Latest / Morning Medical with Dr. Chow / COVID-19 Resurgence, Vaccine Updates, and Mental Health Risks Post-Pandemic

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COVID-19 Resurgence, Vaccine Updates, and Mental Health Risks Post-Pandemic · Morning Medical with Dr. Chow

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Good morning and welcome to another episode of Morning Medical with Dr.
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Chow.
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I'm Dr.
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Chi-Ming Chow, and today we'll be discussing some of the latest medical and health news from
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around the world.
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Our first topic is about the anticipated rise in COVID-19 cases this fall and the potential
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arrival of new vaccines.
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As the World Health Organization warns about a 'worrying comeback' of COVID-19 amid a summer
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surge of infections, new vaccines may soon come to Canada this fall.
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Health Canada has told Global News that it is currently reviewing submissions from Pfizer,
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Moderna, and Novavax for their updated COVID-19 shots.
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These vaccines target the most recent strains circulating and will be approved if they are
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deemed safe and effective.
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Nicholas Janveau, a spokesperson for Health Canada, stated in an email on Tuesday, 'Health
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Canada will authorize the vaccines if, following a thorough and independent scientific
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review of the evidence, we determine that the vaccines meet safety, quality, and efficacy
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standards.'
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Starting this fall, the National Advisory Committee on Immunization, or NACI, strongly
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recommends the most recently updated COVID-19 vaccines for both previously vaccinated and
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unvaccinated individuals who are at increased risk of SARS-CoV-2 infection or severe COVID-19
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illness.
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This includes everyone aged 65 or older, long-term care home residents, pregnant people,
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those with underlying medical conditions, and people from Indigenous communities.
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Receiving the most recently updated COVID-19 vaccine is expected to provide a better immune
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response against circulating COVID-19 strains compared to earlier vaccines.
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This is particularly important for those at increased risk for COVID-19 infection or severe
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illness.
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The latest Canadian wastewater data, as of Tuesday, shows a 'moderate' viral activity
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level of COVID-19 in the country.
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However, this could change in the coming months as schools reopen and the weather gets cooler.
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Experts believe that we are likely to see a significant amount of COVID-19 in the fall and
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winter.
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Allison McGeer, an infectious disease physician at Sinai Health in Toronto, noted in an
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interview with Global News, 'I think from what we’ve seen, we are expecting there’s going to
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be a significant amount of COVID in the fall and winter.
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COVID is still a concern in Canada, and people should get vaccinated.
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There’s still very clearly a benefit to getting your shot when they’re available in Canada to
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protect you through the winter.'
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Since the start of the COVID-19 pandemic, the virus has constantly changed and mutated into
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different variants.
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This has kept vaccine makers on their toes to update their shots.
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The KP.3 variant is currently dominating in Canada, accounting for the majority of the
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COVID-19 cases in the country.
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KP.3 is the genetic cousin of KP.1 and KP.2, which are playfully dubbed the 'FLiRT'
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variants.
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These originate from JN.1, the Omicron subvariant that fueled the winter surge.
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Pfizer and Moderna’s updated mRNA vaccines, which are seeking Health Canada approval, both
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target the KP.2 variant.
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The pharmaceutical companies have stated that this variant was selected and prioritized in
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consultation with the Public Health Agency of Canada.
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Sophie Morin, a Pfizer Canada spokesperson, said, 'The introduction of a KP.2-adapted
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vaccine is expected to provide improved immunity and help protect against the strains
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that are believed likely to be circulating in the fall.'
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Moderna added that choosing KP.2 for its updated shots aligns with the Food and Drug
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Administration’s, or FDA's, recommendation, 'ensuring a unified approach in North America
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to best address the dominant strains in this region.' Shehzad Iqbal, Moderna Canada’s
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country medical director, told Global News, 'As COVID-19 continues to mutate, these updates
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help ensure that vaccines provide the best possible effectiveness during the peak
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respiratory season.'
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Novavax’s protein-based formula vaccine is also seeking Health Canada approval.
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This vaccine targets the JN.1 variant but is active against KP.2 and KP.3, in addition to
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other JN.1 sublineage strains.
