A health emergency has been declared in Southern California’s Orange County due to rapidly spreading viral infections that are sending more children to the hospital, health officials said Tuesday. The county health officer issued the declaration Monday due to record numbers of pediatric hospitalizations and daily emergency room visits, the county’s health care agency said in a press release, according to the Associated Press. The move allows the county of 3 million people to access state and federal resources and enlist assistance from non-pediatric hospitals to help care for sick children, said Dr. Regina Chinsio-Kwong, the county’s health officer. “Our concern here is that it is reaching even record levels,” Chinsio-Kwong told reporters. “We want to make sure we are prepared to care for any sick child in the county who falls ill and requires hospital care.” The county has seen a growing number of children with respiratory syncytial virus (RSV), while flu cases are also starting to rise. The situation is similar in much of the country where doctors are bracing for the possibility that RSV, flu and COVID-19 could combine to stress hospitals.
Heart inflammation risk remains low after third vaccine dose, study finds
A third dose of the Moderna or Pfizer COVID-19 vaccine does not increase the risk of heart inflammation more than a second dose, according to a preprint study being presented Saturday at the American Heart Association’s Scientific Sessions. Cases of acute myocarditis were rare according to the study, which collected data from millions of patients in Southern California between Dec. 2020 to Feb. 2022. Among the 2.9 million people in the study who received a second dose of an mRNA vaccine, 26 developed myocarditis that required hospitalization. Among the 1.4 million who received the third dose, nine were hospitalized for myocarditis. The majority of cases happened within seven days of vaccination, most were mild, and the symptoms resolved without extensive intervention. “It is an important question because with additional doses of COVID-19 mRNA vaccines being recommended, it is essential to monitor its safety,” said Dr. Mingsum Lee, the study’s senior researcher and a cardiologist at Kaiser Permanente Los Angeles Medical Center, in a statement. Other studies have shown the risk of myocarditis is much higher after COVID-19 infection than after vaccination.
Education Secretary Cardona tests positive
Education Secretary Miguel Cardona, who has been vaccinated and boosted against the virus, tested positive Tuesday and has mild symptoms, the Education Department said in a statement. He tested positive the morning after he attended Halloween festivities at the White House, the Associated Press reports. President Biden and his wife, Jill, hosted a trick-or-treat event at the White House on Monday, but the Education Department said they are not close contacts of Cardona, as defined by the Centers for Disease Control and Prevention. Cardona, 47, separately welcomed elementary school trick-or-treaters to the Education Department on Monday and later spoke at the Association of Art Museum Directors’ annual meeting.
Trump tax trial derailed by coughing witness
The criminal tax fraud trial of the Trump Organization was temporarily suspended on Tuesday after the prosecution’s first witness, company controller Jeffrey McConney, tested positive for COVID-19. The witness coughed several times during his testimony earlier in the day and on Monday in Manhattan Supreme Court and subsequently tested positive for the virus during the lunch break, CBS News reports. McConney, 67, was ordered to isolate for six days by Justice Juan Merchan, who said the trial could resume on Nov. 7.
New money available to understand COVID among animals
Researchers exploring COVID-19 in animals have until Jan. 15 — or until Jan. 31 for Tribal researchers — to apply for grants from a new $30 million pool the U.S. Department of Agriculture is making available to “build an early warning system” to help stop the next coronavirus outbreak in non-human creatures. Goals include learning to detect new variants more quickly, determining which animals are more or less susceptible and better understanding and preventing COVID transmission in animals. The funding sets aside $5 million specifically for Tribes or those working on their behalf, and $25 million for all researchers, including those from Tribes.
