Category: Health News Today

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Press Briefing by White House COVID-19 Response Team and Public Health Officials

Via Teleconference

11:06 A.M. EST

MR. ZIENTS:  Good morning, and thanks for joining us.  Today, we’ll start with an update from Dr. Walensky on the state of the pandemic and CDC’s COVID-19 surveillance efforts.

Dr. Walensky.

DR. WALENSKY:  Good morning.  Thanks, Jeff.  I’d like to start by walking you through today’s data. 

The current seven-day daily average of cases is about 247,300 cases per day, a decrease of about 44 percent over the previous week. 

The seven-day average of hospital admissions is about 13,000 per day, a decrease of about 25 percent over the previous period.

And the seven-day average of daily deaths are at about 2,400 a day, which is an increase of about 3 percent over the prior week. 

This week, we reached a tragic new mark of 900,000 deaths in this country from COVID-19. 

Each week, I share with you the burden of disease in the United States, including case counts, hospital admissions, and the number of deaths.  Much of the data I readily share is because we have made huge strides in our ability to effectively monitor this virus, and new tools allow us to prepare and react to an evolving virus and inform response measures in near real time. 

Today, I’d like to walk you through just a few of the layers of surveillance we have in place, some that we have been expanding and developing over the past two years and others that are bedrocks of our public health work. 

Let’s start at the local community level where our biggest question is: Can we quickly identify spikes in cases?  As people with COVID-19 shed the virus, testing in wastewater or our sewage systems can help us monitor COVID-19 in communities and provide an early warning of increased COVID-19 cases to help communities prepare. 

Last week, CDC publicly released national wastewater surveillance data, tracking more than 400 testing sites across the country in 212 communities, which we will double to more than 800 testing sites in the next four weeks. 

On this map, you can see the testing sites that we monitor and trends in the levels of the virus.  Communities in blue have decreasing levels of virus, while communities in red and orange have increasing levels. 

This is a powerful tool that, when paired with traditional public health surveillance, can help us identify where the disease is spreading and how best to distribute resources. 

We’ve also made significant progress in syndromic surveillance, defined by the ability to identify symptoms and cases that are suggestive of COVID-19 disease.  Through syndromic surveillance, we can answer questions about disease severity and patient populations with the highest burdens of disease — crucial information to inform guidance and prevention measures. 

More than 6,000 healthcare facilities across the country, representing over 70 percent of emergency departments, contribute data to our syndromic surveillance and help us understand where and how the virus is having an impact. 

In addition to monitoring where the virus is and how disease presents in the community, our genomic surveillance can quickly identify variants so that we can understand their impact.  Each week, CDC analyzes genomic sequences from all 50 states and uses these sequences to understand the spread of variants across the country. 

On this slide, you can see the projections of variant proportions for the last 14 weeks.  Omicron, shown in pink and purple, now represents nearly 100 percent of viruses circulating in the United States. 

Our cohort studies and state-level surveillance data provide detailed and regular reports of how our vaccines are working in the real world among diverse populations, giving us faster and better data to know that our vaccines are working against new and emerging variants. 

You’ve heard me discuss many of these platforms before, like our hospital surveillance through CDC’s COVID-NET and IVY; our collaboration with seven integrated healthcare and public health research centers through VISION; surveillance of infection is essential in frontline workers in HEROES-RECOVER; and our nationwide surveillance of vaccine effectiveness in children and young adults in overcoming COVID-19. 

Taken together, these studies provide us an in-depth and comprehensive understanding of how vaccines are working with participations in sites nationwide. 

And importantly, COVID-19 vaccines are being administered under the most intensive vaccine safety monitoring effort in the United States’ history. 

Our nationwide vaccine safety networks — such as V-safe, which provides personalized and confidential health check-ins via text message — and other systems — such as VAERS, the Clinical Immunization Safety project, and the Vaccine Safety Datalink — empower us with the data of any rare side effects or reactions after vaccination or boosting.

This is a huge amount of data.  CDC — along with our partners across government; state and local jurisdictions; academia; and healthcare — has cast a wide and comprehensive net over the country to follow the virus and its impacts in real time. 

And we will continue these data as our guiding — using these data as our guiding source as we look to what comes next.

I know there will come a time when we move from a phase of crisis to a point where COVID-19 is not disrupting our daily lives.  And as we all look forward to this next step, I want to instill in everyone that moving forward from this pandemic will be a process that’s led by our surveillance and our data. 

I’m confident that CDC and our public health partners are well positioned to lead the way. 

Thank you.  And now, with that, I will turn things back over to you, Jeff. 

MR. ZIENTS:  Thanks, Dr. Walensky. 

Now, let’s move to booster shots.  We know that there are a number of different ways to view progress on boosters, depending on which data set you’re looking at.

For example, some people assess boosters as a proportion of all adults who are fully vaccinated, while others look at the total U.S. adult population, even though not every adult is eligible for a booster shot yet.

So, before I turn to Dr. Fauci on the effectiveness of booster shots, I want to review how we assess the available data and use the best available data to measure the progress we’re making on getting people booster shots.

CDC data aggregated from state health departments shows that more than 90 million booster shots have been administered.  We know that that is likely undercounted as some people reported their booster as a first shot and others forgot their vaccination card altogether.

States have been matching data and have encountered some challenges across different channels, which has led to delayed reporting for booster shots in many states.

CDC is working with states to address these issues to improve the data.

At the same time, CDC conducts a weekly survey, which is a nationally representative survey of over 16,000 adults.  Looking at the CDC survey results, you get a more up-to-date picture of the progress we are making on boosters.

Based on the latest CDC survey, we estimate over two thirds  of all eligible adults and over 80 percent of all eligible seniors — those most at risk  and most vulnerable — have received a booster shot.

CDC’s survey results are consistent with the Kaiser Family Foundation survey which shows 70 percent of eligible adults report they’ve gotten a booster.

So, we have a strong foundation to build on, with most eligible adults boosted.

In fact, we estimate at least two out of three adult — eligible adults in the U.S. are now boosted — two out of three eligible adult Americans with a booster shot.

And across the last two months, we’ve made important strides on equity, with the majority of booster shots going to people of color, in a very improvement from the prior two months.

The significant progress we made on boosters is one of the reasons why we were able to confront Omicron with fewer disruptions to schools and businesses than in prior surges.  And we clearly need to keep driving this progress.

So , our message is clear: All eligible individuals should get their booster shot right away.  Booster shots are free.  They’re available at 90,000 convenient locations across the country and, as Dr. Fauci will discuss, critical to getting people the highest level of protection.

With that, over to you, Dr. Fauci.

DR. FAUCI:  Thank you very much, Jeff.  What I’m going to do now over the next couple of minutes is to just build on what Jeff said and talk to you, based on real data, why it is so critically important to get booster shots.

I’m going to talk about laboratory data, clinical trial data, and real-world data.

Next slide.

So there are multiple — and I can’t show them all — in vitro studies that show that COVID-19 vaccine booster doses markedly increase the neutralization of variants, including what we’re dealing with currently, namely Omicron.

