(C) Daily Kos This story was originally published by Daily Kos and is unaltered. . . . . . . . . . . The Month of May in Covidlandia [1] ['This Content Is Not Subject To Review Daily Kos Staff Prior To Publication.'] Date: 2024-06-04 Covid. It’s still decent out there right now, but I am seeing a few more cases in the office, and wastewater surveillance has been trending up a bit. So welcome back to some monthly highlights from a place I call Covidlandia. Here I present recent news, scientific discoveries, and medical knowledge that caught my attention and that is of interest to primary care. I curate and comment, and realize that one human being cannot possibly keep up with everything. But I try to highlight useful, actionable stuff. January, February, March, April. And now May. Covidlandia is a unique place. Here we try to see the gradient between black and white, carefree and cautious, pandemic beginning and end. I’m going to start with highlighting a study on children, and then review some chemistry for those who don’t usually have a chance to do chemistry anymore. Finally I’ll point you towards the full post on my website, which is much too long (and chock full of goodies) to fully post here. Mercy! Kids with long Covid can’t run and play as well. Objectively. There has been a lot of gaslighting, trivialization, and dismissal of the potential harms of Covid in kids. Most seem to be doing pretty well after Covid, but many are not. Estimates for the incidence and prevalence of long Covid in kids range from about 1% if you check with the CDC… to 10 - 20% if you check with this recent study published in Pediatrics. That would be up to 6 million kids with some combination of: …(lingering) cough, headaches, fatigue, and loss of taste and smell, new symptoms like dizziness, or exacerbation of underlying conditions. Children may develop conditions de novo, including postural orthostatic tachycardia syndrome, myalgic encephalomyelitis/chronic fatigue syndrome, autoimmune conditions and multisystem inflammatory syndrome. A recent study in The Pediatric Infectious Disease Journal confirms that 90% of kids with suspected long Covid who underwent exercise testing had objectively impaired functional capacity (expressed by a low VO2 peak), signs of deconditioning, and cardiogenic inefficiency. This compared to just 10% of kids without the diagnosis of long Covid. To me this shows that we should still be keeping kids up to date with recommended vaccines, not sending them immediately back to school when sick, and asking them to wear a mask when they return to school while still contagious with Covid to protect their teachers and friends somewhat. Maybe 7 days from the start of symptoms would be a decent thing to do. And here are the guidelines for treating or not treating your child when they have Covid. As usual, the focus is narrowly on preventing hospitalization and death, but we can assume some children develop lingering and permanent issues as a result of infections. Antivirals can help reduce risks of long Covid in adults. Poorly ventilated spaces are a boon for coronaviruses One way of conceptualizing how coronaviruses and other infectious particles hang in the air is to picture another person smoking. You are going to smell those particles, delivered like viruses into your nose. Turns out it’s not just the buildup of viruses that happens in poorly ventilated spaces, but the carbon dioxide gas itself alters the acid base chemistry of the air, making it more acidic. This lower pH is favorable for SARS CoV-2 viruses, and actually drives more infections, too. As a college student I taught chemistry over two summers, so I just thought this one was fascinating (even as I did not have time to really pour over the details or relearn stoichiometry). Increasing the concentration of carbon dioxide (CO2) in the air limits the increase in pH of respiratory aerosols, thereby improving the aerostability (ability to remain infectious in aerosol form) of SARS-CoV-2. Even moderate increases in CO2 concentration (e.g., from 500 ppm to 800 ppm) significantly improve the aerostability of SARS-CoV-2 variants, including the Delta and Omicron variants. The improved aerostability of SARS-CoV-2 at higher CO2 concentrations is predicted to increase the overall risk of COVID-19 transmission, especially in poorly ventilated indoor environments. Primary care relevance? Ventilation. Go for it. ~ Thanks for reading these first two updates! I have about 10 more items, including a Covid reality check for June, in the full Covidlandia post on my substack Examined… but it’s about a 10 minute read so I’ll spare the casual reader. 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