Coronavirus Updates January 2025

[missy]

The Dose (January 3)​

Respiratory season is getting ugly, Covid vaccines are effective, Costco eggs, and H5N1, backyard flocks and bird feeders.​

KATELYN JETELINA JAN 3

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Fall respiratory weather report: High and increasing​

It’s getting ugly out there, folks. The number of people going to the doctor for a cough or fever (defined as an “influenza-like illness” or ILI) is well above epidemic levels at this point. The sickest communities are in the West and South, but the entire map below will soon be lit up red.

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Levels of ILI; Source: CDC; Annotated by YLE
The “big three”—flu, Covid–19, and RSV—are increasing quickly. Flu is causing the most burden on healthcare systems, but Covid-19 wastewater is increasing fast, which means hospitalizations and deaths will soon follow.

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Wastewater viral activity. Source: CDC
Norovirus—think nausea, vomiting, diarrhea—continues to have quite the season, with the number of positive tests and outbreaks abnormally high. Norovirus spreads through contaminated surfaces, so as always, wash those hands. Unfortunately, this virus is one of the hardest viruses to kill, so a quick dose of hand sanitizer doesn’t work. Bleach-based products on surfaces are the best.

Fall Covid-19 vaccine provides additional protection​

The first data on the effectiveness of this fall’s 2024-2025 Covid-19 vaccine is in, and it’s looking good!
A preprint was released on patients at a Veterans Affairs hospital. Scientists tallied the number of people who did (and did not) have Covid-19 from September- November 2024 and whether they got this fall’s Covid-19 vaccine (specifically the Pfizer 2024-2025 KP.2 formula). Among 44,598 infections, the Covid-19 vaccine reduces:

• Hospitalizations by 68%
• Emergency department and urgent care visits by 57%, and
• Outpatient visits by 56%

The vaccine worked best for those over 65 years old. This study is very preliminary (it only covered two months with little Covid-19 transmission), but the findings aren’t surprising—they are generally consistent with what scientists have found in previous years.
It’s easy to wonder if we’ve had enough Covid-19 boosters by now, but as the virus mutates, vaccines—like flu vaccines every year—provide additional protection to our immune systems.

H5N1, severe disease, backyard flocks, and birdfeeders​

A Louisiana resident is in the hospital after contracting H5N1 from their backyard flock. This case had the same H5N1 strain as a teenager in Canada who was fighting for their life last month. (A recent NEJM case studydescribed how severely sick this teenager was: intubation for 3 weeks, temporary support to the heart and lungs called ECMO, plasma exchange, 3 antiviral medications, and more.) The H5N1 strain involved in both severe cases—called D1.1—is found among birds and differs from the strain circulating among cows (B3.13).
If you have a backyard flock, you should take precautions to reduce the risk of spreading disease:

1. Keep your flock contained: isolate your birds from visitors and other birds.
2. Prevent germs from spreading by cleaning shoes, tools, and equipment.
3. Reduce the risk of transmission by avoiding sharing tools and equipment with neighbors.
4. Know the warning signs of infectious bird diseases among the flock, including fatigue, abnormal drop in egg production, swelling or discoloration of the eyelids/comb/wattles/shanks, stumbling or falling down, diarrhea, or unexplained death.

If one of your birds is sick or dies unexpectedly:

1. Avoid contact with the sick or dead bird. Assume other birds in the flock and their enclosures, droppings, feeders, and water sources are also infectious. (If you can’t avoid contact completely, take steps to protect yourself.)
2. If possible, isolate the bird from other animals and pets. (Don’t let your dog near it.)
3. Immediately report sick or dead birds to your state veterinarian or the U.S. Department of Agriculture (1-866-536-7593).

What about bird feeders? Birds that gather at feeders (like cardinals, sparrows, and bluebirds) do not typically carry H5N1. The USDA does not recommendremoving backyard bird feeders for H5N1 prevention unless you also care for poultry. The less contact between wild birds and poultry (by removing sources of food, water, and shelter), the better.

