I keep getting flashbacks of Mark Twain, in Life on the Mississippi, talking about how becoming a professional riverboat pilot left him incapable of *not* noticing hidden patterns in every ripple along his later-in-life journeys. I’ll keep doing these weekly updates, but don’t be afraid to let me know if I’m oversampling H5N1 or other emerging disease outbreaks, okay?
You can't divorce the social context of a disease outbreak from the outbreak response, @WHO's chief scientist @JeremyFarrar told me yesterday in an interview about the #H5N1 #birdflu in cows situation. The social context of this one sure is challenging. https://t.co/zHWWAolE8t
— Helen Branswell 🇨🇦 (@HelenBranswell) May 7, 2024
Jeremy Farrar, now the World Health Organization’s chief scientist, was working in Vietnam 20 years ago when the H5N1 virus started to spread across Asia — at that point in poultry. He recalls there was a reluctance among farmers to cull their chickens because they weren’t being compensated for them. Movement of infected birds to evade culling only served to disseminate the virus, which in the years since has spread to all continents except Australia.
It’s important to keep that experience in mind, he told STAT Monday, as the H5N1 bird flu virus now spreads among dairy cattle in the U.S. Farrar stressed that the social context is key in responding to disease threats like H5N1, noting that a similar reluctance among dairy farmers to report outbreaks or allow testing of their workers is adding to the challenges in assessing how much transmission is occurring and the risk it poses to people.
“You can’t just take the virus and the biological surveillance and divorce it from the environment and the social construct that it’s happening in,” Farrar said in an interview from WHO headquarters in Geneva. “That’s the reality.”…
While he believes the risk of a human flu pandemic triggered by the H5N1 virus is low, should it happen, the social context will also be crucial, Farrar continued. The mental toll of the taxing Covid-19 pandemic hangs over the public, health care workers, public health agencies, and governments. Getting people to again buy into measures that might slow spread, such as social distancing or school closures, would likely be tough, he said.
“The hangover is absolutely true across all societies, I think,” Farrar said. “Public health agencies but also health care workers around the world are shattered. … It’s a global phenomena and the world’s willingness to either have vaccines, mRNA, or otherwise, and have any school closures, masks, whatever interventions you may talk about, would not be the same as they were back in 2020.”
All the more reason, Farrar suggested, to take the actions needed to ensure the spread of bird flu in cows does not trigger a worse crisis. “That makes the case that we better do what we can to avoid an event happening because I think the response would understandably be very different.”
3. What we should be concerned about is that fact that the viruses is getting way too many chances. It keeps expanding its tropism. The more animals it replicates in, the more chances it gets to sample new configurations.
4/— Marc Johnson (@SolidEvidence) May 4, 2024
5. In my opinion we should be focusing our attention on wastewater testing downstream of meat processing plants (for all types of animals). It wouldn't matter what tissue the virus is in, it would end up in the water and give us an early warning.
6/— Marc Johnson (@SolidEvidence) May 4, 2024
Not great (but sadly predicatable):
'They need to back off': Farm states push back on Biden’s bird flu response. Let’s call this what it is: a blind spot in pandemic preparedness. @kakape https://t.co/3Iz9ltQN1Z via @politico
— Marion Koopmans, publications: https://pure.eur.nl (@MarionKoopmans) May 7, 2024
Politico: Covid lessons remain unlearned as avian flu infects cattle, hospitals say
"The politics are, if anything, further against public health than they were before the [Covid] pandemic.”
POLITICOhttps://t.co/bEdtc0YWPV
— CoronaHeadsUp (@CoronaHeadsUp) May 7, 2024
US: Raw milk continues to sell despite H5N1 outbreak in cows
"Our consumers don't like the FDA. If the FDA says to do something, they will do the opposite,"
Reutershttps://t.co/r5W5Jhidhw
— CoronaHeadsUp (@CoronaHeadsUp) May 2, 2024
Happily, Biobot wastewater monitoring (updated May 6th) shows continuing low levels of covid-19 virus concentration.
Last night's update: 47,281 new cases, 557 new deaths https://t.co/ZMFHxRXED0
— BNO News (@BNOFeed) May 6, 2024
This is the 42nd week in a row with more than 500 new COVID deaths in the U.S., or 57,511 deaths during the same period.
— BNO News (@BNOFeed) May 5, 2024
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FT: Health systems and employers count economic cost of long Covid
Covid 'has dealt a long-lasting blow to the productivity of health systems, with ripple effects on the wider workforce.'https://t.co/5dE1OAiquPhttps://t.co/u7VSQxNMMP
— CoronaHeadsUp (@CoronaHeadsUp) May 7, 2024
… The impact of long Covid — defined as symptoms that continue or develop three months after an initial infection, and last at least two months — has dealt a long-lasting blow to the productivity of health systems, with ripple effects on the wider workforce.
But four years after the emergence of the pandemic, attempts to assess how large and enduring the hit will be are hampered by a dearth of data that accurately quantifies the effects of long Covid on the labour market and the finances of healthcare providers.
