China calls concerns over vaccine diplomacy "narrow-minded"

 Concerns about China using vaccines to sway other countries are “narrow-minded,” a top political advisory body said, apparently dismissing a notion among rival powers that Beijing exploits the fight against COVID-19 to boost its global influence.

Guo Weimin, spokesman for the Chinese People’s Political Consultative Conference (CPPCC), said some suspect China is using COVID-19 vaccines to “expand our geopolitical influence.”

“This idea is extremely narrow-minded”, Guo said at a news conference on Wednesday ahead of the opening of the annual meeting of CPPCC on Thursday. China’s President Xi Jinping has pledged to make China’s vaccines a “global public good.”

The Financial Times newspaper on Wednesday reported that the United States is working with allies Japan, India and Australia on a plan to distribute COVID-19 vaccines in Asia to counter the influence of China. It cited people familiar with the talks.

China’s rival India is using its strength as the world’s biggest maker of vaccines for various diseases to improve regional ties during the pandemic by providing COVID-19 vaccines to a range of countries, pushing back against Beijing’s political and economic in Asia.

China plans to provide 10 million doses of COVID-19 vaccines to global vaccine sharing scheme COVAX. Vaccines from Chinese firms are already being rolled out in several countries, including Brazil, Indonesia, Turkey and the United Arab Emirates.

https://www.reuters.com/article/us-china-parliament-vaccine/concerns-over-china-vaccine-diplomacy-narrow-minded-political-advisory-body-idUSKCN2AV0V6

Alphabet-backed Oscar Health raises $1.2 billion in IPO

 Oscar Health Inc OSCR.N, a health insurance startup backed by Google parent Alphabet Inc GOOGL.O, sold shares in its initial public offering (IPO) on Tuesday at $39 apiece, above its target range, to raise $1.2 billion.

The IPO gives New York-based Oscar Health a market value of $7.7 billion. The target price range on the offering of 31 million shares was raised earlier on Tuesday to $36-$38 per share, up from $32-$34.

Oscar Health sells health insurance coverage to individuals, families, small businesses and Medicare users, with 529,000 customers on its technology platform across 18 states.

In 2020, Oscar Health said its customers grew 75% year-on-year as the COVID-19 pandemic increased demand for healthcare delivery through online, mobile and at-home methods.

Oscar Health said its premiums jumped 60% to $1.67 billion in 2020. The company, however, ceded most of the claims to reinsurance firms, causing revenue to fall 5.2% to $462.8 million. Net losses widened to $406.8 million from $261.2 million in the previous year, according to regulatory filings.

Oscar Health was founded in 2012 by its chief executive, Mario Schlosser, Kevin Nazemi and Joshua Kushner, the younger brother of Jared Kushner, the son-in-law of former U.S. President Donald Trump. In 2018, Alphabet took a nearly 10% stake in Oscar Health for $375 million.

Shares in Oscar Health will begin trading on the New York Stock Exchange on Wednesday under the symbol "OSCR."

Goldman Sachs, Morgan Stanley and Allen & Company are lead underwriters for the offering.

https://www.nasdaq.com/articles/alphabet-backed-oscar-health-raises-%241.2-billion-in-ipo-2021-03-02

4 COVID-related skin complaints everyone should look out for

 The most common symptoms of COVID-19 are fever, a dry cough, and losing your sense of taste and smell. Other signs that are frequently seen include headaches, muscle and joint pain, nasal congestion, and fatigue.

A less common symptom are rashes of various forms. These have been slower to be reported, partly due to the wide variety that have appeared in COVID-19 patients, making it more challenging to establish a consistent correlation.

Nevertheless, knowing how COVID-19 affects the skin is important. A recent study found that for 17% of COVID-19 patients with multiple symptoms, skin rashes were the first symptom to appear, while for 21% of patients rashes were their only symptom. Being able to identify the effects of COVID-19 on the skin may allow cases to be spotted earlier – or even picked up altogether in people who are otherwise asymptomatic. This could help limit transmission.

With that in mind, here are the four main types of skin changes to look out for, and the possible reasons why they occur.

Chilblain-like lesions

These are red, swollen or blistering skin lesions that affect mainly the toes and soles of the feet, colloquially known as “COVID toes”. Over the course of one to two weeks, the lesions will become even more discoloured and will flatten, and after this they will spontaneously resolve without treatment.

