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Report: The Unvaccinated Infected With Delta Remain Contagious

Editor’s note: Find the latest COVID-19 news and guidance in Medscape’s Coronavirus Resource Center.

The CDC is expected to announce this week that new data shows people vaccinated against COVID-19 who become infected with the Delta variant can spread it and infect others, The New York Times reported late Thursday.

The revelation is one reason the agency reversed course this week and said fully vaccinated people should go back to wearing masks in many cases.

The new findings also are a reversal from what scientists had believed to be true about other variants of the virus, the Times said.

The bottom line is that the CDC data shows people with so-called breakthrough cases of the Delta variant may be just as contagious as unvaccinated people, even if they do not show symptoms.

ABC News reported earlier Thursday that the CDC’s updated mask guidance followed an outbreak on Cape Cod, where crowds gathered for the Fourth of July.

As of Thursday, 882 people were tied to the outbreak centered in Provincetown, Massachusetts. Of those who live in Massachusetts, 74% were unvaccinated. ABC said the majority were showing symptoms of COVID-19.

Aaron Gould Sheinin is executive editor of WebMD and Medscape.

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CoVizu: Making visual sense of variation in SARS-CoV-2 genomes

Phylogenetic analysis of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which is the agent responsible for the coronavirus disease 2019 (COVID-19), is crucial to detecting emerging variants around the world. However, due to the rapid input of millions of viral genomes, this time-consuming analysis is being overstretched.

A new study published on the preprint server bioRxiv* proposes a solution to this problem in the form of a new method that can both evaluate and visually represent high numbers of SARS-CoV-2 genomes. The technology, which is based on the Python platform, allows incomplete or problematic genomes to be filtered out, while mutations of all types are separately stored as one set per genome.

Study: CoVizu: Rapid analysis and visualization of the global diversity of SARS-CoV-2 genomes. Image Credit: Tartila / Shutterstock.com

The researchers then incorporated all genomes that have identical features into variants and found the symmetrical differences between the sets of mutations for paired variants. This was used as the basis on which a phylogenetic tree was constructed, with short or low support value branches being integrated into one that is mapped as an ancestral variant.

Through the use of this approach, a little over 1.5 million genomes can be analyzed in about nine hours. This analysis then constructs a tree representation with variants shown as horizontal lines and beads showing each sample by its date of collection.

Background

Among the outstanding developments during this pandemic has been the extensive and swift sharing of genomic information about SARS-CoV-2. On the Global Initiative for Sharing All Influenza Data (GISAID) database alone, there are now over two million SARS-CoV-2 sequences.

By sharing this information, researchers around the world are able to complete phylogenetic analysis of the virus in an effort to help trace its divergence at local and global levels. One such tool is Nextstrain, which produces interactive visualizations of the diversity of this virus. Despite its utility, Nextstrain can only contain about 3,000 sequences in its computational base for each visualization as a result of limitations on the complexity of the calculation and the scale of the drawing.

With large phylogenies, the number of possible trees increases at a rate beyond exponential. Again, the virus spreads faster than it mutates, such that source and new infections share the same genome. Sequencing errors and missing genomic data are also often encountered, which further contributes to confusion surrounding the precise nature of the phylogeny.

Visual representation is also difficult because all samples with identical sequences form part of the same node, even though they come from different periods and locations, with different epidemiological significance. These differences can be represented in other ways; however, the methods used to do this are very complex and demand high computational power.

Presenting CoVizu

The current paper deals with CoVizu (derived from ‘coronavirus visualization’), which is a current project operating in the public domain comprised of a Python-based backend and a JavaScript-based ‘frontend.’ The backend consists of an analytical process to tease out evolutionary relationships, which is comparable to the frontend, which is a visual representation of such relationships.

CoVizu offers visual mapping of lineage relationships using the Pango lineage system.

How CoVizu works

The raw sequences used here, which are assigned to a Pango lineage, have a specified length and have been labeled with the date, month, and year of collection. All filtered data is then aligned against the SARS-CoV-2 reference genome.

The resulting sequence alignment/map (SAM) output is processed to remove all mutations and genetic divergences from the reference strain. The set of features for each genome serves as a compact label.

Any problematic sites or other specified exclusion criteria were investigated before constructing a time-scaled phylogenetic tree based on the earliest valid sample of each lineage. All insertions are first removed to get a multiple sequence alignment of these early samples.