Study highlights virus’ impact on brain: “A silent killer”
COVID-19 has been shown to trigger inflammation in the brain, activating a similar response as Parkinson’s disease, according to a study published Tuesday in Nature’s Molecular Psychiatry. A research team at the University of Queensland in Australia identified a potential future risk for neurodegenerative conditions in people who have had COVID-19 — and also a possible treatment. “We studied the effect of the virus on the brain’s immune cells, ‘microglia’ which are the key cells involved in the progression of brain diseases like Parkinson’s and Alzheimer’s,” lead author Trent Woodruff said in a statement. “We found the cells effectively became ‘angry’, activating the same pathway that Parkinson’s and Alzheimer’s proteins can activate in disease, the inflammasomes.”
Dr. Eduardo Albornoz Balmaceda of the university’s School of Biomedical Sciences said the research shows a spike protein of the virus triggers a “fire” in the brain, which begins a chronic and sustained process of killing off neurons. “It’s kind of a silent killer because you don’t see any outward symptoms for many years,” he said. “It may explain why some people who’ve had COVID-19 are more vulnerable to developing neurological symptoms similar to Parkinson’s disease.”
But the researchers may have also discovered a potential treatment in inhibitory drugs which are currently in clinical trials with Parkinson’s patients. “We found it successfully blocked the inflammatory pathway activated by COVID-19, essentially putting out the fire,” Balmaceda said. “The drug reduced inflammation in both COVID-19-infected mice and the microglia cells from humans, suggesting a possible treatment approach to prevent neurodegeneration in the future.”
UCSF’s Wachter weighs indoor dining risks while traveling
Dr. Bob Wachter, chair of UCSF’s Department of Medicine, has become known on Twitter for using his comfort level for eating indoors as an indicator of COVID-19 pandemic trends. In September, he declared that he was ready to ditch his mask and dine inside again in his hometown of San Francisco, using the threshold of daily COVID cases falling below 5 for every 100,000 residents in the region. But on Tuesday, Wachter clarified it’s not a one-size-fits-all approach. When he travels to New York City on Friday, he said he would avoid indoor crowded settings there because the daily case rate is 29 per 100,000. “The same encounter there is 4x riskier Covid-wise than here,” Wachter tweeted.
Asked by one of his followers if he trusted the New York Times data he cited since so few people report their test results to public health agencies, Wachter said, “Bottom line is that the raw reported case numbers are significant underestimates (by 5-10-fold) but the trends can be trusted since they correlate quite well with other numbers that are not subject to reporting bias.” Another follower asked him about his seemingly shifting threshold, since the data show San Franciso reporting 7 cases per 100,000. “No bright line,” Wachter said. “If it’s <5, I wouldn’t hesitate to eat indoors. At 5-10 (ie, SF now), I’ll do it if it’s best/only option, but prefer outdoors. Over ~10-15, risk is higher than I’d like, since that # correlates w/ >2% chance that any asymptomatic person has Covid & is infectious.”
Bivalent COVID vaccine may not be more protective than other boosters. Experts still recommend it
Hopes were high in early fall that the new double-barreled COVID-19 booster shot would be a holiday gift like no other, and protect everyone this year. But very few people have gotten the new shot. And some of those who have are still getting breakthrough infections, bolstering the findings of two small, preliminary studies that suggest the new shot is no magic shield after all and may give no greater protection than the previous booster shot. Read more here about the bivalent booster studies and reaction from experts.
Shanghai Disney guests barred from leaving as park closes for testing
Guests at Disneyland in Shanghai were briefly blocked from leaving the park Monday, the Associated Press reported, so government officials could test around 400,000 people for coronavirus infections. Guests were later allowed to leave and no details of a potential outbreak were immediately released. The closure of the park and the mandatory testing is in keeping with China’s enduring and strict “Zero COVID” strategy, which seeks to aggressively test and lock down locations where outbreaks occur.
