The Covid-19 Thread: News, Preparation Tips, Etc

PatDM'T

Well-Known Member
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Fungal infections can be devastating. And one in particular – mucormycosis – is adding to the burden of suffering in a country already in a deep Covid-19 crisis. We've seen reports from India of infections with mucormycosis, often termed "black fungus", in patients with Covid-19, or who are recovering from the coronavirus.

As of March this year 41 cases of Covid-19-associated mucormycosis had been documented around the world, with 70% in India. Reports suggest the number of cases is now much higher, which is unsurprising given the current wave of Covid-19 infections in India.
But what is mucormycosis, and how is it linked with Covid-19?

What is mucormycosis?
Mucormycosis, formerly known as zygomycosis, is the disease caused by the many fungi that belong to the fungal family "Mucorales". Fungi in this family are usually found in the environment – in soil, for example – and are often associated with decaying organic material such as fruit and vegetables.

The member of this family most often responsible for infections in humans is called Rhizopus oryzae. In India though, another family member called Apophysomyces, found in tropical and subtropical climates, is also common.

The fungi that cause mucormycosis are found normally in soil and on rotting organic material but can infect humans when they get a chance (Credit: Science Photo Library)

The fungi that cause mucormycosis are found normally in soil and on rotting organic material but can infect humans when they get a chance (Credit: Science Photo Library)

In the laboratory, these fungi grow rapidly and have a black-brown fuzzy appearance.
Those that cause human disease grow well at body temperature and in acidic environments – the kind seen when tissue is dead, dying or associated with uncontrolled diabetes.

How do you get mucormycosis?
Fungi in the Mucorales family are considered opportunistic, meaning they usually infect people with an impaired immune system, or with damaged tissue. Use of drugs which suppress the immune system such as corticosteroids can lead to impaired immune function, as can a range of other immunocompromising conditions, like cancer or transplants. Damaged tissue can occur after trauma or surgery.

There are three ways humans can contract mucormycosis – by inhaling spores, by swallowing spores in food or medicines, or when spores contaminate wounds.

Inhalation is the most common. We actually breathe in the spores of many fungi every day. But our immune systems and lungs, if healthy, generally prevent them from causing an infection.


When our lungs are damaged and our immune systems suppressed, such as is the case in patients being treated for severe Covid-19, these spores can grow in our airways or sinuses, and invade our bodies' tissues.

Mucormycosis can manifest in the lungs, but the nose and sinuses are the most common site of mucormycosis infection. From there it can spread to the eyes, potentially causing blindness, or the brain, causing headaches or seizures.

Crematoriums in New Delhi have been struggling to cope with the deaths caused by Covid-19 and secondary infections like mucormycosis are adding to the problems (Credit: Reuters)

Crematoriums in New Delhi have been struggling to cope with the deaths caused by Covid-19 and secondary infections like mucormycosis are adding to the problems (Credit: Reuters)

It can also affect the skin. Life-threatening wound infections have been seen after injuries sustained during natural disasters or on battle fields where wounds have been contaminated by soil and water.

In the environment
There have been very few mucormycosis infections associated with Covid-19 in countries other than India. So why is the situation there so different?

Before the pandemic, mucormycosis was already far more common in India than in any other country. It affects an estimated 14 in every 100,000 people in India compared to 0.06 per 100,000 in Australia, for example.

Globally, outbreaks of mucormycosis have occurred due to contaminated products such as hospital linens, medications and packaged foods. But the widespread nature of the reports of mucormycosis in India suggests it's not coming from a single contaminated source.

A recent summary of Covid-19-associated mucormycosis showed 94% of patients had diabetes​


Mucorales can be found in soil, rotting food, bird and animal excretions, water and air around construction sites, and moist environments.
Although never compared, it may be that Australia has a lower environmental burden of Mucorales than in India.

But there could be another factor at play in India – diabetes.
When diabetes is poorly controlled, blood sugar is high and the tissues become relatively acidic – a good environment for Mucorales fungi to grow. This was identified as a risk for mucormycosis in India (where diabetes is increasingly prevalent and often uncontrolled) and worldwide well before the Covid-19 pandemic. Of all mucormycosis cases published in scientific journals globally between 2000-2017, diabetes was seen in 40% of cases.
A recent summary of Covid-19-associated mucormycosis showed 94% of patients had diabetes, and it was poorly controlled in 67% of cases.