A substantial number of these lesions have been seen, primarily in adolescents and young adults with no or only mild symptoms of COVID-19. They make up the majority of skin issues associated with the virus. In two international reports on different types of suspected COVID-related skin conditions, around 60% of patients with skin complaints reported these lesions.

However, given these lesions correlate with mild disease, many of the patients with them in these studies didn’t qualify for a COVID-19 test at the time, and 55% were otherwise asymptomatic. So while the swift rise of these lesions during the pandemic suggests they’re associated with COVID-19, direct confirmation of this hasn’t been established. It’s possible they’re caused by some other related factor.

The red swelling of these lesions often appears on the top of the toes, close to the nail. Ternavskaia Olga Alibec/Shutterstock

Exactly when they appear is also somewhat unclear. In a study analysing 26 patients with suspected COVID-related skin changes, 73% presented with chilblain-like lesions. None of the patients had respiratory symptoms and they were all COVID-negative at the onset of their lesions. An explanation is that these lesions appear only after a long delay – up to 30 days after infection.

The cause of these lesions has been debated. A possible culprit could be type 1 interferons, proteins that regulate the antiviral properties of the immune system. The theory is that high production of these interferons might result in patients rapidly clearing the coronavirus, but also cause injury to blood vessels and increased inflammation. This would explain the coincidence of mild or nonexistent disease, negative tests and skin damage.

Another theory concerns ACE2, the molecule that the coronavirus uses to get inside cells. It is present on many types of cell, including those in the sweat glands, which are common on the palms of the hand and soles of the feet. This could make these areas particularly vulnerable to damage from the virus.

Or, it could be that damage to blood vessels, caused either by the immune response or the virus, leads to cell death and multiple mini blood clots in the toes.

Maculopapular rash

This term describes both flat and raised areas of discoloured skin. A study of 375 patients in Spain found that 47% of patients with COVID-related skin changes had this kind of rash.

These were associated with more severe COVID-19 symptoms, and were mainly found on the trunk in middle-aged to elderly patients. They tended to last 7-18 days, appearing 20-36 days after infection.

A suggested cause is the body’s immune system going into overdrive. In some patients, a hyperinflammatory phase occurs 7-10 days after infection, which leads to tissue damage and, potentially, more severe disease and death.

Hives

Also known as urticaria, these are raised areas of itchy skin. In a study involving four hospitals in China and Italy, 26% of COVID-19 patients that complained of skin changes presented with hives.

Hives typically precede or present at the same time as other symptoms, making them useful for diagnosis. They are more common among middle-aged patients and are associated with more severe disease. Viral infections are a known trigger of hives, as they cause the breakdown of cells and the release of histamine through a cascade of reactions in the immune system.

Severe urticaria may feel like it is stinging or burning. namtipStudio/Shutterstock

However, it’s important to remember that hives are also a noted side-effect of many drugs that have been used to treat COVID-19, such as corticosteroids and remdesevir.

Vesicular lesions

These are clear fluid-filled sacs under the skin, similar to those seen in chicken pox. They are less common compared to the skin conditions above: in the previously mentioned Spanish study of skin changes associated with COVID-19, only 9% of patients had these vesicles.

However, they are thought to be a more specific indication of someone having COVID-19 than those already listed, and so are more useful for diagnosis. They appear to present in patients with mild disease around 14 days after infection. It’s thought that they’re caused by prolonged inflammation, with antibodies attacking the skin and damaging its layers, resulting in fluid-filled sacs.

Vassilios Vassiliou

Senior Clinical Lecturer in Cardiovascular Medicine, University of East Anglia

Subothini Sara Selvendran

Visiting Researcher in Medicine, University of East Anglia

https://theconversation.com/four-covid-related-skin-complaints-everyone-should-look-out-for-152716

States where pregnant women can get the Covid vaccine now

In recent weeks, pregnant women have been prioritized for coronavirus vaccinations across the country.

Washington, D.C. and 15 states — most recently including Kentucky, Illinois and Florida — have added pregnancy to their lists of eligible high-risk conditions, according to NBC News' research. The Centers for Disease Control and Prevention considers Covid-19 an acute threat during pregnancy. Eight states are not following the CDC's recommendation to prioritize pregnant women over the general population.

