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Time to end hospital COVID-prevention protocols?
Is Nosocomial SARS-CoV-2 Still Worth Preventing? JAMA Network Open, Nov. 10, 2023.
An editorial in JAMA Network Open called for managing nosocomial (hospital-acquired) COVID-19 based on frequency, morbidity and preventability: How many cases exist in the community, how dangerous is the current strain, and to what extent (how easily and at what dollar and resource cost) can infections be prevented?
The Harvard- and Brigham and Women’s Hospital-based authors recognized two schools of thought on this topic.
Since the virus is far less dangerous now than during the declared emergency, the downsides of mitigation (masking, distancing) now outweigh its potential benefits. On the other hand, hospital patients are already sick, older and suffering from weakened immunity and chronic conditions so they need protection.
Their conclusion is a compromise. Since many COVID-19 hospitalizations were caused by exacerbation of existing conditions or treatment delays — rather than the viral infection itself — the authors wrote, “We have reached a point at which we can be selective about both the measures we choose and when we implement them.”
FDA looks to ban brominated vegetable oils
Revocation of Authorization for Use of Brominated Vegetable Oil in Food; Federal Register, Nov. 3, 2023.
As part of its ongoing reassessment of previously evaluated and approved food ingredients, the U.S. Food and Drug Administration (FDA) has proposed banning brominated vegetable oil in foods.
Brominated vegetable oil is a vegetable oil modified by the addition of bromine, a minor ingredient that acts as an emulsifier to prevent citrus-flavored oils from floating to the top in some beverages.
Found in at least 70 popular drinks and gum, brominated vegetable oils have been the subject of safety investigations for decades.
The FDA’s action results from recent studies demonstrating illness in test animals receiving doses of the oil approximating typical human exposure. A 1997 paper linked the additive to bromism, a condition characterized by headache, fatigue, neurologic issues and progressive memory loss in humans.
In a 2022 study, 6-week-old rats fed brominated vegetable oil experienced enlarged thyroid glands and detectible levels of bromine in major organs.
The study’s results added to earlier work in rats and pigs demonstrating “that oral exposure to BVO is associated with increased tissue levels of inorganic and organic bromine, and that the thyroid is a potential target organ of toxicity.”
Post-vaccine fatigue is different than typical vaccine reactions
Chronic Fatigue and Dysautonomia following COVID-19 Vaccination Is Distinguished from Normal Vaccination Response by Altered Blood Markers; Vaccines, Oct. 26, 2023.
Chronic fatigue and autonomic nervous system issues (dysautonomia) after a COVID-19 shot differ from normal vaccination responses, according to a paper in Vaccines.
By testing blood drawn before vaccination and six months afterward, German researchers demonstrated that this effect, post-acute COVID-19 vaccination syndrome (PACVS), is distinguishable from typical vaccine reactions.
In vaccinated individuals unaffected by PACVS, antibodies involved in cardiovascular regulation and immune regulation undergo “long-term adjustment,” eventually returning to normal levels.
However, this process is disrupted in PACVS-affected vaccinated as measured by levels of interleukin 6 and interleukin 8, which are involved in inflammation, and antibodies against the angiotensin II type I, or AT1 receptor, which regulates blood pressure control and electrolyte balance, and the α2b-adrenergic, or α2b-adr receptor, which the virus uses to enter cells but is also involved in cognition and smooth muscle contraction.
Underserved teens not getting mental healthcare
Estimates of Major Depressive Disorder and Treatment Among Adolescents by Race and Ethnicity; JAMA Pediatrics, Oct. 9, 2023.
A JAMA Pediatrics study revealed that 1 in 5 adolescents suffered from depression during the first pandemic year, 2020, but fewer than half who needed treatment got it.
Researchers at Cambridge Health Alliance and Harvard surveyed 10,743 teens ages 12-17 of whom 51.1% were male, 51.2% white, 23.3% Hispanic, 14.1% Black, 5.1% Asian American, and 6.3% were multiracial.
Depression rates were 26.5% for multiracial subjects, 22.0% (for Hispanics), 20.2% (whites), 14.6% (Asian Americans) and 14.5% (Blacks).
All racial and ethnic groups were underserved, but those most affected by depression received the least treatment. Depressed white teens received care just 45% of the time, followed by 39.5% (for Blacks), 33.3% (Asian Americans), 29.2% (Hispanics) and 21.1% (multiracial).
The authors concluded that strategies for combating mental health issues in adolescents should focus not on simple depression rates among various demographics, but on underserved populations.