A perfect storm

People with diabetes and obesity tend to develop more severe Covid-19 infections. This means they're more likely to receive corticosteroids, which are frequently used to treat Covid-19. But the corticosteroids – along with diabetes – increase the risk of mucormycosis.

Meanwhile, the virus that causes Covid-19 can damage airway tissue and blood vessels, which could also increase susceptibility to fungal infection.

Mucormycosis can be life threatening in patients already struggling against a disease such as Covid-19 (Credit: Money Sharma/AFP/Getty Images)

Mucormycosis can be life threatening in patients already struggling against a disease such as Covid-19 (Credit: Money Sharma/AFP/Getty Images)

So damage to tissue and blood vessels from Covid-19 infection, treatment with corticosteroids, high background rates of diabetes in the population most severely affected by the coronavirus, and, importantly, more widespread exposure to the fungus in the environment are all likely to be playing a part in the situation we're seeing with mucormycosis in India.

Treatment challenges
In many Western countries, we've seen increased cases of another fungal infection, Aspergillosis, in patients who had severe Covid-19 infections, needed intensive care management and received corticosteroids. This fungus is also found in the environment but belongs to a different family.

As Aspergillosis is the most common opportunistic fungus globally, and we have tests to rapidly diagnose this infection. But this is not the case with mucormycosis.

For the many patients affected with mucormyosis, the outcome is poor. About half of patients affected will die and many will sustain permanent damage to their health.

Mucormycosis can spread to the eyes, potentially causing blindness, or the brain, causing headaches or seizures​


Diagnosis and intervention as early as possible is important. This includes control of blood sugar, urgent removal of dead tissue, and antifungal drug treatment.

But unfortunately, many infections will be diagnosed late and access to treatment is limited. This was the case in India prior to Covid-19 and the current demands on the health system will only make things worse.

Controlling these fungal infections will require increased awareness, better tests to diagnose them early, along with a focus on controlling diabetes and using corticosteroids wisely. Patients will need access to timely surgery and antifungal treatment. But there also needs to be more research into prevention of these infections.

* Monica Slavin is an expert in lung infections at the Royal Melbourne Hospital and head of the department of infectious diseases at the Peter MacCallum Cancer Centre in Melbourne, Australia.
* Karin Thursky is a professor of microbiology at The Peter Doherty Institute for Infection and Immunity, in Melbourne, Australia and director of the National Centre for Antimicrobial Stewardship.
This article
originally appeared on The Conversation, and is republished under a Creative Commons licence.


Source: https://www.bbc.com/future/article/...he-black-fungus-hitting-indias-covid-patients
 

dancinstallion

Well-Known Member
This Olympics ain’t looking too good.



They'll be alright. Everyone/athletes traveling there are vaccinated right? Oh I see the Japanese have a low Vaccination rate.


Japan is about to inact the CommonPass.

CommonPass​

Share your current health status so you can safely return to normal life.
 
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awhyley

Well-Known Member
They'll be alright. Everyone/athletes traveling there are vaccinated right? Oh I see the Japanese have a low Vaccination rate.


Japan is about to inact the CommonPass.

CommonPass​

Share your current health status so you can safely return to normal life.

I thought that there was a link in here, but it's not clickable. Here is CommonPass for those who want to read up.
Link: https://commonpass.org/

This is might work for the Japanese who have a strict moral system, high moral code, but it's the travelers who will mess this up.
 

Black Ambrosia

Well-Known Member
They'll be alright. Everyone/athletes traveling there are vaccinated right? Oh I see the Japanese have a low Vaccination rate.


Japan is about to inact the CommonPass.

CommonPass​

Share your current health status so you can safely return to normal life.
I’m guessing the athletes will be fine. They’re vaccinated and usually at optimal health. For them the only issue might be encountering variants that the vaccines can’t handle.

Is everybody else traveling there vaccinated? Sounds like they’ll be taking covid back home if they don’t already have it.
 