As states move forward with plans to add pregnant women to their eligibility lists, Pfizer-BioNTech has begun a clinical trial of their vaccine's effect on pregnant women to supplement the lack of data about pregnancy and the vaccines.

Pregnant women have no biological reason for concern, said Dr. Brenna Hughes, vice chair of obstetrics and quality at Duke Medical. "Based on the biologic mechanism of vaccines, we can't see a biologic reason it would be unsafe."

All pregnant women are at a greater risk of complications if exposed to the coronavirus and should be vaccinated as soon as they are eligible, no matter how far along in their pregnancies they are or if they are breastfeeding, Hughes said.

The CDC recommends that all states include pregnant women in its phase 1C of vaccinations; not all states are following the guidelines, and some may require pregnant women to have doctor's notes or verification of their pregnancies before they get vaccine shots.

Many states recommend, some on their websites, that those eligible with high-risk health conditions, such as pregnancy, consult with their doctors before they schedule their vaccination appointments.

In New Mexico, those seeking vaccinations may be asked to verify any health conditions, pregnancy included, before they get shots. In New York, you must have proof of your current eligibility, which may be a doctor's letter, medical information with evidence of underlying condition or a signed certification. Florida requires a note from a doctor, and those in Washington, D.C. must show proof that they meet the eligibility criteria.

https://www.nbcnews.com/health/health-news/map-here-are-states-where-pregnant-women-can-get-covid-n1259291

Promising Results with Antibiotics For Covid-Linked Psych Disorders

 Emerging data shows that, after COVID-19, some survivors experience major neuropsychiatric symptoms.  Although COVID-19 primarily targets the human respiratory system, it also affects other parts of the body including the central nervous system (Chaves Filho et al., 2021).

It is known, of course, that infections generally trigger inflammation in the body. Normally this is a helpful protective response of the immune system to an invasion. Although it is still early days in understanding this phenomenon, previous documentation of other systemic viral infections provides possible insights. For some people, inflammation triggers an autoimmune response. The immune system becomes over-alert and indiscriminate; in its over-reaction, it begins to attack the body itself.  This may be what is happening when neuropsychiatric symptoms appear in individuals after COVID-19. (Troyer et al., 2020).

In a just-published study, Chaves Filho et al. (2021) assert that the severe acute respiratory syndrome caused by COVID1-9 has the potential to lead to neuroinflammation that leads to the manifestation of psychiatric symptoms. They review studies that document that some COVID-19 patients experience confusion, disturbed attention, depression, anxiety, insomnia, emotional lability, and irritability.  They suggest in response the use of certain kinds of antibiotics as a possible treatment of neuropsychiatric and neurological manifestations after COVID-19.

These authors (Chaves Filho, et al. 2021) report that COVID may lead to brain infection in two possible routes: (1) “neuronal cells transported along olfactory axons to the brain” and (2) components of the virus may cross the blood-brain barrier (BBB). Once the virus invades the Central Nervous System (CNS) it induces inflammation and leads to neuroinflammation.  

Antibiotics for post-COVID19 neuropsychiatric manifestations
Inflammation and oxidative stress are among the root causes of several neurological and neuropsychiatric symptoms.  Antibiotics, some of which have a powerful anti-inflammatory impact in addition to their antimicrobial impacts, could possibly address these symptoms (Chaves Filho et al., 2021).

Tetracyclines are a group of broad-spectrum antibiotics that may prevent or address the inflammation caused by COVID. Minocycline and Doxycycline in particular were found to be useful to address viral infections such as “Dengue, Ebola, HIV, Zika and Influenza A” (Chaves Filho et al., 2021).

Based on their review of literature, Chaves Filho et al. (2021) report, “Promising results have been obtained in clinical trials using tetracyclines for major psychiatric disorders, such as schizophrenia and major depression.” They suggest therefore that antibiotics such as Tetracyclines that have both antiviral and anti-inflammatory effects with minor side effects should be considered as “the most promising strategies".  Doxycycline and Minocycline handicap viral replication, reduce severe viral-induced inflammation and autoimmune response, and have the additional benefit of being cost-effective.

The growing body of evidence regarding the link between inflammation and neuroinflammation and how they link to psychiatric symptoms has big implications for mental health practitioners, educators, and patients.  It is important that we expand broad awareness of it.

*This study report is not a substitute or recommendation for the use of antibiotics without consulting a medical professional. 

