Dr. John House said one thing is certain about Covid: it is mutating much more rapidly than the development of effective vaccines and treatment.
“There is no doubt Covid is spreading rapidly in Arkansas again,” House said. “Our new daily case counts have been running between 1,500 and 2,500 for several weeks. The actual number is no doubt much higher as many people are testing positive at home using the free tests provided by the government. Those test results are not reported.
“So, wear your mask in places where you will be around a lot of people for more than a few minutes, particularly if you are over age 70, or you have other diseases which seem to increase your risk for a bad outcome with covid (diabetes, hypertension, obesity, etc.).”
Eureka Springs is awash in news of residents who have come down with Covid in mid-July. Often people who get the now dominant Covid variant BA.5, which is considered the most contagious variant yet and in the running for the most contagious virus ever seen, are not even showing symptoms before testing positive for Covid-19 and passing it to family members and friends.
The Arkansas Department of Health reported one additional death for Carroll County added in the past week bringing that total at 107. ADH reported 77 new cases in Carroll County the week between July 11-18, and the number of active cases climbed from 118 to 139. Active cases peaked Jan. 31 at 498. ADH shows the active cases in Carroll County are near the level of the 145 cases reported Feb. 14 during the earlier omicron surge.
Active cases in Arkansas continue to climb to levels not seen for months. ADH’s online report for July 18 showed 16,619 active cases. That is up from 10,141 three weeks earlier. ADH said the state’s hospitalizations are at 402, up about 50 percent in the past two weeks.
Eureka Springs Hospital reports 14 positives out of 60 Covid tests from July 11-17, a 23.33 percent positivity rate.
A PubMed.gov study states that the positivity rate is a better indicator for the spread of the disease than the number of confirmed cases. “Therefore, it is highly advised to use measures based on the positivity rate when indicating the spread of the disease and considering responses accordingly because these measures consider the daily number of tests and confirmed cases,” states the article. “Positivity rate: an indicator for the spread of Covid-19 states.”
Gov. Asa Hutchinson has said he would like to see Covid test positivity rates of below ten percent.
Health authorities have said BA.5 can cause symptomatic illnesses among people fully vaccinated and boosted but lowers the chance of hospitalization, and hospitalizations are increasing in people whose vaccinations have taken place five or more months earlier.
The Centers for Disease Control and Prevention recently released a report that two doses of the Pfizer or Moderna vaccines were only 24 percent effective in preventing hospitalization from March through June among people who received their second dose at least five months earlier. The vaccines were deemed 55 percent effective for people 50 or older who received a booster dose at least four months earlier. Second boosters at least seven days earlier were judged to raise the effectiveness to 80 percent.
ESI earlier published a report that the antiviral treatment Paxlovid could be a “game changer,” and some who have taken Paxlovid have reported that it initially made them feel better much faster. But then symptoms returned, and they tested positive again.
Science Magazine, a peer-reviewed academic journal of the American Association for the Advancement of Science, has reported prescriptions for Pfizer’s Paxlovid have skyrocketed in recent weeks.
“That’s good news for many Covid-19 patients, as the pill has been proven to reduce severe disease from SARS-CoV-2 infections,” Science reported. “But a bevy of new lab studies shows the coronavirus can mutate in ways that make it less susceptible to the drug… Researchers have found some of those mutations in variants already circulating in infected people, raising fresh concerns that physicians could soon lose one of their best therapies for fighting Covid-19.
“…Confirming anecdotal reports widely reported by media, several studies have found a small percentage of infected people who receive the normal five-day course initially feel better, only to have their symptoms rebound. And questions have grown about whether Paxlovid helps those who aren’t at high risk of serious disease—Pfizer earlier this month halted a large trial of the drug in standard risk Covid-19 patients because it was failing to show statistically significant protection against death or hospitalization.”
House said he has prescribed Paxlovid a dozen times or more. Most recently, however, he had a handful of very high-risk patients for whom he prescribed Paxlovid, but there was none to be found in any of the local pharmacies. Consequently, those patients went without.
“So far, they have fared well (they are all vaccinated),” House said. “I haven’t yet had any patients report to me a rebound following five days of Paxlovid. I have heard several high-profile virologists familiar with the medication suggest that a 10-day course may be more appropriate.”
Rutgers Today reports that, “An analysis of SARS-CoV-2 variants sequenced in a scientific database GISAID has found some mutant strains of the virus could resist the Covid-19 medication Paxlovid.
“Our findings show that doctors should reserve Paxlovid for the highest risk patients, the ones who need it most, because if Paxlovid is widely used, it will mostly destroy the variants it can treat, and the variants it cannot treat will become dominant,” said senior author Jun Wang, an associate professor in the Department of Medicinal Chemistry at the Rutgers Ernest Mario School of Pharmacy. “If that happens, we will be right back where we started, with no treatment for the disease.”