I’m not in the medical or science field. I’m just a 78 (almost) year old woman who tries to stay fit and gets her vaccines. I think it’s important for hospitals to report the high hospitalizations for Covid and flu. Otherwise, the public will not know how important it is to stay updated on their vaccines.
Because it's not making the headlines, your work is all the more important. Thank you for offering information not easily available elsewhere. Thanks also for notice about the public comment in May.
Thank you for this. I write the KnoxvilleCovid19news on Reddit. I have been studying covid as a safety committee member for UPS, then as a political candidate and now with my writing since January 2020. We are the only municipality our size in the nation that hasn't installed a wastewater testing facility, despite the fact that we are home to our states largest land grant research university. Our death rate during covid was almost three times that of Madison Wisconsin, our demographic sister, and our County Mayor disbanded our Board of Health when they acted in an ethical manner, rather than do what he commanded. I misplaced a decimal point in November 2020 and figured out the path we were taking would lead to pediatric deaths and advocated for as strong a Covid response as possible. It turned out the misplaced decimal point was irrelevant as the later strains ofd Covid seemed to include more children and I I got louder and the pushback to what I was saying became stronger, it became more and more apparent that a child would indeed die. During the PR campaign involved in the disbanding of our Board of Health, both anti-vaccination, anti-mask and covid is a hoax propaganda dominated our County Government propaganda and, despite our court ordered mask mandate in schools, the Mayor Jacobs normalized the sending of sick kids to school, and at that point it became academic. Fourteen months after I noticed the anomaly, after a massive, preventable exposure, my neighbors six year old daughter, the one I watched play every day , who brought me the same joy my children brought me when I watched them grow up, passed away. Glenn Jacobs still denies culpability for this event. I disagree. I will continue to work for wastewater testing. Ironically peoples ears are perking up when I mention that with a 20-40 percent H5N1 contamination in our pasteurized milk supply, not really dangerous now, but an indication that there's things going on that we don't know. Thank you for the work you do. You are a valuable resource. I will continue to push for the reinstatement of our Board of Health. Terrorism is defined as officials using fear and intimidation and violence against a population for political reasons. Glenn Jacobs covid response in Knox County Tennessee was a terrorist act as defined by the Patriot Act and internatiuonal law.
I feel your pain Mr Fischer. The denial is really a product of ignorance and unwillingness to consider the public at large. Your anecdote about your young friend was heart-rendering and your Mayor couldn’t possibly understand how his decisions could have such an outcome. Again, denial is ignorance. We’ve seen it in our medical community as the pandemic swept across our area, EUA protocols were made available (subsidized of course) and yet patients succumbed. Our post-acute recovery facility received many victims of COVID19 and our efforts to apply a novel yet highly effective therapeutic regimen (not the HCQ/ivermectin/vitamin stuff to be clear) was met with profound resistance and outright refusal to examine the how and why it was successful even in the later stage of the multisystems disorder when there was no measurable virus by PCR. This occurred even in the context of repeated failures of the acute ICU therapies and many victims were subsequently ordered to receive comfort care despite pleas from family or personal advocates. Perhaps you would find interest in my latest post about our discoveries also in this substack. It details much of our experiences for the past 5 yrs. Patient advocacy and the public health has many detractors in our experience.
Thank you for your reply. I'm not very good at substack and don't get paid for my work. I'm finding writing history of covid as well as preparing a response for our next outbreak to be a full time job.
Researching, conferencing and collaborating to understand the novel virus in the context of a novel therapy has been a huge challenge. Educating, allegedly educated practitioners has been an even greater challenge. As a physician (now retired) when confronted with an apparently hopeless scenario like a progressive COVID19 multisystems disorders even after applying all the official protocols, is it ethical or moral to throw up one’s hands and declare that you’ve done all that you know to do, when what’s been done is merely what others have told you to do and not of your own research and confidence? Maybe I’m an outlier and should toe the line and do what I’m told? My education and desire to “do good, but first do no harm” says that it’s my responsibility to be a patient’s advocate, not just an employee for medical services to get a paycheck. Why can’t physicians be trusted to use their best judgment for the patient’s benefit? This is a novel infection with a novel human host response. I/we believe a repurposed drug approach with sound biological principles is sufficient to satisfy purists that can accept only large RCTs for any chance of success. In the cases of an emergent pandemic the evidence comes from the 4+ decades of treatment addressing the same sorts of physiological derangements with consistent success. Best of luck for the proposed response. It is our hope that the new concepts my colleagues and I have uncovered will be applied to similar viral syndromes that include a vigorous cytokine response, tissue hypoxia, alterations in cognition, hypercoagulopathies leading to emboli and strokes, coronary, renal, and pulmonary complications as seen in Covid19 as well as sickle cell disease.
