Chest CT findings in patients with Omicron versus Delta variants in SARS-CoV-2 infection

The SARS-CoV-2 omicron variant shows fewer and less severe changes on chest CT than the delta variant, according to a paper published in Radiology.  However, it does have at least one distinct manifestation that of bronchial thickening.  More of the patients who contracted the omicron variant had normal results on computed tomography.  The SARS-CoV-2 omicron variant spreads rapidly but has lower rates of hospital admission and disease severity.

Covid-19 Pandemic; four countries - four tales

United States

A country of 330 million reports nearly 55 million cases during the last two years and 825,000 deaths or 2485 deaths per million due to Covid-19.  Sixty two percent of its population has been completely vaccinated and 21% has received a 3rd dose.  Although the U.S. is the leader in the development of vaccines their acceptance by the population has been mixed mostly due to political and cultural reasons.  In the past week the average daily cases per 100,000 people was 116 with the 14-day trend increasing.

Greece

A country of 10 million reports 1.1 million cases and 21,800 deaths or 2080 deaths per million.  The country had very few cases and deaths in the first wave of the pandemic.  This success story was due to a very strict lockdown.  Its vaccination program with 65% of its population completely vaccinated and 30% having had their 3rd dose is above average in Europe.  In the past week the average daily cases per 100,000 people was 195 with the 14-day trend increasing.

Taiwan

A country of 23 million instituted very good epidemiological measures since the beginning of the pandemic and reports only 17,000 cases that caused 848 deaths or 37 deaths per million.  In Taiwan 68% of its people are completely vaccinated and 1% had the 3rd dose.  The average daily cases per 100,000 people of the past week was 0.1 case with the 14-day trend increasing. 

New Zealand

A country of 5 million had 13,000 cases and 44 deaths or 9 deaths per million.  New Zealand enacted a very strong lockdown early in the pandemic and recently enacted a successful vaccination campaign with 78% of its people being fully vaccinated and with 7% having the 3rd dose.  The average daily cases per 100,000 people in past week was 1.2 with the 14-day trend increasing.

Discussion

Since Covid-19 was first diagnosed in China approximately 2 years ago it has infected 290 million people worldwide and has caused 5.5 million deaths according to JHU.  A total of nearly 9 billion doses of vaccines have been administered worldwide.  Although we now know that vaccines are not totally effective in the prevention of the disease, vaccinated individuals are not as sick as the non-vaccinated ones and definitely save lives especially among elderly individuals.  According to a recent study by WHO/ECDC nearly half a million lives have been saved in Europe alone in less than a year.  

The country with the worst death toll is Peru with 6,000 deaths per million and the country that has fared the best is China with 3 deaths per million.  The average daily cases in China per 100,000 people in past week was zero.

On Jan 1, 2021 the daily count of cases worldwide was 580,000 while on the first day of 2022 the number has surpassed the 1 million due to the latest mutation of the virus "omicron" which very transmissible.

In the last two years we learned that lockdowns work but they adversely economies therefore cannot continue for a long time.  Social isolation is also effective but it affects adversely people's psychology.  In spite of the worldwide upheaval the pandemic caused there were success stories such as the speedy development of vaccines.  The development of mRNA vaccines especially is noteworthy as they will likely be used not only in the prevention of viral diseases but the treatment of other diseases such as cancer. Also several antiviral medications have been developed and approved for use in the treatment of patients with Covid.

Conclusion   

The above mentioned advancements will be used in the prevention and control of diseases and will benefit the health of humans for many decades into the future. In closing, I will make a prediction from lessons learned from prior pandemics which usually last 3 years; thus 2022 will be the last year that Covid-19 will be classified as a pandemic becoming from an endemic disease instead one of several viral disease that afflict humans.

Whole Lung Irradiation as a Novel Treatment for Covid-19 Pneumonia

A study published in ScienceDirect reports on a novel treatment of 25 patients with proven Covid-19 pneumonia.  All patients diagnosis was proven with an RT-PCR test, had SpO2 less than 94% on room air and a respiratory frequency of less than 24 per minute.  Patients were treated in accordance with standard Covid-19 guidelines and received a single fraction of low dose radiation therapy (LDRT) of 0.5 Gy to both lungs within 10 days of the onset of symptoms and/or 5 days of hospital admission.

LDRT was well tolerated by all patients.  A significant improvement in oxygenation was noted.  Demand for supplemental oxygen showed also a significant reduction in the post-RT period with 88% recovering completely with 10 days and being discharged from the hospital in 6 days.  Three patients deteriorated and died.

The authors concluded that based on their initial experience, LDRT is a promising treatment in a select group of patients with moderate to severe Covid-19 pneumonia and should be further investigated by a larger series.

Major Increase in Telehealth during Covid-19 Pandemic

 A cohort study published in JAMA of more than 36 million individuals in the US found a dramatic increase in telehealth use during the first four months of the Covid-19 pandemic.  In this study, in-person visits decreased by 37% while telehealth visits accounted for 23% of all interactions, compared with 0.3% in 2019.  Behavioral health encounters were far more likely than medical contacts to take place virtually (46% vs 22%).  Persons living in areas with limited resources were less likely to use telehealth (27% vs 20%).  The costs also decreased by 15%.  The findings of this study are relevant to physicians, administrators, and payers regarding telehealth's potential role during the pandemic and afterward.