References

Chaves Filho, A. J. M., Gonçalves, F., Mottin, M., Andrade, C. H., Fonseca, S. N. S., & Macedo, D. S. (2021). Repurposing of Tetracyclines for COVID-19 Neurological and Neuropsychiatric Manifestations: A Valid Option to Control SARS-CoV-2-Associated Neuroinflammation?. Journal of Neuroimmune Pharmacology, 1-6.

Troyer, E. A., Kohn, J. N., & Hong, S. (2020). Are we facing a crashing wave of neuropsychiatric sequelae of COVID-19? Neuropsychiatric symptoms and potential immunologic mechanisms. Brain, behavior, and immunity.

https://www.psychologytoday.com/us/blog/expressive-trauma-integration/202102/promising-results-using-antibiotics-psych-disorders

Gov. Abbott Says It's Time to ‘Open Texas 100%'

 

• Effective next Wednesday, March 10, all businesses can open with 100% capacity.
• Statewide mask mandate ends next week; masks still encouraged to be worn
• State sets records for number of vaccines administered in a day

Texas Gov. Greg Abbott (R) says it's time to "open Texas 100%" and ended the statewide mask mandate, effective next Wednesday, citing downward trends in hospitalizations and the availability of medicines and vaccines to keep people from requiring hospitalization.

The governor delivered a statewide address Tuesday from Montelongo's restaurant in Lubbock where he said the state mandates were no longer needed in the battle against COVID-19 and that he was issuing a new executive order (GA-34) that rescinds most of his other pandemic-related orders.

The new executive order allows all businesses, of any type, to open to 100% capacity and, though the governor strongly encouraged people to continue wearing face coverings in public, he said people will no longer be required to do so.

The executive order also removes the ability of local authorities to impose a mask mandate. Abbott's order said: "Individuals are strongly encouraged to wear face coverings over the nose and mouth wherever it is not feasible to maintain six feet of social distancing from another person not in the same household, but no person may be required by any jurisdiction to wear or to mandate the wearing of a face covering."

Tarrant County Judge Glen Whitley, who had recently extended his mask mandate until May 25, rescinded that order based on the governor's action Tuesday saying it was confusing to people but that he'd wished Abbott had carried the mandate at least through Spring Break. Dallas County Judge Clay Jenkins, meanwhile, was upset by Abbott's order.

“Nothing the governor does anymore surprises me. It was disappointing. But again, we need to focus on what the doctors, the facts and the science tell us we need to do to stay safe. If we’ll do that as a community, then we can still reach herd immunity,“ said Jenkins.

The governor rationalized the move by saying hospitalizations of people infected with the virus are at the lowest they have been in the last four months and that the number of active COVID-19 cases are less than half of what they were a month ago and that they are also at their lowest point since November.

When Abbott put the restrictions in place last summer, the number of hospitalizations was half of what they are today and the total number of cases since March was fewer than 2,500. As of Monday, data from the Texas Department of State Health Services estimates there are currently 156,989 active cases of the virus in the state and that more than 5,600 people are hospitalized.

Still, the governor contends recent data trends indicate "far more Texans are recovering from COVID than contracting it" and that "state mandates are no longer needed."

"Removing state mandates does not end personal responsibility or the importance of caring for your family members and caring for your friends and caring for others in your community," Abbott said. "Personal vigilance to follow the safety standards is still needed to contain COVID, it's just that now state mandates are no longer needed. Texans should continue following medical advice on preventing COVID."

Abbott said if businesses want to impose their own capacity restrictions or implement other safety protocols, they have the right to do so and can operate their business as they want to at this time, however people and businesses don't need the state telling them how to operate.

Citing statistics from the Centers for Disease Control and Prevention, Abbott said more than 10 million Texans are believed to have recovered from COVID-19 and "have the proven ability to beat the disease."

To reassure local leaders and citizens concerned the removal of the mask mandate and reopening of all businesses may be coming too quickly, Abbott said the executive order allows for restrictions to return should hospitalizations of COVID-19 patients top 15% for more than seven consecutive days. In that case, Abbott said county judges in those areas would be permitted to use mitigation strategies to prevent the further spread of the disease. However, Abbott said those judges may not jail people for not following orders, they may not invoke any penalties for not wearing a mask and they must allow businesses to operate at least at 50% occupancy.