Thanks. Two questions. I know we'd all like to get a step ahead of the virus, but since we don't know what the next variant of concern will be, what else could we do other than manufacture for the most recent (JN.1) variant? Second - what is the latest on how long one remains actually infective of others? Case in point - my wife is now at least 15 days out from symptom onset, got her Paxlovid on symptom day two, and yet still tests positive. We masked around each other for the first week, still keep a six+ foot distance, and have HEPA filters in her bedroom and in the dining/kitchen area where we hang out. She needs to get some dental work but the message is "call us when you test negative." Is she still actually contagious to others at this point? What does the science say?
I'm in the same boat! I'm antigen testing positive still, but I'm only on Day 10 and live alone. Some friends have said that I should just start life again if I want to with a KN94 mask or other, but I just don't feel right about being out in the world while testing positive. I WFH and have lots of sweet support from my community (grocery and meal delivery). I haven't gotten too antsy because I am still recovering energy-wise, so an outing hasn't been calling my name to hard just yet. I have masked and taken walks around the block just to get moving/outside. But curious how much longer this will go on!
Is the following true, and how does it affect the answer to George's question? I've read that the duration of positivity partly depends on the sensitivity of the test, not necessarily due to duration of infectivity: All else equal, PCR will test positive the longest (because it can detect smaller amount of viral material); then non-PCR molecular (like Lucira, the home "PCR" test), then antigen based tests. In other words, the antigen tests "should" become negative first. But that implies that all of these tests could read positive in a person no longer infective, because they're detecting non-infectious pieces of dead virus.
Very disappointing to see the loss of hospital data. The core functions of public health are assessment, assurance, and policy development. Without essential data to assess and inform our policies, we can't assure that the right things are done the next pandemic..... History repeats.... :( Bob Rauner, MD, MPH
I am not uninformed, and I am a former veterinarian. Trust has been broken. Lies have been distributed. Profit has been made. The rich and powerful have grown more rich and powerful. Confidence in the information we have access to is lacking. Fear mongering about the development of new potential pandemics is rampant. We still don't know the truth about Covid, and we probably never will. I suspect that you are well-intentioned, but from the top down, it's all about the money these days. A very disappointing state of affairs.
I am a bit mystified by your remarks. Of course there is money involved in all this - effective medical & veterinary treatments frequently require lots of R&D and cost money. This is like many other fields of endeaver. I do not see what you mean about "it's all about the money". I live outside the US, so perhaps its easier for me to see these issues.
And the "the truth about CoVID?" - what do you mean here? We know a lot about coVid, but of course we don't know everything.
There are many knowns and plenty more unknowns but the inference of some great conspiracy I chalk up to mixed messages and the spread of misinformation and not some single entity directing the information like we are puppets. A few of us have made efforts to understand the disease and the targets of the disease beyond the preventive vaccines and antivirals. We have collaborated with scientists to expand our clinical expertise and it has taken us into the biology and immunology of the viral and host interaction. When there were zero approved therapies we “borrowed” a successful therapy with decades of patient success and a sound safety profile in another disorder with multisystem inflammation. It’s repurposing - a novel approach but not requiring a novel designer drug from our Pharma labs. Interested readers may review my comments elsewhere in this same Substack.
Maybe due to laziness, I couldn't find your more detailed description of this. It sounds pretty interesting, and relevent for Long CoVID. If you have time drop me a link to your more detailed notes on this - no rush, I'm travelling for the next 2 days. Your other comments that I saw here looked really interesting. I'm not a clinician, (in the distant past I did vaccine R&D), so I'm interested in your take on this.
@YLE and interested readers: So, lots of uncertainties confront us with the upcoming Fall season’s plethora of potential viral illnesses. Thank you for keeping your readers/subscribers up to date with your insights and personal recommendations. For those readers that have read any of my many comments about the need for a credible therapeutic intervention above and beyond preventive vaccines, the literature describing such therapies has been scant to absent, aside from the Pfizer product. I/we contend that repurposed drugs that are well-studied and declared to be safe should be at the forefront. It seems that subsequent to the debacles of hydroxychloroquine and ivermectin, repurposed drugs have ALL been lumped into a generic basket of wannabes. Now, efforts to find the magic bullets are based upon molecular screening, experience of which has shown that few potential drugs ever get to human clinical trials. A.I. for molecular screening, however sophisticated it may be or become as it evolves, appears to be the latest tool, but realistically even that could take years and millions of dollars to find that acorn on the forest floor.