Next slide.

This is the slide that shows the genomic mean titer of antibody, namely the proteins that neutralize the virus.  If you look at the far left-hand side of the slide, seven months after people receive a second dose and before the booster, look how low the response is to Omicron, which is the bar that has the red circles.  It’s 23.

One month after the booster, it goes way up into the highly protective zone of 850.  And even six months after the booster, it is still at a high level of 136 — way above what it was seven months after the second dose.  So, that’s representative laboratory data.

Next slide.

Now, a randomized controlled clinical trial showed the dramatic impact of the booster dose in preventing symptomatic disease.  And the data are really striking.  I’ll show you one clip of that on the next slide.

As you can see in red are individuals who’ve gotten two doses — it says placebo, but it’s two doses — without the booster.  And this is a  Pfizer study, but it really holds true with other products like Moderna.

If you look at the result in blue of the cumulative incidence of COVID-19 following a booster shot, the difference is dramatic.

Next slide.

Now we’ll move to real-world effectiveness studies showing that booster doses reconstitute the waning protection, especially against severe disease, hospitalization, and deaths.

So, next slide.

So, here, we look at individuals less than six months after the second dose.  And on the  far left, you see when you’re dealing with Delta, it’s 90; when you’re dealing with Omicron, it’s 81.  But more than six months after the second dose, it wanes with Omicron to 57, holding up a bit better with Delta.

But after the third dose, you get protection at 90 percent with Omicron, which  is even better than after six months after the second dose.  Again, another example of the critical importance of boosting.

Next slide.

Here is another way of looking at it.  When you look at symptomatic disease and hospitalizations, again, when you’re dealing with Omicron, on the far left, the protection against symptomatic disease is quite low at week 25, following two doses.  If you look at the boost, it goes up substantially to 40 percent. 

But the critical data are on the right-hand part of the slide.  If you look at hospitalizations and look at two doses of the Pfizer BioNTech either at 2 to 4 weeks or 10 to 14 weeks, it’s still way up there at 75 percent.

Next slide. 

And again, if you look at CDC data, which shows a dramatic reduction in the risk of hospitalization and death for people who’ve received a booster dose, we can see that on the next slide. 

And this is a summary of data: If you compare a fully vaccinated person with one who has received a booster shot, and look at the monthly rate of COVID-19 associated hospitalizations during a timeframe of December 2021, there was a 45-fold higher likelihood of an unvaccinated person in the age range of 50 to 64, and a 51-fold higher likelihood of an unvaccinated age 65 and older of being hospitalized when you compare it to an individual with a boost.

Next slide.

When you look at death rate, again, the data are really rather striking.  If you look at unvaccinated in red and look at the death rate per 100,000 compared to a fully vaccinated person who’s not been boosted — showing you why vaccinations even without boosts are important.  But look what the booster does: It brings back the death rate per 100,000 to a remarkably low level. 

So, we can only come to one conclusion on the last slide: that  COVID-19 vaccines, booster shots can keep you out of the hospital and certainly can save your life.

Back to you, Jeff.

MR. ZIENTS:  Thanks, Dr. Fauci. 

Before we open for questions, I want to highlight how far we’ve come in our fight against COVID.

Last week, we learned the U.S. economy created 6.6 million new jobs in the President’s first year in office.  That’s the best 12 months of job creation in our nation’s history. 

Notably, this includes 467,000 jobs created in January and 510,000 in December.  Those were the two months when we were at the height of the Omicron surge.

The first time we faced a similar threat from COVID back in April of 2020, we lost around 20 million jobs in one month.  Even as we face the extremely transmissible Omicron variant and saw a record number of cases, businesses stayed open and our economy kept growing stronger.  That’s because we’re in such a different position today in terms of our ability to manage this virus. 

We have over 210 million people fully vaccinated and vaccines freely available.  And we have more tools like boosters, treatments, masks, and tests that give us additional layers of protection. 

Today, fully vaccinated and boosted Americans are able to keep living their lives safely, even when this virus throws us a curveball.  And we’re able to keep our kids in school and keep our businesses open.

As the President said on Friday, January was a tough month for this country, but we got through it together.  Over the past three weeks, daily cases are down over 65 percent; hospital admissions are down 40 percent.

The President’s COVID plan is working.  We’re moving toward a time when COVID won’t disrupt our daily lives, a time when COVID won’t be a constant crisis but rather will be something we can protect against and treat. 

With that, let’s open it up for a few questions.  Over to you, Kevin.

MODERATOR:  Thanks, Jeff.  We’ve got a lot of questions today.  So, let’s actually try to keep it to one question. 

First, let’s go to Zeke Miller at the AP. 

Q    Thanks.  In the last week, we’ve seen a number of Democratic-led — -run states move back towards normalcy, removing mask mandates.  New York is expected to follow today.  We saw Connecticut, other states lift mask requirements in schools. 

You’ve talked a lot about leading — the President trying to lead the nation out of the pandemic, but right now, the federal response seems to be following what a lot of states are doing.  Is the White House planning for emerging — bringing the country out of the pandemic?  And what would that plan look like?

MR. ZIENTS:  Well, thanks for the question.  So while cases and hospitalizations, as Dr. Walensky showed, are trending downward, we do remain focused on fighting the Omicron surge.  So, that’s priority number one. 

The President, as I just mentioned, has been clear that we’re moving toward a time when COVID won’t disrupt our daily lives, a time when COVID won’t be a constant crisis so we’re no longer fearing lockdowns and shutdowns, but getting back to safely doing what we all love.  In doing so, we will rely on the powerful set of tools that have been built: the vaccines, the booster shots, treatments, and testing. 

For the last several weeks, we’ve been working closely with Secretary Becerra, our team of doctors.  And the White House COVID Response Team under the President’s leadership is reaching out to governors and outside public health experts and doctors and local public health officials on steps we should be taking to keep the country moving forward. 

We know that in different areas of the country, cases have fallen more significantly, and this will lead to different approaches and different timing.  And we will continue to coordinate closely with state and local leaders. 

Next question.

MODERATOR:  Let’s go to Sabrina Siddiqui at the Wall Street Journal.

Q    Thank you so much.  This is a question for Dr.  Walensky.  I just want to follow up on current guidance around masks, because, you know, the last CDC recommendation was that there should be indoor masking in public settings where transmission is substantial or high.  According to CDC data, that appears to still be the entire country — the case in the entire country where community transmission is high.  So is that still the recommendation?

And furthermore, you’ve also recommended that there be universal masking in schools.  Is that — is that a recommendation you stand by as states are also moving to drop — or to lift mask mandates for teachers and students in schools?

MR. ZIENTS:  Dr. Walensky?

DR. WALENSKY:  Yeah, thank you, Sabrina.  So we certainly understand the need and desire to be flexible, and we want to ensure the public health guidance that we’re providing meets the moment that we’re in.

As we’ve discussed and as you noted, cases and hospitalizations are falling.  This is, of course, encouraging.  And that leads us, of course, to have us look at all of our guidance based on the latest data and the science and what we know about the virus. 

