News from the USA, United States of America

Mij said:
Tens of thousands died with, or of, measles annually in 19th Century America. By 1960 -- before the vaccine’s introduction -- improvements in sanitation and nutrition had eliminated 98% of measles deaths.
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Actually, it was a lot more than tens of thousands but the graphs on this are interesting. My guess is that from 1919 to 1960 measles-related reported deaths went down maybe by 96%. I doubt that had much to do with sanitation since in the 1960s most children still got measles. The oddest thing about the graph is that even in1960 measles seems tone very under-reported.

But whether this has anything to do with nutrition, either, seems to me unclear. In the UK routine hospital care for sick children probably got going in the 1940s and 1950s, fuelled, but not initiated by the NHS. I guess something similar happened in the USA. The problem of febrile convulsions became recognised. And something simple that may have made a huge difference was the general availability of paracetamol (1947) as well as soluble aspirin to block the sort of fever that is dangerous in infants.

All speculative and probably notary relevant to current policy. Giving vitamin A when a child has got measles is unlikely to get their immune system up and running in time. You need to have been giving the child a decent diet from birth. And there is presumably little or no evidence for supplementing vitamin A makes any difference to risk even then.
 
Paul Offit (pediatrician/vaccine advisory board member-ACIP) wrote a substack email delineating RFK2's support of the very antiquated miasma theory of disease (pre-Robert Koch [pre-microbes]) which informs RFK2's nutrition and sanitation emphasis underlying the resurgence of measles outbreaks (according to RFK2's public communication on this topic).

Offit's substack is a vital repository of science (truth) in this era of the dismantling the structure and mission of the CDC and FDA. He is super well-versed on vaccine safety and efficacy studies--it is his career field.

Another excellent substack is Katelyn Jetelina's Your Local Epidemiologist. She is great at addressing in depth current disease issues such as bird flu, covid, Ebola, measles, polio, and more.

Microbe TV which publishes a podcast every Saturday featuring Vincent Rancaniello PhD (virologist at Columbia U) and Daniel Griffin MD (Infectious Disease MD) doing their"Clinical Update" in which the week's disease data and journals and news are discussed.

Excellent information, all of them. And now essential.
 
Assume there's a thread on somewhere but couldn't find

DW: 'Have US scientists found the key to long COVID treatment?'

'COVID-19 disrupts the ability of lung tissue to repair itself and can lead to debilitating long COVID. Researchers have found a drug that could reverse the damage, offering hope for millions of people worldwide.'

'Now, a new study published in the journal Science has discovered lung inflammation is a major cause. Data in mice and humans found infection with the SARS-CoV-2 virus, which causes COVID-19, impairs the ability of immune cells to repair lung damage. '

'The study gives hope in treating long COVID, although further testing is required for the treatment to reach clinics.'

"We demonstrated that an FDA-approved drug can enhance lung recovery and reduce long COVID-related tissue damage," said study lead author Jie Sun, an immunologist at the University of Virginia.

"We discovered that lung tissue from individuals who succumbed to acute COVID or suffered from severe respiratory long COVID exhibited decreased levels of peroxisomes in a type of immune cell responsible for tissue healing," said Sun.

Peroxisomes are tiny organelles inside immune cells. They are detox centers that remove toxic molecules and help tissues to heal after being damaged.

"This research suggests that SARS-CoV-2 leads to dysfunctional peroxisomes. This, in turn, leads to impaired healing and scarring after infection – leading to long-term symptoms," said Ziyad Al-Aly, a senior clinical epidemiologist and long COVID researcher..

'The benefit of 4-PBA is it is already approved by drug regulators like the US Food and Drug Administration (FDA) to treat urea cycle disorders. This means it has already been deemed safe to use as a treatment in humans, which could accelerate clinical trials testing it for long COVID.'

Al-Aly said the study is part of a mobilization of scientists making significant progress on long COVID in the last five years.

"While we have not completely solved the puzzle of long COVID, we have made significant progress in just five years. The amount of progress made is huge in a relatively short amount of time," he said.
 
Pittsburgh Post-Gazette: 'Long COVID has impacted about 1M in Pa. But what do we know about it?'

'Practices for treating long COVID have evolved as researchers and physicians learn more'

'As researchers explore theories about the drivers behind long COVID in order to tailor treatments, one has to do with viral persistence: remnants of the SARS-CoV-2 protein that the body, for some reason, is unable to clear. Researchers have also seen signs of autoimmune dysfunction and mass inflammation from long COVID.'