Beware of salmonella linked to some Costco eggs​

FDA set the highest safety alert—a Class I recall—for some Costco eggs, distributed to Tennessee, Alabama, Georgia, North Carolina, and South Carolina. Handsome Brooke Farms Kirkland brand of organic pasture-raised eggs is linked to possible Salmonella exposure.

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Class I designations are reserved for products with the highest possible health risk, meaning there’s a “reasonable probability that the use of or exposure to a violative product will cause serious adverse health consequences or death.” There are no recorded human cases yet, but let’s keep it that way—spread the word and throw these eggs out if you have them in your fridge.

So… what’ll be “healthy” in 2025?​

‘Tis the season of New Year's resolutions! According to a recent AP poll, most resolutions this year focus on health, exercise, and diet.

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Fifty percent of people aim to eat healthier, but what’s really considered healthy these days? Well, just in time for the new year, FDA updated the definition to align with the latest science. (The last time this definition was updated for food labeling requirements was in 1994!)
Starting in February 25, 2025, if a company wants to claim their new food is “healthy” on a package, they must meet two requirements:

1. The food must contain a certain amount of one of the five food groups (fruits, vegetables, grains, proteins, dairy).
2. The food cannot exceed added sugar, sodium, or saturated fatlimits based on the food and its customarily consumed amounts.

The changes remove limitations on total fat and cholesterol and the required provisions of vitamin A, vitamin C, calcium, iron, protein, and fiber—things that could simply be added to foods.
Basically, this updated definition aims to focus on more nutrient-dense foods, emphasizing food groups (and the overall nutrition profile) rather than individual nutrients in isolation. While this is progress in the right direction, it’s imperfect. For example, full-fat plain yogurt cannot be “healthy” under this guidance, but low-fat flavored yogurt with some added sugar could be.
What’s next? Reporting food as “healthy” is voluntary. Foods already on the market must comply by February 2028.
In the meantime, FDA is developing a “healthy” symbol that could be used for front-of-package labeling. While only time and research will tell how effective these labeling strategies are, it’s a step in the right direction, updating considerably outdated nutrition guidance, encouraging industry to reformulate foods, and making it easier for the public to make healthier choices.

 

[missy]

From Bloomberg

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Dark rooms and metallic tastes ​

Most people have experienced that moment when those dreaded two red lines appear on their lateral flow test. But for me, testing positive for Covid is even more disheartening. As I’ve written about previously, I’ve tried to avoid getting sick since developing long Covid more than two years ago, because being reinfected has the potential to undo any recovery I’ve made. So when I tested positive again recently, I braced myself for some difficult weeks ahead. During the first few days, I couldn’t tolerate daylight or artificial light, which meant spending a lot of time lying down in the dark. My brain had thoughts, but I wasn’t able to form them into words. My ribs hurt from all the coughing, while food tasted metallic. I often think about the infection in 2022 that developed into long Covid, wondering whether there was anything I should have done differently. Did I not take enough time to recover? Did I try to do too much, too soon? So this time around, I was more mindful of the recuperation process. I slept a lot, took over-the-counter medicine and vitamins, ate three balanced mealsa day and drank plenty of water. A week later, I was no longer testing positive, but I still had light sensitivity issues, prompting concerns that it might turn into a longer-term issue: some people suffering from long Covid have been confined to a dark room. Neil Lagali, a professor in experimental ophthalmology at Linköping University in Sweden, has been conducting research with his colleagues on eye problems following mild Covid infections. The most common symptom they found in a study of a hundred people in Sweden was light sensitivity, also known as photophobia. One possible explanation is related to nerves in the brain that regulate the amount of light entering the eye. Because of the slower pupil response, people are getting too much light and “it’s kind of overwhelming the brain,” he says. About a third of the people Lagali and his colleagues examined were on sick leave because their eye problems prevented them from doing their jobs, he says. Getting reinfected with Covid can also make eye issues worse. While the symptoms can alleviate over a longer period of time, recovery “seems to be very slow,” Lagali says. Taking eye drops, wearing color-tinted glasses and taking part in eye-training programs can help. For my part, I bought blackout curtains, lowered the screen brightness on my devices and saw an optician to get my eyes tested. The results confirmed my eyes were healthy, even though my head still hurt from the light. I started another round of nicotine patches and spoke to my doctors — one thought the light sensitivity issues sounded similar to migraines. Although my light intolerance subsided in the weeks after the reinfection, it hasn’t gone away completely and sensory overload continues to be an issue. I now switch my phone to dark mode between sunset and sunrise to ease the strain on my eyes. It’s still too early to know for sure what longer-term impact the reinfection might have, but I’m trying to not over-exert myself while also avoiding situations where I might get sick again. In the meantime, I’m just glad that — for most of the time — I can be back in a room with the lights on. — Lisa Pham "

