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Coronavirus dashboard for January 10: how “mild” Omicron is depends upon how much you lag the data

  – by New Deal democratSo, how “mild” or not, is Omicron? It depends on whether you lag the data on hospitalizations and deaths or not.The original story out of South Africa was that Omicron was extremely mild. Despite a huge spike in infections,…

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 - by New Deal democrat

So, how “mild” or not, is Omicron? It depends on whether you lag the data on hospitalizations and deaths or not.


The original story out of South Africa was that Omicron was extremely mild. Despite a huge spike in infections, deaths barely budged. As Omicron took hold in Europe and the US, South Africa disappeared from the picture.  Which is too bad, because here is what has been happening with deaths: 


In the past week, deaths in South Africa tripled. Mind you, deaths - so far, anyway - at 13x their pre-Omicron low, are nowhere near the 80x+ increase in cases. But the point is, deaths lag cases, and until you wait about a month to see how deaths play out, you really don’t know how “mild” Omicron is.

And the bad news for the US is, compared with South Africa and even the UK, Omicron hasn’t been as “mild” so far, as shown in the below set of graphs comparing cases, hospitalizations, ICU admissions, and deaths (again, so far):


A week ago, the story in the US was still how “mild” Omicron has been, as shown in this graph of cases, hospitalizations, and deaths from New York City (perhaps the earliest hard hit metro area):


There’s just one problem with the above graph: hospitalizations and deaths aren’t shown with any sort of lag. Deaths on January 2 are compared with hospitalizations on January 2 and new cases on January 2.

But when you put in an appropriate lag, the situation looks much different, as in the below graph in which deaths are lagged 21 days for NYC and two other metros:


Or the below graph, including ICU patients with a 14 day lag compared with infections:


All of a sudden, Omicron doesn’t appear that much milder at all.

This is something I’ve been following since the onset of the Omicron wave. Since hospitalizations started to spike about 10 days after the onset of the wave, i crunched data with a 10 day lag. While I don’t have a graph to show you, I can tell you that each time I have done this, it gives me a result of hospitalizations increasing at a rate of between 65% to 80% of cases. ICU admissions lag hospitalizations by only a day or two, and have gone up at about 50% of the rate of cases. Because the Omicron wave only started in earnest on December 15, 3 1/2 weeks ago, we are only beginning to see the trend in deaths.

But we already have more hospitalizations for COVID than we have ever had before in the US, and the system is beginning to break down - and we haven’t even reached the peak yet. As a society, the US seems to have just given up.

Since I hate only passing on gloom and doom, let me give you a few rays of daylight.

First, the Omicron wave seems to have already peaked in several places where it hit early: Puerto Rico, DC, and New Jersey. In two other places, New York and Hawaii, it hasn’t peaked yet:


Finally, Omicron is infecting so many people that within a month or two it is going to be difficult for COVID to find a victim who doesn’t have at least some resistance via vaccinations or prior infection:


About 62% of the US population has been fully vaccinated (but only about 36% being boosted as well, according to the CDC). Another 12% have received at least one dose. And over 18% have had *confirmed* cases. The likelihood is that, including asymptomatic infections or infections of people who didn’t bother to get tested, at least double that percentage, somewhere on the order of 40% of all Americans, have been infected.

If we just randomly assign that 40% of infected people among all those vaccinated and unvaccinated, that’s roughly 85% of the US population that should have at least *some* resistance to renewed infection. Another month of Omicron is probably going to take that up to 90%.

It’s possible there is a doomsday variant out there, but it’s more likely that, as COVID becomes endemic, each wave displays less and less virulence, not because they are inherently “milder,” but simply because the vast majority of the population has some, increasing, level of immune resistance.

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FDA to soon authorize Pfizer’s COVID booster shot for younger kids – NYT

U.S. health regulators are expected to authorize a booster shot of Pfizer/BioNTech’s COVID-19 vaccine for children aged 5 to 11 as soon as May 17, the…

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FDA to soon authorize Pfizer’s COVID booster shot for younger kids – NYT

(Reuters) – U.S. health regulators are expected to authorize a booster shot of Pfizer (PFE.N)/BioNTech’s COVID-19 vaccine for children aged 5 to 11 as soon as Tuesday, the New York Times reported on Monday, citing people familiar with the matter.

The companies submitted an application to the U.S. Food and Drug Administration for the authorization last month.

They have cited data from a mid- to late-stage study showing a third dose of their shot increased protection against the original coronavirus version and the Omicron variant among children in the age group. read more

It is unclear how much demand there is for the third dose in the age group. Just 28.8% of children aged 5 to 11 are fully vaccinated, according to data from the U.S. Centers for Disease Control and Prevention.

Empty vials of the Pfizer-BioNTech coronavirus disease (COVID-19) vaccine are seen at The Michener Institute, in Toronto, Canada January 4, 2021 in this file photo. REUTERS/Carlos Osorio/File Photo

A meeting of outside vaccine experts on an advisory committee to the Centers for Disease Control and Prevention has been scheduled for Thursday, the report said.

The FDA declined to comment, while Pfizer and BioNTech did not respond to requests for comment.

Reporting by Mrinalika Roy in Bengaluru; Editing by Anil D’Silva

Our Standards: The Thomson Reuters Trust Principles.

 

Reuters source:

https://www.reuters.com/business/healthcare-pharmaceuticals/fda-authorize-pfizers-covid-booster-shot-younger-kids-soon-nyt-2022-05-16

 

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FDA declines to authorize common antidepressant as COVID treatment

The U.S. Food and Drug Administration decided not to authorize the antidepressant fluvoxamine to treat COVID-19, saying the data has not shown the drug…

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FDA declines to authorize common antidepressant as COVID treatment

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(Reuters) – The U.S. Food and Drug Administration has decided not to authorize the antidepressant fluvoxamine to treat COVID-19, saying that the data has not shown the drug to be an effective therapeutic for fighting the virus.

