Plus, stores raise test kit prices as agreements with feds expire, no link between vaccines and pre-term births, and more. Email not displaying correctly?
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** ‘Flurona’ is not the next big new thing to worry about
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A pharmacy in New York City offers vaccines for COVID-19, flu, shingles and pneumonia on Monday, December 6, 2021. (AP Photo/Ted Shaffrey)

The word making the internet rounds now is “flurona,” which is a combined infection of the seasonal flu and the unique coronavirus behind COVID-19. The Times of Israel ([link removed]) reported the first confirmed case of “flurona” on Sunday and the internet ([link removed]) and social media freak-out began.

But wait. This is not new. Dr. Anthony Fauci and others warned ([link removed]) that we would probably see a confluence of the flu and the COVID-19 virus. It is called a coinfection, and The Atlantic reported a couple of months ago ([link removed]) that “they happen all the time.”

In 2021, we still don’t know much about how—or how often—the flu virus and SARS-CoV-2 act in tandem within the same body. A very early study from China in January 2020 found zero cases of coinfection ([link removed](20)30211-7/fulltext) of these two pathogens among 99 COVID-19 patients, but a follow-up, conducted a month later at a COVID-19 hospital, concluded that about one in eight had both diseases at the same time ([link removed]) . Whatever the historic prevalence of coinfection, the twindemic never happened last winter. Perhaps due to mask wearing and social distancing, flu numbers in the U.S. were much, much lower ([link removed]) than normal during the 2020–21 season.

PolitiFact also tracked down the background ([link removed]) on this new phrase.

But now, a new flu season is starting to spread. This Centers for Disease Control and Prevention flu map ([link removed]) is still based on almost two-week old data:
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(CDC)

Here is a story ([link removed]) from Houston about a teenager who tested positive for both flu and COVID-19. KHOU reports ([link removed]) :

“We are seeing an increase in the number of influenza cases in the country in general and we should not forget about it in the midst of this omicron surge," Dr. Hana El Sahly, professor of molecular virology and microbiology at Baylor College of Medicine ([link removed]) said.

The CDC says ([link removed]) more than 1,800 people are in U.S. hospitals with the flu right now and the number is growing. Montana recently recorded a pediatric influenza death ([link removed]) ; the majority of seasonal flu cases there are among children. In fact, in the last week of 2021, the number of flu-related physician visits fell above the norm from recent years.

While these coinfections are not rare, they complicate treatment and recovery for COVID-19 patients. The Atlantic said:

According to an analysis from last spring of more than 100 studies, people who tested positive for both SARS-CoV-2 and a second pathogen had triple the odds ([link removed]) of dying compared with those who had only COVID-19.

You can get vaccinated against COVID-19 and the flu ([link removed]) at the same time. But remember, they are different vaccines. One does not protect against the other virus. The CDC recommends the vaccination for anyone over age 6 months ([link removed]) . With few exceptions.


** Walmart and Kroger raise home COVID test kit prices as agreements with feds expire
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Back in September ([link removed]) , President Joe Biden gave Walmart and others big props for offering home COVID-19 tests at cost. He said in a nationally broadcast speech:

While that production is ramping up, my administration has worked with top retailers, like Walmart, Amazon, and Kroger’s, and tonight we’re announcing that, no later than next week, each of these outlets will start to sell at-home rapid test kits at cost for the next three months. This is an immediate price reduction for at-home test kits for up to 35 percent reduction.

As he said, the agreement was for three months. Now, the time is up — and so is the price. This week Walmart raised prices on the tests from $14 to $19.88. Kroger and Walgreens are charging $23.99.


** Research shows no link between vaccines and pre-term births
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The CDC’s newest research ([link removed]) involving 40,000 women found there is no link between taking the COVID-19 vaccine and premature births. The study also found no connection between the vaccines and babies born smaller or less developed than expected. NPR summarizes these findings ([link removed]) .


** Time to ditch the cloth mask and upgrade to KN95s
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A registered nurse stands on line looking to buy KN95 face masks in Whittier, Calif., Tuesday, April 7, 2020. (AP Photo/Damian Dovarganes)

It is amazing to me that we are still talking about how to buy and wear masks, but we are. It is amazing to me that the CDC and others are not saying clearly “wear an N95 or KN95 mask,” not just “wear a mask,” but they are.