Peppermynt

Defying Gravity
I’m guessing the athletes will be fine. They’re vaccinated and usually at optimal health. For them the only issue might be encountering variants that the vaccines can’t handle.

Is everybody else traveling there vaccinated? Sounds like they’ll be taking covid back home if they don’t already have it.
Sometimes those at optimal health may do poorly due to that cytokine storm situation - where a healthy system over performs and ends up doing more damage.
 

Black Ambrosia

Well-Known Member

Breakthrough coronavirus cases after vaccines are very rare and mostly due to variants, a new CDC report found

  • Around 10,000 out of 100 million vaccinated Americans got COVID-19 after their shots, the CDC found.
  • Most of these "breakthrough infections" were caused by variants of concern, such as B.1.1.7.
  • But these infections were still rare and mostly mild — a sign that vaccines are holding up well.
By the end of April, more than 100 million Americans had received their coronavirus vaccines.

Clinical trial data had indicated that the vaccines would reduce their risk of getting symptomatic COVID-19 by around 66% to 95%, depending on which shot they got. A new report from the Centers for Disease Control and Prevention suggests that was indeed the case.

Still, as of April 30, around 10,000 Americans had developed "breakthrough infections" — cases of COVID-19 diagnosed at least two weeks after they were fully vaccinated. That's a rate of about 0.01%.

Around 27% of those infections were asymptomatic, meaning the vaccines performed as expected by preventing people from feeling sick. Another 10% of people with breakthrough infections were hospitalized (some for reasons other than COVID-19, though most were sick from the disease). And 2% of people with breakthrough infections — 160 individuals in total — died.


Overall, the new data indicates that breakthrough infections are extremely rare and mostly mild.

"Even though FDA-authorized vaccines are highly effective, breakthrough cases are expected, especially before population immunity reaches sufficient levels to further decrease transmission," the CDC wrote in the report.

The report also found that most breakthrough infections in the US — around 64% of cases, based on a sample of 555— were caused by variants of concern. That includes B.1.351 (the variant first identified in South Africa), B.1.1.7 (discovered in the UK), P.1 (found in Brazil), and two variants discovered in California: B.1.427 and B.1.429.

B.1.1.7 represented the majority of breakthrough infections, 56%, while B.1.351 represented the least at just 4%. Meanwhile, B.1.429 made up 25% of breakthrough infections, and B.1.427 and P.1 each represented 8%.

That 64% figure is pretty close to the CDC's estimate of the total share of US coronavirus cases caused by variants of concern. From March 28 to April 10, these variants represented around 70% of all the coronavirus strains sequenced by the CDC. This alignment in numbers suggests that vaccines are protecting people from variants about as well as from the original strain.

Real-life studies also suggest that vaccines are holding up well against variants.

New research found that people in Qatar who were fully vaccinated with Pfizer's shot were 75% less likely to get a COVID-19 case caused by B.1.351 than unvaccinated people were. They were also around 90% less likely to develop COVID-19 caused by B.1.1.7.

Even so, some people will get sick after their shots. Anna Kern, a 33-year nurse practitioner in Ferndale, Michigan, was among them.

"It feels weird to be a statistical anomaly," Kern told Insider.

Kern received her second dose of Pfizer's vaccine in January. She tested positive for COVID-19 in April after being exposed to the virus through an unvaccinated coworker who wasn't diligent about mask-wearing.

"I feel like those people who are getting COVID after being vaccinated for the most part are the people who have been really, really cautious for a really long time," Kern said. "So when you do get it, you feel lots of guilt — like, what did I do wrong? How could I have been more cautious?"

Kern said her primary symptoms were chills and fatigue, but she thinks the vaccine helped prevent a more severe outcome.

"I am still very grateful that I was vaccinated," she said. "I know this could have been a lot worse."
 

Everything Zen

Well-Known Member
^^^ Which is another reason I will be wearing a N95 when I go to this outdoor concert in June and the devil may care. I don’t care that it’s in socially distanced pods of 4-6 people. I’m fully vaxxed and want to start some attempt at life again. The people I’m going with all say that they’re fully vaxxed but I don’t trust ANYONE.
The concert was canceled and I am actually relieved. :look: I’m trying to support the recovery efforts but people need to recognize that “normal” is gonna take TIME.
 
