COVID case rates in the Bay Area have now exceeded those of the devastating surge in the winter of 2021 to 2021, which was caused by what we now know as the “epsilon” variant. A massive survey of COVID-19 survivors sheds new light on predictors of long COVID. And UCSF chief of medicine Dr. Bob Wachter tweeted that 6.2% of people in San Francisco screenings not exhibiting COVID-19 symptoms tested positive for coronavirus infection, according to the latest hospital data.
Virus spread increasing in all 58 California counties
Each of California’s 58 counties is seeing a rising reproduction rate, which means the virus spread is likely increasing statewide. The effective reproduction number, representing the average number of people to whom each infected person spreads the coronavirus, is above 1 in every county, according to state data. In the Bay Area region, the estimated number is highest in Solano County (1.79); Contra Costa and Santa Clara counties (1.60); and Alameda, San Mateo and Sonoma (1.52) counties. Nearly all the counties fell below 0.05 following the winter omicron surge. Statewide, the highest rate is in Stanislaus County at 2.62, indicating that each infected person is spreading the virus to about three others; and lowest is in Humboldt County at 1.16, which is still above the baseline.
UCSF doc says “supercharged” variants, eased restrictions driving surge
With the number of coronavirus cases in the Bay Area surpassing the peaks of last year’s winter surge, many are wondering how the region that fared so well for most of the pandemic is now California’s COVID hot spot. Dr. Peter Chin-Hong, an infectious disease expert at UCSF, said during the school’s most recent town hall discussion there are a variety of factors at play. “Much of this is driven by less previous exposure to natural infection,” he said. “But there’s also supercharged transmissible variants now, at the time when people are going out like everyone else.” He said the BA.2 subvariant is 30% to 50% more transmissible than its parent omicron coronavirus variant and its BA.2.12.1 sublineage is another 25% more transmissible. He said it’s unlikely that increased testing is skewing the numbers — and they may be much higher because people are testing at home and not reporting their results. “Restrictions have been dropped in all areas,” he said. “And there’s the risk of everyone who’s visiting as well.” During the same discussion, Ralph Gonzales, chief innovation officer for UCSF Health, said cases are rising substantially on the medical center’s campus without any sign of relief, likely reflecting community spread in San Francisco. “It’s likely to go up for a couple of weeks,” he said.”I know that’s not good news but that’s what the data is pointing to.” He noted that UCSF hospitals are now back at “critical staffing” levels.
Vaccination does not prevent long COVID, new research finds
Currently available COVID vaccines may prevent hospitalization and death but they do not significantly cut the risk for long COVID, according to a study published Wednesday in the journal Nature Medicine. Using data from the U.S. Department of Veterans Affairs, which included medical records of nearly 34,000 vaccinated people and more than 113,000 who were unvaccinated during the delta phase of the virus, the researchers from Washington University in St. Louis found that the shots made little difference in reducing persistent symptoms between the two groups. “Altogether, the findings suggest that vaccination before infection confers only partial protection in the post-acute phase of the disease; hence, reliance on it as a sole mitigation strategy may not optimally reduce long-term health consequences of SARS-CoV-2 infection,” the researchers wrote. Future vaccine formulations may be able to better address long COVID.
Fourth dose of Pfizer vaccine wanes faster than third, study confirms
A fourth dose of Pfizer’s COVID-19 vaccine provides additional protection against coronavirus infection and severe COVID-19 outcomes compared with three vaccine doses, but its effectiveness wanes faster, according to a study published Tuesday in the journal BMJ. The 10-week study, conducted in Israel during the omicron wave of the virus, compared outcomes of 69,623 adults with three doses of the Pfizer vaccine against 27,876 adults who received the fourth dose. It found that the additional dose offered 65.1% protection at the third week, but that level fell to 22% by the end of the research period. The authors suggest vaccine developers work on improving their formulas. “A stabilization effect of additional doses on immune memory should be further investigated, as well as studies on mucosal vaccines,” they wrote.
