Portal, AZ - Rodeo, NM

Serving The Communities Of Portal and Rodeo  (www.portal-rodeo.com)

Coronavirus Update

Covid

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Part 1 - Prepared By Dr. Howard Topoff


What Causes Long Covid?

Three Leading Hypotheses


Mild or moderate COVID-19 lasts about two weeks for most people. But in some people, long-term effects of COVID-19 can cause lingering health problems and wreak havoc for months. This condition can affect anyone – old and young, otherwise healthy people and those battling other conditions. It has been seen in those who were hospitalized with COVID-19, patients with very mild symptoms and even some people who had virtually NO symptoms. Studies indicate that about 10% of people infected with COVID-19 will experience long-haul symptoms - the most common being:

    •    Fatigue.

    •    Symptoms that get worse after physical or mental effort.

    •    Fever.

    •    Lung (respiratory) symptoms, including difficulty breathing or shortness of breath and cough.


Hypothesis 1: Cells and tissues that control blood flow are damaged and the blood’s tendency to clot is amplified. Scientists think damage to tiny blood vessels and minuscule clots are the culprit to deteriorated lung function.


Hypothesis 2: The coronavirus keeps hurting people by stubbornly enduring in the body, even after acute infection passes. Studies have shown the virus is capable of persistence in a wide range of body sites, especially nerves and other tissues. Many people, post Covid positive testing harbor viral RNA in their body, including in the brain, muscle, gut, and lungs. Many organs even had evidence of replicating virus.


Hypothesis 3: The immune system is perturbed, even 8 months after people first tested positive. It was assumed that immune cells galvanized to fight off infection would have calmed down over that time span. So, it was a surprise that these immune cells did not recover. In some people, white blood cells that typically recruit other cells to sites of infection were highly activated, which may explain why the patients’ levels of interferons, proteins the body makes to fight invaders, were sky high 8 months after infection. The participants also had a dearth of inactivated T cells and B cells, a population of cells that normally putters about awaiting instruction to counter pathogens. Collectively this signaled chronic inflammation, which can cause a host of health problems.   


Of course, some combination of these three processes may be at work in cases of long Covid. When the pandemic started min January 2020, we had a lot to learn about the coronavirus that causes Covid. Two and a half years later, we still have many questions. You can read a more detailed account of the causes of long Covid in Science Magazine at:


https://www.science.org/content/article/what-causes-long-covid-three-leading-theories  

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The Worst Virus Variant Is Here. The Pandemic Is Not Over.


The coronavirus is speeding up once again, mutating, evading immunity and still on the march. The arrival of subvariant BA.5 should be a reminder that the finish line in this race is nowhere to be seen.


What’s BA.5? This is the latest subvariant of omicron, which stormed the planet late last year and caused a huge wave of infection. As of now, BA.5 and a closely related variant, BA.4, account for about 70 percent of all infections in the United States.


Eric Topol professor of molecular medicine at Scripps Research, says that BA.5 “is the worst version of the virus that we’ve seen.” He adds, “It takes immune escape, already extensive, to the next level, and, as a function of that, enhanced transmissibility,” well beyond earlier versions of omicron. There has not been a marked increase in hospitalizations and deaths, he reports, because there is so much immunity built up from the winter omicron wave. But there are aspects of this new variant very much worth keeping an eye on as the United States remains stuck at an uncomfortably high plateau of pandemic misery. 


Evolution has given it more fitness, a term that incorporates its ability to transmit, grow and evade immunity; the variant shows “marked difference from all prior variants,” reports Dr. Topol. One way it does so is by evading the body’s immune system, and BA.4 and BA.5 together are “the most immune-evasive variants” seen in multiple studies to date.


We should reinforce the need for the familiar mitigation measures: high-quality face masks, better air filtration and ventilation, and avoiding exposure in crowded indoor spaces. Sound familiar?  The greatest need is for next-generation vaccines that are more broadly protective, more durable (with longer-lasting immunity) and that can dampen transmission.

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President Biden Taking Paxlovid

President Biden has begun taking a course of Paxlovid, after testing positive for COVID-19. The antiviral medicine is recommended for early treatment by the Centers for Disease Control and Prevention.

Paxlovid, which combines two different antiviral drugs, has been found to be highly effective at reducing the risks of hospitalization and death for COVID-19 patients with mild or moderate symptoms. It's linked to a quicker recovery and a return to good health. But in some cases, patients report a "Paxlovid rebound" in which the disease returns.


What kind of regimen is the president on?


Paxlovid comes in pill form, in contrast to remdesivir, the intravenous antiviral drug that former president Trump was given when he contracted COVID-19 and was cared for at Walter Reed National Military Medical Center.



The standard Paxlovid regimen is to take three pills twice a day, for five days. It's not authorized for extended use. The FDA recommends the drug for people with mild-to-moderate coronavirus cases who "are at high risk for progression to severe COVID-19, including hospitalization or death."

Early symptoms for Biden, 79, included "an occasional dry cough," along with a runny nose and fatigue, Dr. Kevin O'Connor, the president's physician, said on Thursday.


What about the Paxlovid rebound?


Paxlovid has been hailed as an important tool to prevent COVID-19's worst effects, and for many people, the main challenge has been getting their hands on the medicine. But it's also been linked to a resurgent COVID-19 infection after the course of pills is finished, known as the "Paxlovid rebound.”


Some people who've taken the medicine say that it quickly eased their symptoms — but that they again tested positive and COVID-19 symptoms returned, anytime from two to eight days after their initial recovery, the CDC said in May.

Dr. Anthony Fauci recently experienced the rebound. And while some people say the second round of symptoms is less severe, Fauci said that for him, the rebound case was worse.

If Biden has a similar experience, it could further delay his return to normal duties.


What are the side effects?


The Food and Drug Administration issued an emergency use authorization for Paxlovid to treat COVID-19 patients last December.

"It leaves a terrible taste in your mouth and also gives some people (me) diarrhea," NPR's Joe Palca reported in May, after being prescribed the medicine.

Both of those reactions, including the taste disorder, dysgeusia, are recognized as potential adverse side effects for the medicine, along with hypertension. Paxlovid can also interact with statins and other drugs, as well as St. John's wort and other supplements, according to the FDA.


How does Paxlovid work?


The medicine is made by Pfizer, and is a combination of two other antiviral drugs, nirmatrelvir and ritonavir.

Nirmatrelvir is a protease inhibitor that "has demonstrated antiviral activity against all coronaviruses that are known to infect humans," according to the National Institutes of Health. Ritonavir previously has been used against HIV; for COVID-19 patients, it serves as a booster to help ensure enough nirmatrelvir is present in the body to be effective.


It's crucial to start on the medicine as soon as a case is diagnosed.

"Paxlovid must be taken within five days after symptoms begin," the Food and Drug Administration said earlier this month. Speed is such an important factor that the FDA has authorized licensed pharmacists to prescribe the drug for people who recently tested positive.

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The CDC posts a very simple web site, indicating the severity of Covid, county by county, with advice on mask wearing. Check ity out at:

Rate of coronavirus (COVID-19) cases in the United States as of
August 6, 2022, by state (per 100,000 people)

Arizona is ranked at #11. New Mexico is much better at #25.

Local Cases August 6, 2022


Rodeo: 31  Animas: 144  Lordsburg: 1022   Portal-San Simon: 71

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Ready Fauci? Here We Go Again!

Monkeypox

Covid