We also look, of course, as Jeff mentioned, to our hospitalizations, looking at the hospitals as a barometer of how they’re doing locally so those decisions can be made at the local level. 

And, of course, we at CDC will keep the public informed about our guidance, and we will clearly communicate those recommendations to the public if and when they are updated.

Thank you.

MR. ZIENTS:  Next question, please.

MODERATOR:  We’ll go to Cheyenne Haslett at ABC News.

Q    Hi, thank you.  Dr. Walensky, you mentioned the specific benchmarks on hospitalization that you’re looking to for when it will be a good time to change some of this guidance for unmasking, both in schools and generally in public for adults.  What exactly will that benchmark be?

DR. WALENSKY:  Right.  So, Cheyenne, we — you know, in part of our review of the surveillance, we look at wastewater, we look at cases, we look at hospitalizations — we’ve been reporting hospitalizations — we look at deaths.  And, of course, those decisions are made at the local level.

But at this time, we continue to recommend masking in areas of high and substantial transmission — that’s much of the country right now — in public indoor settings.  And so we’re, of course, taking a close look at this in real-time, and we’re evaluating rates of transmission as well as rates of severe outcomes as we look at updating and reviewing our guidance.

MR. ZIENTS:  Next question, please.

MODERATOR:  We’ll go to Victoria Knight at Kaiser Health News.

Q    Thanks so much for taking my question.  So, I’ve been talking to people who are immunocompromised, people who are disabled, living with chronic illnesses, and they’re all telling me that they’re feeling like they are being left behind, especially in light of a lot of states lifting their mask mandates, and they’re feeling like their needs are not being considered moving forward after Omicron.  So what is your message to them?  What do you expect them to do?  Do they need to just stay in their houses?  What is your message to people like that?

MR. ZIENTS:  Dr. Walensky?

DR. WALENSKY:  Right.  So this is among the considerations that we take into account as we work on all of our recommendations.  We, of course, have to make recommendations that are, you know, relevant for New York City and rural Montana.  We have to make recommendations that are met — relevant for the public, but also for the public who is immunocompromised and disabled.  And so, that — all of those considerations are taken into account as we work on our guidance. 

MR. ZIENTS:  Next question, please. 

MODERATOR:  Let’s go to Kaitlan Collins at CNN.

Q    Thanks so much.  Dr. Walensky, you just said that you do continue to recommend masking indoors in areas of high transmission, and that you said that that’s most of the country right now.  So are you seeing any data that supports the decisions of these governors to drop mandates?  And when it comes to masking, should people be listening to the CDC or listening to their governors?

DR. WALENSKY:  Kaitlan, we’ve always said that these decisions are going to have to be made at the local level and that policies at the local level will look at local cases, they’ll look at how local hospitals are doing, they’ll look at local vaccination rates.

And they, as I understand it, in many of these decisions are using a phased approach.  Not all of these decisions are being made to stop things tomorrow, but they’re looking at a phased approach.

And so, what I would say is: Again, they have to be done at the local level.  But I’m really encouraged that cases are continuing to drop dramatically, hospitalizations are continuing to drop dramatically as people are making these decisions and as we are working on our guidance.

So I’m encouraged to see those trends.

MR. ZIENTS:  Next question, please.

MODERATOR:  Let’s go to Sheryl Stolberg at the New York Times. 

MR. ZIENTS:  Sheryl?

Q    Can you hear me?

MR. ZIENTS:  Now we can, yes.

Q    Sorry about that.  Thank you for taking this question — it’s for Dr. Walensky.  Dr. Walensky, the states have been asking explicitly, governors have been asking explicitly for guidance from the CDC on mask-wearing and how to relax mitigation numbers. 

Is the CDC prepared to provide guidance to the governors?  And when will it do so?

DR. WALENSKY:  Sheryl, thank you.  And I’ll simply go back to: Yes, we are prepared.  We are working on that guidance.  We are working on, you know, following the trends for the moment. 

What I will say though is, you know, our hospitalizations are still high, our death rates are still high.  So, as we work towards that and as we are encouraged by the current trends, we are not there yet.

MR. ZIENTS:  Next question, please.

MODERATOR:  Let’s go to Kristen Welker at NBC.

Q    Hi, everyone.  Thanks so much for doing this call.  I know that you have spoken in the past about the fact that we could be moving closer to having a vaccine for children under the age of five.  And obviously, when you look at some of the polling, it’s potentially concerning: Just 3 in 10 parents of children under the age of five say that they’ll get their child vaccinated. 

Can you update us on your latest efforts once those vaccines are approved to reach those parents who are still skeptical?  What should they know?  And why should they have confidence in the vaccines once they are approved?  What will your messaging be, and what are your latest outreach efforts?

MR. ZIENTS:  Well, Dr. Fauci, maybe you can do a minute or two on the under-five vaccine status.  And then I’ll talk some about both the operational issues and the — answering questions and building confidence work. 

Dr. Fauci.

DR. FAUCI:  Yeah.  Thank you, Jeff. 

Yes, the data from the trials on children from 6 months to 24 months, as well as those from 21 months to — up to the end of 4 years have been conducted by the pharmaceutical company, in this case, Pfizer. 

The data have been submitted to the FDA, and the FDA VRBPAC, or their advisory committee, will be meeting on February 15th.  I think people need to be assured that any decision that the FDA makes, as is historically always the case with them, will really be based on the scientific data of both safety and efficacy.  And we can assure you that the decision will be based on that. 

And if, in fact, approved, it will be approved on the fact that the data show clear efficacy and safety. 

So, I’ll go back to you, Jeff, for the rest of that question.

MR. ZIENTS:  Thanks, Dr. Fauci.  So, operationally, we will be ready once FDA and CDC make their recommendations.  As we talked about last week, this vaccine is specifically formulated for these young kids.  So, we’re launching a new program specially for kids under five.

The planning process is well underway.  CDC is working with states to help them prepare.  We’ve secured enough vaccine supply for all kids in this age group — all 18 million.  We have enough needles, syringes, and kits.  And these are all specially formulated, are made for this age group to send alongside the vaccine.

And we’re working closely, you know, with pediatricians and family doctors and children’s hospitals and pharmacies to make sure the vaccine is available at thousands of locations across the country — locations that parents know and trust. 

We can start packing and shipping the vaccine once FDA makes its decision.  So, we will be prepared for those parents that are eager to get their kids vaccinated. 

I think the second part of your question is — there are parents that are — that do have questions, and we need to answer those questions.  And we’ve learned through our efforts across the last year that the best messengers are local messengers — local community groups and leaders, doctors, and other health practitioners. 

So, we are working closely with HHS to line up that group and make sure that they have the materials that they need, the training they need to be able to answer the questions that parents have about getting their kids vaccinated. 

Next question, please.

MODERATOR:  Last question.  Let’s go to Josh Wingrove of Bloomberg.

Q    Hi there.  Thank you very much.  Dr. Fauci, can you talk a little bit more about what you think the data show now of the need for a shot beyond the third dose, beyond a booster?

