Summer Covid-19 Update
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- Опубліковано 7 вер 2023
- In our inaugural Grand Rounds of the academic year, we will explore the current landscape of the Covid pandemic in the setting of this summer’s uptick in cases. We’ll cover the new booster, today’s variants, and how individuals and institutions should respond to current trends. The session will begin with an epidemiology update by the returning George Rutherford, followed by a panel discussion in which George will be joined by Peter Chin-Hong and Monica Gandhi.
Speakers
Peter Chin-Hong, MD, is professor of medicine, Division of Infectious Diseases at UCSF Health; associate dean for regional campuses, UCSF School of Medicine.
Monica Gandhi, MD, MPH, is professor of medicine and associate chief of the Division of HIV, Infectious Diseases and Global Medicine at ZSFG; director of the UCSF-Gladstone Center for AIDS Research and medical director of the HIV Clinic (“Ward 86”) at San Francisco General Hospital. Her new book, Endemic, reviews the public health response to the pandemic.
George Rutherford, MD, is professor of epidemiology, preventive medicine, pediatrics and history; acting executive director, Institute for Global Health Sciences.
Note: Closed captions will be available within 48-72 hours after posting.
Program
Bob Wachter: Introduction
00:03:47-00:16:15 - George Rutherford, professor of epidemiology, preventive medicine, pediatrics and history; acting executive director, Institute for Global Health Sciences
00:16:17-00:52:36 - Panel discussion with George Rutherford, Peter Chin-Hong, professor of medicine, Division of Infectious Diseases at UCSF Health; associate dean for regional campuses, UCSF School of Medicine, and Monica Gandhi, professor of medicine and associate chief of the Division of HIV, Infectious Diseases and Global Medicine at ZSFG
00:52:38-1:01:52 - Q&A
See previous Medical Grand Rounds:
• June 29: The Final Covid-19 Grand Rounds: What Have We Learned? • The Final Covid-19 Gra...
• June 22: A Fireside Chat with Lindsey Criswell, Director of NIAMS • A Fireside Chat with L...
• June 15: Climbing to New Heights in Lung Transplantation: Surgical & Medical Innovations to Improve Outcomes
• Climbing to New Height...
• June 8: Multimodal Treatment of Obesity: Lifestyle Interventions, Medications, & Bariatric Surgery
• Multimodal Treatment o...
See all UCSF Covid-19 grand rounds, which have been viewed over 3M times, at • UCSF Department of Med... .
Hmmm...I was looking for my comment, but it seems to have disappeared. My question is this: About 45 minutes into this discussion, Dr. Rutherford states clearly that there are NO cardiac side effects from the Novavax vaccine. That is not what I have heard elsewhere. I would love to know his sources for that information, because for many of us that would be our vaccine of choice if that were indeed the case. Please inform. Thank you!
Thank you for keeping this vital and relevant information accessible to all on UA-cam!!!!
Appreciate this video and the information given, however I find it leaves me with some concerns based on some deep discrepancies between outcomes of infection that go beyond LC- no mention of this and unknown risks of repeat infections. Also, the idea of again changing the CDC recommendations to fit peoples behaviour seems very backward to me- I understand the worry about trust, but for me, this type of logic impacts my confidence a great deal. Joe Biden is much older and the pressure to not mask is intense, so that should not guide our policies. We can learn from this experience and change, yes? Finally, to say the data says masks don’t work excludes other studies and medical professionals that say that they do. On the one hand we had less RSV and flu while masking and distancing but it doesn’t apply to covid? It does require better masks, agreed on that, but reducing risk including better ventilation should be standard practice for this virus and the future.
Its still so disruptive when outbreaks occur- people loose staff and can’t run their businesses effectively.
Regardless, it’s a major accessibility issue in hospitals and doctors offices now. Really interesting the social and political aspects of this pandemic and wherever we are in it.
You may want to look at the Paxlovid data and immunity data of those who have been exposed. Repeat infections are not lasting as long due to immune system recognizing Omicron. Long Covid data in JAMA.
There is some data of reduction of Long Covid by 30%. Epic SR: showed the results-what are the groups that it benefits the most. Please look to JAMA as they papers in Press that have not been published yet some of the open sourced data is showing 93-94% prevention of long Covid-19. Observation study and retroactive studies. They are not RCT.-Metaformin Trevlovir. (no drug interactions).
Are the mRNA Gene Transfection Therapies safe and effective against SARS-CoV-2 infection?