'An out-of-whack nervous system is one emerging theory of long COVID and illnesses with similar symptoms, such myalgic encephalitis and chronic fatigue syndrome, or ME/CFS, which Lane’s symptoms mirrored, and postural orthostatic tachycardia syndrome, or POTS, which Apodaca’s symptoms mirrored'

'Dysautonomia symptoms were especially frustrating for Apodaca, who spent years as a high performer at his job and rarely got sick. The brain fog in particular was unlike anything he’d experienced.'
 
NPR: 'Scientists are making progress in better understanding Long COVID'

'Scientists have made progress in understanding Long COVID over the last five years. Patient advocates hope that research will continue under the Trump administration'

Scott: "Long COVID can be debilitating for many people. Are scientists any closer to understanding?"

Will Stone: "They are. Researchers have coalesced around a handful of explanations. There seem to be multiple underlying drivers of illness depending on the patient. One big focus has been the idea of viral persistence, that people never fully clear the infection. But there are others related to immune dysfunction, blood clots, the reactivation of other viruses. These could ultimately trigger symptoms like brain fog, like fatigue, shortness of breath, something called post-exertional malaise.

The challenge here remains translating some of these insights into treatment. There are still no approved drugs for Long COVID. The approach is often to manage symptoms and try to improve quality of life. And what are the challenges in coming up with treatment? It comes down to clinical trials. There just aren't enough of them. A few years ago, there were a handful looking at, drugs, Dr. Michael Peluso told me by his count there are now about 50, including some that Peluso is involved in at the UCSF, but he says the reality is we just need a lot more for."

Peluso: "There are dozens of existing drugs that should be tested. We have drugs that can target almost every single one of the different mechanisms we think might be contributing to Long COVID. But so far, we've launched way too few trials to actually do that with intense effort. And Scott, one of the major barriers here is that drug makers are still on the sidelines, to some extent, over and over again. The reason is, there's not a reliable biological measurement of the condition, a biomarker that can be tracked across multiple trials...We know how many people are infected. That's hard to pin down. Research, including CDC data, has found about 18 million adults in the US have long COVID....

Here's what Hannah Davis told me, she has Long COVID herself, and co founded an advocacy group called the Patient-Led Research Collaborative.

Hannah: "It has been downplayed. We have seen so much Long COVID In the last year...What are you hearing from patients? More resources, more funding. The federal government has funded Long COVID research through its RECOVER Initiative. Last year, an additional $660 million was appropriated that's to be spent over the next four years, including on clinical trials. Now, obviously, there's huge uncertainty about federal funding for scientific research in general under the Trump administration. I spoke to Megan Stone about this. She's a patient and directs the Long COVID Campaign. Stone has been in DC, lobbying Senators and the administration to, among other things, to protect those funds from any cuts. Actually, this past week, she was at the confirmation hearing for Trump's pick to lead the National Institutes of Health, and she managed to get a moment with him afterwards.

Meighan: "Afterwards, he said to me, we're going do the research to find a solution to this. I hope so. If the administration doesn't meet the patient community, then we will keep calling for action the same way that we did under President Biden. Regardless of party or political position, Long COVID patients have been failed by our leaders."

Will: "...Stone says, Long COVID patients just don't have the luxury to sit this out over the next four years..."
 
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"...Stone says, Long COVID patients just don't have the luxury to sit this out over the next four years..."

Early days yet. Wait until you hit four decades with no useful advance in understanding or treatment.
 
Chicago Tribune: 'Five years ago, COVID gripped the world in fear. Now local scientists, doctors warn Trump’s policies are weakening public health'

Fully vaccinated and relatively healthy at the age of 41, Johanna Claudette of the Irving Park neighborhood thought the positive test in February 2022 wouldn’t be a big deal.

But within days, her memory became spotty. Her heart raced and she became fatigued. Today, she said, she’s still grappling with blurry vision, chest pain and brain fog — all symptoms of the chronic condition called long COVID, which can linger for months or even years after an initial infection and which has afflicted millions worldwide.

For those suffering from long COVID, the consequences of the pandemic continue today.

Claudette said she never imagined the many ways the virus would transform her life, work and relationships.
 
ABC 7 New York: 'COVID Impact: 5 years later'

Researchers don't have all the answers to that, Hsu said. But large numbers of people - many of them previously young, active and healthy - "are now effectively disabled because of long COVID."

"I think the majority of people are still dealing with ongoing symptoms and are nowhere near back toward their baseline."

Researchers are learning how the virus can persist in the body for years, Hsu said, and they've seen hints that abnormal blood clotting may be at the root of some problems.