Tree construction and clustering analysis

Subsequently, a maximum likelihood tree is developed, the scale is changed using a predefined mutation rate of 8×10^-4 substitutions/site/year. Clustering analysis was performed by the neighbor-joining method, which shows the relationship between various genomes in terms of which came first and how others are derived from the earlier strains.

Some adaptations used at this point to prevent overtaxing computational memory, and ensure that insertion-deletion mutations are included, are forming variants, comprising all genomes with identical sets of features. The symmetric difference is estimated per paired variant set, for feature sets. This is the sum of all terms found in either of the variants, but not both.

Further processing is used to arrive at a bootstrap replicate, processing rarer lineages together and more commonly sampled ones separately.

Finally, a consensus tree is generated, containing all the splits that were present in half or more of the bootstrap trees, with branch lengths assigned as averages of the lengths in all the trees that show each split. If the average length is below 0.5 mutations, the branch is collapsed.

For terminal collapsed branches, the variant label is mapped to the internal node directly, while for internal branches, in the same circumstances, the variant is mapped to its parent. This allows the same internal node to be linked to more than one variant.

The labeled internal nodes are thus considered to be ancestral or parental variants that have been found in a genome sequence. The final tree is converted into a JSON file, with node lists and edge lists consisting of sample labels according to a variant, and paired ancestral-new variants, with branch lengths and bootstrap support values.

Visual representation

The visualization of this data is as a single webpage that contains a time-scaled tree relating Pango lineages, along with a bead plot that shows variations within any given lineage. The program also allows each individual sample to be shown for any given lineage, variant, or bead.

The tree can be set to show the number of samples that are sorted from newest to oldest, mean deviation from the molecular clock, or sampling location by region. Hovering the mouse over any of the rectangular elements on the tree brings up a summary of the lineage-related statistics and all mutations that are seen in half or more of the samples.

The CoVizu front-end presented as a single webpage at https://filogeneti.ca/CoVizu. Visual information is arranged into three panels (emphasized with rectangular boxes and labels) to present the data at decreasing levels of granularity from left to right. The leftmost panel displays a time-scaled tree relating Pango lineages, coloured by geographic region in this instance. Selecting a lineage updates the middle panel to display a beadplot of its variants and samples. In this example, we have selected lineage B.1.362.2, which was sampled predominantly in Europe and comprised 99 samples grouped into 59 variants. The rightmost panel depicted here displays a scrollable table of sample accessions, names, and collection dates.

The bead plots try to highlight mutations of public health concern, with larger beads representing a greater number of samples collected on the same day and the color representing the region that provided most of the samples. This format makes it easier to sense how frequently a variant of interest behaves over time.

Imported infections can be identified by observing the same or very similar variants in different regions. Variants that have not been sampled but are thought to exist, judging from the common ancestry of other variants, are represented by horizontal line segments without beads.

The panel at the right side of the three-part webpage shows sample details. A search box is also present.

What are the implications?

“The standard phylogenetic toolkit is not up to the task of processing the overwhelming number of publicly accessible viral genomes. CoVizu is under continual development. We welcome suggestions for additional features, with the hope that this rapid analysis and visualization system can provide a unique, useful resource for public health monitoring and basic research.”

*Important notice

bioRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.

Journal reference:

Ferreira, R., Wong, E., Gugan, G., et al. (2021). CoVizu: Rapid analysis and visualization of the global diversity of SARS-CoV-2 genomes. bioRxiv. doi:10.1101/2021.07.20.453079.. https://www.biorxiv.org/content/10.1101/2021.07.20.453079v1

Posted in: Device / Technology News | Medical Science News | Medical Research News | Disease/Infection News

Tags: Coronavirus, Coronavirus Disease COVID-19, Genetic, Genome, Genomic, Influenza, Mutation, Pandemic, Phylogeny, Public Health, Research, Respiratory, SARS, SARS-CoV-2, Severe Acute Respiratory, Severe Acute Respiratory Syndrome, Syndrome, Virus

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Dr. Liji Thomas

Dr. Liji Thomas is an OB-GYN, who graduated from the Government Medical College, University of Calicut, Kerala, in 2001. Liji practiced as a full-time consultant in obstetrics/gynecology in a private hospital for a few years following her graduation. She has counseled hundreds of patients facing issues from pregnancy-related problems and infertility, and has been in charge of over 2,000 deliveries, striving always to achieve a normal delivery rather than operative.

