The Delta and Other Variants Long COVID Vaccines - COVID-19 Medical Update for IH/OS SIG July 20, 2021

COVID-19 Medical Update for IH/OS SIG
           July 20, 2021

 • The Delta and Other Variants
 • Long COVID
 • Vaccines

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Delta and Other Variants
• CDC monitoring 4 notable variants in the United States:
   • B.1.1.7 (Alpha): This variant was first detected in the United States in December 2020. It was
     initially detected in the United Kingdom.
   • B.1.351 (Beta): This variant was first detected in the United States at the end of January 2021.
     It was initially detected in South Africa in December 2020.
   • B.1.617.2 (Delta): This variant was first detected in the United States in March 2021. It was
     initially identified in India in December 2020.
   • P.1 (Gamma): This variant was first detected in the United States in January 2021. P.1 was
     initially identified in travelers from Brazil, who were tested during routine screening at an
     airport in Japan, in early January.
• These variants seem to spread more easily and quickly than other variants, which
  may lead to more cases of COVID-19. An increase in the number of cases will put
  more strain on healthcare resources, lead to more hospitalizations, and potentially
  more deaths.
• So far, studies suggest that the current authorized vaccines work on the circulating
  variants. Scientists will continue to study these and other variants.
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Delta and Other Variants

Beta

                Delta

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Delta and Other Variants
• U.S.

• Global

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Long COVID
• Post-COVID conditions are a wide range of new, returning, or ongoing health
  problems people can experience four or more weeks after first being infected – as
  many as 30%.
• Even people who did not have COVID-19 symptoms in the days or weeks after they
  were infected can develop post-COVID conditions.
• Objective laboratory or imaging findings should not be used as the only measure or
  assessment of a patient’s well-being; lack of laboratory or imaging abnormalities
  does not invalidate the existence, severity, or importance of a patient’s symptoms or
  conditions.
• CDC is investigating several hypotheses, including damage to blood vessels,
  autoimmune effects, and ongoing infection.

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Long COVID Symptoms/Signs
• Difficulty breathing or shortness of     •Headache
  breath                                   •Fast-beating or pounding heart
• Tiredness or fatigue                     •Joint or muscle pain
                                           •Pins-and-needles feeling
• Symptoms that get worse after physical
                                           •Diarrhea
  or mental activities
                                           •Sleep problems
• Difficulty thinking or concentrating     •Fever
  (sometimes referred to as “brain fog”)
                                           •Dizziness on standing (lightheadedness)
• Cough                                    •Rash
• Chest or stomach pain                    •Mood changes
                                           •Change in smell or taste
                                           •Changes in period cycles

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Long COVID Prevention/Treatment
• Prevention:                                            •Treatment:
• The best way to prevent post-COVID conditions is by    • Many post-COVID conditions can be managed by primary
  getting vaccinated.                                      care providers, with the incorporation of patient-centered
• COVID-19 vaccination is recommended for all              approaches to optimize the quality of life and function in
  people ages 12 years and older, including if you had     affected patients.
  COVID-19 or a post-COVID condition.                    • Aspirin, antihistamines, and other anti-inflammatories
                                                           are being tested specifically for management of Long
                                                           COVID symptoms.

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Vaccines

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Vaccine Considerations
• 3rd doses, boosters, etc.
   • July 8th joint statement by CDC and FDA indicating that the initial vaccine series’
     remain effective against variants, including the Delta variant.
   • “Virtually all COVID-19 hospitalizations and deaths are among those who are
     unvaccinated.”
• Mixing the mRNA vaccines (1st dose of one, 2nd dose of the other) has been
  considered acceptable by the CDC in “rare circumstances” since January,
  but there is currently no public initiative to create a hybrid vaccine from
  either different manufacturers or constituted of different COVID-19 strains.
• “Breakthrough cases” (infections among fully vaccinated individuals)
  remain relatively rare and fully-expected, particularly given the extremely
  low standard of vaccine efficacy (50%) established by the FDA for this
  pandemic 5,492 cases out of more than 159 fully vaccinated individuals.

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