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Discussion thread VII - COVID-19: Endemic Stage

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.

===

https://www.who.int/news-room/speec...marks-at-the-media-briefing-27-september-2023
 
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.


https://www.thenews.co.nz/opinion/covid-cannot-just-be-wished-away/
 
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.
 
Not medical advice!

Due to family pressure I ate INSIDE a restaurant today. This is the first time since January 2020. We went at 8 am and asked to be seated no where near anyone else. We purposely chose a low volume time. We sat in the back directly under an air vent. It was so fun. Before I went in I used a nose treatment and had an N95 in my purse just-in-case. We left at 9 am before the Sunday breakfast rush. When I got home I gargled with Listerine mouthwash. My husband and I were recently vaccinated so hopefully this will prevent us from any severe COVID-19 symptoms. Trying to find life hacks to fully participate in society again.....I will add some links below....
 
Some links:

A Brighton Collaboration standardized template with key considerations for a benefit/risk assessment for the Novavax COVID-19 Vaccine (NVX-CoV2373), a recombinant spike protein vaccine with Matrix-M adjuvant to prevent disease caused by SARS-CoV-2 viruses
https://flutrackers.com/forum/forum...-spike-protein-vaccine-with-matrix-m-adjuvant

The Astounding Physics of N95 Masks
https://www.youtube.com/watch?v=eAdanPfQdCA

Pathogens . Differential Effects of Antiseptic Mouth Rinses on SARS-CoV-2 Infectivity In Vitro
https://flutrackers.com/forum/forum...uth-rinses-on-sars-cov-2-infectivity-in-vitro

Build Environ . Dispersion of droplets due to the use of air purifiers during summer: Focus on the spread of COVID-19
https://flutrackers.com/forum/forum...during-summer-focus-on-the-spread-of-covid-19

Am J Infect Control . High technology and low technology measures to reduce risk of SARS-CoV-2 transmission
https://flutrackers.com/forum/forum...res-to-reduce-risk-of-sars-cov-2-transmission
 
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.

https://www.leparisien.fr/societe/a...pad-14-11-2023-CSEBXRKCRBCRTH3UYDYTMNLPMU.php
 
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.
 
kiwibird said:
​ filedata/fetch?filedataid=33791From https://twitter.com/RajeevJayadevan/status/1724684569469911116 Is this indicating that recent infection leads to an increased susceptibility?
Click to expand...

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.

https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(23)00325-5/fulltext#
​
 
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.
 
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.
 
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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what air-purifyer do you use ?
Xiaomi 3H was best in German tests,
I got a used one at $120 at ebay
 
Is this for me? We were going to make our own with a box fan and air filters but we ran out of time. We used fans only and they were placed to push air away from the at-risk people. In addition, we had the activities outside in a screened room.
 
States trashing troves of masks and pandemic gear as huge, costly stockpiles linger and expire

By The Associated Press and JENNIFER PELTZ and DAVID A. LIEB
Published: Dec. 20, 2023 at 6:12 AM CST|Updated: 2 hours ago

(AP) - When the coronavirus pandemic took hold in an unprepared U.S., states scrambled for masks and other protective gear.

Three years later, as the grips of the pandemic have loosened, many states are now trying to deal with an excess of protective gear, ditching their supplies in droves.

With expiration dates passing and few requests to tap into its stockpile, Ohio auctioned off 393,000 gowns for just $2,451 and ended up throwing away another 7.2 million, along with expired masks, gloves and other materials. The now expiring supplies had cost about $29 million in federal money.

A similar reckoning is happening around the country...

An Associated Press investigation found that at least 15 states, from Alaska to Vermont, have tossed some of their trove of PPE because of expiration, surpluses and a lack of willing takers.

Into the trash went more than 18 million masks, 22 million gowns, 500,000 gloves, and more. That’s not counting states that didn’t give the AP exact figures or responded in cases or other measures. Rhode Island said it got rid of 829 tons of PPE; Maryland disposed of over $93 million in supplies.
...
“Anytime you’re involved in a situation where you’re recalling how difficult it was to get something in the first place, and then having to watch that go or not be used in the way it was intended to be used, certainly, there’s some frustration in that,” said Louis Eubank, who runs the South Carolina health department’s COVID-19 coordination office. The state has discarded over 650,000 expired masks.
...
https://www.fox8live.com/2023/12/20...ic-gear-huge-costly-stockpiles-linger-expire/
 
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