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Vietnam reports record 7,968 coronavirus cases on Saturday

FILE PHOTO: Gilrs walks in a overpass as they wear protective masks in the street amid the coronavirus disease (COVID-19) outbreak in Hanoi, Vietnam, January 29, 2021. REUTERS/Thanh Hue

HANOI (Reuters) – Vietnam’s health ministry reported 7,968 coronavirus infections on Saturday, a record daily increase and up from Friday’s record of 7,307.

More than two-thirds of the cases are in Ho Chi Minh City, the ministry said in a statement.

After successfully containing the virus for much of the pandemic, the Southeast Asian country has been facing a renewed outbreak of the virus, with southern business hub Ho Chi Minh City and surrounding provinces accounting for most new infections.

The ministry on Friday said it would extend a lockdown in the city until Aug. 1 and impose stricter restriction measures in the capital Hanoi from Saturday. The measures include a stay-home order, a ban on gatherings larger than two people and the suspension of public transport.

The capital city on Saturday also suspended motorbike delivery services, including by companies such as ride-hailing firms Grab and GoJek, adding to its existing restriction measures.

The National Assembly, the country’s lawmaking body, decided to cut short its meeting in Hanoi by three days to end on July 28, due to the outbreak.

Vietnam has so far recorded 90,934 coronavirus infections and at least 370 deaths.

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Moderna COVID-19 vaccine gets EU regulator endorsement for teens

(Reuters) -Moderna’s COVID-19 vaccine could become the second shot okayed for adolescent use in the European Union after regulators on Friday recommended approving it for 12- to 17-year-olds.

FILE PHOTO: An employee shows the Moderna coronavirus disease (COVID-19) vaccine at Northwell Health’s Long Island Jewish Valley Stream hospital in New York, U.S., December 21, 2020. REUTERS/Eduardo Munoz

Use of the vaccine, Spikevax, will be the same in adolescents as in people over 18, the European Medicines Agency (EMA) said, adding the shot produced a comparable antibody response to that seen in 18- to 25-year-olds.

Vaccinating children has been considered important for reaching herd immunity and in light of the highly contagious Delta variant. Moderna in May said its vaccine was found to be safe and effective in teenagers.

The EMA said the two-dose vaccine is given four weeks apart, and its human medicines committee’s recommendation was based on a study of 3,732 participants.

Most children with COVID-19 develop only mild symptoms or none. Yet children remain at risk of becoming seriously ill and can spread the virus. Pfizer and German partner BioNTech’s vaccine was approved for teen use in May.

The regulator said common side effects in teenagers after vaccination with Spikevax were similar to those seen in older people. But due to a smaller study size, the trial could not detect new uncommon side effects or estimate the risk of known ones such as myocarditis and pericarditis.

“The overall safety profile of Spikevax determined in adults was confirmed in the adolescent study; the CHMP (Committee for Medicinal Products for Human Use) therefore considered that the benefits of Spikevax in children aged 12 to 17 outweigh the risks,” the EMA said here.

Heart inflammation such as myocarditis and pericarditis have been listed by the EMA as a possible, but rare side effect from use of mRNA vaccines such as Moderna’s and Pfizer’s in adults.

Spikevax is already being used in the European Union for people over 18, and in the United States and Canada. The company has also sought authorisation in the United States and Canada for use in adolescents.

Formal approval from the European Commission would be needed to start rolling out the vaccine for teenagers.

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Bharat Biotech terminates Covaxin deal with Brazil's Precisa

FILE PHOTO: Indian Health Minister Harsh Vardhan holds a dose of Bharat Biotech’s COVID-19 vaccine called COVAXIN, during a vaccination campaign at All India Institute of Medical Sciences (AIIMS) hospital in New Delhi, India, January 16, 2021. REUTERS/Adnan Abidi

SAO PAULO (Reuters) – Bharat Biotech has terminated a memorandum of understanding to sell its COVID-19 vaccine Covaxin to Brazil’s Precisa Medicamentos, the Indian company said on Friday without disclosing the reason.

Bharat’s statement said it will continue to work with Brazilian healthcare regulator Anvisa to obtain all required approvals for the use of Covaxin in the country.

There have been allegations in Brazil of irregularities in the government’s efforts to buy 20 million doses of the vaccine using Precisa as an intermediary.