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Novavax president and chief executive officer John C.
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Jacobs said in a July statement.
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Allison McGeer further explained that the predominant KP.3 variant circulating across
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North America is 'pretty well covered by these new vaccines.' She added, 'You get some
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coverage from the old vaccine, but there’s no doubt that the new vaccines are better adapted
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to it.'
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It is likely that Health Canada will approve the updated vaccines 'within the next few
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weeks,' McGeer said.
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She mentioned that for most people, it is a good idea to wait for the new shots.
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However, those who are at greater risk or are traveling might want to talk to their doctors
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about getting vaccinated earlier.
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Pending approval, Canada has secured a 'sufficient supply' of COVID-19 vaccines to
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meet provincial and territorial requirements for the fall and winter, according to Nicholas
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Janveau.
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Severe COVID-19 has been linked to elevated risks for depression and serious mental illness
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in the weeks and months following infection, especially among unvaccinated individuals.
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This finding comes from a comprehensive cohort study involving over 18 million individuals in
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the United Kingdom.
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The study found that compared to the period before a COVID-19 infection or to individuals
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without an infection, those hospitalized for COVID-19 had substantially higher risks for
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depression in the four weeks after admission.
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This was true both in the pre-vaccine era and among unvaccinated and vaccinated individuals
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in the vaccine era.
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In the pre-vaccine era, the adjusted hazard ratio for depression was 16.3, while for
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unvaccinated individuals it was 15.6, and for vaccinated individuals, it was 12.9.
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Importantly, the risk for depression remained elevated up to a year later for all three
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groups.
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Similarly, elevated risks for serious mental illness were observed among hospitalized
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patients in the four weeks following a COVID-19 diagnosis.
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Jonathan Sterne, PhD, of the University of Bristol in England, and his colleagues reported
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these findings in JAMA Psychiatry.
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In the pre-vaccine era, the adjusted hazard ratio for serious mental illness was 9.71.
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For unvaccinated individuals, it was 8.75, and for vaccinated individuals, it was 6.52.
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Rates of various mental illnesses, including anxiety, post-traumatic stress disorder, eating
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disorders, addiction, and self-harm, were higher in the first four weeks after a COVID-19
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hospitalization.
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Jonathan Sterne noted, 'The main surprise was that the association of COVID-19 with
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subsequent mental ill-health appeared restricted to severe COVID-19 that led to
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hospitalization.
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There was little association of COVID-19 that did not lead to hospitalization with subsequent
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mental ill health.'
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The term 'serious mental illness' in this study encompassed conditions such as schizophrenia,
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schizoaffective disorder, bipolar disorder, and psychotic depression.
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The authors suggested that vaccination might mitigate the adverse effects of COVID-19 on
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mental health.
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They hypothesized that potential mechanisms include reduced systemic inflammation and
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psychological benefits of vaccination, such as reduced concern about COVID-19 and increased
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social engagement.
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Jonathan Sterne emphasized, 'The main benefit of COVID-19 vaccination is that it provides
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substantial protection against severe COVID-19.
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Therefore, our findings underscore the importance of COVID-19 vaccination,
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particularly in groups at highest risk of severe COVID-19.'
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He added, 'Serious mental illnesses are associated with more intensive healthcare needs
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and longer-term health and other adverse effects.
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Therefore, longer-term monitoring for the onset of new mental illnesses among patients
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hospitalized because of COVID-19 may be justified.'
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Regardless of whether patients with COVID-19 were hospitalized, in the pre-vaccine era, the
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overall risk of depression in the four weeks following infection was 93% higher than before
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or without COVID-19.
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The overall risk of developing serious mental illness was 49% higher.
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Among unvaccinated individuals, the overall risks of depression and serious mental illness
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were also elevated, with adjusted hazard ratios of 1.79 and 1.45, respectively.
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The incidence of depression up to 28 weeks later and of serious mental illness across all
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time periods was greater in people aged 60 years and older.
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This may reflect increased risk for severe disease as well as anxiety about severe
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outcomes, the authors pointed out.
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Notably, the incidence of mental illnesses remained elevated for more than 28 weeks after
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a COVID-19 diagnosis.