Abbott said the downward trend in cases and hospitalizations was due in part to the success the state has had in administering vaccines. The various vaccine hubs and clinics around the state were administering about 1 million doses per week, the governor said, and that on Tuesday the state set a single-day record of administering 216,000 doses. The governor said that so far more than 5.7 million doses have been administered in the state and that by next Wednesday that number will be nearly 7 million doses.

Also by next Wednesday, Abbott said more than half of all seniors in the state will have received a dose of the vaccine and by the end of the month all of the state's seniors will be able to receive the shot.

Abbott didn't say when, but he hinted that the groups of people who are currently eligible for the vaccine will expand soon beyond groups 1A and 1B. Abbott made no mention about teachers, whom many have hoped would be provided priority access to the vaccine.

The executive order issued Tuesday rescinds one of Abbott's most wide-ranging executive orders relating to the virus -- the one issued June 26, 2020 closing bars and limiting other businesses to 50% capacity.

When that order was issued just over eight months ago, the seven-day average of COVID-19 cases and the number of total Texans hospitalized with the virus was lower than it was through Sunday.

On June 26, Texas' seven-day average of new coronavirus cases was 5,091 and there were 5,523 COVID-19 hosptializations statewide.

On Sunday, the state's seven-day average was 5,816 -- the lowest it'd been since Oct. 20 and down from a peak of 19,528 on Jan. 16. There were 5,611 people hospitalized with the virus in Texas on Feb. 28.

The hospitalization rate in Trauma Service Area E, which includes most of North Texas, dropped below 15% Feb. 11 and has not exceeded the number since. The percentage dropping below that threshold for seven straight days allowed bars to reopen, increased capacity at some businesses to 75% from 50% and allowed the resumption of elective surgeries.

The percentage of COVID-19 patients to bed capacity is down to just 9%, and the ICU COVID-19 patients are 24% of total ICU capacity, down from 50% six weeks ago.

"We do not want to let our guard down. We must continue wearing masks, physical distancing, washing hands, and get vaccinations in as many arms as possible," CEO of Dallas-Fort Worth Hospital Council Stephen Love said Monday. "Spring breaks are coming and we need everyone to do their part to keep the COVID-19 virus spread as low as possible."

The major differences between March 2021 and June 2020, of course, are the availability of antibody therapeutic drugs to treat COVID-19 and the rollout of the COVID-19 vaccines.

According to data compiled by The New York Times from the Centers for Disease Control and Prevention, 6.2% of Texas residents had been fully vaccinated and 12.2% had received their first dose. The single-shot Johnson & Johnson COVID-19 vaccine started to ship nationwide on Monday and was being administered in North Texas on Tuesday.

https://www.nbcdfw.com/news/local/texas-news/abbott-to-make-statewide-announcement-tuesday-in-lubbock/2567387/

Abbott HIV Vaccine Research Findings: 'Another Step Toward Unlocking A Cure'

 Abbott Laboratories 

ABT 0.33% has announced a potential research breakthrough that could lead to advancements and potential vaccines for the treatment of HIV.

What Happened: Abbott’s researchers have joined a team of scientists from Johns Hopkins University, the National Institute of Allergy and Infectious Diseases, the University of Missouri-Kansas City and the Université Protestante au Congo in studying approximately 10,000 people in the Democratic Republic of Congo who have tested positive for HIV antibodies but have low to non-detectable viral load counts that occurred without the use of antiretroviral treatment.

Why It's Important: These new findings, which were published Tuesday in EBioMedicine — part of The Lancet — could offer a significant new lead in mitigating the HIV crisis.

An estimated 76 million people have been infected with HIV since the disease was first identified, and 38 million people today are living with the virus.

Furthermore, the DRC is home to the oldest known HIV strains, which provides further insight into the disease’s origins.

"Global surveillance work keeps us ahead of emerging infectious diseases — and in this instance we realized we had found something that could be another step toward unlocking a cure for HIV," said Michael Berg, an associate research fellow in infectious disease research at Abbott and lead author of the study.

"The global research community has more work to do — but harnessing what we learn from this study and sharing it with other researchers puts us closer to new treatments that could possibly eliminate HIV."

https://www.benzinga.com/general/biotech/21/03/19942357/abbott-announces-hiv-vaccine-research-findings-another-step-toward-unlocking-a-cure