Focusing on SARS-Cov2 viral replication is often insufficient to contain or eliminate the virus or to mitigate/modulate a naive host’s immune response. The only currently approved anti-viral therapy must be given within 5 days of symptoms, but testing may not be positive for at least 4-5 days (as has been described for this latest JN.1 variant). Some do not tolerate the drug, some have underlying disorders requiring other drugs that contraindicate Paxlovid; there are some whose symptoms do not promptly respond to the 5 day regimen; the uninsured are faced with the post-EUA Pfizer MSRP of $1390 for the 10 capsules. While the statistics support a significant reduction in hospitalization and mortality if Paxlovid is given in a timely manner, there are those aforementioned issues. An available, affordable, consistently effective, tolerable, durable and safe repurposed drug is what is needed.
Delve into the issue deeply and you will discover research from not so famous Institutions creating laboratory experiments that do clarify this infectious-immune disorder we know as COVID19. The research is based upon the SARS-Cov2 virus’ ultimate targets. These targets are the critical multisystems neuroreceptors, the a7 nicotinic acetylcholine receptors, whose anti-inflammatory functionality are rendered dysfunctional when COVID19 has established itself. In immune competent patients with previous coronavirus exposure the illness may not become fatal. For the victims that are vulnerable and naive relative to previous coronavirus exposure or vaccine, a serious outcome may be more the norm. Give some NSAID or a slug of a steroid to suppress the cytokine response, one might ask? It has only been shown to be of help in the setting when an ICU victim has increasing needs for supplemental oxygenation and impending mechanical ventilator support, but it’s no panacea for the progressive outpatient with early but significant respiratory symptoms in the early days after infected or symptom onset. What is needed is a multifunctional therapeutic that is capable of minimizing viral replication AND blocking the interface between the SARS-Cov2 spike protein RBD and the host ACE2 receptor. That same drug should have pharmacodynamic properties to reverse multisystems vasoconstriction in the context of declining tissue oxygenation; provide nitric oxide to dilate vessels; increase marrow progenitor cell proliferation of fetal hemoglobin with its enhanced oxygen carrying capacity to release oxygen readily into starved tissues; shift the early IgG immune globulins to a more specific IgG immune globulin to contain the immune response to the spike protein antigenic stimulation. The key is the drug’s multifunctional beneficial effects on restoring the function of the immune-disrupted a7 nicotinic acetylcholine neuroreceptors. There is such a drug and it can be repurposed.
Why hasn’t this important research ongoing for the past 4+ years had any press? Why hasn’t there been any interest by representatives of the FDA, a sponsor for the Cure Drug Repurposing Collaboratory and the CUREID website whose mission was to solicit therapies from practicing physicians? Our information on nearly 500 solicited HIPPS compliant case reports achieved the #2 spot until the CURE ID data gathering methodology reverted to screening electronic data bases from large clinics/hospital systems. After many months of physician order collections, the search revealed the top 2 treatments for COVID19: NaCl infusion and O2 by face mask, respectively. Seriously! Evidently not a single filter was applied. A few millions dollars of taxpayers money wasted, it would seem. Dr Jetelina bemoans the lack of communications from certain Federal Agencies, and her points are well taken. The lack of common sense would appear to top that particular deficiency.
Exquisite experiments by our Biochemist/Immunologist collaborators have provided new concepts and supports the contention that one specific immune modulator hydroxyUREA (HU), provides a credible, durable therapeutic. HU was discovered in 1869 in Germany; has well-documented pharmacodynamics that were capitalized and utilized as an adjunct for HIV in the 1980s. HU has been a mainstay for this genetic AND multisystems inflammatory disorder for over 4 decades. The WHO describes hydroxyUREA as an essential drug. HU is confidently used to save lives and reduce mortality for sickle cell victims and has FDA-approval for continuous use from age 2 through life. This relatively simple molecule is one a known therapeutic entity and is an immune modulator. Few appreciate the potential benefits of HU (not counting the ~2,500 recipients of HU for acute episodes over the past 5 yrs). Only a handful of undaunted practitioners actively engaged with COVID19 victims in all phases of the disorder and throughout all the variants have witnessed the prompt and durable effects without ADRs or issues of safety.
Refs:
The most recent studies are described by our collaborators in this publication:
HU interaction with critical targets of the pandemic virus-host immune response:
Hydroxyurea interaction with α7 nicotinic acetylcholine receptor can underlie its therapeutic efficacy upon COVID-19. J Neuroimmunol. 2023 Dec 15;385:578244. doi: 10.1016
An article describing the nuances of this multifunctional drug from a pharmacological view:
Repurposing of Hydroxyurea Against COVID-19: A Promising Immunomodulatory Role. Assay Drug Dev Technol. 2022 Jan;20(1):55-62
The role of the neuroreceptors and possible role in PASC:
The role of α7 nicotinic acetylcholine receptors in post-acute sequelae of covid-19. Int J Biochem Cell Biol. 2024 Jan 11;168:106519
Really appreciate these updates. Would like to keep track of availability and effectiveness of Pemgarda, the new Covid prophylaxis for immunocompromised individuals which was recently approved by the FDA.