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U.S. administers 336.1 million doses of COVID-19 vaccines – CDC

FILE PHOTO: Doses of Pfizer coronavirus disease (COVID-19) vaccines are seen in a mass vaccination site supported by the federal government at the Miami Dade College North Campus in Miami, Florida, U.S., March 10, 2021. REUTERS/Marco Bello/File Photo

(Reuters) – The United States has administered 336,054,953 doses of COVID-19 vaccines in the country as of Thursday morning and distributed 388,738,495 doses, the U.S. Centers for Disease Control and Prevention said on Thursday.

Those figures are up from the 335,487,779 vaccine doses the CDC said had gone into arms by July 14 out of 388,295,385 doses delivered.

The agency said 185,135,757 people had received at least one dose while 160,408,538 people are fully vaccinated as of Thursday.

The CDC tally includes two-dose vaccines from Moderna and Pfizer/BioNTech, as well as Johnson & Johnson’s one-shot vaccine as of 6:00 a.m. ET on Thursday.

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Delta Variant Drives Rising COVID Case Counts in Every State

Editor’s note: Find the latest COVID-19 news and guidance in Medscape’s Coronavirus Resource Center.

The number of COVID-19 cases is going up in every state as the Delta variant continues to spread across the nation.

An analysis by The New York Times of data from state and local health agencies showed a 7-day average of about 28,000 new cases a day on Thursday, a major jump from around 11,000 daily cases on June 20. That’s still better than the last surge in January, when there was a 7-day average of about 255,000 new cases a day.

“This will definitely be a surge,” Michael Osterholm, PhD, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, told the Times. “It won’t be as big as what happened in January. But we still have 100 million people in the United States who are susceptible to COVID-19.”

The CDC says the Delta variant is now responsible for about 59% of new COVID-19 infections in the nation.

Hospitalizations are not nearly as high as during the dark days of January, but they’re rising from last month, especially in areas with low vaccination rates.

In Springfield, MO, health officials are seeking state funding to set up a field hospital to handle the overflow of patients, USA Today reported. That was a tactic used in California during the worst days of the pandemic.

“Over the past week, we have seen dramatic increases in COVID-19-related cases,” said Katie Towns, the interim Greene County, MO, Health Department director. “We need help.”

Less than half of the adults in Missouri are fully vaccinated, according to the Times.

The Times said new cases are up 70% in the last 2 weeks in Mississippi, where only 43% of adults are vaccinated. That’s the lowest rate in the nation.

The Mississippi State Department of Public Health is now advising everybody over 12 to get vaccinated, all people to wear masks when indoors in public areas, and everybody over 65 to avoid indoor mass gatherings — whether they’re vaccinated or not.

National health officials keep urging people to get vaccinated, especially because the three vaccines given emergency use authorization have been shown to give strong protection against the Delta variant.

But vaccine hesitancy remains, especially in the Southern and Midwestern states.

The Times said only about 530,000 people in the U.S. are being vaccinated a day, down from 3.3 million a day in April. Less than half the U.S. is fully vaccinated, the CDC says, though 79% of people over 65 — the most vulnerable demographic — are fully vaccinated.

“In March, people flooded to our vaccination sites — all we had to do was open a door,” Ben Weston, MD, the director of medical services for the Milwaukee County Office of Emergency Management in Wisconsin, told the Times. “Now we have to go out and find people.”

About 48% of people in Milwaukee County are fully vaccinated, The Times reported.

L.A. County Makes Indoor Masking Mandatory

Los Angeles County public health officials are once again making face masks in indoor public places mandatory — not just advisable — regardless of a person’s vaccination status. The new masking order takes effect Saturday.

Because of the Delta variant, case counts have soared since the state government reopened the economy on June 15, L.A. County Public Health said in a news release.

The Health Department reported 210 new COVID cases on June 15, compared to 1,537 new cases on Thursday — the highest number since mid-March. Thursday’s test positivity rate was 3.7%, up from .5% on June 15.

The Delta variant accounted for 71% of all sequenced cases from June 27 to July 3, the Health Department said.

“We expect to keep masking requirements in place until we begin to see improvements in our community transmission of COVID-19,” L.A. County Health Officer Muntu Davis, MD, said in the release.

Sacramento and Yolo counties in California are now recommending, but not requiring, that residents wear masks in indoor public places, according to SFGate. California Gov. Gavin Newsom said last week there was no immediate plan for a statewide requirement.

Austin, TX, Brings Back COVID Protocols

Because of a surge in infections, the city of Austin, TX, is returning to Stage 3 protocols, the city government said in a news release.