“Based on the review of available scientific evidence, the FDA has determined that the data are insufficient to conclude that fluvoxamine may be effective in the treatment of nonhospitalized patients with COVID-19 to prevent progression to severe disease and/or hospitalization,” the agency said in a document published on Monday.

University of Minnesota professor Dr. David Boulware submitted the emergency use authorization request to the FDA that would have allowed doctors to prescribe fluvoxamine maleate to treat COVID-19 in non-hospitalized patients.

The generic drug belongs to an old, widely-used class of antidepressants called selective serotonin reuptake inhibitors, or SSRIs.

Boulware said that his request is less urgent with the availability of drugs like Pfizer Inc’s (PFE.N) Paxlovid, but he still believes the data supports the drug’s use in some COVID patients.

“There are effective therapeutics that are available. But not everyone has access to them. Not everyone can tolerate them. Some people have contraindications,” Boulware said in an interview. “And if you go elsewhere in the world, low- and middle-income countries, they have access to no therapeutics.”

Boulware’s submission relied on data from three trials, especially a study of 1,497 non-hospitalized COVID patients in Brazil.

While the Brazilian study met its primary endpoint, showing a roughly 30% drop in hospitalizations in the group that received fluvoxamine, the FDA said there were uncertainties about the assessment, which measured reduction in emergency department visits lasting more than 6 hours.

Signage is seen outside of the Food and Drug Administration (FDA) headquarters in White Oak, Maryland, U.S., August 29, 2020. REUTERS/Andrew Kelly/File Photo

Boulware said FDA had used a different measure to count hospitalizations in other drug trials, including only acute care that lasted at least 24 hours.

“The standard that they were holding for fluvoxamine was a different standard than the other big pharma trials, with Paxlovid and (Merck’s) molnupiravir and the monoclonals,” he said of other authorized COVID therapeutics.

“I was really quite disappointed that they did that,” he said.

Reporting by Leroy Leo in Bengaluru and Michael Erman in New Jersey; Editing by Bill Berkrot

Our Standards: The Thomson Reuters Trust Principles.

 

Reuters source:

https://www.reuters.com/business/healthcare-pharmaceuticals/fda-declines-authorize-common-antidepressant-covid-treatment-2022-05-16

 

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Spread & Containment

Coronavirus may be linked to cases of severe hepatitis in children

A chain of events possibly triggered by unrecognized infection with the SARS-CoV-2 coronavirus could be causing the mysterious cases of severe hepatitis…

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Coronavirus may be linked to cases of severe hepatitis in children

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(Reuters) – The following is a summary of some recent studies on COVID-19. They include research that warrants further study to corroborate the findings and that has yet to be certified by peer review.

SARS-CoV-2 could be at root of mysterious hepatitis in kids

A chain of events possibly triggered by unrecognized infection with the SARS-CoV-2 coronavirus could be causing the mysterious cases of severe hepatitis reported in hundreds of young children around the world, researchers suggest.

Children with COVID-19 are at significantly increased risk for liver dysfunction afterward, according to a report posted on Saturday on medRxiv ahead of peer review. But most of the children with acute hepatitis – which is generally rare in that age group – do not report a previous SARS-CoV-2 infection. Instead, the majority have been found to be infected with an adenovirus called 41F, which is not known to attack the liver. It is possible that the affected children, many of whom are too young to be vaccinated, may have had mild or asymptomatic COVID infections that went unnoticed, a separate team of researchers suggest in The Lancet Gastroenterology & Hepatology. If that were true, they theorize, then lingering particles of the coronavirus in the gastrointestinal tract in these children could be priming the immune system to over-react to adenovirus-41F with high amounts of inflammatory proteins that ultimately damage the liver.

A firefighter from the Marins-Pompiers of Marseille (Marseille Naval Fire Battalion) administers a nasal swab to a child at a testing site for coronavirus disease (COVID-19) in Marseille, France, September 17, 2020. REUTERS/Eric Gaillard

“We suggest that children with acute hepatitis be investigated for SARS-CoV-2 persistence in stool” and for other signals that the liver damage is happening because the spike protein of the coronavirus is a “superantigen” that over-sensitizes the immune system, they said.

Face-down position unhelpful for awake patients

For hospitalized COVID-19 patients who are breathing on their own but with supplemental oxygen, lying face down might not help prevent them from eventually needing mechanical ventilation, according to a new study.

In the study, 400 patients were randomly assigned to usual care or to standard care plus intermittently lying on their stomach, a position known to improve the course of illness in sedated patients on mechanical ventilators. Over the next 30 days, 34.1% in the prone-positioning group and 40.5% in the usual-care group needed to be intubated and put on a ventilator, a difference that was not statistically significant. There might have been a reduction in the risk for intubation with prone positioning among some of the patients, researchers said on Monday in JAMA, but they could not confirm it statistically from their data. The average duration of prone positioning per day was roughly five hours, less than the target of eight to 10 hours per day.

“Long hours of awake prone positioning are challenging and highly influenced by patient comfort and preference,” the researchers said. “The most common reason for interruption of prone positioning was patient request, which might have been related to overall subjective improvement or related to discomfort from prone positioning.”

Click for a Reuters graphic on vaccines in development.

Reporting by Nancy Lapid and Megan Brooks; Editing by Bill Berkrot

Our Standards: The Thomson Reuters Trust Principles.

 

Reuters source:

https://www.reuters.com/business/healthcare-pharmaceuticals/coronavirus-may-be-linked-cases-severe-hepatitis-children-2022-05-16

 

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