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Discussion thread VII - COVID-19: Endemic Stage

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  • US -

    Sore throat, then congestion: Common Covid symptoms follow a pattern now, doctors say
    ...
    Sept. 16, 2023, 6:00 AM CST
    By Aria Bendix

    Doctors say they're finding it increasingly difficult to distinguish Covid from allergies or the common cold, even as hospitalizations tick up.

    The illness' past hallmarks, such as a dry cough or the loss of sense of taste or smell, have become less common. Instead, doctors are observing milder disease, mostly concentrated in the upper respiratory tract.

    "It isn’t the same typical symptoms that we were seeing before. It’s a lot of congestion, sometimes sneezing, usually a mild sore throat," said Dr. Erick Eiting, vice chair of operations for emergency medicine at Mount Sinai Downtown in New York City.

    The sore throat usually arrives first, he said, then congestion.
    ...
    "Just about everyone who I've seen has had really mild symptoms," Eiting said of his urgent care patients, adding, "The only way that we knew that it was Covid was because we happened to be testing them."
    ...
    For the most part, the doctors said, few patients require hospitalization — even those who show up at emergency rooms — and many recover without needing the antiviral pill Paxlovid or other treatment.
    ...
    Daignault said emergency rooms generally aren’t seeing the shortness of breath, low oxygen rates or viral pneumonia that led some patients to be put on oxygen tubes or ventilators in the past.

    Instead, he said, the typical Covid patients hospitalized in Burbank are older and suffering dehydration, loss of appetite, weakness or fatigue.
    ...
    Doctors who treat Covid describe the ways the illness has gotten milder and shifted over time to mostly affect the upper respiratory tract.

    "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
    -Nelson Mandela

    Comment


    • WHO Director-General's opening remarks at the media briefing – 27 September 2023

      27 September 2023
      ...
      First, as the northern hemisphere winter approaches, we continue to see concerning trends for COVID-19.

      Among the relatively few countries that report them, both hospitalizations and ICU admissions have increased in the past 28 days, particularly in the Americas and Europe.

      Meanwhile, vaccination levels among the most at-risk groups remain worryingly low.

      Two-thirds of the world’s population has received a complete primary series, but only one-third has received an additional, or “booster” dose.

      COVID-19 may no longer be the acute crisis it was two years ago, but that does not mean we can ignore it.

      Countries invested so much in building their systems to respond to COVID-19.

      We urge countries to sustain those systems, to ensure people can be protected, tested and treated for COVID-19 and other infectious threats.

      That means sustaining systems for collaborative surveillance, community protection, safe and scalable care, access to countermeasures and coordination.

      ===

      "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
      -Nelson Mandela

      Comment


      • New Zealand

        Opinion


        Covid cannot just be wished away

        By Dr Greg White - Cromwell GP -October 28, 2023

        ...
        Now Covid is over I can move on and we can put it behind us. Many of you probably nodded. That’s because of the power of suggestion.

        Health workers and scientists, however, live and study in the real world where SARS2 is the third leading cause of death now behind cancer and heart disease, and ahead of accidents.

        And before you think ‘‘well, they were old’’, one was less than 10, one in their 30s, two in their 40s is this week’s readout, along with hundreds hospitalised.
        ...
        The elephant in the room that is never mentioned is Long Covid. Unfortunately, it is looking likely this mysterious new disease is simply chronic Covid infection, i.e. persistent long term viral disease. Think herpes and HIV.

        So far this affects 5%-10%, but it may be more over decades. It has ground down many HCWs, leading to shortages.

        Every organ studied, including the retina, testes, heart, immune cells and brain, has shown viral persistence.

        That we accept this as OK is hard to reconcile.
        ...
        Colleagues and I are not fearful. We are experts in risk management.

        And right now the risk remains high, despite the urgency of normal.


        Kia ora again. Now Covid is over I can move on and we can put it behind us. Many of you probably nodded. That’s because of the power of suggestion. Health workers and scientists, however, live and study in the real world where SARS2 is the third leading cause of death now behind cancer and [...]

        "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
        -Nelson Mandela

        Comment



        • This is not medical advice. if you have any medical questions please consult your medical practitioner.