Thank you for this update (and your gift for clearly synthesizing multiple information strands)! QUESTION: Is the Spring recommendation for either mRNA-based vaccines or Novavax? Also, why is the testing/production cycle longer for protein subunit (Novavax) vaccines than for mRNA-based? Is it biology or something about the production process?
Is there a downside to getting the vaccine this spring and then again in the fall? Elsewhere I read about the risk of over vaccination but am not sure these are from credible sources. Please provide a post or comment on the pros and cons of getting boosters for those who are not obviously high risk. Some fit in the cusp of high risk or have never had covid and only have immunity from the vaccines. Thanks!
Some guy in Germany managed to overvaccinate by something like a hundredfold. Last I heard, they were not advising this and they were studying the guy. He showed no early ill effects, as I understand.
From Lancet: "A German man who voluntarily received 217 coronavirus jabs over 29 months showed “no signs” of having been infected with the virus that causes Covid-19 and had not suffered from any vaccine-related side effects, according to a study published in the medical journal Lancet Infectious Diseases.
Mandatory nationwide reporting of hospital data is incredibly important. People in rural areas need accurate information just as much as those in urban areas.
Thanks for the update. Last Spring I got a vaccine and traveled nationally and internationally and did not get covid as far as I know. I did not wear masks because I felt my level of immunity was probably high haven gotten every available vaccine to date. This year I think I will pass on the vaccine and wait for the fall vaccine. I will be flying this summer but will wear a mask in the airports and on the planes. Hope I don’t regret my decision.
I made it through the period when a vaccine was not available with masking, distancing and XClear nasal spray. I believe in the N95 masks ability to protect the wearer(retired RN).With the lower incident of covid, being fully vaccinated, distancing and going back to more consistent mask wearing I feel relatively safe until the Fall vaccine is available. The present vaccine, that is not providing much immunity to the present variant, will not afford much more immunity than I have right now just using masks and nasal spray again. I will update if my rationalization proves to be wrong. 🤞🏻
I'd say an N-95 would take your risk factor down to almost immeasurable until we figure out where this virus is going. I would be interested in updates.
In our area when a patient without known co-morbidities has an acute thromboembolism, arrhythmia, a coronary ischemic event, myocarditis, cholecystitis without stones (acalculous) that responds poorly to antibiotics, bone marrow dyscrasias (red cell aplasia being but one) it would be unusual to have a comment in the hospital record that a documented hx of a pos COVID19 infection 6-8 mos would have relevance. Since a hallmark of acute and Long Covid is a multisystem inflammation in the form of these vascular events from endotheliitis, these specific events are in reality a late manifestation of that prior COVID19 disorder. It would seem that administrations and physicians are burned out dealing with Covid and thus ignoring the relationships is one way to make it go away! Sounds absurd doesn’t it? Denial in another form as I view it.
Katelyn, since the FliRT variants are "children of" JN.1, would a JN.1 formulated booster still have broad protection against them? I know the XBB booster from last fall was shown to have good coverage for JN.1 despite their distance; these sound closer, so would they theoretically work well?
I am traveling to Germany the end of this month and was planning on getting my Covid booster in the next week or so-Novavax hopefully to avoid all the side effects I have. If I weren't travellig I would not be getting a booster (under 65, healthy)Do we have any idea what the situation is in other countries? and if so, how would I find out?
I'm not expecting anyone to read this far back on a post but... I did go to Germany. I did get the Novavax 3 weeks before. AND I came down with Covid on the flight home. It wasn't as bad as in Sept 2023 but it was real. So whatever was floating around Europe was different enough that whatever the shot covered. Now i'm wondering whether to do Novavak for the fall, MRNA (which makes me sick for 3 days) or skip b/c I had covid less than 6 months ago.
Thanks for updating on the hospital reporting requirement - please do let us know when comments open so that word can spread.
It was open when I commented today :)
I’m not in the medical or science field. I’m just a 78 (almost) year old woman who tries to stay fit and gets her vaccines. I think it’s important for hospitals to report the high hospitalizations for Covid and flu. Otherwise, the public will not know how important it is to stay updated on their vaccines.
Because it's not making the headlines, your work is all the more important. Thank you for offering information not easily available elsewhere. Thanks also for notice about the public comment in May.