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[missy]

Ophthalmology

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COVID-19 Takes a Greater Toll on Kidneys Than Pneumonia​

Edited by Shrabasti Bhattacharya

TOPLINE:​

COVID-19 survivors show a more pronounced decline in kidney function than those who recover from pneumonia caused by other infections. This decline in kidney function, measured by the estimated glomerular filtration rate (eGFR), is particularly steep among individuals who require hospitalization for COVID-19.

METHODOLOGY:​

• SARS-CoV-2, the virus that causes COVID-19, has been associated with acute kidney injury, but its potential impact on long-term kidney function remains unclear.
• Researchers investigated the decline in kidney function after COVID-19 vs pneumonia by including all hospitalized and nonhospitalized adults from the Stockholm Creatinine Measurements Project who had at least one eGFR measurement in the 2 years before a positive COVID-19 test result or pneumonia diagnosis.
• Overall, 134,565 individuals (median age, 51 years; 55.6% women) who had their first SARS-CoV-2 infection between February 2020 and January 2022 were included, of whom 13.3% required hospitalization within 28 days of their first positive COVID-19 test result.
• They were compared with 35,987 patients (median age, 71 years; 53.8% women) who were diagnosed with pneumonia between February 2018 and January 2020; 46.5% of them required hospitalization.
• The primary outcome measure focused on the mean annual change in eGFR slopes before and after each infection; the secondary outcome assessed was the annual change in postinfection eGFR slopes between COVID-19 and pneumonia cases.

TAKEAWAY:​

• Before COVID-19, eGFR changes were minimal, but after the infection, the average decline increased to 4.1 (95% CI, 3.8-4.4) mL/min/1.73 m2; however, in the pneumonia cohort, a decline in eGFR was noted both before and after the infection.
• After COVID-19, the mean annual decline in eGFR was 3.4% (95% CI, 3.2%-3.5%), increasing to 5.4% (95% CI, 5.2%-5.6%) for those who were hospitalized.
• In contrast, the pneumonia group experienced an average annual decline of 2.3% (95% CI, 2.1%-2.5%) after the infection, which remained unchanged when analyzing only patients who were hospitalized.
• The risk for a 25% reduction in eGFR was higher in patients with COVID-19 than in those with pneumonia (hazard ratio
  

 

[missy]

Long COVID Patients Frustrated That Federal Research Hasn't Found New Treatments

Over $1 billion of funding has so far failed to bring any new therapies to market

www.medpagetoday.com

 

[Calliecake]

CNN reported yesterday that the Federal Health Agencies have been directed to halt communications. This includes US Health and Human Services, US Center for Disease Control and Prevention, US Food and Drug Administration and National Institute of Health.

 

[josieKat]

CNN reported yesterday that the Federal Health Agencies have been directed to halt communications. This includes US Health and Human Services, US Center for Disease Control and Prevention, US Food and Drug Administration and National Institute of Health.

Not just communications, at least wrt NIH. I had colleagues who were in the middle of study/review sessions who were sent home abruptly. Much of my community is panicked about whether this will be a temporary shutdown or if science funding in general is going to have to figure out another non-federal (probably privatized) way. There are so many Covid and other pandemic/disease repercussions (nevermind the potential loss of funding for basic biomedical and other scientific research)!

 

[missy]

"
For the first time in its more than 60-year history, the CDC's Morbidity and Mortality Weekly Report (MMWR)opens in a new tab or window did not go out as scheduled because of a communications pause at federal health agencies issued by the Trump administration.

Past editors of MMWR and prior leaders of CDC lamented the lack of publication, and its potential impact on the distribution of vital public health information.