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The estimated excess risk of depression at 28 weeks after COVID-19 was 1,033 per 100,000
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people in the pre-vaccine era and 1,008 per 100,000 among the unvaccinated.
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Among vaccinated individuals, the risk was less than half that, at 451 per 100,000.
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The trend for serious mental illness at 28 weeks was similar, with an estimated excess
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risk of 235 and 209 per 100,000 in the pre-vaccine era and among the unvaccinated,
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respectively, versus 53 per 100,000 in the vaccinated group.
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The study analyzed data from three cohorts during the pre-vaccine (January 2020 to June
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2021) and vaccine eras (June to December 2021, the Delta variant period).
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This included over 18 million adults during the pre-vaccine era, of whom more than one million
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had a confirmed COVID-19 diagnosis.
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During the vaccine era, the study included over 14 million vaccinated adults and over three
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million unvaccinated adults, with hundreds of thousands of confirmed COVID-19 diagnoses in
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each group.
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The average ages of the pre-vaccine and vaccinated cohorts were 49 and 53 years,
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respectively, and about half were female.
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The average age of the unvaccinated cohort was 35 years, and about 42% were female.
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Diagnoses of COVID-19 were confirmed by test results, by a general practitioner, or from
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hospital or death records.
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The authors acknowledged several limitations to the study.
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Unvaccinated people may have been less likely to test for COVID-19 or use health services,
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leading to a possible underestimation of effects.
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Conversely, people with a diagnosis of COVID-19 and related hospitalization may have been more
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likely to be diagnosed with mental illness in a hospital setting.
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It is also possible that the mental health effects observed were not unique to infection
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with SARS-CoV-2.
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This study was supported by the COVID-19 Longitudinal Health and Wellbeing National Core
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Study, funded by the Medical Research Council and the United Kingdom National Institute for
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Health and Care Research.
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Jonathan Sterne and his co-authors reported relationships with various organizations,
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including AstraZeneca, the Bennett Foundation, the Wellcome Trust, and the National Health
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Service England, among others.
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Suicide risk is significantly higher for female doctors compared with the general population,
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according to an analysis of evidence from 20 countries.
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The researchers said that while suicide rates among doctors have declined over time, and risk
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varied across different countries and regions, the results highlighted a need for continued
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research and prevention efforts.
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Their findings were published in the BMJ journal.
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According to previous estimates, one doctor dies by suicide every day in the United States,
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and about one every 10 days in the United Kingdom, but evidence on suicide rates for
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physicians is inconsistent across countries.
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To address this, researchers led by the University of Vienna in Austria analyzed the
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results of observational studies published between 1960 and 2024 that compared suicide
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rates among doctors with the general population.
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A total of 39 studies from 20 countries were included.
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The researchers found no overall increase in suicide risk for male doctors compared with the
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general population.
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For female doctors, however, suicide risk was significantly higher—76% higher—than the
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general population, the BMJ reported.
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While there was no overall increase found among male physicians when compared with the general
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public, a separate analysis of the data revealed male doctors did have a higher risk of
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suicide compared with other professional groups with 'similar socioeconomic status.'
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Analysis of the 10 most recent studies compared with older studies showed a decline in suicide
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rates over time for both male and female doctors.
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'Overall, this study highlights the ongoing need for suicide prevention measures among
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physicians,' the research team wrote in the BMJ.
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'We found evidence for increased suicide rates in female physicians compared with the general
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population, and for male physicians compared with other professionals.'
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The recent COVID-19 pandemic has put additional strain on the mental health of physicians,
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potentially exacerbating risk factors for suicide such as depression and substance use.
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In a linked editorial, experts from Doctors in Distress, a charity offering support to
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healthcare workers, wrote, 'Persistently high rates of suicide among female doctors need
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particularly urgent attention from researchers, health leaders, and policy makers, including
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studies to explore likely contributors such as discrimination and sexual harassment, to
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characterize those at highest risk and to develop and evaluate gender-specific
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interventions to protect female doctors’ mental health.'
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'All doctors must have access to early intervention and confidential treatment
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services so that they do not suffer in silence,' the editorial continued.