As you know, boosters are being given as early as five months — we are approaching five months now — some of the — first folks who got it.

What do we know about how often or if further shots will be needed going forward, and in particular, whether we might need specific types of shots for any variant?  Thank you.

DR. FAUCI:  Yeah.  Yeah, thank you for that question.  That’s obviously an issue that have been followed very closely.  Because as I’ve said in answer to questions on previous press conferences — similar questions — is that you follow individuals for a period of time after the third dose and you measure a number of phenomenon.  You measure laboratory phenomenon, but you measure the real-world data on the efficacy in preventing, for example, hospital visits, as well as hospitalizations.

And I believe that you’re going to be hearing data about that as they — data become available.  And that should not be within a very long period of time. 

I think you should be appreciative of the fact that when you’re talking about any decisions that will be made — and I’m not anticipating any of that now — but that has to be put into the context of whom you’re talking about.

For example, there may be the need for yet again another boost — in this case, a fourth-dose boost for an individual receiving the mRNA — that could be based on age, as well as underlying conditions. 

So, I don’t think you’re going to be hearing, if you do, any kind of recommendations that would be across the board for everyone.  It very likely will take into account what subset of people have a diminished, or not, protection against the important parameters such as hospitalization.

MR. ZIENTS:  Thank you, everybody.  We look forward to the next briefing. 

11:37 A.M. EST

To view the COVID Press Briefing slides, visit: https://www.whitehouse.gov/wp-content/uploads/2022/02/COVID-Press-Briefing-2.9.22-clean.pdf

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Abnormal immune system activity may explain long COVID

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A new study suggests SARS-CoV-2 infections may cause long-term disturbances to the immune system, resulting in long COVID. Image credit: Jenny Evans/Getty Images
  • Researchers worldwide are continually updating the scientific knowledge around SARS-CoV-2, the virus that causes COVID-19.
  • In the most recent update, scientists in Australia report that atypical immune activity persists in people with long COVID 8 months after infection with SARS-CoV-2.
  • Their research shows that long COVID features increased levels of specific immune biomarkers in the body.
  • Their findings provide a crucial foundation to enhance our understanding of long COVID, an emerging chronic condition.

Scientists have spent the last few years trying to understand the novel coronavirus, SARS-CoV-2, which is responsible for the COVID-19 pandemic.

As new variants of the SARS-CoV-2 virus emerge, scientists continue to study their effects to find ways of keeping the global population safe.

In line with ongoing scientific efforts, a new study has reported that individuals with long COVID experience dysfunctional immune activity 8 months after the initial COVID-19 illness.

Long COVID, also known as post-acute COVID-19, is a term to describe the effects of COVID-19 that linger for weeks or months beyond the initial illness. The symptoms often involve respiratory and physical distress and, more recently, cardiovascular distress.

The study, led by scientists at The Kirby Institute, University of New South Wales, Australia, appears in the journal Nature Immunology.

“Our observations provide an important foundation for understanding the pathophysiology of this syndrome and [may suggest] potential therapeutic avenues for intervention,” the study authors write.

“Our study indicates an ongoing, sustained inflammatory response following even mild-to-moderate acute COVID-19, which is not found following prevalent common cold coronavirus infection,” Dr. Chansavath Phetsouphanh, a senior research associate and co-lead author of the study, told Medical News Today.

However, he added that “more research from bigger cohorts is required to validate [their] findings.”

The researchers followed 147 individuals for 8 months following a diagnosis of COVID-19.

They were interested in studying the pathophysiological, immunological, and clinical outcomes following infection with SARS-CoV-2.

In the study, the team defined long COVID as the occurrence of one of three major symptoms of fatigue, chest pain, or shortness of breath in the fourth month of infection. A total of 31 out of 147 individuals fitted the description.

The scientists then matched the individuals using gender and age, with 31 asymptomatic controls from the same cohort who did not report symptoms in the fourth month but were symptomatic during the acute phase of COVID-19.

The researchers also recruited a fresh population of individuals who tested negative for SARS-CoV-2 alongside individuals who had contracted other human coronaviruses but not SARS-CoV-2. This group served as the control.

Finally, the experimenters collected blood samples from each group to examine the biomarkers associated with long COVID. In medicine, a biomarker refers to “a characteristic that is objectively measured and evaluated as an indicator of normal biological processes, pathogenic processes, or pharmacologic responses to a therapeutic intervention.”

At first glance, the scientists noted that the long COVID and control groups had significantly higher levels of six immune biomarkers compared with the control group.

However, from the fourth month, they noticed a drop in the elevated biomarker levels in the control group while the long COVID group still maintained high levels of biomarkers.

Specifically, the team noticed that two types of biomarkers — known as interferons — were elevated in the long COVID group 8 months after infection with SARS-CoV-2. Scientists describe interferons as a type of protein that body cells make in response to the presence of viruses.

As well as elevated levels of interferons, Dr. Phetsouphanh and his team discovered that the long COVID group had highly activated immune cells but lacked naive T and B cells. These cells are responsible for helping the immune system respond to novel pathogens that it has not yet encountered.

Taking these findings into consideration, the scientists concluded that:

“SARS-CoV-2 infection exerts unique prolonged residual effects on the innate and adaptive immune systems and that this may be driving the symptomology known as [long COVID],” the study authors write.

Dr. Deepti Gurdasani, a senior lecturer at the Queen Mary University of London, who was not involved in the research, responded to the study on Twitter, saying that its results “in practical terms [are] unclear — but concerning nevertheless.”

“Understanding [the meaning of the] immune dysregulation that was clearly present at least at 8 months, and possibly longer will take time,” she wrote, pointing out that “long COVID clearly shows a different immunological profile compared to people who don’t have persistent symptoms.”

She added:

“Whether this is because of [the] persistence of [the] virus, virus antigen, or auto-immunity post-infection isn’t known yet. It could be one of these or even a combination — but all possibilities should concern us.”

The study authors report several limitations in their research.

First, because of the timing of ethics approvals and cohort setup, the scientists could not collect samples during the period of acute infection. As a result, they were unable to determine whether elevations in biomarker levels during the recovery period correlated with the levels observed in acute infection.

Additionally, the definition of long COVID in the study was set internally by the researchers, given the lack of international consensus on its definition.

Nevertheless, the scientists note that the inclusion of the most common persisting symptoms of long COVID alongside rigorous research practices helped ensure the validity of their findings.

Needless to say, the research is still largely exploratory, and more studies are necessary to confirm the findings. However, the study results could one day potentially inspire better treatments for people living with long COVID.

For live updates on the latest developments regarding COVID-19, click here.

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Increased risk of death following hospitalization

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Scientists a short while ago followed people immediately after hospitalization with COVID-19. Allison Meal/Bloomberg by means of Getty Visuals
  • A new examine finds that individuals hospitalized with COVID-19 have an improved risk of dying or readmission afterward.
  • The danger of loss of life write-up-hospitalization is optimum for individuals with preexisting dementia.
  • Also, the risk of dying from any cause is 4–5 times better after release from the medical center for folks with COVID-19, as opposed with the common population.
  • Men and women hospitalized with other ailments are about fifty percent as probably to die of any induce as people who acquired cure for COVID-19.