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lavaflow99

In search of the next vacation
The concert was canceled and I am actually relieved. :look: I’m trying to support the recovery efforts but people need to recognize that “normal” is gonna take TIME.
Yeah I'm not understanding the immediate rush to normal. Like many people want 2018 life to be here like now. There is still a pandemic going on last I checked.

And it's annoying when people keep questioning why those of us not racing to be outside, to travel, to go to restaurants, etc. We will get there when we are ready!! In the meantime, we just want to sit back and watch those who want to be outside to see what happens :look:
 

Crackers Phinn

Either A Blessing Or A Lesson.
I went to the Walmart grocery store and Smart & Final early morning on Sunday because Instacart pissed me off. When I was checking out I heard but didn't see somebody at the entrance of Walmart coughing like they were hacking up a lung. I assume they had a mask on. Some random man kept getting within my social distancing space round the store and when I was checking out he tried to holler. :barf:

I think I'm going to just use Amazon a few more times before I venture out again.
 

mensa

Well-Known Member
I went to the Walmart grocery store and Smart & Final early morning on Sunday because Instacart pissed me off. When I was checking out I heard but didn't see somebody at the entrance of Walmart coughing like they were hacking up a lung. I assume they had a mask on. Some random man kept getting within my social distancing space round the store and when I was checking out he tried to holler. :barf:

I think I'm going to just use Amazon a few more times before I venture out again.
I get SO MAD when they get too close. Some of the white women do it too!!!!!
 

oneastrocurlie

Well-Known Member
Our mask mandate was officially over June 1st. Plenty of folks at Kroger and Target without them. 50/50 maybe. Groups of people were mixed. Parents didn't have them on but kids did. A guy wouldn't but the lady would. I can't recall if the dealer required it when I got my oil change but one guy in the lobby didn't have one on and everyone else I saw did.

Festivals and what not are ramping back up too.

I will say I was proven wrong. Our million dollar vax a thon actually did increase vaccinations. The latest winner didn't get his until after the drawing was announced.
 

oneastrocurlie

Well-Known Member
I had an employee who had Covid last year ask me today if they were "technically" already vaccinated.

I actually laughed out loud.

Speaking of work, we didn't have any reported covid cases in May. Most people are still working from home but the warehouse folks and like 50 other people are in the office. They are trying to get the rest of us back in over the summer. So what's the most logical thing to do next: drop the mask requirement (for those who are vaccinated). Operating on the honor system of course.

Ohio is done with mask ok. Done.
 

yamilee21

Well-Known Member
I think people in general are testing way less at this point. In NYC, I’ve noticed an increase in people not bothering to test unless they have severe/obvious symptoms, for several days. I’m not convinced cases are quite as low as the official numbers would indicate.

Also, the research isn’t complete enough to publicize this yet, but it seems the B.1.617 (Indian) variant is more easily able to infect *fully vaccinated* people than the other variants of concern... which is why the “everything is reopened at full capacity, masks optional” attitude is especially worrisome.
 

lavaflow99

In search of the next vacation
I think people in general are testing way less at this point. In NYC, I’ve noticed an increase in people not bothering to test unless they have severe/obvious symptoms, for several days. I’m not convinced cases are quite as low as the official numbers would indicate.

Also, the research isn’t complete enough to publicize this yet, but it seems the B.1.617 (Indian) variant is more easily able to infect *fully vaccinated* people than the other variants of concern... which is why the “everything is reopened at full capacity, masks optional” attitude is especially worrisome.
I agree. Just like the infamous Drump said if you test less, you will have less positives. :rolleyes:

That’s why hospitalizations and deaths will be the better metric fo follow. If those remain super low then I will be more convinced that the vaccines are working.

But I’m still double masking, avoiding crowds and not traveling. That is just me :look:
 

Evolving78

Well-Known Member

Black Ambrosia

Well-Known Member
This is interesting. My PCP's policy on appointments is so strict I assumed he was vaccinated. I'm confident at a minimum he's tested regularly if he's not vaccinated but I plan to ask soon. They won't even open the door to let you in if you don't have proof of vaccination or a recent negative covid test performed by their office.
 
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