          Today I received a Novavax COVID-19 vaccine from Publix. I am a senior and at high risk for a bad COVID-19 outcome. I have no idea how effective it will be for me. I know that it will not prevent me from getting COVID-19. I got it because it is a non mRNA vaccine and I am curious about it. My hope is that if I am exposed to COVID-19 I will not be hospitalized and/or have any serious symptoms. This is only PART of my defense. I am still not going to any large gatherings but I plan to attend a couple of family gatherings during the holidays of about 10 people. There will be an air flow design to the events with an air purifier, and fans in the room. I am also taking an N95 mask just-in-case someone is coughing. I still wear an N95 inside public places. The weather is great outside this time of year in Florida so I will be attending events outside and in screened-in areas. I am still not going to any inside restaurants but plenty have nice outside patios.

          I don't care what anybody else thinks about my choices. They are not any type of political statement. I am doing me. I respect everyone else's decisions for them.

          As far as I know I have not become ill with COVID-19 since the beginning. I have routinely taken the shots, worn an N95 mask, and limited my social activities. The worst side effect of the shots has been a sore arm for a day. I know of no other side effect.

          Vaccines are medicine. Please consult your medical practitioner before taking any medicine.

          Do not take medical advice from the internet.

          Take care of you.

          Comment


          • kiwibird
            kiwibird commented
            Editing a comment
            Unfortunately had to visit someone in hospital a couple of weeks ago. The windows were opened and there was a huge air purifier in the area away from the window. Hopefully other hospitals, restaurants and offices will start taking these sort of precautions. No sign of any of the staff or patients having any respiratory disease - so - great.

          • sharon sanders
            sharon sanders commented
            Editing a comment
            As a followup to my little experiment....As far as I know I did not get COVID-19 after spending an hour in a restaurant. Here are the options:
            1) No one in the restaurant had an active case of covid,
            2) I did get covid but the effects were so mild I did not realize it (Novavax vaccine credit?),
            3) As the restaurant began to get more busy someone with covid did appear but sitting under a air vent blowing air away from us plus the other actions taken above prevented and/or killed the virus in the mouth, nose, throat before the virus could replicate.

            I have no idea but I have always thought a layering of prevention methods was necessary to avoid COVID-19. I will be doing all of the same things I indicated above for the holidays at family events. I am still wearing an N95 mask in all inside public venues like grocery stores etc.

            COVID-19 is a real disease and for some people it is deadly. Others experience life altering circulatory/neurological symptoms. I am going to try to avoid an infection for as long as possible.

            As a reminder - I am NOT offering medical advice. If you are sick and/or have any medical questions - consult your medical practitioner.

          • sharon sanders
            sharon sanders commented
            Editing a comment
            So for Thanksgiving we had fans in the rooms directing air away from the vulnerable people group. Before the two events I did a nose prep and gargled with Listerine. There were 10 people total at each event - ages 9 - 88. I did not wear an N95 mask. As far as I know I did not contract COVID-19. Again, this is not medical advice. I am trying to find life hacks to be able to do more things in society.

        • France -

          Translation Google


          After the Covid epidemic, a report calls for “absolute visiting rights” in nursing homes

          The psychological consequences of these restrictions during the epidemic were “immense” for elderly people and their loved ones.


          By Le Parisien with AFP
          November 14 , 2023 at 11:27 a.m.


          Avoid such an “inhumane” situation from happening again. The inability to say goodbye to loved ones during the Covid-19 epidemic had created trauma for many families. A report to be published this Tuesday calls for the right to visit nursing homes to be included in law. In March 2020, the coronavirus epidemic led the executive to take unprecedented containment measures against the population in the hope of stemming the spread of the virus and limiting its impacts, particularly on populations. the most fragile.

          Nursing homes were then confined, visits prohibited, isolation in rooms at the urging of the Ministry of Health became widespread. Families have been refused access to their loved ones at the end of their lives or, when the ban is lifted, can only see them from afar, through Plexiglas windows.

          The consequences for residents and their loved ones were “immense”, notes to AFP Laurent Frémont, one of the co-authors of the report “Hindered links, forbidden farewells”, commissioned by the executive and which must be submitted to ministers Aurore Bergé (Solidarity) and Agnès Firmin Le Bodo (Health professions).