N95 masks approved by the National Institute of Occupational Safety and Health are so named because they can filter 95% of particles in the air ([link removed].) . They don’t 100% guarantee that you won’t get infected any more than a vaccine will, but they are another line of defense against the virus.

Earlier this week, The Wall Street Journal published a chart showing how different kinds of masks perform. Keep in mind, the data on which this chart is based is pre-omicron, so you can expect all of these times are shorter now. We don’t know how much shorter, but shorter.
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(The Wall Street Journal)

How do we know that masks reduce virus transmission? This conclusion is not reliant on one study. This conclusion is based on meta studies, or studies of studies.

Here is a meta study that combined 72 studies of everything from hand washing to social distancing to closing schools. It found that mask wearing works to reduce transmission of the virus behind COVID-19.
* Of the studies in this mega study, mask-wearing reduced COVID-19 transmission by 53%. (Dr.Katelyn Jetelina ([link removed]) points you to other significant mask studies ([link removed]) .) One of the limitations of this finding is exactly what you see pointed out in the Wall Street Journal chart above. The degree of prevention is directly related to the quality of the masks used in the study.
* Physical distancing reduced the virus transmission by about 12% (of course, isolation was more effective, with a 74% reduction.)
* School closings were found to reduce transmission by 62% (but come with a big downside to learning). It is interesting that Japan saw no reduction in COVID-19 after closing schools.
* Business closures reduced risk around 12%.
* Travel restrictions and border closures cut transmissions by 11%.


** Ambulance responses are slowing with so many workers out sick
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Check locally to see if what is unfolding in Los Angeles ([link removed]) is happening near you. There, wait times for ambulances are increasing as more workers get sick and 911 calls are pouring in from people needing ambulances.


** Hospitalized with covid or hospitalized from covid?
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I am paying attention to this story from theLos Angeles Times ([link removed]≷=us) that is tracking a big jump in COVID-19 patients in Los Angeles hospitals.

Roughly two-thirds of patients who have tested positive at hospitals run by the L.A. County Department of Health Services were admitted for something other than the coronavirus, according to Health Services Director Dr. Christina Ghaly.

The question that you have to keep asking is whether this change in how COVID-19 cases end up in hospital-reported data is a reason that COVID hospitalization numbers today may not be an apples-to-apples comparison to previous era of the pandemic, when people were hospitalized only because they had COVID-19.


** The risk of various activities right now
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A week ago, I told my local gym that I would not be around for a month or so because it does not require masks, almost nobody in my class wore one, and the tiny, jam-packed space has no HEPA filters on its AC.

This new British research finds ([link removed]) that if you are outside or in a well-ventilated space in a small group, talking, singing and even heavy exercise for a short time is a pretty low threat if you are wearing a mask. And even without a mask, the risk is fairly low. But as you increase activity, density of people in a space and time of exposure, the risk goes up. Of course, the danger level also depends on how many infected people you are near and how infectious those people are when you encounter them. So, to my eyes, this chart is something of a guideline more than an empirical answer.
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A graphic from a study called Practical Indicators for Risk of Airborne Transmission in Shared Indoor Environments and Their Application to COVID-19 Outbreaks (Environmental Science & Technology ([link removed]) )

And a special thanks to Dr.Katelyn Jetelina ([link removed]) , who found these dandy flowcharts to help you figure out what to do if you test positive for COVID-19 or if you have been exposed to somebody who is infected. They were produced by the Maine Center for Disease Control and Infection:
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(Maine Center for Disease Control and Prevention)
[link removed]
(Maine Center for Disease Control and Prevention)


** Lottery incentives don’t increase vaccinations
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A new study by researchers at Boston University ([link removed]) found that the prospect of winning a bunch of money in a sort of lottery does not significantly increase COVID-19 vaccination rates. The researchers found that result based on a study of an Ohio experiment to try to convince people to get vaccinated. But even when the study expanded to 15 more states that were trying the lottery incentive, the researchers found the same results: no improvement in the vaccination rate. The states that offered incentives turned out to have about the same vaccination rates as those that did not.

We’ll be back Monday with a new edition of Covering COVID-19. Are you subscribed? Sign up here ([link removed]) to get it delivered right to your inbox.
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