Inside Medicine. What Are You Seeing? [COVID-19 medical news]

If we live in masks forever, the transmission of all respiratory diseases will be reduced. I don’t see anyone, myself included, signing up for living out their years perpetually covered up.

The current vaccines, even with a third dose, are not as effective at preventing infection from this variant. They are still highly protective against severe disease. That’s what we need to move forward. Turning a disease with significant morbidity and mortality into a cold was always the end game.

Will people still get long Covid, and some even die, yes. People die from influenza and the common cold. We all face risk everyday without much thought, from driving our car (40k Americans die per year) to swallowing food (5000 American deaths per year). There has to be a point where we view Covid, like we do other mostly transient, but potentially harmful illnesses…without much thought. I think we’re close.

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Thanks for that.
I privately have been concerned that in the future we will see increased autoimmune diseases in those who are Covid survivors. Other viruses do this. When I saw the marked inflammatory responses in the tissues of people with Covid, and then long Covid, the virus remaining in the tissue after symptoms have cleared, the news of EBV causing multiple sclerosis, hearing Dr. Appel talking about how Alzheimer’s and ALS are a result of abnormal immune reactions, physicians posting asking others if they’re seeing increased numbers of Grave’s disease in recovered people. Just more and more red flags/warning signs popping up.

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That all matches what our medical lad has told us regarding what he’s heard on the job. How much are they going to see down the road and will we have enough medical personnel to handle it all considering how many people have had Covid? There’s what is seen for illness and some (relative to illness) death, but what’s unseen could also be pandemic problematic even among those with seemingly minor cases. Research is going on where he works (and elsewhere I’m sure). Only time will tell.

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This is a protein subunit vaccine under development that is based on attaching a SARS-CoV-2 spike protein to a hepatitis B surface protein to increase immune response. The viral proteins are produced in yeast, and the vaccine prototype does not require ultra-cold storage.

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It looks like the J&J (Janssen) vaccine held up as well as or better against cases of COVID-19 during the Omicron wave than the Moderna or Pfizer vaccines, although all were far better than being unvaccinated.

That seems to be consistent with some previous studies that suggest that, while it was not as effective initially and against the ancestral virus that all of the vaccines targeted, it loses less effectiveness over time and against variants compared to the Moderna and Pfizer vaccines.

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When I jokingly said I got a Moderna boost after my initial Pfizer doses so I could eventually get every brand stamp, I might have unknowingly been more accurate than I realized. :stuck_out_tongue_winking_eye:

I m till waiting to see what my MDs recommend. I have had 3 Pfizer’s so far, as have H and my mom.

So are you (or anyone else here) looking for a J&J booster?

Way too early to know, but this looks promising:

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I think it’s too early to know. It would depend on the alternatives at the time they recommend a 4th. Plus, the mRNAs are pretty equivalent and can be substituted. I don’t know that data on that for JnJ with nRNA. I wouldn’t automatically reject it though.

“This population-based cohort study from clinical practice in the US found that Ad26.COV2.S was associated with stable and durable VE for at least 6 months across high-risk patient subgroups and in geographic areas with high Delta variant incidence.” (Study of medical insurance claims data over March to August 2021.)

Post-COVID there is a 40% increased risk of developing diabetes.

It was evident in Black people and white people; it was evident in young folks and in older folks; it was evident in males and females; and, most importantly, it was also evident even in people who had no risk factors for diabetes at all.

This kind of stuff is so scary to me. Here is a link to the study.

https://www.thelancet.com/journals/landia/article/PIIS2213-8587(22)00044-4/fulltext#%20

Once again, I haven’t combed through every detail. It’s a massive study. It uses the VA data, which means there’s an older male skew, but it’s so big they can draw conclusions for several characteristics. Vaccination status is not mentioned as far as I can see, but the risk did vary by severity of COVID infection.

I really wish we had this data too.