The city recommends that unvaccinated or partially vaccinated people wear masks at indoor and outdoor gatherings or while dining, shopping, and traveling. People who are unvaccinated or partially vaccinated and considered high-risk should avoid those activities altogether.

Vaccinated people don’t need to wear masks during those activities, the news release said.

“While the Delta variant has likely been circulating in our area for a while, we now have confirmation through sequencing that it is here,” said Desmar Walkes, MD, the health authority for Austin-Travis County.

“Disturbingly, we are now experiencing a rise in COVID hospitalizations that could overwhelm our city’s ICUs. Almost all these hospitalizations involve those who have not been vaccinated. This is a plea for people to become vaccinated, so we do not put our ICU capacity at risk,” Austin Mayor Steve Adler said in the news release.

But the Texas Tribune pointed out that the Stage 3 guidelines don’t carry the weight of law. Last May, Gov. Greg Abbott banned pandemic mandates.

MLB Game Postponed After Six Yankees Test Positive

A Thursday game between the Boston Red Sox and the New York Yankees was postponed when six Yankee players tested positive for COVID-19, Yankees general manager Brian Cashman said, according to CNN.

“We have three positives, and we have three pending that we’ve had rapid tests on,” Cashman said. The rapid tests are being confirmed with other tests, he said.

The three players with confirmed positive tests were all vaccinated, he said. In March, eight “breakthrough” cases were reported with the Yankees.

Sources

The New York Times: “After a Steep Plunge in Virus Cases, Every State Is Seeing an Uptick,” “See How Vaccinations Are Going in Your County and State.”

USA Today: “Health leaders ask for funding to set up ‘alternate care site’ as hospitals strain under new COVID-19 infections.”

Mississippi State Department of Public Health: “Preventing COVID-19: Recommendations and Requirements.”

L.A. County Public Health: “L.A. County Community Transmission of COVID-19 Increases from Moderate to Substantial; Reinstating Masking Indoors for Everyone — 1,537 New Confirmed Cases of COVID-19 in Los Angeles County and 3 Deaths.”

SFGate: “LA County requires masks again, 2 California counties recommend.”

City of Austin: “COVID-19 News Update.”

Texas Tribune: “Austin announces stricter coronavirus protocols for unvaccinated residents as cases increase. But it can’t legally enforce them.”

CNN: “Game postponed after 6 New York Yankees have tested positive for Covid-19, team says.”

https://www.usatoday.com/story/news/local/ozarks/2021/07/14/missouri-delta-variant-surge-springfield-health-leaders-seek-covid-alternate-care-site-hospitals/7969633002/

https://msdh.ms.gov/msdhsite/_static/14,21866,420.html#prevention

http://publichealth.lacounty.gov/phcommon/public/media/mediapubhpdetail.cfm

recommend ithttps://www.sfgate.com/bayarea/article/Yolo-County-face-mask-recommendation-16316894.php

https://www.austintexas.gov/news/austin-public-health-moves-stage-3-risk-based-guidelines

https://www.texastribune.org/2021/07/15/coronavirus-texas-austin-protocols/

https://www.cnn.com/2021/07/16/us/new-york-yankees-covid-tests-spt/index.html

https://www.webmd.com/vaccines/covid-19-vaccine/news/20210514/new-york-yankees-report-8-breakthrough-covid-cases

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“I spoke to 6 doctors until one believed me”: women explain their long Covid frustration

Written by Hollie Richardson

Hollie is a digital writer at Stylist.co.uk, mainly covering the daily news on women’s issues, politics, celebrities and entertainment. She also keeps an ear out for the best podcast episodes to share with readers. Oh, and don’t even get her started on Outlander…

From not knowing how to articulate the symptoms to not being taken seriously, here’s why women are so frustrated by conversations with their GP about long Covid.

When we first went into lockdown in March last year, 36-year-old Hatty became really ill with coronavirus symptoms, including breathlessness, chest pain, swollen lymph nodes and night sweats. Because there wasn’t any official testing available at the start of the pandemic, she was never officially diagnosed with having Covid-19.

“After that, I went through a series of symptoms, from losing a lot of my hair, my periods stopping, brain fog and fatigue,” she tells Stylist. “I’ve been suffering from long Covid but, because I didn’t get that initial diagnosis, my GP hasn’t been very helpful. Before getting coronavirus, I was hugely fit – going to the gym four to five times a week, but I was only just able to start exercising properly again after 15 months.”