Emerging variants are the most evasive yet, study finds
The continuous evolution of the omicron coronavirus variant has led to the “rapid and simultaneous” emergence of numerous variants that display growth advantages over the currently dominant BA.5 strain, according to a pre-print paper by Chinese researchers published Sunday in bioRxiv. The team found that despite evolving separately, the newer generation of omicron offshoots share convergent mutations that make it easier for them to evade neutralizing antibody drugs (NAb) and convalescent plasma, including those from BA.5 breakthrough infection. BQ.1.1.10, BA.4.6.3, XBB, and CH.1.1 are “the most antibody-evasive strain tested, even exceeding SARS-CoV-1 level,” the researchers wrote. They added that the current level of community immunity achieved by widespread infections and the new bivalent vaccine boosters are unlikely to provide sufficient protection against infection, calling for the prioritization of broad-spectrum coronavirus vaccines and NAb drugs.
Quarantine traps visitors inside Shanghai Disney Resort
China’s “Zero COVID” strategy led to an abrupt lockdown at the Shanghai Disney Resort on Monday that sent hundreds of visitors unsuccessfully scrambling for the exit gates, Reuters reports. At 11:39 a.m. local time, all the people at the main theme park and surrounding shopping areas were told that they were required to remain inside until they provided a negative test result. Several social media posts showed that the rides continued to operate while the guests were subjected to mandatory testing. Those who tested negative were allowed to leave the resort, but are required to isolate and test for three additional days, per China’s strict COVID policy. If they test positive during that time, they will be required to enter a quarantine facility. There were a total of 10 confirmed cases reported in Shanghai on Oct. 30, all in people who were asymptomatic.
CDC director Walensky has a rebound infection
Rochelle P. Walensky, director of the U.S. Centers for Disease Control and Prevention, has experienced a rebound infection after testing negative for the coronavirus following her initial infection last week. She had recently completed a course of the antiviral Paxlovid. The agency said in an update on Monday that Walensky “experienced mild symptoms from her recent COVID-19 infection, completed a course of Paxlovid, and, after a period of isolation, tested negative for the virus. On Sunday, Dr. Walensky began to develop mild symptoms and has again tested positive. Consistent with CDC guidelines, she is isolating at home and will participate in her planned meetings virtually.”
Another variant to watch? BA.5.2.6 arrives in the U.S.
Less than a month since the Centers for Disease Control and Protection started tracking BQ.1 and BQ.1.1, the highly contagious omicron subvariants make up nearly a third of the total coronavirus variants circulating in the United States, according to data published Friday. But federal health officials also added another subvariant to the mix, BA.5.2.6, which made up 2.8% of the cases last week. The immune-evasive strain is the “top emerging lineage” in Europe, according to data from GISAID. In two weeks, it has gone from appearing in 4% of sequenced cases in Ireland to 28%. BA.5.2.6 is also growing in proportion in Ukraine, France, and the United Kingdom. Parts of the U.S. are reporting nearly double the national average of the new subvariant, including Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island and Vermont, where BA.5.2.6 accounted for more than 5.5% of the sampled cases last week.
Even people who don’t take Paxlovid can see symptoms return, study shows
Many reports have documented people experiencing rebound COVID-19 infections after completing a course of the antiviral Paxlovid — including high-profile patients such as President Biden and Anthony Fauci — but new research shows that even people who do not take the medication can experience a return of symptoms after two days of testing negative. In a study published in JAMA Network Open, researchers at the University of California San Diego School of Medicine tracked 13 defined COVID-19 symptoms for 29 days in 158 untreated study participants. They found that more than one-third of the participants who reported complete resolution of symptoms for at least two consecutive days reported a return of symptoms.“It is clear that COVID-19 has waxing and waning of symptoms, whether they are treated or not,” said the study’s lead author Davey M. Smith, an infectious disease specialist at UCSD Health who earlier this year led a study that suggested Paxlovid rebound was likely due to insufficient drug exposure. The team’s latest research aims to shed more light on the frequency of reinfections. “COVID rebound is a real phenomenon. It is complex, involving multiple factors, and its biological underpinnings remain unclear. More research is required,” said Smith.