May 25 coronavirus news

People taking methotrexate—commonly used by patients with rheumatoid arthritis, psoriasis and other autoimmune diseases—may not have a full immune response to mRNA vaccines, according to new research published Tuesday in the journal Annals of Rheumatic Diseases. 

The researchers, from New York University Langone Health and FAU Erlangen-Nuremberg and Universitätsklinikum Erlangen in Germany, looked at patients with immune-mediated inflammatory diseases (IMIDs), some taking methotrexate and others who weren’t. They also looked at healthy control participants. All were vaccinated with BNT 162b2, Pfizer/BioNTech’s Covid-19 mRNA vaccine, and assessed at baseline and after receiving their second shot.

In both the New York and German cohort, lower numbers of people taking methotrexate achieved adequate immune responses than those who were not taking it and those who were healthy. 

The researchers found that 28 of 45 (62.2%) receiving methotrexate achieved adequate immunogenicity compared to 204 of 208 (98.1%) of healthy controls and 34 of 37 (91.9%) patients with IMID not taking methotrexate. 

It is noted that in both New York and Germany, patients who were taking methotrexate were older on average than IMID patients who were not taking it and control patients. 

The research also notes that certain essential T-cells needed for fighting off infection were induced in healthy adults and IMID patients not taking methotrexate but were not induced in those who were on the medication. 

The authors say that the research does have some limitations. These include a small sample size, the fact that they only tested the Pfizer/BioNTech mRNA vaccine and that they did not include participants who had previous asymptomatic Covid-19 infections. 

The authors say that the results suggest further study is needed into how to optimally protect IMID patients against Covid-19. 

A new study out of the United Kingdom takes a closer look at three cases of a rare stroke event following administration of AstraZeneca’s Covid-19 vaccine. 

The research, published Tuesday in the Journal of Neurology Neurosurgery & Psychiatry, looked at three patients who experienced ischemic stroke, where blood clots occur in arteries and block blood flow to the brain.  

These three cases are the first cases of ischemic stroke described in connection to the blood clotting previously reported alongside the AstraZeneca vaccine.  

“During the current period of Covid vaccination a high index of suspicion is required to identify thrombotic episodes following vaccination,” said Hugh Markus, a professor at the University of Cambridge who contributed to the research. 

“However, it is important to remember that these side-effects are rare, and much less common than both cerebral venous thrombosis and ischaemic stroke associated with Covid-19 infection itself," he added.

One of the patient experienced symptoms six days after vaccine administration, while another had symptoms 21 days after receiving the vaccine. One patient died. 

Patients ranged in age from 35 to 43, and researchers said the presence of stroke in these patients highlights the need to look for vaccine-induced immune thrombotic thrombocytopenia, the clotting condition that has been associated with AstraZeneca’s vaccine, in patients presenting with stroke symptoms. 

Several Canadian provinces are cautiously announcing reopening plans as the country slowly recovers from a third wave of Covid-19. 

Dr. Theresa Tam, Canada’s chief public health officer, said Tuesday that the infection rate has fallen about 40% since the peak of activity in mid-April. 

However, she said that hospitalizations and critical care admissions have only dropped by 15% and 10% respectively. 

Canada’s prime minister said he was hopeful the accelerating pace of vaccination would enable the country to return to a more normal way of life by fall. 

“We will have more than enough doses in Canada by the end of June to give a first dose to every Canadian who wants one, and second doses will continue to ramp up through June and into the summer,” said Justin Trudeau during a news conference in Ottawa Tuesday. 

Health Canada said more than half of all Canadians are now partially vaccinated but less than 5% are fully vaccinated.  

With new, daily cases of Covid-19 dropping, both BC and Quebec announced reopening plans Tuesday that were still cautious compared to the US and the UK.

In BC, residents can now meet a few friends at a restaurant and dine indoors again and significantly, people can start inviting visitors into their homes again. 

The provincial government laid out a phased-in reopening that will allow for more organized sports, travel, and larger indoor gatherings later in spring and early summer. 

Quebec announced it would finally lift a months-long curfew throughout the province this Friday, restaurant patios can also reopen everywhere and small social gatherings outside can resume. 

But it was a different picture in Manitoba where the province is in the middle of a devastating third wave. To cope with rising intensive care admissions, public health officials said they will continue to transfer patients out of province and are even looking into the possibility of sending patients to North Dakota for treatment but only if absolutely necessary. 

Kentucky Gov. Andy Beshear announced that in-person visitation at all of Kentucky’s Department of Corrections (DOC) state prisons and Department of Juvenile Justice (DJJ) facilities will resume the week of June 20. 

According to the governor, the new in-person visitation guidelines only apply to DOC’s 14 state prisons and not to county jails. Visitors will have to schedule their visitation in advance, Beshear said.

According to Beshear, as of today, 76% of adult inmates housed in state custody have been vaccinated.

“And so, to those in custody – good for you! Good for you! I know you’ve seen the harms of this virus and thank you for responding in such a responsible way,” the governor said. 

Beshear said DOC will continue to offer the Covid-19 vaccine to all individuals at the time of intake and for any inmates who have declines and now want to change their mind. 