A new review finds that getting introduced from the medical center after getting procedure for COVID-19 does not assure survival.

Individuals who have survived at minimum 1 7 days just after release from the healthcare facility for treatment of COVID-19 are a lot more than two times as probably to die or return to the healthcare facility more than the subsequent a number of months than the common inhabitants.

Dr. Krishnan Bhaskaran, lead creator of the present review and professor of statistical epidemiology at the London College of Cleanliness & Tropical Medicine in the United Kingdom, told Professional medical News Right now:

“This won’t be fully because of to lasting effects of the virus — we know that COVID-19 picks on a lot more susceptible men and women in the 1st spot, in addition there are generic adverse outcomes of currently being seriously sick and hospitalized. That’s why, the challenges had been additional identical when we as opposed [them with those for] hospitalized flu individuals.”

The examine findings ended up nevertheless hanging, explained Dr. Bhaskaran.

“Two points which stood out in the COVID-19 clients have been the significant danger of rehospitalization or loss of life attributed to the COVID-19 condition alone, and the superior possibility of dying from dementia, specially in those with preexisting dementia sickness,” he spelled out.

The examine seems in PLOS Drugs.

Using the Countrywide Health Support (NHS) England’s OpenSAFELY details, Dr. Bhaskaran and his colleagues in contrast wellbeing information from 24,673 people who experienced been hospitalized for COVID-19, a demographically matched standard-population command group of 123,362 folks, and 16,058 individuals who had been hospitalized for influenza.

The researchers tracked the individuals’ wellbeing for up to 315 times soon after hospitalization. Throughout this period of time, the examine authors produce,

“COVID-19 clients had better dangers of all-cause mortality, readmission or loss of life thanks to the preliminary an infection, and dementia death, highlighting the importance of post-discharge monitoring.”

Put up-discharge clients who had COVID-19 ended up 4–5 situations much more probable to die from any result in than the associates of the handle team. Their possibility was just about double that of folks previously hospitalized for influenza.

“It was about,” claimed Dr. Bhaskaran, “to obtain that clients with dementia experienced a higher risk of dying from their dementia subsequent a COVID-19 hospitalization.”

Dr. Bhaskaran speculated that portion of the purpose for the particular vulnerability of individuals with dementia simply experienced to do with hospitalization itself.

He mentioned: “We know that encountering crucial sickness and hospitalization, in general, can accelerate cognitive drop: folks are put under strain, maybe supplied new drugs, and taken out of their routines. Infections can also trigger quick-expression delirium in some circumstances, which may possibly then accelerate dementia.”

Even so, he extra:

“Something far more precise to COVID-19 that may well have brought about particular issues is the diploma of social isolation that sufferers confronted in the course of their health issues. Traveling to was prohibited or extremely constrained, and any human contacts that were permitted necessary face coverings and protecting equipment. Whilst this was all significant for infection management, just one can imagine the added confusion and alienation to patients by now having difficulties with dementia sickness.”

Seeking ahead, the authors create,

“Risks might be minimized or mitigated by raising monitoring of sufferers in the months next clinic discharge, and increased consciousness among the people and clinicians of prospective problems.”

Dr. Bhaskaran underscored this to MNT, declaring:

“Measures like pre-discharge chance evaluation and a lot more proactive publish-discharge checking seem probable to minimize the challenges to people today dealing with even more serious problems immediately after their preliminary medical center stay, so we would like to see such steps explored more. It will be important to collect knowledge as distinctive threat minimization techniques are trialled, so we can learn what functions.”

For stay updates on the most recent developments about COVID-19, click on below.

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Xavier Becerra, HHS secretary, has been a background player for much of his tenure. He says that’s about to change.

In an exclusive job interview, Becerra reported he thinks the federal government’s steerage on the Covid-19 pandemic has been way far too perplexing, and fixing that issue starts by acknowledging it.

“The American persons never have a ton of time to check out to do the science and crunch the numbers,” Becerra stated. “They anticipate the gurus to give them the reply.”

Of class, the science all-around the virus is constantly altering, Becerra stated, but he said administration officials want to understand that the confusion triggered by how tough it truly is been to continue to keep up with the guidance coming out has been counterproductive, and perhaps costing lives.

“Here is a big difference amongst conveying a concept that is accurate and a concept that’s crystal clear: How you say it can be the variance involving knowledge it and not, or following it and not,” he claimed. Questioned if he could precisely peg the present direction on testing, isolation, masking and extra, he presented, “I almost certainly could.”

Becerra and his allies in the administration are embarking on an energy to bulk up the secretary’s function, from possessing a substantive conference with Biden, which he has never done, to showing up at White Dwelling information briefings, which he has also never performed.

However White Property officers say they are keen to see him phase up — “He has the potential to converse, and I consider he values that conversation,” White Residence Covid-19 process drive director Jeff Zients informed CNN — some men and women familiar with the inner discussions say skepticism remains that Becerra will be capable to.

The tried reboot for Becerra comes as the Biden administration faces criticism for its general public well being messaging on the pandemic, a little something resources inside the administration say the former California congressman and condition lawyer general could aid resolve.

On the other hand, Becerra’s perceived absence in the Covid element of his occupation was set in motion by his rushed appointment to the work and a framework created for the administration’s pandemic response that disempowered him. That was accentuated by dynamics that fell into location throughout his delayed affirmation and is now leading to rising annoyance with the secretary the two within and outside the administration.

That sensation arrives as leading Latino leaders have been privately reaching out to senior White Household aides, expressing they be concerned that Becerra, one particular of the most trusted leaders in Latino politics, is remaining thrown underneath the bus in a way that is enraging and could build further issues for connections with Latino voters.

If the predicament won’t improve swiftly, “I would be upset,” claimed Nathalie Rayes, president and CEO of the Latino Victory Job, “but I assume that he will continue on taking part in a vital job.”

Administration officials who’ve been in meetings and digital phone calls with the secretary say he’s taken a conflict-averse tactic in dealing with the administration’s other Covid-19 leaders. But that can come off as the secretary rarely inquiring substantive issues, offering the sensation that he is treating the phone calls additional as briefings on decisions presently created devoid of him.

Becerra normally asks if officers have the resources they have to have. He asks what the roadblocks are and how he can assist knock them down. Continue to, even though Dr. Anthony Fauci, main Biden medical adviser and infectious ailments specialist, and most other officials doing the job on the pandemic technically report to Becerra, which is not the way it feels to most, internally or externally.

As a substitute of pushing for a location for himself on Covid reaction, Becerra has targeted on the other operate of his massive division, which has provided a reduce-profile operational part in the Covid reaction and traveling about the nation to converse to affected hospitals and wellness clinics right.

