[COLUMN] COVID deaths up!

THE Centers for Disease Control and Prevention (CDC) announced that COVID-19 hospitalizations rose by 19 percent and COVID deaths by 21 percent last week. A recent report stated that the United States has 2,690 new cases, with a total of 108,174,265 cases and 1,174,146 deaths since the pandemic started.

Twenty-six states had a substantial increase in hospital admissions recently, with South Dakota taking the lead at 127 percent increase.

The culprit is “Pirola” (nickname for COVID-19 BA.2.86), a new highly mutated strain sparking grave concern around the world, first detected in Denmark on July 24, 2023, then Michigan. This variant has undergone a large number of mutations compared to previous omicron subvariants, the dominant strain in 2021. Pirola has been found in humans and wastewater samples in several countries, including the U.S.

“As of Aug. 31, the BA.2.86 variant has been linked to 28 cases in 10 countries,” per the global virus database GISAID. These include United States, Canada, Denmark, Sweden, Portugal, Israel, the United Kingdom, South Africa and France, according to CDC.

More virulent?

The fear, expressed even by the World Health Organization (WHO), is that BA.2.86 may be capable of bypassing immunity and infect people who have recovered from COVID infection or who are fully vaccinated. So far, since there are only a few cases, scientists are still observing its behavior.

“Early sequencing data show BA.2.86 has 34 more mutations in its spike protein than BA.2, which drove a COVID surge in 2022, and 36 more than XBB.1, which rapidly took over the U.S. in early 2023,” according to an August 24 paper in medical journal The BMJ. The number of mutations can affect how contagious a virus is, how it responds to treatment, and how severely it affects people. The symptoms are basically the same as of the previous strains.

The current variant, EG.5 or Eris subvariant of Omicron XBB, accounts for the largest proportion, 20.6 percent, of infections in the U.S. The next most common is FL.5.1, followed by XBB.1.16 as of August 19. Globally, EG.5 and XBB.1.16 are the most prevalent, 21 percent, according to WHO.

There are not enough cases of BA.2.86 to fully understand its behavior, transmissibility, response to vaccines, and how the immune systems may interact with this virus.

A ‘different’ disease

Remember, this is a “new disease” and should be treated like one. All the shots, including the two last boosters, may not be effective for this new strain, BA.2.86.

My suggested concept that any NEW strain of COVID-19 be treated like an entirely “different” disease entity is an over-simplification to make my readers understand easier why we need a NEW vaccine for this new strain, and why all the vaccines we received so far may not be effective for this new strain. A new strain may need a new vaccine. Time will tell.

All strains of COVID viruses are related but each strain behaves differently and responds differently, like the original Wuhan virus, the Delta, and the Omicrons. So, here comes BA.2.86, which is making everyone in the medical community nervous.

New booster

Since this new strain should be considered a “different disease,” we need a new vaccine, tailored to this virus, to control BA.2.86. It is anticipated that the Food and Drug Administration (FDA) will authorize the updated “reformulated” booster, which will be available by mid- or end of September, especially for high-risk individuals, like the immunocompromised and those 65 and over with health issues. Added to the new booster, “people can protect themselves by wearing a mask, practicing social distancing, avoiding sick people and maintaining good hygiene,” according to the CDC.

Masking controversy

It is most unfortunate that even laymen are joining the fray in the medical community “expressing their personal medical opinion” about the value of masks during an epidemic or pandemic. The common misconception is that masks are useless in preventing the spread of an infectious disease, like COVID-19. The KN-95 mask is NOT useless; otherwise surgeons and nurses in the operating room would have done away with masks – used in the OR to protect the patient. And during this pandemic, physicians and all first responders would not have been wearing masks if masks were of no value. Masks minimize the viral dose hitting the face. With a massive dose, the body’s immune system is overwhelmed, and the person gets infected.

Some of the reasons why the value of masks was not maximized the past 3 years are: some people refused to wear them (freedom of choice, civil rights, etc.), others used them improperly with noses uncovered, many not using the recommended KN-95 or any mask at all.

And some do not do social distancing! In an epidemic or pandemic, mitigating measures would be highly effective if there was 100 percent compliance by at least 95 percent of people.

Of course, masks are not 100 percent protective (because they are not air-tight, so viruses could still get in), and so with bullet-proof vests worn by security and military personnel when bullets are flying all over. Some of those wearing bullet-proof vests have died from gunshot wounds. Does this mean we should do away with bullet-proof vests, because they are “useless,” of no value, simply because they do not prevent deaths 100 percent? During a dust storm or when someone farts, or during a gas leak, doesn’t covering our mouth and nose reduce the dust particles, fart, and fumes we inhale? Wouldn’t you feel more secure if a stranger near you who sneezes or coughs was wearing a mask and you were also wearing one?  Plain common sense.

The idea of using a mask and doing social distancing is to minimize the viral dose that hits our face/nose. Masks certainly do that. If there are 100 people wearing masks and the other hundred are not, and you spray talcum powder into their faces, which group do you think will have more powder on their face? Masks are valuable, albeit not 100 percent. Like bullet-proof vests, as I stated.

If masks (worn by surgeons for the past 103 years) are useless, would you allow the surgeons (and nurses, techs) operating on you or your loved ones not to wear them, or would you go close to a COVID-infected person without a mask, not wearing a mask yourself? Mis- or dis-information kills worse than the virus. Indeed, a no-brainer.

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The main objective of this column is to educate and inspire people live a healthier lifestyle to prevent illnesses and disabilities and achieve a happier and more productive life. Any diagnosis, recommendation or treatment in our article are general medical information and not intended to be applicable or appropriate for anyone. This column is not a substitute for your physician, who knows your condition well and who is your best ally when it comes to your health.

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The opinions, beliefs and viewpoints expressed by the author do not necessarily reflect the opinions, beliefs and viewpoints of the Asian Journal, its management, editorial board and staff.

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Philip S. Chua, MD, FACS, FPCS, a Cardiac Surgeon Emeritus based in Northwest Indiana and Las Vegas, Nevada, is an international medical lecturer/author, Health Advocate, newspaper columnist, and Chairman of the Filipino United Network-USA, a 501(c)3 humanitarian foundation in the United States. He was a recipient of the Indiana Sagamore of the Wabash Award in 1995, presented by then Indiana Governor, later Senator, and then presidential candidate, Evan Bayh. Other Sagamore past awardees include President Harry Truman, President George HW Bush, Muhammad Ali, and Astronaut Gus Grissom (Wikipedia). Websites: FUN8888.com, Today.SPSAtoday.com, and philipSchua.com; Email: [email protected].

 

Dr. Philip S. Chua

Philip S. Chua, MD, FACS, FPCS, Cardiac Surgeon Emeritus in Northwest Indiana and chairman of cardiac surgery from 1997 to 2010 at Cebu Doctors University Hospital, where he holds the title of Physician Emeritus in Surgery, is based in Las Vegas, Nevada. He is a Fellow of the American College of Surgeons, the Philippine College of Surgeons, and the Denton A. Cooley Cardiovascular Surgical Society. He is the chairman of the Filipino United Network – USA, a 501(c)(3) humanitarian foundation in the United States.

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