He's hopeful that treatments will be found, but at the moment, the answers about long COVID remind him of how doctors felt at the start of the pandemic. "We want to help, but we don't have effective therapies to help just yet."

He emphasized how serious long COVID can be. Some of his patients are formerly high-energy, highly accomplished people who now are so drained that they can't get out of bed to come to his clinic. "I can only see them virtually, and it's just devastating."
 
New York Times: 'A Clearer Picture of Covid’s Lasting Effects on the Body'

'Five years on, scientists are starting to understand how the virus can lead to long-term, sometimes invisible changes'

'Some of these effects, such as chronic fatigue and brain fog, are considered long Covid, defined as symptoms from an infection that persist for at least three months.'

'Scientists are still working to identify all the factors that contribute to lasting neurological issues after Covid. But one culprit seems clear: persistent inflammation, which damages neurons and inhibits the creation of key connections between synapses. All of this may cause symptoms like those described above.'

'It’s not clear why these circulatory problems happen, but scientists hypothesize that in some patients, inflammation harms certain nerve fibers outside the brain and spinal cord that regulate the squeezing ability of blood vessels. This could result in impaired blood flow, said Dr. David Systrom, a pulmonary and critical care physician at Brigham and Women’s Hospital in Boston.'

'In some patients with long Covid, it also appears that the muscles are less able to extract oxygen from the blood than normal, hampering their ability to keep up with exercise, Dr. Systrom said. In addition, the mitochondria — the energy-producing powerhouses of cells — may not work properly or at full capacity, delivering another hit to muscle tissue.'
 
Science News: '5 years after COVID-19 became a pandemic, are we ready for what’s next?'

Al-Aly: 'There are now more than 20 million Americans living with long COVID..it can be severely disabling, to the point of people being in bed and losing their jobs.'

'Unfortunately, we haven’t really cracked the code for treating long COVID. There are still no established treatments approved by the FDA.

'Scientists across the globe dropped everything they were doing and said, “Okay, we’re going to focus on long COVID.” There’s no other condition that, within the span of five years, we have this many academic publications — about 40,000 and counting.

'Then, really the patient community that led the way. Patients with long COVID helped us understand that long COVID is happening, alerted the medical community and guided us in every step of the way in understanding long COVID.'
 
Aspen Daily News: 'For some, the pandemic never ended'

'Vega Brhely, a 45-year-old cyclist...struggled with extreme fatigue, a spiking heart rate, nervous system dysregulation and brain fog. Yet her bloodwork came back “normal"....'

'They speak of a brain fog that robbed them of their vocabulary — like looking in the refrigerator, staring at a head of lettuce, and not knowing what it’s called — and of a “numbing and debilitating” fatigue that can leave them bedridden for days, an exhaustion so all-consuming that even a sip of water seems out of reach.'

“I don’t know who I am — I don’t know if it’s worth going on,” she thought, and called a friend just so she could have someone to talk to. “They said, ‘Good vibes only,’ and hung up on me.”

Long COVID is common — “extremely common,” according to Dr. Todd Davenport, a professor and chair of the physical therapy program at the University of the Pacific and chair of the international advocacy organization Long COVID Physio.

In fact, like many infection-associated chronic conditions that Davenport studies, it’s “probably the most common thing you (have) never heard of.”
 
PBS: “The COVID pandemic’s lingering physical and mental toll, five years later”

(~8 min segment)

Aubrey Nagle, Philadelphia: "Once I did get infected, I pretty quickly, within 6 weeks or so, I noticed drastic changes in my health - eventually we did determine it was Long COVID"

Mei'lani Eyre, Seattle: "Long COVID has taken a lot from me. I've seen my mobility, is crazy limited. I've also seen my cognitive ability is limited."

Steph Fowler, Chicago: "I feel like I'm living in a different reality than other people."

Ali Rogin, PBS: "We heard in that clip, some people struggling with Long COVID. They talk about how they feel their existing in a reality that's different than other people...dealing with lasting impacts.."

Sacha McBain, Rush University Med. Center: "It's incredibly isolating...you're trying to access care, thinking about navigating work and family roles..uncertainty about how to move forward.."
 
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MPR News: 'Osterholm predicted a pandemic for years. Then the battle against COVID-19 became personal'

'And with so many people simultaneously experiencing long COVID, Osterholm said it’s pushed the medical field to better understand what can sometimes be written off as patients' imagined or ill-defined conditions'

“Hopefully, this offers hope to [people with chronic immune diseases] too, that now there is a new effort being made to understand these immune system responses that are just out of whack,” he said
 
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