Eden*, 29, also caught Covid in March, and again in January this year: “I’ve been having intermittent conversations with my GP over the last seven or eight months, whenever I’ve felt particularly unwell and worried. I’ve not been ‘diagnosed’ with long Covid, but the most prominent side effects from having it twice have remained consistent: ringing in my ears and an unreliable sense of smell.

“Some of the other symptoms I’ve been experiencing – heart palpitations, chest pain, light-headedness, fevers and nausea – have been more temperamental during this time. The difficulty in articulating my concerns about having long Covid to my GP is definitely not helped by the potential that these symptoms are side effects of new medication or stress.”

It took Jess six months to find a doctor who believed she had long Covid symptoms: “The five doctors I spoke to before that told me I was experiencing anxiety,” she says.

And NHS worker Rachael, who is waiting to have her first face-to-face GP appointment about her long Covid symptoms, is worried about crying in the consultation: “But is it not a normal reaction to cry when long Covid has left you completely debilitated and you want answers and support?” she asks.

According to the NHS, many people who catch Covid-19 usually feel better in a few days or weeks, and most make a full recovery within 12 weeks. For some people, however, symptoms can last longer. This is called post-Covid-19 syndrome or long Covid. The Office for National Statistics has just announced that 6.2% of adults may have experienced long Covid since the start of the pandemic, which includes 3.6% who said they had and 2.6% who said they were unsure. People are advised to speak to their GP about any lingering symptoms to learn how to manage them and rule out any other conditions.

And yet, according to a number of women who Stylist spoke to, there is much hesitancy in reaching out to GPs about long Covid. Along with the knowledge that women’s medical issues are often not taken seriously by health professionals (it takes some women years to get an endometriosis diagnosis), there’s also the fact that long Covid wasn’t a known condition until last year after thousands of people started to self-diagnose. Then, there’s the issue that a lot of the symptoms mentioned are psychological as well as physical. In fact, ONS research shows that people who may have had long Covid are more likely to be depressed and anxious. Is this leading to a disconnect between GPs and patients in discussions around long Covid?

Long Covid: is there a disconnect between GPs and patients in long Covid discussions?

Charlie Palmer, MSK corporate clinical lead at Vita Health Group, says researchers and healthcare professionals are still working to understand the causes, treatment options, and potential recovery times of long Covid. But one recent study in China reviewed patients post-hospitalisation and found that most patients had at least one on-going symptom – particularly fatigue or muscle weakness, sleep difficulties, anxiety or depression – six months after the onset of symptoms.

“In some cases, due to the complexity of symptoms, the process of gaining a long Covid diagnosis may be frustrating and could affect mental wellbeing,” Palmer tells Stylist. “But individuals who feel unwell should definitely escalate their symptoms to their GP or healthcare professional, to seek appropriate medical help and potentially access the NHS Your Covid Recovery programme (an online resource developed for anyone to access).

For people who are struggling to articulate concerns about long Covid, she suggests: “Keep a diary of the symptoms you are experiencing and share this with your GP in your appointment. The symptoms of long Covid can fluctuate and if you see your GP on a low symptom day, this will help explain what you are experiencing, even if you are not feeling it at that moment.

“Describe the impact your symptoms are having on your everyday life. Does fatigue prevent you from walking to the shop? Do you find you have brain fog which prevents you from working? Also, have a think about any trade-offs you find yourself making. Are your symptoms causing you to pick between cooking dinner and having a shower, for example? Many of the symptoms of long Covid are invisible, and it can be difficult for people to recognise difficulty or discomfort in such cases.

“If you are concerned about potential bias in your appointment or feel anxious that you will not be taken seriously, don’t hesitate to explain this to your doctor. Know that your GP is there to support you and being upfront with your concerns will help you feel empowered. Your job is not to convince them to take you seriously.”

Beyond making sure your GP knows exactly what your symptoms are, there is also a growing conversation about how long Covid sufferers should approach the issue with their employer. According to a study by the Trades Union Congress, respondents described the poor treatment that they experienced at work because they had long Covid. Workers were faced with disbelief and suspicion, with around one fifth (19%) having their employer question the impact of their symptoms and one in eight (13%) facing questions from their employer about whether they had long Covid at all.

Palmer advises: “Have an open discussion with your employer, not only to ensure the appropriate support is provided at work, but also as some companies may have access to mental and physical health services, as well as Covid recovery programmes through occupational health or private healthcare schemes.”

