Enlarge (credit: Nozin.com )

More than four years after SARS-CoV-2 made its global debut, the US Food and Drug Administration is still working to clear out the bogus and unproven products that flooded the market, claiming to prevent, treat, and cure COVID-19.

The latest example is an alcohol-based sanitizer meant to be smeared inside the nostrils. According to its maker, the rub can protect you from becoming infected with SARS-CoV-2 and other nasty germs, like MRSA, and that protection lasts up to 12 hours after each swabbing. That all sounds great, but according to the FDA, none of it is proven. In a warning letter released Tuesday, the agency determined the sanitizer, called Nozin, is an unapproved new drug and misbranded.

While ethyl alcohol is used in common topical antiseptics, like hand sanitizers, the FDA does not generally consider it safe for inside the nostrils—and the agency is unaware of any high-quality clinical data showing the Nozin is safe, let alone effective. The FDA also noted that, for general over-the-counter topical antiseptics, calling out specific pathogens it can fight off—like SARS-CoV-2 and MRSA—is not allowed under agency rules without further FDA review. Making claims about protection duration is also not allowed.

Enlarge (credit: Getty | Thomas Trutschel )

The Centers for Disease Control and Prevention is preparing to update its COVID-19 isolation guidance, moving from a minimum five-day isolation period to one that is solely determined by symptoms, according to a report from The Washington Post .

Currently, CDC isolation guidance states that people who test positive for COVID-19 should stay home for at least five days, at which point people can end their isolation as long as their symptoms are improving and they have been fever-free for 24 hours.

According to three unnamed officials who spoke with the Post, the CDC will update its guidance to remove the five-day minimum, recommending more simply that people can end their isolation any time after being fever-free for 24 hours without the aid of medication, as long as any other remaining symptoms are mild and improving. The change, which is expected to be released in April, would be the first to loosen the guidance since the end of 2021.

Enlarge / The influenza virus from an image produced from an image taken with transmission electron microscopy. Viral diameter ranges from around 80 to 120 nm. (credit: Getty | BSIP )

Key indicators of seasonal flu activity declined in the first week of the year, signaling a possible reprieve from the high levels of respiratory virus transmission this season—but the dip may only be temporary.

On Friday, the Centers for Disease Control and Prevention released its latest flu data for the week ending on January 6. Outpatient visits for influenza-like illnesses (ILI) were down that week, the first decline after weeks of rapid increases. Flu test positivity and hospitalizations were also down slightly.

Percent of outpatient visits for respiratory illnesses by week. (credit: CDC )

But transmission is still elevated around the country. Fourteen states have ILI activity at the "very high" level in the current data, down from 22 the week before. And 23 states have "high" activity level, up from 19 the week before. (You can see the week-by-week progression of this year's flu season in the US here .)

Enlarge / A vial of the updated 2023-2024 formula of Pfizer's COVID-19 vaccine at a CVS Pharmacy in Eagle Rock, California, on September 14, 2023. (credit: Getty | Irfan Khan )

Staying up to date on COVID-19 vaccines can cut the risk of COVID-related strokes, blood clots, and heart attacks by around 50 percent in people ages 65 years or older and in those with a condition that makes them more vulnerable to those events, according to a new study from the Centers for Disease Control and Prevention .

The finding, published this week in the CDC's Morbidity and Mortality Weekly Report, should help ease concerns that the shots may conversely increase the risk of those events—collectively called thromboembolic events. In January 2023, the CDC and the Food and Drug Administration jointly reported a preliminary safety signal from their vaccine-monitoring systems that indicated mRNA COVID-19 vaccines may increase the risk of strokes in the 21 days after vaccination of people ages 65 and older. Since that initial report, that signal decreased, becoming statistically insignificant. Other vaccine monitoring systems, including international systems, have not picked up such a signal. Further studies ( summarized here ) have not produced clear or consistent data pointing to a link to strokes.

In May, the FDA concluded that the evidence does not support any safety concern and reported that "scientists believe factors other than vaccination might have contributed to the initial finding."

Enlarge / A child with measles. (credit: Greene, Charles Lyman )

The US may be heading to a "dangerous vaccination tipping point," with immunization rates falling so low that population-level immunity is now at risk, and we will likely see thousands of needless deaths this respiratory virus season, two top officials for the Food and Drug Administration warned in a recent JAMA commentary .

FDA Commissioner Robert Califf and top FDA vaccine regulator Peter Marks noted the profound benefits of lifesaving vaccines—which save millions of lives in the US each year—and their established safety, which is monitored both passively and actively through multiple, overlapping federal safety monitoring systems. And yet, "an increasing number of people in the US are now declining vaccination for a variety of reasons, ranging from safety concerns to religious beliefs," thanks to the rise of anti-vaccine misinformation spread on social media and elsewhere on the Internet.