"This is a concerning precedent that public health messages won't be left to public health professionals and experts, and instead will be potentially controlled by politicians," Sonja Rasmussen, MD, a former editor of MMWR who worked at the CDC for 20 years, told MedPage Today.



"If they have information that they believe is important enough to get out in the MMWR ... I, as a physician, want to be able to have that information to take the best care of my patients," she added.

Tom Frieden, MD, MPH, who served as CDC director from 2009 to 2017 and is now president and CEO of Resolve to Save Lives, said MMWR has published "without a break every week since 1960" and its predecessor publications did so weekly since 1887.

"The bottom line is every day the publication is delayed, doctors, nurses, hospitals, local health departments, and first responders are behind the information curve and less prepared to protect the health of all Americans," Frieden said in a statement shared with MedPage Today.

Richard Besser, MD, who served as acting CDC director for 6 months in 2009, urged the Trump administration to expeditiously lift the pause.

"Not a day goes by when CDC isn't tracking a potential threat to our health," Besser said in a statement to MedPage Today. "Cutting off communications from CDC puts our health at risk and prevents our doctors, nurses, and public health leaders in our communities from doing their jobs."



The pause went into effect on Tuesday and is in effect through Feb. 1, according to the Associated Pressopens in a new tab or window, which obtained a memo from acting HHS Secretary Dorothy Fink, MD. It applies to public communications including press releases, social media posts, and websites, as well as anything intended to be published in the Federal Register, and, of course, MMWR.

MMWR has published without fail every week since its inception -- though each year the Christmas week report is published in a double issue the following week, Rasmussen told MedPage Today. Even during government shutdownsopens in a new tab or window the report has been put together by a skeleton crew, said another former CDC employee, who did not want to be named.

The first Trump administration also tried to gain control over MMWR, which had published information about the COVID pandemic that conflicted with messaging from the White Houseopens in a new tab or window.

It's unknown what information will be missed during this pause, though three reports about H5N1 were supposed to be published in this week's edition, according to the Washington Postopens in a new tab or window.



The former CDC employee who did not want to be named told MedPage Today they suspect the administration may not have realized the full implications of this gag order on the valuable resources, and that conversations are likely happening behind the scenes to try to convince the new administration to let MMWR go out. They pointed out that MMWR staff are still working and that if this pause continues through next week as currently planned, the articles would likely be put in the Feb. 6 issue.

Missing too many publications can result in getting delisted in Medline, which would mean the MMWR would no longer be an official publication of the National Library of Medicine. The institution did not respond to MedPage Today's inquiries on how many publications would have to be missed for this to happen.

Tina Tan, MD, president of the Infectious Diseases Society of America (IDSA), called the pause in publication of MMWR "a disaster."

Trump's Gag Order Halts CDC Publication

MMWR did not publish as usual at 1 p.m. today

www.medpagetoday.com

"These types of publications really are necessary to get out public health information to the public and to practitioners in a timely manner," she told MedPage Today.

While IDSA is also tracking ongoing public health threats like H5N1 and rising respiratory virus cases, the communications pause is impacting them, too, Tan said. IDSA was supposed to have a joint clinician call with the CDC today to address the most prominent public health threats related to H5N1 -- a meeting weeks in the making that had to be cancelled.

Becky Smullin Dawson, PhD, MPH, an epidemiologist at Allegheny College in Meadville, Pennsylvania, said that MMWR focuses the public health community's attention and "helps to generate conversations, new research, public health programming, medical interventions, and health communications."

"Taking away the MMWR from the public health community is equivalent to taking away a vital source of nutrition," she said. "There will be a void when the electronic version of the MMWR is not in my inbox."

As of press time, the CDC did not reply to a request for comment.

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Not just communications, at least wrt NIH. I had colleagues who were in the middle of study/review sessions who were sent home abruptly. Much of my community is panicked about whether this will be a temporary shutdown or if science funding in general is going to have to figure out another non-federal (probably privatized) way. There are so many Covid and other pandemic/disease repercussions (nevermind the potential loss of funding for basic biomedical and other scientific research)!