Thank you for this. I write the KnoxvilleCovid19news on Reddit. I have been studying covid as a safety committee member for UPS, then as a political candidate and now with my writing since January 2020. We are the only municipality our size in the nation that hasn't installed a wastewater testing facility, despite the fact that we are home to our states largest land grant research university. Our death rate during covid was almost three times that of Madison Wisconsin, our demographic sister, and our County Mayor disbanded our Board of Health when they acted in an ethical manner, rather than do what he commanded. I misplaced a decimal point in November 2020 and figured out the path we were taking would lead to pediatric deaths and advocated for as strong a Covid response as possible. It turned out the misplaced decimal point was irrelevant as the later strains ofd Covid seemed to include more children and I I got louder and the pushback to what I was saying became stronger, it became more and more apparent that a child would indeed die. During the PR campaign involved in the disbanding of our Board of Health, both anti-vaccination, anti-mask and covid is a hoax propaganda dominated our County Government propaganda and, despite our court ordered mask mandate in schools, the Mayor Jacobs normalized the sending of sick kids to school, and at that point it became academic. Fourteen months after I noticed the anomaly, after a massive, preventable exposure, my neighbors six year old daughter, the one I watched play every day , who brought me the same joy my children brought me when I watched them grow up, passed away. Glenn Jacobs still denies culpability for this event. I disagree. I will continue to work for wastewater testing. Ironically peoples ears are perking up when I mention that with a 20-40 percent H5N1 contamination in our pasteurized milk supply, not really dangerous now, but an indication that there's things going on that we don't know. Thank you for the work you do. You are a valuable resource. I will continue to push for the reinstatement of our Board of Health. Terrorism is defined as officials using fear and intimidation and violence against a population for political reasons. Glenn Jacobs covid response in Knox County Tennessee was a terrorist act as defined by the Patriot Act and internatiuonal law.
I feel your pain Mr Fischer. The denial is really a product of ignorance and unwillingness to consider the public at large. Your anecdote about your young friend was heart-rendering and your Mayor couldn’t possibly understand how his decisions could have such an outcome. Again, denial is ignorance. We’ve seen it in our medical community as the pandemic swept across our area, EUA protocols were made available (subsidized of course) and yet patients succumbed. Our post-acute recovery facility received many victims of COVID19 and our efforts to apply a novel yet highly effective therapeutic regimen (not the HCQ/ivermectin/vitamin stuff to be clear) was met with profound resistance and outright refusal to examine the how and why it was successful even in the later stage of the multisystems disorder when there was no measurable virus by PCR. This occurred even in the context of repeated failures of the acute ICU therapies and many victims were subsequently ordered to receive comfort care despite pleas from family or personal advocates. Perhaps you would find interest in my latest post about our discoveries also in this substack. It details much of our experiences for the past 5 yrs. Patient advocacy and the public health has many detractors in our experience.
Thank you for your reply. I'm not very good at substack and don't get paid for my work. I'm finding writing history of covid as well as preparing a response for our next outbreak to be a full time job.
Researching, conferencing and collaborating to understand the novel virus in the context of a novel therapy has been a huge challenge. Educating, allegedly educated practitioners has been an even greater challenge. As a physician (now retired) when confronted with an apparently hopeless scenario like a progressive COVID19 multisystems disorders even after applying all the official protocols, is it ethical or moral to throw up one’s hands and declare that you’ve done all that you know to do, when what’s been done is merely what others have told you to do and not of your own research and confidence? Maybe I’m an outlier and should toe the line and do what I’m told? My education and desire to “do good, but first do no harm” says that it’s my responsibility to be a patient’s advocate, not just an employee for medical services to get a paycheck. Why can’t physicians be trusted to use their best judgment for the patient’s benefit? This is a novel infection with a novel human host response. I/we believe a repurposed drug approach with sound biological principles is sufficient to satisfy purists that can accept only large RCTs for any chance of success. In the cases of an emergent pandemic the evidence comes from the 4+ decades of treatment addressing the same sorts of physiological derangements with consistent success. Best of luck for the proposed response. It is our hope that the new concepts my colleagues and I have uncovered will be applied to similar viral syndromes that include a vigorous cytokine response, tissue hypoxia, alterations in cognition, hypercoagulopathies leading to emboli and strokes, coronary, renal, and pulmonary complications as seen in Covid19 as well as sickle cell disease.
I got out of TN after living there for 15 years. What a mess of a state with awful leadership.
I do not know what we would do without your tireless reporting.. We are so lucky...The word THANK YOU is not enough. You are the BEST
Thanks. Two questions. I know we'd all like to get a step ahead of the virus, but since we don't know what the next variant of concern will be, what else could we do other than manufacture for the most recent (JN.1) variant? Second - what is the latest on how long one remains actually infective of others? Case in point - my wife is now at least 15 days out from symptom onset, got her Paxlovid on symptom day two, and yet still tests positive. We masked around each other for the first week, still keep a six+ foot distance, and have HEPA filters in her bedroom and in the dining/kitchen area where we hang out. She needs to get some dental work but the message is "call us when you test negative." Is she still actually contagious to others at this point? What does the science say?