“We have growing evidence that the burden of long Covid is still exacerbating pressure on our health systems,” said Hans Kluge, European regional director of the World Health Organization. “But countries are not monitoring and reporting data consistently. We need better reporting, surveillance and diagnostics, but also data on hospitalisations, mortality and healthcare costs.”
Without this, he warned, “we will continue to shoot our policy bullets in the dark”. The WHO aims to determine the extent of long Covid among health workers involved in rehabilitating Covid patients in Armenia, Georgia, Italy, Poland and the UK.
One EU estimate suggests that long Covid may have cut labour supply in the bloc by up to 0.5 per cent in 2022, the equivalent of more than 1mn full-time workers. Studies in the US and UK have reached broadly similar conclusions — suggesting the condition has driven the recent increase in workplace absence in many countries.
But no one knows how many people who stopped or scaled back work because of long Covid have been forced to leave their jobs for good — and how many have been able to return, either in a reduced role or gradually resuming their previous responsibilities…
It is far from clear how long economies will be affected. An estimated 36mn people across WHO’s European region, which covers 53 countries with a total population of almost 1bn, may have experienced long Covid symptoms in the first three years of the pandemic, said Kluge. He added that the condition’s prevalence was about 1.7 per cent of the EU population in 2021 and nearly 3 per cent in 2022.
In the US, the Census Bureau’s Household Pulse Survey shows that 1.7 per cent of American adults were reporting “significant activity limitations” as a result of long Covid in February and early March this year.
Robust data is sparse, however, making it hard to tell whether long Covid is a growing problem, or one mostly affecting people who fell ill early in the pandemic and have not recovered…
Hospital admissions for Covid rise again in Thailand
Since January this year, Thailand has recorded 13,057 patients and 93 fatalities due to Covid-19. Of the total admissions, 501 developed lung inflammation and 187 were put on ventilators.https://t.co/5RJyTJIU1b
— SARS‑CoV‑2 (COVID-19) (@COVID19_disease) May 8, 2024
WHO: 'Significant increase' in COVID-19 in Thailand
"1672 new admissions and 9 deaths in the week prior, with 390 seriously unwell patients of which 148 required mechanical ventilation in hospitals on 27 April."
WHO, 02 May 2024https://t.co/ivDnYlqdph pic.twitter.com/yPemEwmaoj
— CoronaHeadsUp (@CoronaHeadsUp) May 2, 2024
Ireland: Covid-19 staff absences in two hospitals cost nearly €400,000 in just nine months
"This study highlights the direct economic cost of healthcare worker work days missed due to Covid-19."
Irish Independenthttps://t.co/7cWlMQ5uHq
— CoronaHeadsUp (@CoronaHeadsUp) May 2, 2024
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The immunology of Covid and the Future
In the new Ground Truths podcast with @VirusesImmunity
An invigorating conversation about #LongCovid, nasal vaccines, the future of the field, and women in science
Audio and transcript with external links posted (see link in profile) pic.twitter.com/7MB1eej9gb— Eric Topol (@EricTopol) May 4, 2024
For a master class in immunology pic.twitter.com/BQ7E17NE9E
— Eric Topol (@EricTopol) May 6, 2024
A step towards a universal, pan-sarbecovirus vaccinehttps://t.co/Q5fUqPlpH6@NatureNano @HowarthSci @Cambridge_Uni and collaborators #nanomedicine
— Eric Topol (@EricTopol) May 6, 2024
Pronounced benefit of Paxlovid in hospitalized patients out to year vs #LongCovid sequelae, including survivalhttps://t.co/KV6pL6Uu8l @TheLancetInfDis
More pronounced for age 65+ and those with 3-dose vaccination. Graph at right is post 21-day mortality pic.twitter.com/GL7ZoNPTfZ— Eric Topol (@EricTopol) May 3, 2024
Your risk of #LongCOVID rises with each additional infection.
A recent study has shown that by their third COVID infection, patients have a 40% chance of developing Long COVID symptoms.
Learn more about the threat of Long COVID: https://t.co/l1s2QF68GH pic.twitter.com/uYjvb3SG7n
— Moderna (@moderna_tx) May 6, 2024
Metformin: Common diabetes drug lowers SARS-CoV-2 viral levels
Four-fold reduction in viral load by day 10.
CIDRAPhttps://t.co/oBmexL4tYg
— CoronaHeadsUp (@CoronaHeadsUp) May 3, 2024
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U.S. ends mandatory reporting of COVID hospitalizations, making it more difficult to monitor the spread of the virus https://t.co/LVMn4KguJF
— BNO News (@BNOFeed) May 3, 2024
The COVID-19 lull in the U.S. may soon come to an end, as a new family of SARS-CoV-2 variants—nicknamed “FLiRT” variants—begins to spread nationwide.https://t.co/uQ4Kqnlm4j
— SARS‑CoV‑2 (COVID-19) (@COVID19_disease) May 1, 2024
My only question is how many people sincerely believe this versus those that pretend they do as part of social signaling. No bones about it, these are bad numbers, it’s just a question of what kind of bad. https://t.co/vJO0k2jNRz
— Jean-Michel Connard ??? (@torriangray) May 2, 2024
Baud
We’re not going to let you retire even if we have to build a lab and grow a virus in it.
