of vaccine doses administered, vaccination dates, and types of vaccines used, was obtained from official vaccination records. For non-residents and individuals lacking official vaccination records in Bizen City, we used self-reported vaccination information, updated at each antibody measurement and survey.
SARS-CoV-2 antibody levels were assessed by collecting 30L of blood using fingertip sampling with the SARS-CoV-2 IgM & IgG Quantum Dot Immunoassay (Mokobio Biotechnology R&D Center Inc., Rockville, Maryland, USA). This assay specifically targets SARS-CoV-2 spike receptor-binding domain (S-RBD immunoglobulin G [IgG]) antibodies. For samples with limited blood volume, appropriate dilutions were made prior to measurement and subsequent adjustment was made. To assess the temporal decline in antibody levels, antibody titers were logarithmically transformed.
Data regarding prior COVID-19 infection among participants, including information on infection dates, diagnosis dates, and severity of illness throughout the course, were sourced from official prefecture records. Comprehensive recording of COVID-19 infection data in Japan ceased after September 27, 2022. In cases of non-residents and individuals lacking official records in Okayama Prefecture, we used self-reported information on COVID-19 infection, which was updated at each antibody measurement and survey. Based on epidemiological surveys conducted by the National Institute of Infectious Diseases, the prevalent strains at the time of infection were classified as follows: the original strain (before March 2021), the Alpha variant (April 2021June 2021), the Delta variant (July 2021December 2021), and the Omicron variant (after January 2022)25.
It is important to note that we only considered information about the most recent infection prior to each measurement date in the analyses and did not include future infections occurring after the measurement date.
Information regarding age and sex were collected through the initial survey. In the fifth (final) survey, participants were asked about their height, weight, current medical conditions, immunosuppressive status (including use of immunosuppressive drugs), alcohol history, and smoking history. Those who reported any of the following as current medical conditions were classified as having underlying medical conditions: hypertension, obesity, dyslipidemia, chronic respiratory diseases, chronic kidney disease, diabetes, cardiovascular diseases, cerebrovascular diseases, or malignancies, and body mass index (calculated using height and weight)30kg/m326. For individuals who did not respond to the final survey, information regarding underlying medical conditions, immunosuppressive status, alcohol history, and smoking history was unavailable. However, participants who indicated any of the following current medical conditions in the first survey were similarly classified as having underlying medical conditions: hypertension, obesity, dyslipidemia, chronic obstructive pulmonary disease, angina/heart attack, stroke, or malignancy.
This study was conducted with full cooperation from Bizen City, with active participation by its residents and local businesses. Participants were provided with detailed explanations of the research and provided their informed consent before initial measurements. Participants were informed of their right to withdraw from participation at any time during the study. Additionally, as a preventive measure against COVID-19, masks, hand sanitizers, and other items were distributed to participants at each antibody measurement visit. This study adhered to the ethical guidelines for research involving human subjects in the life sciences and medical fields and received approval from the Institutional Review Board of Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences (No. K2205-061).
This study targeted participants aged18years who underwent at least one antibody measurement between June 3, 2022, and March 27, 2023 and had received a minimum of three vaccine doses by the time of measurement. After describing the attributes of participants corresponding to each recent vaccination dose, using both a measurement-based and a participant-based approach, we further categorized each IgG measurement value into previously infected and uninfected groups based on the infection status of the participants at the time of measurement. Additionally, we presented the median, interquartile range, and geometric mean titer of the measured IgG, along with its 95% confidence intervals, stratified by past infection status, the number of most recent vaccinations, and the number of months elapsed since the recent vaccination. We then used box plots to depict the logarithmically transformed antibody levels after each vaccination, categorized by the number of doses and time since vaccination.
We used simple linear regression analysis to visually represent the observed data and to qualitatively assess the temporal dynamics of antibody titers across prior infection status. Subsequent inclusion of a quadratic term in the regression model did not match the decay pattern observed in the actual data, as evidenced by the trajectories plotted (Supplementary Fig. S1 online). In particular, the coefficient associated with the quadratic term was insignificantly small, indicating a negligible deviation from linearity. Therefore, we concluded that a linear regression model was more appropriate to illustrate the gradual decline observed in the empirical data over time. Its important to note that this visualization analysis was designed to elucidate temporal trends and was distinct from our main analysis, which was designed to statistically compare antibody titers between individuals with and without prior infection.
Following the manufacturers instructions for the assay kits, considering the uncertainty of measurements exceeding 30,000 antibody units per milliliter (AU/mL), we modeled the temporal decay of antibody levels post-vaccination using a Bayesian linear mixed-effects interval-censored model with noninformative prior distributions13,27. We opted for noninformative Jeffreys prior distributions to maintain objectivity in our analysis, especially considering the uncertainty associated with measurements exceeding 30,000AU/mL. We used a multivariable model, including COVID-19 history (dichotomous), prevalent strains at time of infection (categories: original, alpha, delta, and omicron), days since infection (continuous), the most recent number of vaccine doses (categorical: 3, 4, 5), sex (dichotomous), and age (categories: 1039, 4059, 6079, and80years) as covariates. To assess the temporal decline in antibody levels post-vaccination, interaction terms with time were included for prior infection, vaccine doses, sex, and age. The model incorporated population-level fixed effects, individual-level random effects for intercepts and slopes, and correlations between random effects. The results were upper-censored at 30,000AU/mL, reflecting the uncertainty of IgG values exceeding the quantification limit. Specifically, data points exceeding 30,000 AU/mL (342/955 datapoints, 26.4% in the previously infected group; 238/5841 datapoints, 3.9% in the uninfected group) were treated as probability distributions that included the upper limit, rather than their actual values.
In sensitivity analyses, we also fitted alternative models, such as the random intercept model and the random intercept and slope model with the quadratic term for time to assess potential non-linear trends. Additionally, the random intercept and slope model without censoring where values above 30,000AU/ml were replaced, was examined to assess the robustness of our findings. All models were conducted in the Bayesian framework with 2500 burn-in iterations and 10,000 iterations performed in posterior simulation. Model evaluation was performed using the Deviance Information Criterion (DIC). We reported detailed information about the models used in our study, including the rationale and codes, following the Bayesian analysis reporting guideline28. Specifically, we used Stata v.18 (StataCorp LLC, College Station, TX, USA) for all analyses and the bayes: metobit command to perform the Bayesian multilevel interval-censored analysis, and we included the code for all models in the Supplementary Table S3 online27,29.
We also conducted a supplementary analysis including underlying medical conditions, immunosuppressive status, smoking history, and alcohol consumption history as covariates to explore potential additional factors influencing antibody dynamics, and excluding 779 data points in which this information was missing.