Thanks from Spain. Here everybody says COVID is over, they don't publish infection or death data and nobody wears a mask. It's frustrating. I have to go to google search trends to know how things are.
Are the mRNA Gene Transfection Therapies safe and effective against SARS-CoV-2 infection?
There is research in the UK that demonstrates the risk of long Covid increases with each infection. Unfortunately, I don't remember the reference.
I've worn ffp3 masks throughout the last year of cancer treatment in the UK and also have increased risk of long Covid due to pre-existing ME. I'm convinced that good fitting ffp3 masks work, based of course on my sample of one... Since I have continued clinical vulnerability, I would prefer health care workers to wear high quality masks
Long covid?
Thank you for uploading those grand rounds videos on UA-cam. Originally I was afraid that the UCSF Department of Medicine would not upload grand rounds videos on UA-cam after the covid pandemic, since life is going back to normal.
thank you for uploading the videos that enables people like me with cerebral palsy from Taiwan can learn from the doctors in the ucsf
Monica makes me scratch my head. This is what I think I heard, but I have to be wrong, right??
Her reason not to recommend vaccines for people under 65 is to remain consistent with the WHO’s advice. This is so she doesn’t confuse people and lose their trust because she feels if there are different messages that is bad? So, she is at one of the top institutions in one of the wealthiest and most advanced countries in the world that has some of the most cutting edge healthcare, and yet she only wants to advise people to do what the WHO recommends for the entire world, where many don’t even have access to care. Why be at a prestigious institution if you feel you can only advise what WHO says. What value does that add?
This was rich… She doesn’t recommend people younger than 65 get vaccinated because not many young people got vaccinated, so therefore she doesn’t want to lose their trust by recommending they get one. (Hmmm, I wonder if when a person at one of the top institutions doesn’t recommend a vax if that encourage more not to get one or to get one).. round and round we go!
You said you would recommend RSV over covid vaccines because you have treatments for covid that work. What is this treatment for long covid you have? If you have one, I’d love to stop being careful.
Monica, you said your reason not to mask is because a study says bad masks don’t work? Hmmm, if only someone at UCSF knew how to find a good mask.
I’m even a patient at UCSF but now wonder why I pay top dollar to do so. I wonder if my doctors only recommend what the masses do vs the most elite?
What I got from her comments is she is selling a book…I stopped listening after the third time she mentioned why she wrote it
I would recommend taking prophylactic measures: Quercetin, zinc, Vitamins C and D, melatonin, NAC, and Xlear nasal spray. I have some Ivermectin on hand for treatment if I think I got COVID-19 since it worked for me once before.
@@benedem4175 We have all these supplements and others on hand as well.
@@benedem4175not sure about the others, but zinc, D, and ivermectin don't work for COVID
FWIW, there isn't a lot of data showing the old bivalent booster helps young healthy people who already got COVID. And there is 0 data on the new booster
This is such a service to all of us docs across the country. Thank you.
Wonderful discussion; thank you so much. I sense a somewhat more light-hearted tone to the discussion than in past years. Hopefully it can stay that way.
Why would you not test prior to visiting a vulnerable person? Transmission can happen when asymptomatic or presymptomatic...
One reason I can think of is lack of easy access to tests, nowadays.
@@patriciahoke4722 but why would the panel treat this so lightly? We can still buy them in the UK. Though I accept some families may well find this unaffordable
@@francescachristy8761 You can still buy them here in the US, but now they are very expensive - like at least $20 (about 30 pounds?). Whereas before the end of the public declaration of emergency, many of us (especially in Democratically-controlled states or municipalities) could get them at 0 cost. I am much less likely to shell out $20 or $25 for two tests these days.
@@patriciahoke4722 wow, that's expensive!!
First presenter provided inaccurate information on new booster. It IS NOT bivalent. Is monovalent does not have Wuhan strain as previous booster did.
That is my understanding as well.
Really good/important catch. Thank you.
@@gferraro8353 yes they did towards the end, but did so quickly.
Really concerning that it was at the end of the 1hr session and that it was a student who happened to ask about that and not the panel.
I greatly appreciate this panel discussion as it is very important to hear experts weigh in, not just the media’s interpretation. Hearing it from the “horse’s mouth.” No dis intended. So we can develop common sense about Covid.
This is the first I’ve heard someone say the new 2023 fall booster will be bivalent with ancestral as well as XBB.1.5. Every other report I’ve seen has said this new booster will be monovalent with JUST the XBB.1.5 strain.