Many others admit that Becerra’s sensibility as a longtime politician with working experience acquiring his concept across to voters could possibly be just what they require ideal now, as the administration struggles to find the balance in between remaining on guard about the pandemic and responding to a state that, two yrs into living with the coronavirus, is significantly finished with the lockdown mentality.

How that most likely alterations in the weeks and months in advance will have ripple outcomes — not just public health and fitness types, but political ones, as well. Becerra is potentially an essential figure in the Democrats’ outreach to Latino voters. It matters for his individual political potential customers, if and when he heads again to California. And in some suspicious corners of the White Property, how this is managed is remaining viewed as a measure of Zients, witnessed as a contender to be a foreseeable future White Property chief of workers.

“You can find a path ahead,” stated just one person who labored in equally the Obama and Biden administrations on associated difficulties, “but he’s acquired to interact and do the function. He cannot do it evenly. He wants to sit at the head of the table, and he demands to have a strong position of look at and be eager to choose the outcomes.”

Not Biden’s initial alternative for the career

Even prior to his to start with day on the task, Becerra was driving.

During the changeover, Biden officers had zeroed in on Gina Raimondo, the then-governor of Rhode Island, known as a technocrat, who had made a remarkably powerful impression on prospect Biden’s managing mate vetting staff. Biden called to converse by means of options, and however he failed to commit, the conversation remaining her telling people today she considered she’d get the provide, according to 3 people today advised about the get in touch with.

In accordance to two individuals acquainted with the changeover, Biden’s team had to swiftly recalibrate subsequent a letter from the Congressional Hispanic Caucus that had known as out a lack of Latino representation in Biden’s Cabinet just after New Mexico Gov. Michelle Lujan Grisham dropped out of favor for the position. That letter, merged with pushback from progressives about putting the enterprise-friendly Raimondo in that location, scrapped the governor’s odds for the function.

Biden aides scrambled. Becerra, a previous congressman who was then the California attorney common, experienced hoped to be thought of for US attorney normal but was by no means offered a great deal thing to consider for that task.

The day ahead of he was announced as health and fitness and human expert services secretary, Becerra was unaware the job was an precise risk. He was introduced on the exact working day in December 2020 that Zients, who experienced helped oversee the choice system, was named as head of the White House’s Covid-19 job drive and presented the genuine electrical power over the administration’s pandemic response.

Raimondo was shifted to Commerce, environment off a insignificant shuffle of other Cupboard jobs. Lujan Grisham turned down her individual follow-up present to be inside secretary.

Coming off the days of wonder drug promotion and speculation on disinfectant injections or shining a bright mild to battle Covid-19 from the Trump administration, Biden insisted that the health professionals and experts be out front on the pandemic. Zients, a expert administration player with a Mr. Correct-It track record from conserving the heathcare.gov website for the duration of the Obama administration and auditing the failing finances through Biden’s campaign, was set in charge as coordinator.

‘A minimal community profile’

Then Becerra’s confirmation was delayed for two months by a number of Republican senators complaining that he wasn’t a medical professional — regardless of that only a few former wellness secretaries at any time experienced professional medical levels.

Then, nearly as soon as Becerra last but not least got on the job, he experienced to prioritize an influx of unaccompanied minors at the border. By the time he could even start off digging in on the Covid-19 pandemic, it was early summer time, and the administration’s pandemic dynamics experienced been very well recognized without him.

Arturo Vargas, the CEO of the Nationwide Affiliation of Latino Elected and Appointed Officers and a buddy of Becerra’s, claimed steering clear of confrontation and the spotlight was “his M-O.”

“He had a reduced community profile in Congress even though he was in management. He was chair of the Congressional Hispanic Caucus he was in leadership in the Democratic Caucus. But he wasn’t in each and every solitary press meeting with the speakers and the party leaders,” Vargas claimed.

More muted than disengaged, Becerra has prolonged that strategy to the sections of the job that have almost nothing to do with the Covid response, like when the administration declared file-breaking Obamacare open enrollment figures two weeks in the past. This integrated outreach efforts by nonconventional media and reliable neighborhood voices in underserved communities, by way of systems overseen by Becerra.

“It can be historic, but it can be not accidental, and it’s not coincidental,” he told reporters about the enrollment figures on a get in touch with saying the success.

HHS officers say he is fulfilled regularly with his global counterparts among health ministers, especially within the G7 nations, and reengaged The usa with the Globe Health Group. Officers say that partnership was especially crucial in encouraging to much better recognize the Omicron variant, fully grasp its neighborhood distribute and allocate sources accordingly.

He’s drawn from his expertise on the House Techniques and Suggests Committee to weigh in on mental house rights issues more than sharing vaccines all over the earth. His encounter as California attorney normal has arrive into participate in when he chimes in on conversations about the legal problems the administration has been drawing over mandates. He’s pushed for Medicare rates to be revised in gentle of a significant rate fall in a best Alzheimer’s medicine.

“He’s pondering about the finish person, and understanding who’s lacking and remaining guiding by domestic or worldwide procedures,” said Loyce Rate, the department’s director of the Place of work of Global Affairs.

Zients reported Becerra’s attention to concerns of fairness has been a regular and valued component of their conversations, whether in their standard Wednesday digital meetings or other verify-ins together the way. As to why Becerra has experienced so numerous people today talking out against him anonymously these days, Zients said, “I never get it.”

But Becerra has a extensive way to go to assert himself.

Requested by CNN for the duration of a excursion to Washington very last week what she assumed of the male who had gotten the job she’d desired, Lujan Grisham claimed Becerra is undertaking “an outstanding occupation” taking care of distribution in spite of holdups in Covid therapeutics and procedure, in addition to prescription drug access and out-of-pocket prices.

She couldn’t try to remember how extended it had been because they’d spoken. She asked an aide standing with her. Ultimately, she pegged it at “8 or nine months.”

Remaining questioned about him, she stated, reminded her that she wanted to chat to him and thought he’d be receptive, as a Latino leader who’s been concentrated on supporting the underserved throughout his vocation.

“I do will need to chat to him about just some thoughts I have about some pilot get the job done for large-poverty states with minority populations that could possibly be a new equity expense, significantly in community wellbeing,” she claimed. “I am hoping to get a a lot more than sympathetic ear, but another person who genuinely understands how crucial it is to offer with states who have equity concerns.”

Recalibrating around what’s not performing

Becerra reported focusing on what has gone mistaken is not the suitable way to glimpse at what is actually happened in excess of the past 12 months.

“When the President takes office and when less than 1{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} of the state has been vaccinated, and now you are at over 250 million people today with at minimum one shot? Which is progress,” Becerra claimed. “We are not finished but, sure. But we scored some touchdowns.”

He proudly pointed out that when he had arrive in as secretary, the proportion of Black Individuals and Latinos who’d gotten at least 1 shot was perfectly underneath the variety of White Us citizens, and that currently these proportions are all approximately even, in the reduced 80s.

“That was not accidental. That was not by possibility. And it wasn’t simple,” he said. “We’re not waiting around for persons to arrive to us to get a shot. We’re heading to them.”