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Katie Hardcastle, a senior research manager at Samaritans, said, 'We’re concerned this new
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global evidence suggests an increased suicide risk in female doctors, as it builds on what we
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know from national data about risk among female health professionals, particularly nurses.
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It’s vital that all health workers who might be struggling are encouraged and supported to seek
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help when needed.'
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In the United Kingdom, the National Health Service said staff wellbeing was a crucial part
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of its workforce plan.
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A spokesperson added, 'There is a range of mental health support available for staff,
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including access to 24/7 confidential support services, coaching, and flexible working
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options, but we know there is much more to do to ensure everyone working in the National
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Health Service feels comfortable asking for help and receives the right support when they
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do.'
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In the United Kingdom and Ireland, Samaritans can be contacted on freephone 116 123, or email
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jo@samaritans.org or jo@samaritans.ie.
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In the United States, you can call or text the National Suicide Prevention Lifeline on 988,
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chat on 988lifeline.org, or text HOME to 741741 to connect with a crisis counselor.
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In Australia, the crisis support service Lifeline is 13 11 14.
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Other international helplines can be found at befrienders.org.
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Artificial intelligence is all around us – from smart home devices to entertainment and social
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media algorithms.
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But is artificial intelligence okay in healthcare?
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A new national survey commissioned by The Ohio State University Wexner Medical Center finds
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most Americans believe it is, with a few reservations.
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The national poll of 1,006 people found that seventy-five percent believe using artificial
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intelligence to minimize human errors is important.
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Seventy-one percent would like artificial intelligence to reduce wait times.
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Seventy percent are comfortable with artificial intelligence taking notes during an
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appointment.
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Sixty-six percent believe artificial intelligence should improve work-life balance
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for healthcare providers.
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To address some of these issues, The Ohio State Wexner Medical Center is piloting the Microsoft
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Dragon Ambient eXperience Copilot application.
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It uses conversational, ambient, and generative artificial intelligence to securely listen to a
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provider-patient visit and draft clinical notes in the patient's electronic medical record.
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Rather than the provider typing the notes during the visit, they can focus on the patient
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then review and edit the notes afterward.
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Ravi Tripathi, Doctor of Medicine, chief health information officer at the Ohio State Wexner
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Medical Center, led the pilot program.
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From mid-January to mid-March this year, twenty-four physicians and advanced practice
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providers in primary care, cardiology, and obstetrics and gynecology tested the technology
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during outpatient clinic visits.
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After obtaining the patient's permission, the provider records the visit through the
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artificial intelligence application.
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Once the visit is complete, the notes are organized and ready for review in less than a
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minute.
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'We found it saved up to four minutes per visit.
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That is time the physician can use to connect with the patient, do education, and make sure
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they understand the plan going forward.
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A few clinicians preferred their old workflow but, overall, eighty percent completed the
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pilot.
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In fact, we allowed them to keep using the artificial intelligence solution afterward
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because it had significantly impacted their practices in the eight weeks of testing,'
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Tripathi said.
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One of the pilot participants was Harrison Jackson, Doctor of Medicine, an internist who
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has been frustrated by the typing that has to take place during each patient visit.
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'Documentation is necessary, but it takes away from the quality of patient interaction during
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a visit.
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I even apologize.
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I say, 'I am sorry, I know I am making more eye contact with the computer than with you,''
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Jackson said.
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After testing artificial intelligence documentation, Jackson reports some occasional
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missteps such as incorrect pronouns or mistaking one word for another – all things he
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said were easily fixed during his chart review.
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He supports the use of artificial intelligence going forward in healthcare.
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'I am spending as much if not more time with each patient, and it is higher quality time
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with more eye contact.
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I often mention aspects of a physical exam out loud for the artificial intelligence program to
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capture, and it prompts a good conversation with my patient,' Jackson said.
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'I have also let our residents use the technology under my supervision, and we have
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noticed the quality of their patient interactions and the quality of plans they
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present have improved.'
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While most Americans also see value in artificial intelligence for healthcare, the
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survey found just over half – fifty-six percent – still find it a little scary and seventy
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percent have concerns about data privacy.