I was wondering the same thing - i was under the impression that this new fall booster will be monovalent targeting the XBB.1.5 strain 🤔
It's monovalent...clarified last 5 min. Of meeting.
@@Everybodylies13 Thank you.
I still mask for so many reasons. Dust, mold, and influenza while fires are burning and producing
Influenza?
Thank you for publishing this. All of these professors are such good communicators, but Monica's diction and method of explaining things makes her an amazingly effective speaker. Very informative, and I wish more of the public could hear this information.
I think it would be useful if Bob told us more about his covid experience.
Was he waccinated and boosted. was he hospitalized. etc
Not everyone thinks it would be useful, ok? It prevented his death or hospitalization. Stop asking stupid questions!
CNN told you everything you need to know. He decided to take a shower while feverish and dehydrated. OOPS. He fractured a cervical vertebra and cracked his skull, plus two lacerations needing stitches. He was sent home with a hard collar, looking (and probably feeling) like someone beat him up. He made some poor choices, including not using a bedside urinal and maintaining hydration while actively ill. A lot of older men have BPH and don't want to get up frequently to pee when they feel so ill. Hence, the bedside urinal that he probably did not have...
@@Cathy-xi8cb thank you for the giggle...
Monica!!! ❤
So George had an "over-reactive" resp. system........, was that after Cov (like Joe B.)....... or is it the cough I am seeing everywhere, and people say: it's an allergic cough.....and then get a PCR and it's positive......... .
This group seems like the perfect combination to discuss up-to-date Covid information. There’s a mix of opinions, and that is very beneficial to listen to from the outside. I really appreciate the time put into this and the accessibility on UA-cam. It’s very much appreciated.
Excellent info thank you!
Thank you for your work!
Just curios as to what precautions you all took prior to this in-person meeting during a surge? Are there HEPA air purifiers running, Long UV, did everyone take a PCR test? Obviously no one is wearing a mask, so I was wondering what other precautions (if any) were taken as you are all seen as leaders and should act accordingly (AKA set a good example).
My guess is that no precautions were taken whatsoever. Both Dr. Ghandhi and Dr. Rutherford are clearly done with precautions. I would hope that Dr. Wachter would also stop with his masks since they clearly didn't help him and his infection clearly didn't kill him. That leaves Dr. Chin-Hong, who seems to be no fool and will leave his precautions behind once he finally, inevitably, gets a covid infection.
It's been years... Natural immunity is a thing and various studies found that asymptomatic spread is almost zero...
Also why are the new boosters still based on the old variant? Are we being scammed... i thought they could update it quickly but they drag their feet.
I'm getting the new vaccine as soon as my HMO releases it. I'm 5x vaccinated. Ofcourse, I'm 83 and have high blood pressure, diabetes and asthma, so I will do everything that I can do not to get this again. I got the Delta strain early when N95 masks were not available. Since I live alone, I caught it at the grocery store as that was the only place I was going at the time. I should have been hospitalized because I was very sick for 3 weeks and my blood oxygen dipped into the 80s. I doubled both asthma inhalers and stayed home because at that time so many hospitalized people died. I'm determined not to get that sick again.
RSV vaccinations aren't available at my HMO at this time either. I inquired.
I am masking with N95 masks any time I go grocery shopping but not when I go for a walk. I usually stay home alot, anyhow. I have increased handwashing, after being outside to get mail or after being in the elevator with other tenants in a 100 unit building.
My daughter and her partner got Covid two weeks ago. Her partner exposed me 2 days prior to noticing symptoms and even though I was in my own home unmasked with him and hugged him I avoided the infection. But my daughter who is in her early 50s as nd asthmatic got a moderate infection and even with Paxlovid it took two weeks to be ready to work from home again. She will get a booster in December.
Wow, 5x vaxed! That is impressive.
Holy crap doc that was one hell of a dent in that metal trash can! I just read about your story in the news. Wow. You know they say raising that core temperature will do good things for interferon, not that I know, but, maybe you should sit down next time you test the limits of hot water and such ;)
Hell, I thought the dent my head put in the wall at the top of my stairs was something, but you win the prize. I learned don't dance around on the stairs as you are running up them, at least drywall is much more plastic. I left the dent there as a marker of my growth, like they do with pencil marks as kids get their growth measured over the years.
You should get that trash can bronzed!
Good to have the band back together and in person. Wondering thoughts on baricitinib for covid and long covid treatment in US. I hear it has been used for treatment of severe cases globally.
Great way to spread c19 amongst Dems and being the numbers up!
Why is high risk now considered 65+ when during the entire pandemic, it was 60+?