Hoping this is just temporary...
The entire system is corrupt and hoping somehow it gets cleaned up and reopened. But who the heck knows. So much chaos right now

 

[missy]

I had colleagues who were in the middle of study/review sessions who were sent home abruptly.

Trump Administration Forces NIH Meeting Cancellations

Researchers and healthcare professionals express concern over the potential impact

www.medpagetoday.com

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Trump Administration Forces NIH Meeting Cancellations​

— Researchers and healthcare professionals express concern over the potential impact​

by Jennifer Henderson, Enterprise & Investigative Writer, MedPage TodayJanuary 23, 2025


ome scientific meetings involving the NIH were abruptly cancelled this week, leaving researchers concerned about their work and the implications for science under the second Trump administration.

An email from an NIH official to a group that reviews federal grant applications for scientific research stated the following: "At the present time, all federal advisory committee meetings are cancelled. We apologize for any inconvenience this may cause and appreciate your understanding."



The email viewed by MedPage Today also noted that a planned meeting for the group on Thursday would be rescheduled. "We will be back in touch with you when we have further information," it concluded. "Thank you for your service to NIH."

Science reportedopens in a new tab or window the NIH is also impacted by an HHS-wide travel ban, as well as by the federal government-wide hiring freeze. It's not clear if the cancellations are related to a recent pause on communications rippling through federal health agenciesopens in a new tab or window -- one that even halted the publicationopens in a new tab or window of CDC's flagship journal Morbidity & Mortality Weekly Report.

In an emailed statement in response to questions regarding the cause and scope of the pause and how it could affect current or future research, NIH confirmed a temporary pause, pointing to a transition in administrations.

HHS "has issued a pause on mass communications and public appearances that are not directly related to emergencies or critical to preserving health," NIH stated. "This is a short pause to allow the new team to set up a process for review and prioritization. There are exceptions for announcements that HHS divisions believe are mission critical, but they will be made on a case-by-case basis."



HHS did not immediately provide additional comment.

Meanwhile, a number of postings by researchers and healthcare professionals on social media expressed concern regarding what the pause would mean for operations at the NIH, a leader of medical research in the U.S. and globally.

"Today's been a helluva day for public health," Mark Hayward, PhD, a population health scientist and professor of sociology at the University of Texas at Austin, wrote on Bluesky Wednesday afternoonopens in a new tab or window. "The muzzling of public health information at CDC, the shutting down of [diversity, equity, and inclusion]-related research projects and training programs, council meetings and scientific peer review panels on hold. A scorched earth approach to population health science and training."

"There's just lots of uncertainty," Hayward further told MedPage Today in an interview. Regarding NIH, this includes questions about what researchers will and won't be able to study going forward. Additionally, there is concern over the effect of "even a small hold" on certain research projects, the potential for cancelling certain projects, economic impact on the home states of research, overall scientific impact, and the availability of "quality research done in a timely way."



"Some very concerning things going on at NIH related to the 'pause' in communication," echoed another posting on BlueSky by Pamela Herd, PhD, researcher and professor of social policy at the University of Michigan in Ann Arbor. "Basic things, like grant review panels, panels that determine whether scored proposals will receive funding, and generic training sessions, all canceled." (The post, from Wednesday, appears to have since been deletedopens in a new tab or window.)

And, "[a]ll NIH study sections canceled indefinitely," Jane Liebschutz, MD, MPH, internal medicine physician and researcher at the University of Pittsburgh, wrote on the platformopens in a new tab or window. "This will halt science and devastate research budgets in universities."

However, she added the following in another postopens in a new tab or window: "Before panic sets [in]. The New NIH Director and Congress will want research to continue, so the machine will start up at some point. Keep writing papers and preparing proposals. AND educate the public about the key role peer review plays in science and the time and infrastructure investment needed."

It remains to be seen how long the pause will last, and what any potential impacts on research ultimately are.


"

 

[dk168]

Nothing to report except for our NHS under a lot of strain due to flu and/or Covid.