It's been a tough year to be a child and arguably even tougher to be a parent raising one during a global pandemic.

Although US children's lives may now be starting to look more normal as an increasing number of people get vaccinated and schools reopen, there's a growing concern for kids’ mental health. We want to hear what your experience raising a child during this unprecedented time has been – the highs, the lows and any concerns you may have for their cognitive development.

Reply using the text box below and your responses may be used in an upcoming episode of Chasing Life hosted by CNN's Chief Medical Correspondent Sanjay Gupta.

Although a vaccine for younger children likely won’t be available by the time school starts in the fall, Dr. Anthony Fauci told the House Appropriations committee on Tuesday that it should be safe for children of all ages to go back to in-person class then. 

Given the percentage of teachers vaccinated already now and into the fall, “there should be no reason not to get children of any age back to in-person school by the time we get to the fall term,” said Fauci, the director of the National Institute of Allergy and Infectious Diseases. Several leaders of the NIH appeared before the committee to discuss the agency’s proposed budget.

There’s already a significant decline in Covid-19 infections and many more people will be vaccinated by the fall, Fauci said. A vaccine for younger children likely won’t be available until late fall, early winter, Fauci said.  

“I don’t have children that young, but I would not be concerned when we get to the fall,” Fauci said.

The US Food and Drug Administration on Tuesday updated its emergency use authorization guidance for Covid-19 vaccines to note that the agency intends to prioritize reviewing EUA requests for the remainder of the current public health emergency – even if that means declining to review other requests.

"Additionally, given the need to address urgent public health priorities, FDA may need to further prioritize among the EUA requests it receives for COVID-19 vaccine candidates," the FDA wrote in its updated guidance. "For the remainder of the current pandemic, FDA may decline to review and process further EUA requests other than those for vaccines whose developers have engaged in an ongoing manner with the Agency during the development of their manufacturing process and clinical trials program as described in this guidance, Emergency Use Authorization for Vaccines to Prevent COVID-19."

Currently, three coronavirus vaccines are authorized for emergency use in the United States – the two-dose Pfizer/BioNTech vaccine for ages 12 and older, the two-dose Moderna vaccine for ages 18 and older and the single-dose Johnson & Johnson vaccine for ages 18 and older.

With nearly 40,000 new cases, the US saw the lowest number of weekly Covid-19 cases among children since early-October, according to the American Academy of Pediatrics.

Children accounted for nearly 20% of the new cases reported late last week. More than 3.9 million children have tested positive since the start of the pandemic as of May 20. 

Depending on the state, children made up between 6% and 19.5% of those who were tested for Covid-19, and 5.2%-34.4% of children tested were positive for the coronavirus.

Children are still considered much less likely than adults to develop severe symptoms of Covid-19 or to die from the disease. Children represented 1.3% to 3.2% of total reported hospitalizations for Covid-19, based on the information provided by 24 states and New York City. Only 0.1%-1.9% of all cases of Covid-19 in children required hospitalization. 

Nine states reported zero child deaths among the 43 states that provided data on Covid-19 mortality. 

 

US public health experts are calling for "urgent action" to assess the Covid-19 risks associated with the upcoming Olympic Games in Tokyo and the additional measures that could be put in place to mitigate those risks.

The experts — including Michael Osterholm from the University of Minnesota and other researchers — wrote in the New England Journal of Medicine on Tuesday that they recommend the World Health Organization "immediately convene an emergency committee" to advise on a risk-management approach for the Tokyo Olympic Games. 

"With less than 2 months until the Olympic torch is lit, canceling the Games may be the safest option. But the Olympic Games are one of the few events that could connect us at a time of global disconnect," the researchers wrote. "For us to connect safely, we believe urgent action is needed for these Olympic Games to proceed."

Due to the pandemic, the International Olympic Committee postponed the Tokyo Olympics last year and rescheduled the Games for this summer — starting on July 23.

"We believe the IOC's determination to proceed with the Olympic Games is not informed by the best scientific evidence. The playbooks maintain that athletes participate at their own risk, while failing both to distinguish the various levels of risk faced by athletes and to recognize the limitations of measures such as temperature screenings and face coverings," the researchers wrote. 

The researchers noted that the IOC's playbooks should classify various sporting events as low, moderate or high risk depending on the activity. For instance, an outdoor sport where competitors are naturally spaced out, such as archery or equestrian, could be considered low risk while indoor contact sports, such as boxing or wrestling, could be considered high risk.

The researchers called for more plans to conduct frequent Covid-19 testing and emphasized that temperature checks could miss pre-symptomatic or asymptomatic cases.

The researchers say that while vaccines are available in some countries, in Japan, where the Olympic Games will be held, less than 5% of the population is vaccinated — and not all athletes participating in the Olympics may be vaccinated. They also noted in the paper that coronavirus variants, which may be more transmissible than the original strain, are circulating widely

"Although several countries have vaccinated their athletes, adolescents between 15 and 17 years of age cannot be vaccinated in most countries, and children younger than 15 can be vaccinated in even fewer countries," the researchers wrote. "In the absence of regular testing, participants may become infected during the Olympics and pose a risk when they return home to more than 200 countries."