Data from the Centers for Disease Control and Prevention last year found that, for the third consecutive year, vaccination rates among kindergartners had continued to slip , with rates of non-medical vaccination exemptions rising to an all-time high. There are now 10 states with vaccination exemption rates over 5 percent, meaning that even if clinicians and health officials manage to vaccinate all non-exempt children, the state will not be able to reach the target of 95 percent coverage needed to curb the spread of disease on a population level.

Enlarge (credit: Maridav )

It’s summer 2021. You rent a house in the countryside with a bunch of friends for someone’s birthday. The weather’s gorgeous that weekend, so mostly you’re all outside—pool, firepit, hammock, etc.—but you do all sleep in the same house. And then on Tuesday, you get an alert on your phone that you’ve been exposed to SARS-CoV-2, the virus that causes COVID-19. How likely are you to now have it?

To answer that question, a group of statisticians, data scientists, computer scientists, and epidemiologists in the UK analyzed 7 million people who were notified that they were exposed to COVID-19 by the NHS COVID-19 app in England and Wales between April 2021 and February 2022. They wanted to know if—and how—these app notifications correlated to actual disease transmission. Analyses like this can help ensure that an app designed for the next pathogen could retain efficacy while minimizing social and economic burdens. And it can tell us more about the dynamics of SARS-CoV-2 transmission.

Over 20 million quarantine requests

The NHS COVID-19 app was active on 13 to 18 million smartphones per day over 2021. It used Bluetooth signals to estimate the proximity between those smartphones while maintaining privacy and then alerted people who spent 15 minutes or more at a distance of 2 meters or less from a confirmed case. This led to over 20 million such alerts, each of which came with a request to quarantine—quite a burden.

Enlarge / Texas Attorney General Ken Paxton. (credit: Getty | Brett Coomer/Houston Chronicle )

Texas Attorney General Ken Paxton sued Pfizer last week, claiming the pharmaceutical giant "deceived the public" by "unlawfully misrepresenting" the effectiveness of its mRNA COVID-19 vaccine and sought to silence critics.

The lawsuit also blames Pfizer for not ending the pandemic after the vaccine's release in December 2020. "Contrary to Pfizer’s public statements, however, the pandemic did not end; it got worse" in 2021, the complaint reads .

"We are pursuing justice for the people of Texas, many of whom were coerced by tyrannical vaccine mandates to take a defective product sold by lies," Paxton said in a press release. "The facts are clear. Pfizer did not tell the truth about their COVID-19 vaccines."

Enlarge / Parents with children who are suffering from respiratory diseases are lining up at a children's hospital in Chongqing, China, on November 23, 2023. (credit: Getty | Costfoto/NurPhoto )

Last week, news stories and a posting on an infectious disease surveillance system raised fears that another novel respiratory pathogen with pandemic potential was mushrooming in northern areas of China—namely Beijing and Liaoning province. The reports referenced " undiagnosed pneumonia " in " clusters " of children, hospitals that were "overwhelmed," and parents who were questioning whether "authorities were covering up the epidemic."

But, rather than a sequel to the COVID-19 pandemic, the situation appears to be merely a side effect of it. According to independent experts and the World Health Organization, it's most likely that China is now experiencing a roaring comeback of a mix of common respiratory infections that were muted during the global health crisis. Many other countries experienced the same surges in the past year or two, including the US. As with the other countries, the wave of infection in China is mostly affecting children, who were less exposed to all sorts of pathogens amid the health restrictions, leaving them more vulnerable to infections now.

The global explosion of COVID-19 transmission and subsequent pandemic health measures severely disrupted common cycles of many infectious diseases worldwide, knocking seasonal respiratory infections like adenoviruses and RSV (respiratory syncytial virus) off their annual cycles. In the US, the 2020-2021 flu season was virtually nonexistent, for instance. But, as the novel coronavirus abated and restrictions lifted, those pathogens vigorously returned. (The US also experienced early and intense peaks of RSV and flu last year.)

Enlarge / A nurse is on night shift at the emergency clinic of the International Peace Maternity & Child Health Hospital of China welfare institute in Shanghai, April 1, 2022. (credit: Getty | Yuan Quan )

Doctors in China are reporting a startling and unexplained spike in fetuses with situs inversus, a rare congenital condition in which the organs in the chest and abdomen are arranged in a mirror image of their normal positions.

In the first seven months of 2023, the rate of fetuses identified with the condition quadrupled compared with historic rates, according to a brief report appearing in the New England Journal of Medicine Thursday .

For the report, doctors from two big obstetric centers in the cities of Shanghai and Changsha combined their centers' clinical records from January 2014 through July 2023. The doctors found that from 2014 to 2022, the yearly total of situs inversus cases was typically about five to six per 10,000 pregnant people undergoing ultrasounds. But, in 2023, the rate jumped to nearly 24 cases per 10,000 ultrasound screenings.