DK

 

[missy]

"

BCG Vaccine May Protect Against Long COVID Symptoms​

Edited by Satish Kumar M

Infectious Diseases - MDedge

The source for latest medical summaries - Infectious Diseases

www.mdedge.com

TOPLINE:​

Administering the Bacillus Calmette-Guérin (BCG) vaccine during the active phase of COVID-19 may help protect against the development of long COVID.

METHODOLOGY:​

• A phase 3 clinical trial initiated in early 2020 investigated the effect of the BCG vaccine injected during active infection on COVID-19 progression in adults with mild or moderate COVID-19. The current study summarizes the 6- and 12-month follow-up data with a focus on long-COVID symptoms.
• Patients who tested positive for severe acute respiratory syndrome coronavirus 2 were randomly assigned to receive either 0.1 mL of intradermal BCG (n = 191) or 0.9% saline placebo (n = 202) within 14 days of symptom onset and were followed up at 7, 14, 21, and 45 days and at 6 and 12 months postinjection.
• Overall, 157 BCG (median age, 40 years; 54.1% women) and 142 placebo (median age, 41 years; 65.5% women) recipients completed the 6-month follow-up, and 97 BCG (median age, 37 years; 49.5% women) and 95 placebo (median age, 40 years; 67.4% women) recipients completed the 12-month follow-up.
• The researchers primarily assessed the effect of the BCG vaccine on the development of the symptoms of long COVID at 6 and 12 months.

TAKEAWAY:​

• Hearing problems were less frequent among BCG recipients at 6 months compared with those who received placebo (odds ratio [OR], 0.26; 95% CI, 0.045-1.0; P = .044).
• At 12 months, participants who received the BCG vaccine exhibited fewer issues with sleeping (P = .027), concentration (P = .009), memory (P = .009), and vision (P = .022) along with a lower long-COVID score (one-sided Wilcoxon test, P = .002) than those who received placebo.
• At 6 months, BCG demonstrated a sex-specific paradoxical effect on hair loss, decreasing it in men (P = .031), while causing a slight, though statistically nonsignificant, increase in women.
• Male sex was the strongest predictive factor for long COVID, cognitive dysfunction, and cardiopulmonary scores at both follow-up assessments.

IN PRACTICE:​

"[The study] findings suggest that BCG immunotherapy for an existing ailment may be superior to prophylaxis in healthy individuals," the authors wrote.

SOURCE:​

The study was led by Mehrsa Jalalizadeh and Keini Buosi, UroScience, State University of Campinas, Unicamp, São Paulo, Brazil. It was published online onNovember 19, 2024, in the Journal of Internal Medicine.

LIMITATIONS:​

Previous mycobacterial exposure was not tested among the study participants. A notable loss to follow-up, particularly at 12 months, may have introduced bias into the results.

DISCLOSURES:​

The study was supported by the Coordination for the Improvement of Higher Education Personnel, Federal Government of Brazil, the General Coordination of the National Immunization Program, Ministry of Health (Brazil), and the National Council for Scientific and Technological Development-Research Productivity. The authors declared no conflicts of interest.


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[missy]

"

The Push for Off-Label Rx to Treat Long COVID: What Works?​

Charlie McCone, a San Francisco marketing specialist, developed long COVID in 2020. Before he recovered, he developed another acute case of COVID, and in 2021 his long COVID worsened. He’s been sick with fatigue and shortness of breath since then, spending many hours of every day in bed.

Only one drug helped his shortness of breath, he said. But doctor after doctor refused to prescribe that drug, Plavix, approved by the US Food and Drug Administration (FDA) to prevent blood clots. McCone began asking for it after doing his own research and learning it showed promise. When he finally found a doctor to authorize a prescription, McCone said, he began to breathe easier again.

McCone, now an advocate for long COVID sufferers as part of the Patient-Led Research Collaborative, a group of researchers and patients with long COVID, felt he had to take alternative steps. With no federally approved treatments for the millions of Americans who have experienced long COVID, some patients and doctors are turning to off-label drugs to manage the condition.

But patients say it is not always easy to get a doctor to prescribe them. And in some cases, insurance will not cover the drugs, ruling them experimental.

In the case of Plavix, Stellenbosch University researchers in South Africa have published results of a blood plasma analysis that found patients with long COVID had microclots — and Plavix may help relieve them.



