Mormad said:

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To be clear, the annual incidence of sudden cardiac death among athletes aged 9-40 is estimated to be between 1/30000 and 1/80000 per year. This estimate, based on at least 13 epidemiologic studies, was established in 2016. Male gender, basketball, and Black race are most at risk, with annual incidence as high as 1/3000. Minnesota alone had 26 sudden cardiac deaths over a 2yr period among high school athletes 10yrs ago. Before the advent of vaccines, one of our own girl soccer players had a stroke. Her story was on gopack.com. There are a multitude of conditions, whether genetic or acquired, that predispose athletes to risk. these tragic events are not new since the onset of covid vaccinations. Have they increased? Time will tell. Good info to know if you have young male athletes, esp if considering vaccination.

Yes, the vaccines have been associated with cardiomyopathy or myositis,esp in young males. It is typically benign, self limited, and easily managed. A small percentage are hospitalized and average length of stay nationally is 2 days. Many are managed with no medicine or simple NSAIDs.

We're either going to hold the media accountable for responsible reporting or we're not.

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Good info. My opinion, based on some of the information posted by other doctors I follow is the following:

If I had a child under the age of 18 and particularly a male child, I would space the two vaccine doses 8-10 weeks apart, instead of 3-4 weeks. I would do this for a couple of reasons:

• Some studies and evidence show spacing out doses further apart will increase the immune system's reaction and increase the level of antibodies above what would occur with more closely spaced doses.
• Potential reduction in the incidence of myocarditis and pericarditis in children, particularly young males who appear to be statistically predisposed to this condition after vaccination and infection.

Also, have you seen any studies yet in the impact of Covid on athletes? There were some early theories that athletes in certain sports were more susceptible to adverse Covid than athletes in other sports. In particular, basketball players were highlighted and it was suggested it could be related to their size/weight ratio and lower BMI? Purely antidotal, but of the college athletes I personally know of who had confirmed cases of Covid, the ones who had the most severe outcomes were basketball players. Of course, I am looking at a very limited pool of athletes across four sports (soccer, football, basketball, volleyball), but it was interesting to me and would certainly be something to study further.

New data out of South Africa on Omicron continues to show it is a less severe variant than previous variants, such as Delta. A recent study demonstrated significantly lower instance of hospitalizations and an even further reduction in patients requiring ICU levels of care.

This study looks at data from 78,000 Omicron patients in South Africa. There are 38 admissions per 1,000 Omicron cases, compared to 101 admissions per 1,000 for Delta. The proportion of hospitalized patients needing ICU is 13% for this wave compared to 30% in previous waves.

— Chise 🧬🧫🦠💉 (@sailorrooscout) December 14, 2021

It looks like Colorado has a governor who is trying to apply some common sense. Too bad NC has a governor who refuses to do the same. I totally agree that the fact vaccines are widely available has ended the government's ability to apply sweeping orders and mandates as it regards people's behavior. At this point, the governor's and other health officials should no longer have the ability to pass these mandates. They should be required to go to the legislative bodies and pass laws instead.

While CA returns to statewide mask mandate, and OR pushes for permanent indoor masking, Dem Gov of Colorado rejects mask mandate, emphasizing that vaccine availability ended the medical emergency that gave public health officials unprecedented power.https://t.co/sip0R7LFPQ

— Dr. Jeanne Noble (@JeanneNoble18) December 14, 2021

I appears there has been a significant jump in daily hospital admissions - two weeks following Thanksgiving. I just plotted the daily hospital admissions on my projected daily admissions chart and you can see them below. It will be interesting to see if these numbers (approximately 200 admitted per day) hold over the next few days or continue to increase. The actual dates below are through 12/10.

Edit: I looked into the age demographics and it appears the large jump in daily admissions is being driven by the 50-79 age groups. Comparing the 7-day average for the previous seven days (151) to the average for the most recent four days (197), I found 65% of the increase in the average is made up of this age group of people. Additionally, the average for 80+ jumped up by 5 per day for these two periods.

Mormad said:

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Thanks for providing this information. It appears lack of severity could be due to vaccines or previous infection for South Africa. In one major area of South Africa, they had a previous infection rate estimated at 70% and in this area, Omicron hospitalizations were extremely low. Hopefully vaccination does help, but some reports I saw out of UK indicate it could be evading people who are fully vaccinated and boosted. For those who are unvaccinated, they could have a tough time with this variant. Due to transmission rates, it will be extremely hard to avoid.

I think we are going to learn a lot about Omicron in the coming week from the UK. It is a heavily vaccinated country (compared to the US) and are taking some severe measures to limit the spread. I spoke with a coworker in the UK yesterday and he was preparing himself for the next round of lockdowns where he lives (located on the southwest coast of England). I believe the UK will provide a better idea of what we will face in the US, since its demographic more closely matches the US than South Africa. South Africa's demographic is younger than the US and this could also be contributing to their better outcomes, from a hospitalization standpoint.

Not directly related to Omicron, but related to vaccines and boosters, I personally know three people who were fully vaccinated and boosted who became infected with Covid last week in an area outside of Winston-Salem. Two of them had traveled to the beach in South Carolina recently and one had not traveled at all. All three have minor symptoms and seem to be on the road to a full recovery. One has some severe health issues and he has done well, likely due to the vaccines and being boosted. With regards to boosters, my son's school is requiring all students and staff/faculty to be boosted by the start of the Spring semester. He will be getting his booster tomorrow, before he returns to campus for bowl practice on Sunday.

Here's a little more information on South Africa and Omicron.

In South Africa’s hard hit Gauteng province, where #Omicron is epidemic, new Covid hospitalizations - while rising - continue to lag the growth in new cases when compared to past covid waves. pic.twitter.com/RuFSmEIq91

— Scott Gottlieb, MD (@ScottGottliebMD) December 14, 2021

Some more recent information as to why the Omicron variant may be more transmittable, but less severe.

HKUMed shows Omicron infects and multiplies 70X faster than Delta in the human bronchus, which may explain why it transmits faster, BUT also shows Omicron infection in the lung is significantly LOWER than the original virus, which may be an indicator of lower disease severity. 🧵

— Chise 🧬🧫🦠💉 (@sailorrooscout) December 15, 2021

Below is a link to a very good article on the anti-viral Covid treatment, Paxlovid. This drug has shown very good results in clinical trial inhibiting the replication of the SARS-CoV-2 virus by blocking a key portion of its replication mechanism. It is important we find some effective treatments, since the Omicron variant (and potentially future variants) are able to evade the body's the antibodies produced by the vaccines and previous infection. As the article below points out, the Omicron variant has demonstrated an approximate 5-fold increased risk of a breakthrough infection for those who are vaccinated. Omicron also seems to be good at evading the monoclonal antibodies that some people are being given as a treatment.

While I approach these reports with some skepticism, I am trying to be optimistic about this new treatment and am looking forward to seeing the full efficacy and side-effects reports, as the drug moves through the review and approval cycle. The article below covers the mechanism the drug uses to block the virus' ability to replicate and why this has the potential to provide an important level of treatment and protection.

Why Paxlovid is a Just-in-Time Breakthrough


The chart below shows the mechanism used by Paxlovid to block viral replication. I found it to be quite helpful in understanding why this treatment might be successful.