Clearly, there is still so much to learn about this disease, which no doubt feeds into the anxiety and frustration of long Covid sufferers. Right now, the main thing is to make sure you’re heard and you receive the right treatment and management tools to get through it.

The NHS has a whole website section dedicated to information on long Covid, and anyone can access the NHS Your Covid Recovery programme.

Anyone who is worried about their mental health can contact Mind, Samaritans or The Help Hub.

And if you’re worried about working while suffering with long Covid, you can speak to someone at Citizens Advice.

Please always make an appointment with your GP about any symptoms mentioned above.

Images: Getty

*Name changed at contributor’s request

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About 4 in 100 COVID-19 hospitalized children may develop neurological complications, a study finds

In a recently published article in The Lancet’s Child & Adolescent Health, scientists have described in detail neurological and psychiatric manifestations of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in children. As mentioned in the study, an estimated prevalence of infection-related neurological complications and pediatric inflammatory multisystem syndrome in hospitalized children and adolescents is about 3.8 cases per 100 patients.

Study: Neurological manifestations of SARS-CoV-2 infection in hospitalised children and adolescents in the UK: a prospective national cohort study. Image Credit: FamVeld / Shutterstock

Background

Besides respiratory and cardiovascular complications, patients with coronavirus disease 2019 (COVID-19) are at high risk of developing neurological symptoms, including encephalopathy, stroke, neuromuscular disorders, and seizures. In pediatric COVID-19 patients, SARS-CoV-2 infection has been found to associate with multisystem inflammatory syndrome in children (MIS-C), which is a rare but serious condition with severe secondary inflammation.

Typically, SARS-CoV-2 associated MIS-C, also called pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS), occurs weeks after infection onset. In a single-center study conducted in the UK, nine pediatric COVID-19 patients have been identified with neurological complications of MIS-C.

Similarly, a study conducted on 1,695 children and adolescents in the US has identified transient neurological symptoms in 365 patients and severe life-threatening neurological complications in 43 patients. However, despite the severity of the condition, not enough studies have been done to estimate the prevalence of neurological complications in SARS-CoV-2 infected children.

In the current study, the scientists have determined the variety and prevalence of neurological or psychiatric complications associated with COVID-19 in hospitalized children and adolescents.

Study design

The study was conducted on 1,334 SARS-CoV-2-infected children and adolescents under the age of 18 years who had been hospitalized for new-onset or pre-existing neurological or psychiatric complications.

The scientists categorized patients into the COVID-19 neurology group if they were diagnosed with a primary neurological or psychiatric disorder associated with COVID-19. Similarly, patients diagnosed with PIMS-TS with neurological manifestations were categorized into the PIMS-TS neurology group.

Important observations

Of all enrolled patients, 52 were identified to have neurological or psychiatric complications associated with COVID-19. Based on this information, the prevalence of neurological/psychiatric disorders in hospitalized pediatric COVID-19 patients was estimated to be 3.8 cases per 100 patients.

The average age of the patients was 9 years. Regarding demographic characteristics, about 69% of patients were Black or Asian, and 31% were White. This indicates that children from minoritized ethnic groups are more susceptible to neurological complications related to SARS-CoV-2 infection.

Of 52 identified patients, 27 were categorized into the COVID-19 neurology group, and 25 were categorized into the PIMS-TS neurology group. The major symptoms of patients in the COVID-19 neurology group were acute demyelinating syndrome, severe encephalopathy, peripheral encephalopathy (Guillain-Barre syndrome), movement disorder (chorea), psychosis, and transient ischemic attack.

In patients belonging to the PIMS-TS neurology group, the major complications were systemic features, encephalopathy, behavioral changes, hallucination, meningism, and signs of peripheral or central nervous system involvement.

Compared to patients in the PIMS-TS neurology group, patients with COVID-19 related primary neurological complications had a significantly higher prevalence of recognized neuroimmune disorders. The frequencies of intensive care admissions and immunomodulatory treatments were significantly higher among patients in the PIMS-TS neurology group compared to that in the COVID-19 neurology group patients.

At the time of discharge from the hospital, about 33% of patients in the COVID-19 neurology group and 28% of patients in the PIMS-TS neurology group had disabilities. In addition, one patient in the PIMS-TS neurology group died due to stroke.

Study significance

The study reveals that in hospitalized children and adolescents with COVID-19, neurological or psychiatric complications are common presentations, with a prevalence of 3.8 cases per 100 patients. Importantly, the study highlights the difference in neurological manifestations between SARS-CoV-2 infected children with or without PIMS-TS.