I'm in the same boat! I'm antigen testing positive still, but I'm only on Day 10 and live alone. Some friends have said that I should just start life again if I want to with a KN94 mask or other, but I just don't feel right about being out in the world while testing positive. I WFH and have lots of sweet support from my community (grocery and meal delivery). I haven't gotten too antsy because I am still recovering energy-wise, so an outing hasn't been calling my name to hard just yet. I have masked and taken walks around the block just to get moving/outside. But curious how much longer this will go on!
Is the following true, and how does it affect the answer to George's question? I've read that the duration of positivity partly depends on the sensitivity of the test, not necessarily due to duration of infectivity: All else equal, PCR will test positive the longest (because it can detect smaller amount of viral material); then non-PCR molecular (like Lucira, the home "PCR" test), then antigen based tests. In other words, the antigen tests "should" become negative first. But that implies that all of these tests could read positive in a person no longer infective, because they're detecting non-infectious pieces of dead virus.
The hosts of TWIV would say no. They have addressed that in recent episodes.
George, I think that’s a question a lot of us have. I wait for the answer.
Very disappointing to see the loss of hospital data. The core functions of public health are assessment, assurance, and policy development. Without essential data to assess and inform our policies, we can't assure that the right things are done the next pandemic..... History repeats.... :( Bob Rauner, MD, MPH
I am not uninformed, and I am a former veterinarian. Trust has been broken. Lies have been distributed. Profit has been made. The rich and powerful have grown more rich and powerful. Confidence in the information we have access to is lacking. Fear mongering about the development of new potential pandemics is rampant. We still don't know the truth about Covid, and we probably never will. I suspect that you are well-intentioned, but from the top down, it's all about the money these days. A very disappointing state of affairs.
I am a bit mystified by your remarks. Of course there is money involved in all this - effective medical & veterinary treatments frequently require lots of R&D and cost money. This is like many other fields of endeaver. I do not see what you mean about "it's all about the money". I live outside the US, so perhaps its easier for me to see these issues.
And the "the truth about CoVID?" - what do you mean here? We know a lot about coVid, but of course we don't know everything.
There are many knowns and plenty more unknowns but the inference of some great conspiracy I chalk up to mixed messages and the spread of misinformation and not some single entity directing the information like we are puppets. A few of us have made efforts to understand the disease and the targets of the disease beyond the preventive vaccines and antivirals. We have collaborated with scientists to expand our clinical expertise and it has taken us into the biology and immunology of the viral and host interaction. When there were zero approved therapies we “borrowed” a successful therapy with decades of patient success and a sound safety profile in another disorder with multisystem inflammation. It’s repurposing - a novel approach but not requiring a novel designer drug from our Pharma labs. Interested readers may review my comments elsewhere in this same Substack.
Maybe due to laziness, I couldn't find your more detailed description of this. It sounds pretty interesting, and relevent for Long CoVID. If you have time drop me a link to your more detailed notes on this - no rush, I'm travelling for the next 2 days. Your other comments that I saw here looked really interesting. I'm not a clinician, (in the distant past I did vaccine R&D), so I'm interested in your take on this.
@YLE and interested readers: So, lots of uncertainties confront us with the upcoming Fall season’s plethora of potential viral illnesses. Thank you for keeping your readers/subscribers up to date with your insights and personal recommendations. For those readers that have read any of my many comments about the need for a credible therapeutic intervention above and beyond preventive vaccines, the literature describing such therapies has been scant to absent, aside from the Pfizer product. I/we contend that repurposed drugs that are well-studied and declared to be safe should be at the forefront. It seems that subsequent to the debacles of hydroxychloroquine and ivermectin, repurposed drugs have ALL been lumped into a generic basket of wannabes. Now, efforts to find the magic bullets are based upon molecular screening, experience of which has shown that few potential drugs ever get to human clinical trials. A.I. for molecular screening, however sophisticated it may be or become as it evolves, appears to be the latest tool, but realistically even that could take years and millions of dollars to find that acorn on the forest floor.
Focusing on SARS-Cov2 viral replication is often insufficient to contain or eliminate the virus or to mitigate/modulate a naive host’s immune response. The only currently approved anti-viral therapy must be given within 5 days of symptoms, but testing may not be positive for at least 4-5 days (as has been described for this latest JN.1 variant). Some do not tolerate the drug, some have underlying disorders requiring other drugs that contraindicate Paxlovid; there are some whose symptoms do not promptly respond to the 5 day regimen; the uninsured are faced with the post-EUA Pfizer MSRP of $1390 for the 10 capsules. While the statistics support a significant reduction in hospitalization and mortality if Paxlovid is given in a timely manner, there are those aforementioned issues. An available, affordable, consistently effective, tolerable, durable and safe repurposed drug is what is needed.
