In COVID-19 clinical update #55, Daniel Griffin reviews recommendations for keeping transmission low in school settings, optimal testing strategies for schools and businesses, impact of vaccines on asymptomatic infections, vaccine safety in PASC patients, and early use of aspirin associated with decreased mortality.
Hosts: Daniel Griffin and Vincent Racaniello
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- COVID-19 in primary and secondary schools (MMWR) 3:37
- Low transmission in elementary schools (MMWR) 6:16
- COVID-19 testing guidance (CDC) 7:45
- COVID-19 vaccines and asymptomatic infections (Clin Inf Dis) 15:29
- Vaccine safety in long COVID (medRxiv) 17:48
- Phase 3 results of antibody cocktail (Regeneron) 22:56
- Aspirin associated with decreased mortality (Anesth Analg) 24:40
- Post-acute long COVID-19 syndrome (Nat Med) 26:31
- Timing, duration, health impact of PASC (medRxiv) 27:30
- Persistent neurologic and cognitive dysfunction in PASC (Ann Clin Trans Neurol) 30:07
- Letters read on TWiV 735 32:36
- Timestamps by Jolene. Thanks!
Intro music is by Ronald Jenkees
Send your questions for Dr. Griffin to email@example.com
Link to Dr. Griffin’s paper Identifying Optimal COVID-19 Testing Strategies for Schools and Businesses: Balancing Testing Frequency, Individual Test Technology, and Cost discussed at 10 minutes and 10 seconds of this podcast.
Re: AstraZeneca adverse effects- a bit like the email asking for 2nd opinion about vaccinating after a possible vaccine-related encephalopathy… No advice until familiar with the case(s).
There were confounding factors when talking about “millions” of doses as the populations across countries were not similar. The 5 cases in the UK, now recognised as being cases of this rare clotting disorder or ‘VIPIT’ were in males as opposed to females but shared the age range (19-59 I believe) where the safety signal emerged. The clearest signal came from Norway where 6 events out of 120 000 vaccinations with very high mortality is a very serious alarm bell. Norway was vaccinating a younger demographic with AZ- frontline e.g healthcare workers. No wonder they ‘erred’ on the side of caution.
Rather than losing the utility of this vaccine it could be limited to the over 65s who are less prone to this effect as far as we know.
This is especially important to the developing countries where the national demographic are often skewed much younger so very different compared to Europe-means many more would be vulnerable to this potential adverse effect and, as the article points out, lacking diagnostics and treatment capability.
I hope someone is making note of all possible contributing factors in these patients and in their family histories, including specifically with regards to the vaccination any marker for potential chronobiological/circadian effects in case there may turn out to be some ideal Goldilocks time of day where the response is ‘just right’
The Science Magazine article says:
A 1/25K risk seems low, in my unqualified opinion, given that 30K seems to be the target size for Random Control Trials. The COVID-19 Science Table for Ontario has a brief for health professionals, named Vaccine-Induced Prothrombotic Immune Thrombocytopenia (VIPIT) Following AstraZeneca COVID-19 Vaccination, says:
This brief also has a decision tree graphic for diagnosis and treatment – same as heparin-induced thrombocytopenia (HIT). The question is how to best communicate this level of risk to the general public in the face of uncertainty while the investigation unfolds. Full transparency with links to “living documents” (updated with timely information as it emerges) seems like the best practice, in my opinion.
Agree about living document- here (UK) there is radio etc silence and the risk/benefit is difficult to work out in the meantime with cases currently still low as a result of lockdown measures. My problem with this is I also have to try and coax someone I am carer for to have the vaccine, currently they’re saying no (basic PDA-type no,not from any particular ideas about vaccines). Harder somehow than deciding for yourself :-/ This against a background of very low risk of exposure
…so this information would be very useful to have as soon as it’s available.
Could get a better feel for it through case studies too.
And if it’s shown up with other virus-vector vaccines?