New Deal democrat
Biobot updated yesterday, showing a very slight (2%) increase in virus particles in the past week. They remain down 83% from their Holiday peak. The CDC’s last update on last Friday showed a 1% decline to a level 91% off from its peak, and only 1% above its all-time low. The increase in Biobot is probably due to the emergence of the new KP.1&2 variants, which when the CDC updates this Friday will probably be shown to be about 50% of all new cases.
Hospitalizations in the week of April 27 declined to another all time low of 5,098 (vs. the 2023 low of 6,325). Unfortunately this is probably the last week for this data, as the CDC has dropped its hospitalization reporting requirement. Future levels will have to be inferred from past correlations to wastewater particles.
Deaths in the week of April 6 were 573. Only the 5 calendar weeks of last July were lower. We probably set a new record low in the last week of April, but we won’t know until the final data for that week is reported in a little over two weeks.
New Deal democrat
From JPWeiland, on the FLiRT variants:
https://www.threads.net/@jpweilandmodels
“The model I posted last week suggests a slight uptick from FLiRT, but it’s entirely possible that the spring weather is able to subdue the takeover of this more evasive variant. We’ll know in a couple of weeks.
“Infection rates are now near 2023 lows, a month earlier than 2023. If FLiRT only stops the decline, this is a good place to be.”
The latest forecast of his model shows a 50% increase in infections over the next month – but from the very low levels of the present, taking us back only to March’s relatively low levels.
Sent from my iPad
TBone
I blew up like a balloon again this week with severe inflammation (even my toes). I had my diamond ring resized when Covid first enlarged me but it is now too small again. When I get smaller (periodically), it falls off my finger. And my cats are all sick, sneezing, coughing, dry red noses, lethargic, and generally miserable. At least they’re still eating. Really tired of illness and worry stalking us.
On a brighter note, every day I wake up grateful that I am retired and can set my own personal schedule that includes no clocks. I put the clocks in the bathrooms when we moved in here, where they belong.
Lapassionara
I read your COVID update every week. Please keep up the good work.
Those COVID denialism statistics are sobering.
lowtechcyclist
I really appreciate the avian flu updates, Ann – it’s helpful to have a sense of what might be coming at us.
OzarkHillbilly
Don’t drink bleach! Cow pies are NOT edible! Breathe!
H.E.Wolf
Thank you, Anne Laurie, for being a riverboat captain. :-)
Soprano2
@TBone: You can go to a jeweler and get a guard for your ring. It fits inside the ring and makes the opening a little smaller so it doesn’t fall off. I got one for $5.
The MO state site seems to be down this morning.
I was asked by someone yesterday if my nephew-in-law who died took the Covid vaccine. I said I didn’t know, which is true, and she muttered something about “so many people have died”, which I didn’t say anything about because it wasn’t a situation where we could discuss it. But yeah, way too many people believe this without any evidence of it at all. They just want to believe it.
Soprano2
@OzarkHillbilly: This is particularly crazy for farmers, because they know better. I wonder how many of these people have Oppositional Defiance Disorder.
Betty
While it is encouraging that Long Covid is finally being treated as a serious problem, it still feels as if efforts at figuring treatments remain very slow.
Liminal Owl
@TBone: Much sympathy; that sounds very difficult. (But glad you’re retired.). May I contact you directly about something unrelated? Or would you email me? Watergirl has my info.
WereBear
People are STILL feeling the after effects. They are kind of tucked inward and seem too busy and/or exhausted to put effort into things as before.
Still processing, no doubt. Me, I picked a fine time for all that research into the Spanish Flu epidemic.
bluefoot
AL: I continue to read your updates every week. I am grateful you’ve continued to do these! I think we may need to buy you a captain’s hat. :)
That poll about COVID and vaccine beliefs is scary. I don’t know how to counteract misinformation that those sorts of entrenched beliefs. The next pandemic (and there will be one eventually, biology and evolution being what they are) is going to fund us woefully unprepared to respond effectively if these beliefs remain entrenched.
bluefoot
Long Covid is no joke. I know several people who are experiencing long Covid, ranging from mild (continued loss of some taste now almost 4 years after initial infection) to severe (extreme fatigue, cognitive problems, cardiac problems including atrial fibrillation unamenable to treatment).
I do know a couple of people whose symptoms of long Covid much improved after their latest booster, so there’s that. Supports the theory that at least some long Covid may be caused by residual virus.
lefthanded compliment
Delurking to say how much I appreciate your ongoing efforts to keep us informed. Many thanks!
la caterina
Thank you for keeping this up, Ann. Your updates are my go-to for covid info. And you deserve an award for your daily posts during the worst of the pandemic!
glc
@Baud: Unfortunately there will be no need for that.
Another for the pile.
Astra-Zeneca moves on
Gretchen
Thanks for all the work that goes into these updates, AL . Much appreciated.