Way to make it political. Just mentioning the observed increase in covid mortality in Republican districts as opposed to democrat districts without offing any context at all is a cheap, lazy, misleading fact. There are obvious and well-known confounders that explain that difference. Please stop continuing the nonsense. I am trying to develop my understanding, and your making it far more difficult for me to trust your opinions when you make such mistakes. How hard is it for you to stick to the data and offer a sober analysis?
George was making a point that it is ridiculous to carry out such studies and that they are published in serious journals, he was not endorsing them.
@@christopherrobinson7541 wowwww, don’t I sound like an idiot…. Well thank you for pointing that out. I’m going to give him a second listen. I guess I’m just not paying attention and jumping to conclusions like a typical moron. Apologies to all, (mostly myself lol).
@@careyjamesmajeski3203 If you are following this channel and are prepared to omit your mistakes, you are far from being a moron; many of the most significant advances in science occur as the result of "mistakes" and the following investigation.
One of my favorite phases is "that doesn't look right".
Perhaps you forgot what that monster did to this country during Covid19? It was the prior administration (trump) who made Covid19 political, he is quoted in a convo with his criminal son in law saying it’s ok if Blue states ppl perish bc they were not supporting him politically anyway.
The misinformation he actively spread, the open disdain for masks , his repression of science, it was easier for him to blame China or the Democrats (lol) for the virus than take productive action. He used the virus to promote his political aspirations using his daily Covid19 briefings to only showcase his personal campaign.
He ordered the vaccine to be made but it was too late to save the half million who needlessly perished while he ignored them the first year, and he eventually got the jab himself and lied about it, caught Covid19 and was hospitalized and lied about it, literally killed others by exposing them to his illness without letting them know.
Thank you!
Thank you for every single person who kept us safe and continues to keep us safe, especially the scientists!
Thank you so much for continuing to watch out for Covid-19. I think it will be a while before we can put this behind us.
I'm predicting before that in 2025?
@@Jtyoutube2467 Crossing my fingers.
Yes I love keeping the fear alive
I wonder how the Dem/Rep discrepancy is correlated or not with income in those counties?
Republicans are older. Most young kids are Democrats, and they get older and become Republicans.
Yay George Rutherford!
The shot killed my Mother! DO NOT GET ANY SHOTS!
If after SARS COV2 infection at some patients,, low temperature agglutinine,, occur (?) did oxigen mix must be warmed?
I started with Coviid 2002 and Mers 2014 and Sars 2 on Jan.2019 and nobody wants to know how I survived with all the doctors that believed they knew.
I have never had covid as far as I know. Should I be terrified? Moderna 2 vaccines and one booster.
A post-pandemic playbook that describes what SHE THINKS we got right and what SHE THINKS we didn't get right. That needs to be underlined, bolded, and otherwise emphasized!
"All these sub-variants are less virulent." This is likely a myth. In Hong Kong, they got hit with Omicron, a sub-variant. So very many people died. Just make sure not to tell them, Omicron is less virulent.
In Hong Kong, the elderly were undervaccinated
Any variant can wreak havoc in a population like that, even if it's milder
@@bullymaguire632 That seems like word play to me.
Yes, agreed. This is also the view from TWIV assessment of research. The point is, the virus is just as destructive in a naive population. It's not that the virus is less destructive, but that there are fewer naive people to infect. There is concern in the UK that immunity in the population is waning, to infection at least. The booster programme has been brought forward for the over 65s. Unfortunately, I think it's with the same bivalent from last year. Hopefully, T cell immunity will hold up but with the new variant, they cannot be sure. There is fear of higher hospitalisations when the NHS is already under considerable strain.
@@francescachristy8761 Yes, I also endorse TWiV wholeheartedly! Very good program. Good luck this Covid/flu season in the UK.
What are the rysk of blood spread of lyposoms with mRNA?
How can decrease that rysk?