Delve into the issue deeply and you will discover research from not so famous Institutions creating laboratory experiments that do clarify this infectious-immune disorder we know as COVID19. The research is based upon the SARS-Cov2 virus’ ultimate targets. These targets are the critical multisystems neuroreceptors, the a7 nicotinic acetylcholine receptors, whose anti-inflammatory functionality are rendered dysfunctional when COVID19 has established itself. In immune competent patients with previous coronavirus exposure the illness may not become fatal. For the victims that are vulnerable and naive relative to previous coronavirus exposure or vaccine, a serious outcome may be more the norm. Give some NSAID or a slug of a steroid to suppress the cytokine response, one might ask? It has only been shown to be of help in the setting when an ICU victim has increasing needs for supplemental oxygenation and impending mechanical ventilator support, but it’s no panacea for the progressive outpatient with early but significant respiratory symptoms in the early days after infected or symptom onset. What is needed is a multifunctional therapeutic that is capable of minimizing viral replication AND blocking the interface between the SARS-Cov2 spike protein RBD and the host ACE2 receptor. That same drug should have pharmacodynamic properties to reverse multisystems vasoconstriction in the context of declining tissue oxygenation; provide nitric oxide to dilate vessels; increase marrow progenitor cell proliferation of fetal hemoglobin with its enhanced oxygen carrying capacity to release oxygen readily into starved tissues; shift the early IgG immune globulins to a more specific IgG immune globulin to contain the immune response to the spike protein antigenic stimulation. The key is the drug’s multifunctional beneficial effects on restoring the function of the immune-disrupted a7 nicotinic acetylcholine neuroreceptors. There is such a drug and it can be repurposed.
Why hasn’t this important research ongoing for the past 4+ years had any press? Why hasn’t there been any interest by representatives of the FDA, a sponsor for the Cure Drug Repurposing Collaboratory and the CUREID website whose mission was to solicit therapies from practicing physicians? Our information on nearly 500 solicited HIPPS compliant case reports achieved the #2 spot until the CURE ID data gathering methodology reverted to screening electronic data bases from large clinics/hospital systems. After many months of physician order collections, the search revealed the top 2 treatments for COVID19: NaCl infusion and O2 by face mask, respectively. Seriously! Evidently not a single filter was applied. A few millions dollars of taxpayers money wasted, it would seem. Dr Jetelina bemoans the lack of communications from certain Federal Agencies, and her points are well taken. The lack of common sense would appear to top that particular deficiency.
Exquisite experiments by our Biochemist/Immunologist collaborators have provided new concepts and supports the contention that one specific immune modulator hydroxyUREA (HU), provides a credible, durable therapeutic. HU was discovered in 1869 in Germany; has well-documented pharmacodynamics that were capitalized and utilized as an adjunct for HIV in the 1980s. HU has been a mainstay for this genetic AND multisystems inflammatory disorder for over 4 decades. The WHO describes hydroxyUREA as an essential drug. HU is confidently used to save lives and reduce mortality for sickle cell victims and has FDA-approval for continuous use from age 2 through life. This relatively simple molecule is one a known therapeutic entity and is an immune modulator. Few appreciate the potential benefits of HU (not counting the ~2,500 recipients of HU for acute episodes over the past 5 yrs). Only a handful of undaunted practitioners actively engaged with COVID19 victims in all phases of the disorder and throughout all the variants have witnessed the prompt and durable effects without ADRs or issues of safety.
Refs:
The most recent studies are described by our collaborators in this publication:
https://doi.org/10.1016/j.bbrc.2024.149825
HU interaction with critical targets of the pandemic virus-host immune response:
Hydroxyurea interaction with α7 nicotinic acetylcholine receptor can underlie its therapeutic efficacy upon COVID-19. J Neuroimmunol. 2023 Dec 15;385:578244. doi: 10.1016
An article describing the nuances of this multifunctional drug from a pharmacological view:
Repurposing of Hydroxyurea Against COVID-19: A Promising Immunomodulatory Role. Assay Drug Dev Technol. 2022 Jan;20(1):55-62
The role of the neuroreceptors and possible role in PASC:
The role of α7 nicotinic acetylcholine receptors in post-acute sequelae of covid-19. Int J Biochem Cell Biol. 2024 Jan 11;168:106519
Case reports from clinicians, not research labs:
The Use of Hydroxyurea in the Treatment of COVID-19.. https://europepmc.org/article/MED/34934823
The role of endotheliitis in COVID19:
https://doi.org/10.1111%2Fijcp.14843
Sullray <at> duck <dot> com
Thanks. I plan to look over this. It sounds really interesting. (Out of town right now so won't get to it for a few weeks).
