I believe that medicine’s potential is much more than the version we see in the world today. A doctor should be an educator with the goal of bringing patients to a place of deeper understanding of who they are in the world. To me, medicine is ultimately about self-empowerment through self-knowledge and growth.
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Warm autumn greetings to you!
It is high time to review some COVID items. Here are 7 of the things we are seeing:
National numbers for new COVID cases are at 40K daily. They have been steady there for a while even though there is a slight uptick over the last week. Local cases are the same as they have been; less than 30 per day in the county on average.
We are hearing a lot in the media about the weather changing and what that might mean for COVID cases. People are indoors more. Then there are those pesky holidays that make us congregate. Health officials are worried. They worry like it’s their job every year, but there’s more for them to worry about this year.
“The challenge with holiday seasons every year is it’s also a time where contagious respiratory viruses — like influenza, RSV, and, again this year, Covid — spread,” said Ashish Jha, the White House Covid-19 response coordinator, during a press conference this week.
The key question: Just how bad will Covid-19 be this winter? Or just how not-that-bad?
Just when you thought the anxiety would penetrate your armor, there’s this from The Institute for Health Metrics and Evaluation (IHME), an independent global health research center:
“MILD WINTER: The U.S. probably won’t see a major surge in COVID deaths this winter,” according to new models from the Institute for Health Metrics and Evaluation (IHME) at the University of Washington in Seattle.
By Feb. 1, 2023, daily deaths are projected to be at a high point of 335, which pales in comparison to the approximate 2,500 daily deaths seen during the Omicron surge around the same time last year, according to a recently published policy brief from the IHME.
The report estimates the COVID-19 infection-fatality rate (IFR) to be below 0.2% as of October 17.
“Many people have been exposed to COVID-19, either through infection or through vaccination, [so we don’t expect] a high hospitalization rate and high mortality rate,” Ali Mokdad, PhD, a professor at IHME and chief strategy officer for population health at the University of Washington, told MedPage Today. “We will see a little bit of a rise, but it will not be as high as what we have seen in the past.”
Also contributing to that flattening of the deaths curve is the fact that current and emerging variants appear less severe and unable to thwart humoral and cellular immunity — though Mokdad warned that the appearance of a new variant that is more severe and immune-evasive could change those predictions. Nonetheless, he said, the probability of that happening is small.”
That’s reassuring! And not so anxiety-provoking.
Researchers have been using antibody levels (B-cells) as a predictor of the helpfulness of injections, but T-cell immunity (the other arm of the immune system) is probably more important with Coronavirus infection. T-cell immunity is the main place where immune memory is stored with COVID and it’s not easy to evaluate. Critics say lack of good quality data leaves us guessing.
Recently quoted percentage that WIV was the source of the pandemic after zoonotic trail still not emerging and new paper presents more analysis of the SARS COV-2 genetic content. In other words, SARS COV-2 was almost certainly not natural and it escaped from the lab. Indigestion-inducing.
In case you want a review of the letters and numbers that are up next: Omicron’s BA.5 is dropping and has come down to be found in just 50% of cases. The newer, more immune-evasive variants such as BQ.1.1 and BA.2.75.2 are being tracked, and appear to be becoming more prevalent. Evusheld and monoclonal antibodies may lose some of their ability to help. However, the pattern has held true so far that the emerging variants are less severe.
How are we doing?: Booster uptake is poor.Nationwide, uptake of the bivalent booster is lagging, with only 7.3% of those eligible having received it, according to the Centers for Disease Control and Prevention. Boosters target both the original COVID-19 strain and omicron subvariant BA.5. Data to support decisions is lackluster. Speculation is good enough for some and important for the high-risk but clearly isn’t satisfactory for the majority.
That’s the COVID round-up and headlines as I saw them.
While we are at it, in case you haven’t heard: “Cases of MONKEYPOX are continuing to decline in the U.S., but the disease is still disproportionately affecting people of color, a White House official said.
“We continue to have a decrease over time,” Demetre Daskalakis, MD, White House National Monkeypox Response deputy coordinator, said at an online briefing. “We’re about 85% down from where we were at the peak of the outbreak. So that’s a lot of hopeful news, that we continue to see monkeypox going under better and better control.”