Meanwhile, Becerra has directed $18 billion in reduction cash to mitigate Covid in rural communities across the state.

Now a top present-day concern is convincing mom and dad to get their youngsters vaccinated. Although vaccines for 5- to 11-year-olds have been authorized for much more than two months, only about 3 in 10 parents have moved forward with the shots, with the rate declining sharply just after Thanksgiving, when the very first hurry of eager moms and dads lined up their children.

Whilst some mothers and fathers are desperately waiting for shots for little ones beneath 5, Becerra and other administration officials know the bigger difficulty is heading to be convincing all the some others who usually are not contemplating it at all.

It would not appear like asserting US Food and Drug Administration approval of Covid-19 vaccines — or putting Fauci or US Facilities for Ailment Handle and Prevention Director Dr. Rochelle Walensky on Tv to communicate about how safe they are — is going to transform that.

“He is surely able to converse and reduce by some of the muddle in a way that is truly valuable,” claimed Dawn O’Connell, the assistant secretary for preparedness and response, who’s been the issue human being on numerous of the Covid-19 operations.

You will find definitely urge for food for adjust. Asked what he would make of the administration’s pandemic messaging, Colorado Gov. Jared Polis, a former Becerra House colleague and a Democrat who’s develop into recognised for his skepticism of continuing the lockdown mentality, quipped, “I are unable to say I really completely know what their Covid messaging is.”

Very first, Becerra will have to actually get in the doorway much more Biden is not the only individual he hasn’t been talking with substantially.

Regardless of knowing Vice President Kamala Harris for several years in California and becoming appointed to her previous task as legal professional general immediately after she was elected to the Senate in 2016, and their shared target on equity troubles, he states he has not talked with her significantly possibly about the previous calendar year.

“Not as usually as you may assume — nicely, I do not know how typically folks believe you speak to the President or vice president, but they are fairly chaotic,” he mentioned, nevertheless he downplayed that as as well appropriate of a aspect. “You want to bounce anyhow, and they are just offering you a way on how superior.”

CNN’s Priscilla Alvarez contributed to this report.

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How does COVID-19 affect the brain?

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A recent article in the journal Science outlines what we know about the neurological consequences of SARS-CoV-2 infection. NICOLAS TUCAT/AFP via Getty Images
  • Neurologic complications from COVID-19 are common and can range from decreased mental clarity to stroke.
  • A recent perspective article outlines what we know about these complications so far.
  • The authors explain how prior assumptions that the virus directly affected brain cells have been disproven.
  • Instead, nervous system injury is likely a result of severe inflammation and neurovascular injury.
  • Neurologic insults from SARS-CoV-2 infection could increase the incidence and severity of neurodegenerative diseases, such as Alzheimer’s and Parkinson’s disease, in future generations.

Early in the pandemic, researchers observed that people recovering from COVID-19 were not returning to their pre-illness state of health — this is now commonly known as “Long COVID.”

Among the myriad persistent symptoms, many people experience headaches, memory issues, and cognitive deterioration.

Researchers from Northwestern University in Chicago, IL, were the first to report that even non-hospitalized people with COVID-19 demonstrated significant cognitive dysfunction that persisted well beyond 6 weeks from the acute infection.

In the journal Science, Dr. Serena Spudich and Dr. Avindra Nath review our current understanding of the neurologic consequences of COVID-19.

Building on clinical observations, autopsy, and laboratory findings, the authors propose theories of causality about how COVID-19 may result in long-term neurologic symptoms.

Neurologic complications of COVID-19 include:

  • loss of smell (anosmia)
  • stroke
  • delirium — a mental state characterized by an inability to rest, illusions, and incoherent thought and speech patterns
  • encephalopathy — a temporary or permanent state of altered brain function
  • psychiatric symptoms
  • peripheral neuropathy — a condition where nerve damage alters the communication between the central nervous system and the rest of the body

The authors acknowledge that the mechanisms by which COVID-19 can wreak havoc on the human nervous system are not well understood.

Cerebrovascular complications, such as a stroke, can occur early in the infection — even before the respiratory effects of the disease. Central inflammatory conditions and peripheral nerve symptoms occur later, typically 2 weeks after the acute infection.

These disparate timelines suggest that the cause of these neurologic symptoms may differ. Studying the cerebrospinal fluid (CSF) offers clues as to underlying mechanisms for neurologic damage in people with COVID-19.

CSF is a fluid that surrounds the spinal cord and brain.

Scientists have observed increases in certain immune-related compounds in the CSF, including:

  • Interleukin-1 (IL-1) and IL-2 proteins, which are inflammatory cytokines produced by the body.
  • Expression of genes controlled by interferon, an infection-fighting protein present during viral infections.
  • Activated T-cells and natural killer cells, which combat viral antigens.
  • Markers that indicate the presence of monocytes — large white cells that fight infection.
  • Breakdown proteins suggesting nerve damage.

Conversely, researchers have not found evidence that the SARS-CoV-2 virus directly impacts the nervous system. For instance, research has shown that the following factors are reduced or absent in people with a SARS-CoV-2 infection:

  • Cells that cause inflammation are not found clustered around the brain, which normally occurs in cases of viral encephalitis — a swelling of the brain.
  • The CNS does not contain viral RNA.
  • Limited presence of SARS-CoV-2 nucleic acid or viral protein in the brain cells of people who died from COVID-19.

When asked about the lack of virus in the CSF and brain cells, Dr. Santosh Kensari, chair, and professor of translational neurosciences and neurotherapeutics at St. Johns’ Cancer Institute in Santa Monica, CA, commented:

“If the virus isn’t there, it’s not directly [causing] the problem — that would be encephalitis — but the viruses can cause systemic problems, like the inflammation that [can] affect every organ system, including the brain — its an indirect effect.”

Adding and subtracting the positive and negative findings helped the authors of the perspective article to formulate a theory regarding the cause of nervous system consequences of SARS-CoV-2 infection.

They do not rule out that the virus may transiently infect the brain very early in infection. However, the authors ultimately conclude that inflammation and widespread vascular dysfunction may be the vector of neurologic damage in people with COVID-19.

Compared with people with influenza, individuals with COVID-19 exhibit an increased risk of stroke. When scientists studied the blood of people who experienced a stroke, they found elevated blood markers of vascular inflammation, tissue death, and thrombosis, which are clots that obstruct blood flow.

Radiologic testing also provides evidence of injury in people who experienced COVID-19. MRIs confirm microvascular damage and brain atrophy, or shrinkage. Positron emission tomography confirms decreased metabolic activity in the brains of people diagnosed with Long COVID.

This evidence, coupled with the system-wide vascular dysfunction seen in people with severe COVID-19, points to vascular injury as a potential cause of stroke, brain, and nerve injury.

The authors conclude that SARS-CoV-2 is absent and markers of inflammation and vascular dysfunction are increased in the brains of people with COVID-19. So, the effects of COVID-19 are likely the result of an intersection of disease-causing mechanisms:

  • Generalized neuroinflammation supported by the presence of immune cells, cytokines, antibodies, and activated microglia, which are specialized neuron damage-fighting cells.
  • Damage to the cells lining the brain’s blood vessels (endothelium).
  • Elevated levels of blood-clotting proteins.
  • Individual susceptibility, including genetics, preexisting health conditions, and immune strength.