CDC warns of rebound infections after Paxlovid treatment
Some patients who take the antiviral Paxlovid can see symptoms of COVID-19 return following a brief period of recovery, the Centers for Disease Control and Prevention said in an advisory on Tuesday. Reports of rebound infections have become increasingly common but the federal health agency still recommends the drug for early-stage treatment of mild to moderate COVID-19 among persons at high risk for progression to severe disease. “Limited information currently available from case reports suggests that persons treated with Paxlovid who experience COVID-19 rebound have had mild illness; there are no reports of severe disease,” the advisory said. “There is currently no evidence that additional treatment is needed with Paxlovid or other anti-SARS-CoV-2 therapies in cases where COVID-19 rebound is suspected.”
Brain fog, headaches could last more than a year after mild infection, study suggests
Lingering neurological symptoms following a COVID-19 infection — such as brain fog, numbness and headaches — can last for more than a year even as other conditions improve, according to a study published Tuesday in Annals of Clinical and Translational Neurology. the report, from researchers at Northwestern University, is one of the longest follow-up studies on COVID patients who initially had mild symptoms and did not require hospitalization. Almost 80% were vaccinated. Using 18 months of data, it found that the neurological symptoms on average lasted 15 months even as other conditions improved. “Long-COVID syndrome is causing a detrimental impact on quality of life and overall productivity which may only continue worsening as the pandemic evolves,” the researchers wrote.
A “lost year” for the HIV fight due to pandemic, CDC says
The battle against HIV in the U.S. was likely dealt a major setback in 2020 due to the coronavirus pandemic, according to the annual HIV Surveillance Report, published Tuesday by the Centers for Disease Control and Prevention. Testing and care plummeted due to stay-at-home orders, disruptions to clinical services, and shortages in materials, the report said. The overall number of HIV diagnoses fell 17% from 2019, but the federal health agency said that was likely due to underdiagnosis and that it will likely take years to know the true impact of the pandemic on combatting HIV. “We definitely had a hit from COVID-19,” said Dr. Demetre Daskalakis, the director of the CDC’s Division of HIV/AIDS Prevention, in an interview with NBC News, calling 2020 “a lost year” for his team.
San Diego schools delay vaccine mandate for a year, in alignment with state
The San Diego Unified School Board, which oversees California’s second-largest school district, voted Tuesday to delay its planned COVID-19 vaccine mandate for students until at least until July 2023, opting instead to rely on mitigation measures such as temporary indoor mask mandates to address outbreaks and surges at individual schools when necessary. The board said its decision was based partly on evidence that existing vaccines lose effectiveness in preventing transmission of the coronavirus a few months after being administered, according to The San Diego Union-Tribune. But they ignored the more significant impact of the shots in preventing serious illness from COVID-19.
About 56% of eligible students age 5 and up in the district are fully vaccinated, and a mandate might not have increased uptake. “The likelihood of making a dent in that is questionable,” Dr. Howard Taras, a UC San Diego pediatrician, said at Tuesday’s meeting. State officials and other large districts, including Los Angeles Unified, have also postponed their vaccine mandates for students pending full federal approval of the shots. San Diego Unified faced additional pressure due to a pair of lawsuits opposing the mandate filed by the founder of an advocacy group that opposes COVID mitigation measures and another individual who was demanding a religious exemption to the rule.
Big jump in Bay Area COVID case rates over past month
The nine counties that make up the Bay Area region currently have the highest coronavirus infection rates in the state, behind only rural Del Norte County. The Bay Area is reporting about 53 new cases per 100,000 residents as of Tuesday, up from 18 per 100,000 a month ago and 42 last week. San Francisco reported about 61 daily cases per 100,000 residents Tuesday, nearly twice the statewide average of 36 per 100,000. A month ago, San Francisco was tallying 24 cases per 100,000 and last week it was 54. The case rates for the Bay Area translate to roughly 4,500 new coronavirus cases per day reported as of Tuesday — about the same as the peak of the winter 2020 to 2021 surge, which was the deadliest period of the pandemic. Case counts likely are much higher because so many people test at home but do not report their results to health authorities and many people do not test at all.