          Restrictions “still inappropriate”
          Among the residents, “we could observe a feeling of abandonment, a withdrawal into oneself, a refusal to eat, and the sliding syndrome ”, a state of psychological distress amplified by isolation which can be fatal, develops the lawyer and founder of the “Hold Your Hand” collective, which defends the right to watch over hospitalized loved ones. For families, “we noted traumatic bereavement , post-traumatic stress, a very strong feeling of guilt and abandonment when goodbyes could not be said”.

          In total, around fifteen measures are put forward, including that relating to the establishment of an “absolute right to receive” for the resident. A measure that is all the more urgent “as we are still seeing inappropriate restrictions on visits today,” denounces Laurent Frémont, who points out “very restrictive” time slots in certain establishments with visits only possible between 2 p.m. and 4 p.m.

          Based on systems already in force in certain establishments, the report considers it possible “to establish no visiting time limit” and to control entries and exits via codes and cameras. In the event of a crisis, as was the case during Covid, restrictions must “be proportionate, limited in time, precisely motivated” and “accompanied by alternative visiting arrangements, in order to preserve rights and avoid isolation. »

          “She died, alone, without us”
          Reproduced in some cases in the report, the thousands of testimonies collected as part of the mission to reflect on visiting rights give voice to the despair, helplessness and anger of families. “She died, alone, without us to hold her hand”, “He died abandoned on a hospital bed, without a presence to tell him I love you, thank you, we are here with you”, perhaps we particularly read. “I couldn't see my father's face again, I went from a Samu door to a closed coffin .”

          “Even in prison, we have the right to one walk a day. This minimum humanity was denied to our parents. They have become things, certainly to be protected, but completely reified during this period,” adds another.

          “Some testimonies reveal a kind of barbarism, the fact of forbidding a spouse from going to assist their loved one at the end of life when they are asking for it, it is something inhumane,” underlines Laurent Frémont. “There were also violations of freedom of conscience for those who requested access to funeral rites, to the last sacraments at the end of life.”

          Pay homage
          Among the other measures recommended in the report are the obligation of training in palliative care and end-of-life support in nursing homes or the appointment of a general controller of places of great vulnerability.

          The report also calls for official recognition of the shortcomings observed via a symbolic day of remembrance or a specific place of contemplation to “give a face to those who left alone”. “It’s a way of paying tribute and ensuring that it doesn’t happen again,” concludes Laurent Frémont, whose father “left alone” three years ago, in the middle of the Covid epidemic.

          "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
          -Nelson Mandela

          Comment


          • From https://twitter.com/RajeevJayadevan/...84569469911116 Is this indicating that recent infection leads to an increased susceptibility?
            "The only security we have is our ability to adapt."

            Comment


            • Originally posted by kiwibird View Post
              From https://twitter.com/RajeevJayadevan/...84569469911116 Is this indicating that recent infection leads to an increased susceptibility?
              It appears that in the elderly who live in a group setting COVID-19 Omicron infection + vaccine does not provide "herd" immunity due to overall weaker immune response in that age range.

              Here is the paper:

              Early Omicron infection is associated with increased reinfection risk in older adults in long-term care and retirement facilities

              ​snip

              Interpretation

              Counterintuitively, SARS-CoV-2 Omicron infection was associated with increased risk of Omicron reinfection in residents of long-term care and retirement homes. Less robust humoral hybrid immune responses in older adults may contribute to risk of Omicron reinfection.



              Comment


              • Please see:

                Am J Prev Med . Trends in Cardiovascular Disease Mortality Rates and Excess Deaths, 2010-2022

                Comment


                • There is no such thing as "new covid".

                  COVID-19 has not left. It keeps mutating to difference forms (variants).

                  Comment


                  • Joël Mossong
                    @joel_mossong
                    ·
                    35m
                    Latest update of BA.2.86* like lineages from GISAID. Still in a relative exponential growth phase with a doubling period of about two weeks. Looks like it could become dominant in the samples going to be collected next week (week 49).
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                    Comment


                    • bump this

                      Comment

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