McCone and others are asking doctors to learn about and use off-label drugs that show evidence of helping long COVID symptoms. Among them:

• Low-dose naltrexone for fatigue
• Nicotine patches for fatigue
• Rapamycin for immune function
• Triptans for headaches
• Beta-blockers for postural orthostatic tachycardia syndrome, dizziness
• Paxlovid for viral persistence
• Plavix and other blood thinners for blood clots

“We don't believe any of these drugs are going to cure patients, but [using them off-label] can be the difference between a patient holding onto their job,” McCone said. “There could be a patient going from being stuck in a dark room to being able to socialize and enjoy their day. This can be difference of a parent being able to take care of their children.”

Not every doctor is going to be comfortable prescribing Plavix, McCone said. But there is some solid evidence to support the idea that low-risk drugs like it can bring long COVID patients a lot of relief, he said.

The Argument for More Aggressive Off-Label Prescribing​

Julia Moore Vogel, PhD, senior program director at the Scripps Research in La Jolla, California, was co-author on a paper published last month in Cell calling for a stronger push for long COVID treatments. The paper noted that “as patients await evidence-based care, many engage in self-experimentation on the edges of medical science.”

Moore Vogel and others say people don’t need to experiment. They can use safe, existing treatments if they know about them and a doctor agrees a prescription is warranted. She would like to see more professional medical groups do more continuing education on long COVID so doctors can learn about the best off-label options.

Groups like the American Academy of Physical Medicine and Rehabilitationhave come up with a guideline on how to treat cardiac, respiratory, and other symptoms in patients with long COVID. But Moore Vogel thinks primary care doctors should take the lead.

“Part of what we're saying is a lot of it falls on the primary care physicians at this point because people are waiting so long to get into those subspecialties,” she said.

She would like to see recommendations for the primary care providers boiled down in simple terms about what is known about first-line, off-label therapies that have emerged.

Sterling Ransone, MD, a family physician in coastal Virginia, agrees that primary care specialists need to be educated on how to detect and treat long COVID.

He says he sees about one long COVID case a week, and sometimes his patients don’t know they have it. Patients will come in a month after symptoms, and he will ask them if they were sick and have tested for COVID.


“I literally had a patient tell me, ‘Is that still a thing?’” he said.

He suggests doctors add long COVID to the list of conditions they rule out when presented with confounding symptoms.

“What we need to do is make sure we always ask about the potential for long COVID with this myriad of symptoms,” Ransone said.


He prescribes off-label medication after doing research, if a patient asks for it, he said.

“If it's somebody I know well and they've got questions about something, I'll absolutely sit down and talk with them and tell them the research that I've done,” he said. “I mean, you know, from a physician standpoint, above all, do no harm, right?”

Once patients and doctors decide to try something, they need to get insurance approval. Some of the medicines are denied insurance coverage and are expensive, Ransone said.


“We have to go through prior authorization processes, and that's just another hurdle these folks unfortunately have to jump over,” he said.

One reason patient advocates say off-label medications are key is that clinical trials take too long, McCone said. Many trials of long COVID treatments are underway, but none have led to conclusive findings that have identified effective standardized treatments for the condition. As a result, the FDA has not approved any standard long COVID treatments in the same way treatments for other viral conditions and diseases have received approval and are widely used.

Patient Advocacy by Patients​

McCone is a patient representative to the National Institutes of Health’s RECOVER-TLC research program, which met this summer to launch a series of clinical trials. He said the organization is making progress, but results from the clinical trials aren’t expected until 2028 — a long time for patients with long COVID to wait.

He noted the upcoming trial of low-dose rapamycin, which researchers hope will address some of the immune or infection-related dysfunction that drives long COVID.

After McCone spent hours in bed for more than a year, he can now work at the computer for about 2 hours a day. His shortness of breath improved after he started taking Plavix.

“That's up from about 30 minutes. I can leave the house occasionally, once to twice a week, depending on the week,” he said.

McCone and others are calling for better continuing education for doctors about long COVID for doctors and more publicly available information to help patients know what drugs are already out there and might benefit them.