For MNT, Dr. Santosh Kensari addressed why some people might be more susceptible to neuropsychiatric complications from COVID-19 infection.

“I don’t think we know fully, but I suspect it is a variety of factors,” he explained. He believes these probably include the severity of COVID-19 and other cardiovascular risk factors, such as type 2 diabetes.

“My philosophy in medicine has completely changed. For example, inflammation is probably 90{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} of aging. Cancer, dementia, all are due to immune function. COVID-19 is making all these things worse because it is driving inflammation.”

– Dr. Santosh Kensari

While laboratory and radiologic evidence support their theories, there is only conjecture on the exact mechanisms at this time.

The authors note that people living with Long COVID may have long lasting immune activation, persistent autoimmune disturbance, or ongoing damage to the endothelium.

Medical experts around the world are worried about the long-term prognosis for people recovering from COVID-19.

From a neurologic standpoint, Dr. Spudich and Dr. Nath are concerned that the neuroinflammation and neuronal injury caused by acute SARS-CoV-2 infection may “accelerate or trigger future development of neurodegenerative diseases, such as Alzheimer’s or Parkinson’s disease.”

And they feel that the neurodevelopmental influences of SARS-CoV-2 infection on children remain unknown.

For MNT, Dr. Santosh Kensari added:

“Chronic inflammation has many causes, including diabetes, obesity, and nutrition. These are a predisposition to autoimmune disorders, and they cause and accelerate the risk of brain-related disorders.”

Given the number of individuals who have experienced COVID-19, the researchers note that the neurologic consequences of COVID-19 represent a global public health problem.

In response to this challenge, the National Institute of Health has established a COVID-19 NeuroDataBank and NeuroBioBank to allow doctors to report and quantify neurologic events from COVID-19.

Drs. Spudich and Nath recommend that rigorous study and interventional trials are needed to dissect why some patients have an acute neurologic illness and others develop chronic disease late in their illness. They propose that understanding the immune dysregulation in individuals with Long COVID holds promise for treatment and long-term management.

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COVID-19 human challenge trial: First results are in

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The results of a United Kingdom-based human challenge trial offer new insights into COVID-19. Dominika Zarzycka/NurPhoto via Getty Images
  • In just-published results, a COVID-19 human challenge trial conducted in the United Kingdom has given unique insights into the progress of SARS-CoV-2 infection.
  • The mean time between exposure to SARS-CoV-2 and development of first COVID-19 symptoms is much shorter than previously thought.
  • Viral load peaked at 5 days after exposure, but active virus was still detectable in some people after 12 days.
  • Peak levels were highest in the nose, reinforcing the importance of wearing a face covering over both nose and mouth.

Imperial College London (ICL) has announced the results of the first COVID-19 human challenge trial. A human challenge trial is a carefully controlled study in which researchers deliberately infect participants with a pathogen to study the effects of that infection.

Prof. Christopher Chiu of ICL led this trial, which researchers carried out in a unit at the Royal Free Hospital in London. The results have not yet undergone peer review and appear on the preprint server Research Square.

Participants in the trial were young, healthy people who had not received a COVID-19 vaccination or had a previous SARS-CoV-2 infection. All those included were 18–30 years old.

Researchers gave all 36 participants a low dose of the original variant of SARS-CoV-2 as a droplet into the nose. They then monitored them for 14 days.

Half of the participants developed a SARS-CoV-2 infection. Two of these participants were asymptomatic. The remaining 16 developed mild symptoms, including a runny nose, sneezing, and sore throat. Some also reported tiredness, headache, slight fever, and muscle aches.

Half of those in the trial did not develop COVID-19 following exposure to SARS-CoV-2. No participants developed serious symptoms.

None of those who acquired an infection developed lung changes, but 12 people experienced anosmia — a loss of sense of smell. All but three people fully regained their sense of smell within 3 months. Researchers continued monitoring participants for 12 months.

This SARS-CoV-2 human challenge trial has revealed new information about the course of the infection.

People develop COVID-19 soon after exposure to SARS-CoV-2. On average, participants who got COVID-19 tested positive for the active virus after only 42 hours. This is contrary to the previous belief that people develop symptoms 5–6 days after exposure. CDC advice has been to test 5 days after suspected contact with SARS-CoV-2.

Viral load increased rapidly following infection, peaking at 5 days after exposure. Those who got the infection still had high levels of active virus 10 days, and some had active virus 12 days following inoculation.

During the course of infection, the virus moved. At around 40 hours after exposure, people had the highest amount of active virus in their throats. The viral load then became higher in the nose.

An important finding of the trial was that lateral flow tests (LFTs) were a good indicator of whether a person has viable virus, even in those without symptoms of COVID-19.

The trial’s insights into the course of SARS-CoV-2 infections could help with the management of COVID-19.

“Our study reveals some very interesting clinical insights, particularly around the short incubation period of the virus, extremely high viral shedding from the nose, as well as the utility of lateral flow tests, with potential implications for public health.”

– Prof. Christopher Chiu, chief investigator on the trial

LFTs can detect even asymptomatic infection with SARS-CoV-2. However, they are less effective at detecting low levels of the virus in only the nose.

People should therefore swab the throat as well as the nose if performing an LFT soon after suspected exposure.

“[O]verall, lateral flow tests correlate very well with the presence of infectious virus,” says Prof. Chiu. “Even though in the first day or two they may be less sensitive, if you use them correctly and repeatedly, and act on them if they read positive, this will have a major impact on interrupting viral spread.”

The researchers found the highest levels of virus in the nose, so they advise that there is a greater risk of viral shedding from the nose. They stress the importance of wearing face coverings correctly to cover the nose and the mouth.

People should also isolate if they contract the infection, as most still have active virus 9 days after exposure to SARS-CoV-2.

“This innovative, careful and ethical human challenge study provides new insights into the brief incubation period of COVID-19 virus infections, helping to explain how the virus is so extraordinarily contagious. The utility of rapid tests in diagnosing infection was confirmed, as well as the importance of mask-wearing as a means of curtailing transmission.”

– Dr. William Schaffner, professor of infectious diseases at the Vanderbilt University Medical Center, Nashville, TN, speaking to MNT

Researchers performed this trial using an early variant of the virus from before the Alpha variant was detected. Investigators are keen to continue human challenge trials using later variants, including Delta.

Dr. Schaffner would like to see further trials. “The study used an early COVID-19 virus strain, and we look forward to results of further studies of the Omicron variant, which [is now] the dominant virus strain worldwide,” he said.

In this trial, only 50{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} of those exposed to SARS-CoV-2 contracted the infection. The researchers now plan to investigate why some people appear to be resistant to SARS-CoV-2 infection.

For live updates on the latest developments regarding the novel coronavirus and COVID-19, click here.