UCSF’s Wachter reconsiders benefits of Paxlovid
UCSF Chief of Medicine Dr. Bob Wachter said he would think twice about recommending the COVID drug Paxlovid after what his wife Katie Hafner experienced: a difficult rebound case of COVID-19 after she took a course of Paxlovid. In a lengthy Twitter thread, Wachter weighed the pros and cons of the drug, noting that several studies have shown its efficacy in reducing hospitalizations by up to 89% in high-risk individuals — “a huge effect,” he said. But he paused at increasing reports of infection returning after someone takes the drug, and noted the second round of illness is often worse. “While rebound cases seem to be mild & self-limited, rebound is still a big bummer,” he said. His wife returned to isolation for about a week and her symptoms worsened, he wrote. Wachter said ultimately he would take the drug if he was infected because it can curb severe outcomes like hospitalization and death, “and my confidence that rebound would be inconvenient but not ultimately super-risky.”
Huge new survey sheds light on who is at risk for long COVID
Results from a new survey of more than 100,000 COVID-19 survivors released Tuesday by the personal genetics company 23andMe offer further evidence of a biological cause for the persistent, sometimes debilitating syndrome known as long COVID. Women were at least twice as as likely as men to report being diagnosed with long COVID, as were those who had previously experienced depression or anxiety, according to the South San Francisco firm. Read more about the fascinating report from 23andMe and how it could help inform treatment of long COVID.
One in five infected adults experience long COVID, CDC says
About 1 in 5 adults between ages 18 and 64 who was previously infected with the coronavirus has reported persistent symptoms more than four weeks being diagnosed, a new study from the Centers for Disease Control and Prevention reported Tuesday. Among those 65 and older, 1 in 4 survivors reported symptoms consistent with the conditions known as “long COVID” or “post-COVID,” including heart, lung, kidney and gastrointestinal issues, pain, fatigue, loss of smell or taste, and mental health problems. “As the cumulative number of persons ever having been infected with (COVID-19) increases, the number of survivors suffering post-COVID conditions is also likely to increase,” the researchers wrote. The study looked at data from March 2020 to November 2021, before the winter surge fueled by the coronavirus omicron variant. They estimated the number of those infected has increased substantially since then.
Mayor of San Jose tests positive for COVID-19
San Jose Mayor Sam Liccardo announced on Monday that he has tested positive for the coronavirus. “After feeling under the weather this evening, I tested positive for COVID-19,” he said on Twitter. “I am thankful that my vaccination has prevented any serious symptoms so far.” The mayor encouraged others to keep up on their vaccination schedules, test frequently and “mask up indoors.”
California’s 2nd-largest school district outlines rules for return of mask mandate
San Diego Unified School District outlined criteria that will guide the reinstatement of mask mandates. In a letter to families that was obtained by CBS News 8, officials from California’s second-largest school district said that starting Wednesday they would evaluate each school and require students to wear masks indoors for the remainder of the 2022 academic year and summer when the school hits specific risk metrics: at least three COVID outbreaks at a school within 14 days, and more than 5% of the school population infected; or when 10% or more of the student population is absent each day due to illness over a three consecutive days. If San Diego County is classified as having a high level of COVID risk by the CDC, all schools in the district will return to indoor masking requirements.
BA.2.12.1 now makes up nearly 60% of cases in the U.S.
BA.2.12.1, the highly transmissible sublineage of the coronavirus omicron variant, accounted for 58% of cases in the U.S. last week, according to data published Tuesday by the Centers for Disease Control and Prevention. The variant is crowding out its parent BA.2 subvariant, which made up 39% of cases sequenced by federal health officials. The original BA.1 omicron, which drove the winter surge, now makes up less than 3% of the proportion of cases nationwide. In the Bay Area, BA.2.12.1 and BA.2 are evenly divided with about 48% of the cases each.