margarita25
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Hey Wings...
Sadly Dr. O has it now.
Episode 132: Looking in the Windows
In this episode, Dr. Osterholm and Chris Dall discuss the latest data on long COVID, bivalent boosters, and mpox. Dr. Osterholm also shares the feedback we've received from our listeners on what this podcast will look like going forward. COVID is coming back in China; lockdowns are not (Buckley...
“Dr. Osterholm: [00:01:42] Thank you, Chris. And welcome back to all of you who are a part of the podcast Family. You know who you are and to anyone who might be listening for the first time, we welcome you and hope that we're able to provide you the kind of information that you're looking for. Let me begin by saying that the last several weeks have been, frankly, overwhelming for me in a way that you can understand. Yes, I am still having some challenges with what might be called long COVID or as we'll talk more today about a more formal title and have had long days with fatigue that have made it sometimes very difficult for me to keep up the schedule that I had before. But I think I am getting better. And in that regard, that's that's good. But the outreach that I have had with so many of you who have sent cards and letters and emails and even some packages, I can't begin to adequately express to you my appreciation for that. You know, it's this podcast was never supposed to be about me. It's supposed to be about a virus that we're all trying to take on. And if anything, it's about you. And you have been so kind, so kind in sharing with me your own life stories, sharing the ideas of what a beautiful place can look like, literally and figuratively...”
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“Chris Dall: [00:16:41] Now to long COVID, which will likely be a significant topic of discussion on this podcast going forward. A team led by researchers at Massachusetts General Hospital published a paper in Jama last week that developed a preliminary definition of post-acute sequelae of SARS-CoV-2 infection or long COVID. Based on 12 symptoms that continue to affect people six months or more after infection. Mike, what did you make of this paper and how important is the development of a definition of long COVID?
Dr. Osterholm: [00:17:11] Well, let me first start out, Chris, by acknowledging that this is an issue that many listeners have been asking about. And as I've already shared with you in this podcast, I have an intense personal interest in this long COVID, as it's been called by so many of us, is clearly one of the biggest concerns that we have right now as pertains to the pandemic. As we just described, weekly COVID hospitalizations and deaths may be low, but long COVID persists as an issue affecting millions of people around the world. Now, this study, which you highlighted in your question, is actually part of what's called the RECOVERY system, an NIH sponsored effort to learn more about the post sequelae. Illnesses associated with COVID recovery actually stands for Researching COVID to Enhance Recovery. And the work that was done here was initiated back in 2022. Now, there's another term that we need to come to understand because we're trying to move away from the concept of long COVID. It was a good term to help people first understand that there was something happening on the back side of acute COVID. But today we're now calling this post-acute sequelae of SARS-CoV-2 infection, as you noted, and we're calling that PASC. So when you hear me talking about PASC, you'll know what I'm talking about.
Dr. Osterholm: [00:18:30] Now, in terms of this study, yes, it did come from a group at Massachusetts General Hospital, but it actually involved 85 different sites in 33 different states, including the District of Columbia and Puerto Rico. So it's a really geographically very representative sample of people that participated in this. And what they did is actually bring together 9800 participants, 89% of whom were infected with SARS-CoV-2. The study reported results for three sub cohorts an acute omicron infection sub cohort, a post-acute pre omicron infection sub cohort and then a post-acute omicron infection sub cohort. So in other words, trying to understand what happened before Omicron, what happened during Omicron and what's happened since that time. And it was of note that among the entire cohort, infected individuals had 1.5 or more times the odds of experiencing 37 different symptoms than uninfected individuals that they followed. Symptoms were experienced at a much higher frequency in the infected group compared to the uninfected group, including exercise, fatigue, malaise, dizziness, brain fog, GI symptoms, etcetera. And what the researchers did is they used this data to create a score by assessing different scores to 12 different long COVID symptoms. A loss of smell or taste had the highest score of eight post-exertional malaise, or in other words, feeling fatigued after exercise, had a score of seven chronic cough, had a score of four brain fog and thirst, had scores of three palpitations and chest pain, had scores of two and fatigue lowered sexual desire or capacity, dizziness, GI symptoms and abnormal movements all had scores of one.
Dr. Osterholm: [00:20:24] Individuals with total scores of 12 or higher are considered to have PASC. So, for example, someone experiencing just thirst and fatigue would have a score of four which would not meet the threshold of PASC according to the scoring system, but someone experiencing post-exertional malaise. Chest pain, brain fog and dizziness would have a score of 14 which would exceed the threshold for PASC. So I think the importance of this study is there's now really an effort to try to define what is actually happening with people following these acute episodes. And as I pointed out, I surely have a true interest in this very issue. I also want to highlight a piece of hopeful information from this study. The researchers found that the proportion of PASC positive infected participants was higher in the post-acute pre-Omicron group than the post-acute Omicron group, meaning that those who were infected before Omicron had a higher rate of past positive illness than those after Omicron showed up.
Dr. Osterholm: [00:21:29] And this proportion of individuals who experienced PASC is still far higher than we anyone would hope it could be. But it's a good sign that it appears to be declining as the virus evolves and that vaccination may at least to some extent protect against PASC. So we still have a lot of questions left about what are the drugs that might be effective in dealing with this, What is the short and long term treatment outcomes? But you need to first define the illness or illnesses that people are experiencing, and that's what this study has really done. And so my hats off to the NIH for this effort. It's been a long time in coming, but it's finally I now highlighting, I think the really. Certain aspect of PASC and that this is something that is real is something that for many of you who are listeners here, you know, you've had it. You understand you've had it. I understand you've had it as I understand my own health situation. So I can only hope that with time we're going to see more and more improvement with regard to past occurrence. And of course, we all hope that we can find therapeutic regimens that will help reduce the symptoms and not just leave it to time to get better.”
Episode 132: Looking in the Windows
In this episode, Dr. Osterholm and Chris Dall discuss the latest data on long COVID, bivalent boosters, and mpox. Dr. Osterholm also shares the feedback we've received from our listeners on what this podcast will look like going forward. COVID is coming back in China; lockdowns are not (Buckley...
I even stopped attending Xmas and Thanksgiving dinners since 2020. But I feel like I'm overly cautious, especially when I see just about everyone else out and about without a mask.