“Read the research, provide some low-risk treatment options to your patients, and let your patient decide,” he advised doctors. “I don't think this is asking you too much. This is a health crisis that's impacting every aspect of society.”



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[missy]

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CIA Backs COVID 'Lab Leak'; Trump Fires Health Watchdog; PEPFAR Funding Freeze​

— Health news and commentary gathered by​

by MedPage Today Staff January 27, 2025

Note that some links may require registration or subscription.

The CIA now believes that COVID-19 most likely originated from a labopens in a new tab or window, but cited "low confidence" in its new assessment. (AP)


The CIA now believes the virus responsible for the COVID-19 pandemic most likely originated from a laboratory, according to an assessment that points the finger at China even while acknowledging that the spy agency has "low confidence" in its own conclusion.

The finding is not the result of any new intelligence, and the report released Saturday was completed at the behest of the Biden administration and former CIA Director William Burns. It was declassified and released Saturday on the orders of President Trump's pick to lead the agency, John Ratcliffe, who was sworn in Thursday as director.


The nuanced finding suggests the agency believes the totality of evidence makes a lab origin more likely than a natural origin. But the agency's assessment assigns a low degree of confidence to this conclusion, suggesting the evidence is deficient, inconclusive, or contradictory.

"I had the opportunity on my first day to make public an assessment that actually took place in the Biden administration. So it can't be accused of being political," Ratcliffe told Fox News' "Sunday Morning Futures." He said the CIA "has assessed that the most likely cause of this pandemic that has wrought so much devastation around the world was because of a lab-related incident in Wuhan. And so we will continue to investigate that moving forward."

Earlier reports on the origins of COVID-19 have splitopens in a new tab or window over whether the coronavirus emerged from a Chinese lab, potentially by mistake, or whether it arose naturally. The new assessment is not likely to settle the debate. In fact, intelligence officials say it may never be resolved, due to a lack of cooperation from Chinese authorities.


The CIA "continues to assess that both research-related and natural origin scenarios of the COVID-19 pandemic remain plausible," the agency wrote in a statement about its new assessment.

Instead of new evidence, the conclusion was based on fresh analyses of intelligence about the spread of the virus, its scientific properties, and the work and conditions of China's virology labs.

Lawmakers have pressured America's spy agencies for more information about the origins of the virus, which led to lockdowns, economic upheaval, and millions of deaths. It's a question with significant domestic and geopolitical implications as the world continues to grapple with the pandemic's legacy.

Sen. Tom Cotton (R-Ark.), chairman of the Senate Intelligence Committee, told "Fox News Sunday" it was important now "to make China pay for unleashing this plague on the world." He mentioned imposing tariffs or passing legislation that would repeal China's permanent most favored nation status.

Chinese authorities have dismissed speculationopens in a new tab or window about COVID's origins as unhelpful and motivated by politics. On Saturday, a spokesperson for China's U.S. embassy said the CIA report has no credibility.

"We firmly oppose the politicization and stigmatization of the source of the virus, and once again call on everyone to respect science and stay away from conspiracy theories," embassy spokesperson Liu Pengyu said in a statement emailed to the Associated Press.

While the origin of the virus remains unknown, scientists think the most likely hypothesisopens in a new tab or window is that it circulated in bats, like many coronaviruses, before infecting another species, probably raccoon dogsopens in a new tab or window, civet cats, or bamboo rats. In turn, the infection spread to humans handling or butchering those animals at a market in Wuhan, where the first human cases appeared in late November 2019opens in a new tab or window.

Some official investigations, however, have raised the question of whether the virus escaped from a lab in Wuhan. Two years ago a report by the Energy Department concluded a lab leak was the most likely origin, though that report also expressed low confidence in the findingopens in a new tab or window.


The same year then-FBI Director Christopher Wray said his agency believed the virus "most likely" spread after escaping from a labopens in a new tab or window.

Ratcliffe, who served as director of national intelligence during Trump's first term, has said he favors the lab leak scenario, too.

"The lab leak is the only theory supported by science, intelligence, and common sense," Ratcliffe said in 2023.

The CIA said it will continue to evaluate any new information that could change its assessment.

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