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'I know patients are concerned about the privacy and the security of their data, but we
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hold the artificial intelligence and this technology to the same standards that we hold
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our electronic medical record,' Tripathi said.
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As of July first, Ohio State expanded ambient documentation access to all providers in
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outpatient settings.
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In the first two weeks of expanded use, one hundred clinicians regained sixty-four hours of
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time and satisfaction scores have improved from patients who say their conversations with their
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physicians were more valuable.
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This study was conducted on behalf of The Ohio State University Comprehensive Cancer Center by
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SSRS on its Opinion Panel Omnibus platform.
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The SSRS Opinion Panel Omnibus is a national, twice-per-month, probability-based survey.
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Data collection was conducted from May seventeenth to May twentieth, two thousand
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twenty-four, among a sample of one thousand six respondents.
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The survey was conducted via web and telephone and administered in English.
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The margin of error for total respondents is plus or minus three point five percentage
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points at the ninety-five percent confidence level.
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All SSRS Opinion Panel Omnibus data are weighted to represent the target population of
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United States adults ages eighteen or older.
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Our final story today is about María Branyas Morera, who recently passed away at the
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impressive age of 117.
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She was the world's oldest person at the time of her death and attributed her longevity to a
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combination of genes, luck, and some key lifestyle factors.
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María lived in Olot, Spain, and was relatively healthy apart from some hearing loss and
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mobility issues.
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Remarkably, she maintained a sharp memory even in her later years.
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In a December 2022 post on the social media platform X, she shared her belief that
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longevity is largely due to luck and genetics.
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While she had a point—some people are indeed genetically predisposed to a longer
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life—lifestyle factors also play a significant role.
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Thanks to a greater awareness of healthy behaviors, medical advances, and public-health
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initiatives, more people are living past the age of 65.
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According to a 2020 report by the United States Census Bureau, the number of centenarians in
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the United States is expected to triple in the next 30 years.
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So, what were María's secrets to a long life?
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Here are her five longevity tips.
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First, María believed in avoiding toxic people.
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She said staying away from toxic individuals helped her live so long.
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And she might be right.
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A 2020 study published in Health Psychology found that people who were criticized by their
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partners had a higher chance of dying early, especially older adults.
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Second, María emphasized the importance of strong family ties.
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She once posted that 'strong, rich, and caring family ties act as a mattress that cushions
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loneliness.' She considered herself lucky in this regard.
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A 2023 study published in BMC Medicine supports this, finding that contact with loved ones is
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linked to living longer.
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Older people who lived alone and did not receive regular visits from family were at a
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higher risk of dying over the course of the study compared to those who did have regular
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visitors.
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Third, María maintained a positive outlook and had no regrets.
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She posted in December 2022 that she had no worries or regrets and was very positive.
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This aligns with findings from a 2023 study by researchers at the Complutense University of
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Madrid, which found that looking for the positives in life was common among
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centenarians.
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Fourth, María avoided excess.
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She mentioned in a 2022 post that she never followed a diet but 'always ate little.' Yumi
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Yamamoto, a centenarian expert at LongeviQuest, noted that Japanese supercentenarians also tend
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to eat a balanced diet and avoid excessive eating or drinking.
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Finally, María ate yogurt every day.
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She posted that yogurt has 'an infinite number of positive properties for the body' and that
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she ate a pot of natural yogurt daily.
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While a 2020 study published in the American Journal of Clinical Nutrition found no
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consistent links between yogurt and a lower risk of dying, dietitians often recommend
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yogurt for its high protein content.
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A 2022 study published in BMC Microbiology found that yogurt can increase gut microbe
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diversity, which is beneficial for gut health.
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So, there you have it—María Branyas Morera's five tips for a long life: avoid toxic people,
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maintain strong family ties, stay positive, avoid excess, and eat yogurt every day.
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While we cannot guarantee these tips will help everyone reach 117, they certainly reflect
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healthy lifestyle choices that can contribute to overall well-being.
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That wraps up today's episode of Morning Medical with Dr.
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Chow.
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Thank you for joining us.
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Stay tuned for more updates on the latest in medical and health news.
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Have a wonderful day, and take care!