27:00 or arguably in a pandemic that has N and S: it isnt (most of our) jobs to well these products. & thr is no shame in pointing that out. _JC
The last time I had covid was in 2021 . But I had it the first time in 2020 and I was caring for my mom at the time. She got it after me and she died from covid. I have never been vaccinated and I avoid large indoor gatherings. And im over 55 . So I am being very careful about it
Im Very very sorry about your mom. i lost my friend/neighbor 42 cyclist to the flu well they puncture his lung when vent.. i was gonna write this
and you were tested for covid. oh there were not tests yet but you know you had it. it was much worse then the 2nd time. The first time was early on in 2020..
but i was being sarcastic cause i hear this story over n over .. i had same story until the court case about my neighbor he had flu not covid . the flu of 2020 was bad and lots death but it was flu.
i did not have test it was 3/2020 it was much worse then when had again 2021 but that’s cause it wasn’t again it was 1st only
peep telling that story w out knowing feeds the severity fear of covid and the idea natural immunity isn’t provided so you need vax .
you don’t get covid again
I have had Long Covid for nearly 20 miserable months and our 12-year-old suffered as a Long Hauler too for the first 6 of these 20 months. I am getting the new vaccine and so is she. When you talk about virility i am deeply saddened and disappointed that at that moment you do not mention AND EMPHASIZE the very real and wildly unpredictable threat TO ALL AGES AND HEALTH STATUSES of developing Long Covid. I am not old, i am not over weight, i had no underlying health conditions pre covid. I was vaccinated but was 8 months out and should have gotten the booster. Our daughter was not yet vaccinated because she had just turned 12 (14 days before contracting covid). Why didn’t I get the booster? Why didn’t we get our youngest child vaccinated as soon as she turned 12? Because i was listening to the people saying that Omicron was less virulent and that kids don’t really have problems if they get Covid 😞 that it was like getting a cold -i would do ANYTHING to turn back time and get both of us up to date before we got infected in January 2022. We have been up to date since then and will continue to be because Long Covid IS PURE MISERY.
Vaccination does very little to prevent infection and again very little to stop the infection becoming Long Covid.
Three years of Long Covid misery for me.
When you asked if a 30 yo adult should get the new vaccine, why didn't one person on the panel mention that the 30 yo would be less likely to transmit it to their aging parents and grandparents. (since they would be less likely to get it) Isn't transmission to others a reason to get the new vaccine for a healthy, young adult? Didn't we find that youth infected a large portion of older adults? I'm not impressed that the conversation focused only on the benefit to oneself. We need to think about others.
Well, um, no, neither the new vaccine nor the old vaccine would prevent transmission very much. There are still many things we don't know about this disease, but it's pretty certain we will all get it.
@@LogoticYou're absolutely right but most people are totally confused about this, unfortunately.
@@Logotic You are not absolutely right, as andy says. The deal is that, overall, the vaccine goes a very long way to preventing severe disease and death. Initially (first few months), after vaccination, it does a good job of preventing infection (and after 2 weeks after vaccination). In other words, for three out of 12 months during a year, on average, you are decently protected against infection and therefore you will be less likely - a lot less likely - to transmit it to others. This all requires a bit of thinking, and is not conducive to one-second drivebys.
@@patriciahoke4722 You've obviously never heard of "negative efficacy."
I need to do an oil change
You do you
I treated post-NICU infants for years in homecare. The local DOH did not require flu vaccination. They don't require COVID vaccination. Parents were shocked when I told them that while I was vaccinated, their other providers did not have to be in order to enter their home and treat their fragile child. NEVER assume that your provider is protecting you from infection unless you ask.
People have a choice in there body's
The COVID vaccines don’t protect from infection or transmission! The Phizer docs they released from a FOIA request state that.
Great discussion. As good as TWIV. TY.
But at odds with TWIV assessment of some research
Agreed. @@francescachristy8761
I appreciate this information. Thank you for all of your years of study.
Good balanced discussion.
Correction: the new booster will not include the ancestral strain.
Wow! Dr. Chin-Hong in a tie! 😄
8:50 no, it is bc workers are more likely to be poor and have less access to healthcare, & more likely to live in food deserts *& standing for poor people and workers are republican issues now* somehow. so, good job team. not to get political. _JC
I find it much easier to learn from this video by listening to it without watching it. I find all the waving of arms and hands (especially from the woman) very distracting. Listen, but don't watch.
*1:00:00** take a crash cart w you too,* why not. travel light, but be prepared. _JC
Woow... sponsored by big pharma.. on reason you would be recommending this.
I personally wish the man at the right did not cough in his hands.... really, still not doing better after all this time.... my two cents
Monica Ghandi? You lost me.
no one will ever trust these scumbags again.
“There’s no reason to be walking around with a mask. When you’re in the middle of an outbreak, wearing a mask might make people feel a little bit better and it might even block a droplet, but it’s not providing the perfect protection that people think that it is. And, often, there are unintended consequences - people keep fiddling with the mask and they keep touching their face.”Dr. Anthony Fauci.
58:00 but for no other disease. (cookoo) _JC