Really appreciate these updates. Would like to keep track of availability and effectiveness of Pemgarda, the new Covid prophylaxis for immunocompromised individuals which was recently approved by the FDA.
Thank you for this update (and your gift for clearly synthesizing multiple information strands)! QUESTION: Is the Spring recommendation for either mRNA-based vaccines or Novavax? Also, why is the testing/production cycle longer for protein subunit (Novavax) vaccines than for mRNA-based? Is it biology or something about the production process?
Is there a downside to getting the vaccine this spring and then again in the fall? Elsewhere I read about the risk of over vaccination but am not sure these are from credible sources. Please provide a post or comment on the pros and cons of getting boosters for those who are not obviously high risk. Some fit in the cusp of high risk or have never had covid and only have immunity from the vaccines. Thanks!
Some guy in Germany managed to overvaccinate by something like a hundredfold. Last I heard, they were not advising this and they were studying the guy. He showed no early ill effects, as I understand.
Reportedly, 217 times to be exact!
From Lancet: "A German man who voluntarily received 217 coronavirus jabs over 29 months showed “no signs” of having been infected with the virus that causes Covid-19 and had not suffered from any vaccine-related side effects, according to a study published in the medical journal Lancet Infectious Diseases.
Mar 5, 2024
Not the only one, I recall some one in India receiving multiple doses. https://www.nytimes.com/2022/01/07/world/india-12-booster-shots.html
Thanks so much for this update!
Mandatory nationwide reporting of hospital data is incredibly important. People in rural areas need accurate information just as much as those in urban areas.
Are you seeing any new data on Long COVID?
Thanks for the update. Last Spring I got a vaccine and traveled nationally and internationally and did not get covid as far as I know. I did not wear masks because I felt my level of immunity was probably high haven gotten every available vaccine to date. This year I think I will pass on the vaccine and wait for the fall vaccine. I will be flying this summer but will wear a mask in the airports and on the planes. Hope I don’t regret my decision.
Not being judgmental, but curious. Why would you take that risk?
I made it through the period when a vaccine was not available with masking, distancing and XClear nasal spray. I believe in the N95 masks ability to protect the wearer(retired RN).With the lower incident of covid, being fully vaccinated, distancing and going back to more consistent mask wearing I feel relatively safe until the Fall vaccine is available. The present vaccine, that is not providing much immunity to the present variant, will not afford much more immunity than I have right now just using masks and nasal spray again. I will update if my rationalization proves to be wrong. 🤞🏻
I'd say an N-95 would take your risk factor down to almost immeasurable until we figure out where this virus is going. I would be interested in updates.
Thanks for the update! I'm wondering whether hospitals will still be required to report Covid-related deaths? Or is that also out the window?
In our area when a patient without known co-morbidities has an acute thromboembolism, arrhythmia, a coronary ischemic event, myocarditis, cholecystitis without stones (acalculous) that responds poorly to antibiotics, bone marrow dyscrasias (red cell aplasia being but one) it would be unusual to have a comment in the hospital record that a documented hx of a pos COVID19 infection 6-8 mos would have relevance. Since a hallmark of acute and Long Covid is a multisystem inflammation in the form of these vascular events from endotheliitis, these specific events are in reality a late manifestation of that prior COVID19 disorder. It would seem that administrations and physicians are burned out dealing with Covid and thus ignoring the relationships is one way to make it go away! Sounds absurd doesn’t it? Denial in another form as I view it.
Katelyn, since the FliRT variants are "children of" JN.1, would a JN.1 formulated booster still have broad protection against them? I know the XBB booster from last fall was shown to have good coverage for JN.1 despite their distance; these sound closer, so would they theoretically work well?
I am traveling to Germany the end of this month and was planning on getting my Covid booster in the next week or so-Novavax hopefully to avoid all the side effects I have. If I weren't travellig I would not be getting a booster (under 65, healthy)Do we have any idea what the situation is in other countries? and if so, how would I find out?
I'm not expecting anyone to read this far back on a post but... I did go to Germany. I did get the Novavax 3 weeks before. AND I came down with Covid on the flight home. It wasn't as bad as in Sept 2023 but it was real. So whatever was floating around Europe was different enough that whatever the shot covered. Now i'm wondering whether to do Novavak for the fall, MRNA (which makes me sick for 3 days) or skip b/c I had covid less than 6 months ago.