By Karen L. Kier
Pharmacist on behalf of the ONU Healthwise Team 

In 1981, Lindsey Buckingham released his first solo album with the single Trouble. Buckingham was the lead guitarist and co-lead vocalist for Fleetwood Mac. When he joined the group, he convinced them to bring Stevie Nicks into the group to sing vocals. Buckingham was known for his fingerpicking guitar style. Fleetwood Mac was inducted into the Rock and Roll Hall of Fame in 1998. 

Trouble continues to brew with COVID-19. It has been almost four years since the shut down of 2020. Surveys tell us Americans are not worried about COVID-19 and a large percentage feel the U.S. government has spent too much on the pandemic. 

Why do we keep bringing it back up?  Science and research are important in understanding the virus and its ability to rapidly change.

As of December 2023, the World Health Organization (WHO) has declared the JN.1 as the latest variant of interest.

This variant is driving the increase in global cases of COVID-19. In parts of the world over 66% of the cases are related to JN.1. This variant was grouped in with its relative variant BA.2.86, but WHO made it a standalone variant in the last month. 

The JN.1 variant was first detected in the US in September and it is becoming the dominant variant replacing BA.2.86. The BA.2.86 variant comprises less than 15% of the US cases. 

Wastewater data points to a winter surge of COVID-19 due to the JN.1 variant, which is far more invasive than BA.2.86. The JN.1 variant has similar symptoms to the other omicron variants but with far more diarrhea. JN.1 seems to have more gut effects. The first week in December saw a significant increase in hospitalizations in the US. New York City is an indicator of what is coming for the rest of the country. 

On November 29, 2023, researchers from Columbia University released a study showing the XBB.1.5 monovalent COVID-19 booster vaccine has activity in neutralizing the JN.1 variant. This is good news for anyone who has received the most recent COVID-19 monovalent booster vaccine. The bad news is only about 14% of the US adult population has received the booster. The vaccine protects from developing severe COVID-19 as well as hospitalizations. 

A November 21, 2023 study in the European Heart Journal determined the risk of heart rhythm problems related to a COVID-19 infection. The study evaluated 1,057,174 people for potential damage to the heart following a COVID-19 infection. The study looked at both tachycardia (too fast) and bradycardia (too slow) compared to a normal heart rate of 60 to 100 beats per minute (pulse). 

The researchers reported after a COVID-19 infection, individuals were 12 times more likely to suffer from a tachycardia abnormal heart beat within the first 30 days after the infection. The risk for too slow of a heart beat was 3 times more likely 30 days after an infection. Those at highest risk for an abnormal heart beat were those who were older with more severe infections and those who were unvaccinated. 

Besides the precautions suggested in the past such as vaccination and masking, a new study from Trinity University found gargling and nasal rinsing with saltwater reduced hospitalizations for COVID-19. The study was in adults ages 18-65 who had tested positive for COVID-19. The study involved a high-dose and low-dose salt solution. 

Both the low-dose and high-dose reduced COVID-19 hospitalization. The low-dose was 2.13 grams (1/5 of a teaspoon) of salt dissolved in 8 ounces of warm water and the high-dose was 6 grams (1 teaspoon) in 8 ounces of water. The participants had to gargle with the saltwater and use it as a nasal rinse for 5 minutes 4 times per day.

The CDC is reporting continued activity of three antivirals to treat COVID-19 infections. Paxlovid (ritonavir-nirmatrelvir), Lagevrio (molnupiravir), and Veklury (remdesivir) are maintaining activity to fight infections. These drugs need to be started as early as possible once symptoms appear, but within the first 5 days. Check with your healthcare provider because Paxlovid has a number of drug-drug interactions. Make sure to give them your medication list. Call your pharmacist about how to avoid these interactions. 

It is not too late to avoid trouble!

ONU Healthwise is offering the flu, RSV, and COVID-19 vaccines. Vaccine clinics occur Monday through Friday from 4 PM to 6 PM. Please call for more information.

ONU Healthwise Pharmacy 
419-772-3784