While patients with PIMS-TS mostly exhibit multiple overlapping neurological symptoms with characteristic brain imaging patterns, such as reversible splenial lesion in the corpus callosum, patients without PIMS-TS are mostly associated with discrete, frequently recognized neuroimmune, primary neurological complications.

Journal reference:

Ray STJ. (2021). Neurological manifestations of SARS-CoV-2 infection in hospitalised children and adolescents in the UK: a prospective national cohort study. The Lancet Child & Adolescent Health. https://doi.org/10.1016/S2352-4642(21)00193-0, https://www.thelancet.com/journals/lanchi/article/PIIS2352-4642(21)00193-0/fulltext.

Posted in: Medical Science News | Medical Research News | Disease/Infection News | Healthcare News

Tags: Adolescent Health, Adolescents, Brain, Central Nervous System, Children, Chorea, Coronavirus, Coronavirus Disease COVID-19, Encephalopathy, Hallucination, Hospital, Imaging, Immunomodulatory, Inflammation, Intensive Care, Movement Disorder, Nervous System, Neurology, Pediatrics, Psychosis, Respiratory, SARS, SARS-CoV-2, Severe Acute Respiratory, Severe Acute Respiratory Syndrome, Stroke, Syndrome, Transient Ischemic Attack

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Dr. Sanchari Sinha Dutta

Dr. Sanchari Sinha Dutta is a science communicator who believes in spreading the power of science in every corner of the world. She has a Bachelor of Science (B.Sc.) degree and a Master's of Science (M.Sc.) in biology and human physiology. Following her Master's degree, Sanchari went on to study a Ph.D. in human physiology. She has authored more than 10 original research articles, all of which have been published in world renowned international journals.

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Coronavirus vaccines: Are there toxins in vaccines? Why are people concerned?

Ruth Langsford admits she’s ‘scared’ of COVID-19 vaccine

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A coronavirus vaccine is currently the world’s best hope for conclusively beating the virus, and an avenue out of social distancing measures. The world has dealt with the virus for more than four months now, with few available treatments and most action preventative. A vaccine may allow the world to extinguish COVID-19, but some people are scared of receiving them.

Are there toxins in vaccines?

Vaccines are an almost modern invention, with the first examples created in the 1930s.

Since then, however, conspiracy theorists have eagerly clutched to them, backed by one now-refuted study in the late 1990s by Andrew Wakefield which claimed to show they caused autism.

Thankfully, doctors have come forward to quell people’s worries about them, insisting they are still effective and do not contain toxins, despite containing some unusual-sounding ingredients.

Dr Michael Barnish, Head of Genetics and Nutrition at REVIV, a leading IV therapy brand, explained how vaccines worked.

He said: “Vaccines contain small pieces of the pathogen they seek to protect against.

“These are either alive, but inactivated, or dead. Vaccines do require additional ingredients to stabilise the solution or increase its effectiveness at stimulating antibody production.

“The dose is the most relevant factor, with regards to these other ingredients.”

“The volume of the solution contained in vaccination injections is so low that it is harmless.

“Being exposed to a healthy diet, rich in minerals, antioxidants and vitamins following vaccination will ensure that these extra ingredients are processed and removed quickly from the body and will also feed the immune response.”

Dr Barnish added some of the ingredients in a vaccine may turn heads, but they are equally harmless.

He continued: “Vaccines do contain aluminium salts though, to enhance the body’s immune response, stimulating greater antibody production.”

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“This helps to make the vaccine more effective. Although aluminium can cause greater redness or swelling at the injection site, the tiny amount of aluminium salts in vaccines has no long-term effect on the body and has been safely used in some vaccines since the 1930s.

“Also amounts of formaldehyde can be found, used to inactivate potential contamination, may also be present in some vaccines.

“This may sound worrying, but the dose of formaldehyde is 100s of times less than what we get from other sources, such as fruit. So, really it isn’t a valid concern.”

One key concern from researchers when it comes to vaccines, however, is whether or not they will provide long-term protection.

Studies show people who contract COVID-19 do retain a level of immunity from the virus for some time, but this is limited.

Scientists analysing 90 patients and healthcare workers at Guy’s and St Thomas’ NHS foundation trust in London found antibody levels fell after three months.

Blood tests found that only 17 percent of people retained the same potent response to the virus after this time scale.

The results suggest people may be able to become reinfected after contracting COVID-19 once, meaning it would act like the common cold.

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