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As the parent of a kid with type 1, I get so annoyed by these titles. I read in the article that 99% of those diagosed with diabetes after COVID were type 2. They are entirely DIFFERENT diseases. Type 1’s for years have tried to change the name.

The article eventually does distinguish between the two types but fails to say that type 1 is an autoimmune disorder. The body attacks its own pancreatic beta cells essentially destroying any possibility of producing insulin for the rest of the person’s life.

The mechanism for developing type 1 has long been explored. My kid was diagnosed 6 months after the coxsackie virus. The idea is that the immune response to the virus involves molecular mimicry in which the immune attack on the virus somehow makes a mistake by attacking pancreatic cells. This could easily apply to COVID.

The mechanism for type 2 would be entirely different, since type 2 is not an autoimmune disorder.

But the massive study that found increased risk of diabetes was 99% type 2. (In fact, 95%+ cases of “diabetes” have always been type 2.)

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I don’t know a lot about diabetes except that type 1 and type 2 are pretty different, but I’ve seen people online say they think Alzheimer’s should be classified as type 3 diabetes, implying it’s part of a continuum in some way. Why, I don’t know. Out of curiosity, what do type 1 people want to change the name to?

The viral connection to type 1 is interesting. One thing I think I have learned out of all this is how very little we seem to know about aftereffects of any viral infection. Like I said, it scares me. I caught a strange horrible respiratory illness in November 2019 (couldn’t have been COVID - too early and it was in rural Montana) that affected my breathing and mental acuity for months afterwards. What was that all about? I’m just glad it was the last time I’ve gotten sick.

Trying to focus on the brighter side, it seems from my layman’s perspective that we have already expanded our knowledge of virus effects quite a bit within my lifetime (thinking about HPV/cervical cancer, Epstein-Barr/MS…). I hope that the amount of research going into COVID has positive impacts on our understanding of other effects like this. If we could end MS or type 1 diabetes with a vaccine, wouldn’t that be amazing?

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Probably many people would like to know whether a breakthrough infection has as much of this type of risk as an unvaccinated infection. The study included those who had “a record of COVID-19 positive tests between March 1, 2020, and Sept 30, 2021”, so it definitely includes both the pre-vaccine time and the time when any adult in the US could have gotten vaccinated.

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just reading this.

On March 15, 2022, the Health Resources & Services Administration (HRSA) announced that the Uninsured Program will stop accepting claims for COVID-19 testing and treatment on March 22, 2022 at 11:59 PM ET due to lack of sufficient funds. HRSA will stop accepting claims for COVID-19 vaccination on April 5, 2022

HRSA has paid approximately $18,784,822,233 in claims for COVID-19 testing, treatment and vaccination since the Uninsured Program’s inception.

Patient with Wiskott-Aldrich Syndrome, an inborn error of metabolism predisposing to dysregulated immunity and infection, had COVID-19 for 146 days. Was given two doses of Pfizer vaccine a month apart. Eventually cleared infection 72 days after first vaccine dose (218 days from start of infection).

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could be the mRNA induced myocarditis isn’t as mild and transitory as initially believed. It seems like something worth keeping a close eye on especially (as noted below) when these young affected men take up sports or other physically stressful activities.

’ In a cohort of adolescents with COVID-19 mRNA vaccine-related myopericarditis, a large portion have persistent LGE abnormalities, raising concerns for potential longer-term effects. Despite these persistent abnormalities, all patients had rapid clinical improvement and normalization of echocardiographic measures of systolic function. For patients with short acute illness, no dysfunction demonstrated by echocardiogram at presentation and resolution of symptoms at follow up, return to sports was guided by normalization of CMR alone. In patients with persistent CMR abnormalities we performed exercise stress testing prior to sports clearance per myocarditis recommendations’

Persistent Cardiac MRI Findings in a Cohort of Adolescents with post COVID-19 mRNA vaccine myopericarditis

https://www.jpeds.com/article/S0022-3476(22)00282-7/fulltext#%20

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