A petri dish containing a model of novel coronavirus

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■ The Omicron surge has driven Covid-19 cases and hospitalizations to record highs in the United States, with NIH Director Dr. Anthony Fauci warning it will “find just about everybody” at least exposed — but vaccinated people will still fare better.

■ Australia’s most populous state recorded over 92,000 new Covid-19 cases on Thursday after the state started including rapid antigen tests in official figures for the first time.

■ Meanwhile, UK Prime Minister Boris Johnson is under growing pressure from lawmakers over a drinks party at Downing Street during the country's first lockdown.

 

Florida Department of Health extends shelf-life of about a million Covid-19 tests

 

Florida Gov. Ron DeSantis announced the expiration date of about a million Covid-19 rapid tests, that expired late last month, has been extended. During a news conference in Bonita Springs Wednesday morning, DeSantis said the tests will be distributed to testing centers and county health departments.

 

The expiration date has been pushed until March 2022, the Florida Department of Health said in a statement.

 

“The end of the summer they had expired. The FDA agreed to extend it for three months. But those three months were almost zero demand in Florida for testing because we had such low COVID,” the governor said.

 

DeSantis criticized the FDA for taking too long to extend the expiration dates.

 

Last week, the DeSantis administration acknowledged that the rapid tests, which were not take-home tests, had expired in a warehouse. The Florida Department of Emergency Management Director said that the stockpile sat idle during the fall when cases fell in Florida and demand was low.

 

CNN reached out to the FDA for comment and to find out how many months past the original expiration date the Covid-19 test can be extended and still produce accurate results but has not yet heard back.

 

Australia’s most populous state reports over 92,000 new Covid-19 cases

 

The Australian state of New South Wales recorded 92,264 new Covid-19 cases on Thursday after the state started including rapid antigen tests in official figures for the first time.

 

Starting Wednesday, residents of New South Wales were able to report the result of their rapid antigen tests by uploading information on an app.

 

Thursday's figures include 61,387 positive rapid antigen tests taken since Jan. 1, with 50,729 of those from the last seven days.

 

Cases detected through PCR tests were down, with 30,877 new cases on Thursday after 34,759 the day before.

 

New South Wales, Australia’s most populous state, has now reported 628,100 total cases, according to the health ministry.

 

Cases have also spiked in Victoria state, where the health ministry reported 37,169 new cases on Thursday.

 

The Australian national cabinet is set to meet on Thursday to consider issues such as expanding the list of essential workers to address supply chain disruptions.

 

Australian deputy prime minister: Djokovic “has to abide by the laws”

 

Australia’s Deputy Prime Minister Barnaby Joyce said tennis star Novak Djokovic “has to abide by the laws” in an interview with CNN affiliate Nine News.

 

“The vast majority of Australians ... don’t like the idea that another individual, whether they’re a tennis player or the king of Spain or the queen of England, can come up here and have a different set of rules to what everybody else has to deal with,” Joyce said, adding that whether people agree with the rules or not, they believe rules should be followed.

“That was the issue with Novak Djokovic,” the deputy prime minister said, “I think that the rules that one person follows is the rules everybody should follow. [Djokovic] is still a child of God like the rest of us, isn’t he? So he has to abide by the laws.”

 

Australian opposition leader Anthony Albanese said the situation with Djokovic’s visa has been “diabolical” for Australia’s reputation.

 

“How is it that a ... visa was granted in the first place? This has been diabolical for Australia’s reputation, just in terms of our competence here and it is extraordinary that — as we are speaking — we still don’t know what the decision will be,” he said.

 

He added: “The decision should have been made before he was granted a visa. Either he was eligible or he wasn’t. Australia has a policy of not allowing unvaccinated people into Australia. It is beyond my comprehension how we have got to this point. … Why is it those checks and balances weren’t in place for ... someone so prominent?”

 

Serbian president says he’s "proud" to have helped Djokovic during Australian visa and vaccine dispute

 

Serbian President Aleksandar Vučić said he was “proud” to help tennis star Novak Djokovic as he faces a visa and vaccination dispute in Australia.

 

“Our job is to help the Serbian citizens. I am proud that through our effort we were able to help one of the best athletes of all times,” Vučić in an interview with public broadcaster Radio Television of Serbia.

 

“I think it is necessary that people are vaccinated," Vučić told RTS, “But I am not one of those who are going to start chasing those who aren't vaccinated, because I find it to be our fault – we have allowed the social networks to impose some nonsense topics that we were unable to deal with.”

 

Vučić also appeared to indirectly address Djokovic’s admission that he did not immediately isolate after testing positive for Covid-19 in December.

 

"If you know you are infected, you shouldn't be going out in public,” Vučić said.

 

Pfizer/BioNTech vaccine is 94% effective against Covid-19 hospitalization in adolescents, data shows

 

The Pfizer/BioNTech coronavirus vaccine appears to be 94% effective against Covid-19 hospitalization among adolescents in the United States, according to a new study of real-world hospital data.

 

The findings, published Wednesday in the New England Journal of Medicine, are consistent with clinical trial results that showed the vaccine's efficacy was 100% against Covid-19 illness among young people.

 

In the new study, "vaccination averted nearly all life-threatening Covid-19 illness in this age group," wrote the researchers from the US Centers for Disease Control and Prevention and various hospitals and universities across the United States.

 

The study included data on adolescents ages 12 to 18 who had been admitted to 31 hospitals across 23 states between July 1 and Oct. 25. Within the data, there were 445 adolescents hospitalized with Covid-19 and 777 hospitalized without Covid-19.

 

The researchers, including CDC epidemiologist Samantha Olson, found that far more adolescents hospitalized with Covid-19 were unvaccinated compared with those who were hospitalized for other reasons. The data showed that among the hospitalized adolescents with Covid-19, 4% were fully vaccinated, less than 1% were partially vaccinated, and 96% were unvaccinated. In comparison, among the hospitalized adolescents who did not have Covid-19, 36% were fully vaccinated, 7% were partially vaccinated, and 57% were unvaccinated.

 

"Despite eligibility for Covid-19 vaccination, 96% of the patients who were hospitalized with Covid-19 and 99% of those who received life support had not been fully vaccinated. We found that vaccination with two doses of the BNT162b2 mRNA vaccine reduced the risk of hospitalization from Covid-19 by 94% among adolescents between 12 and 18 years of age in the United States," the researchers wrote, using the official name of Pfizer/BioNTech's vaccine, BNT162b2.

 

The study did not include information on which coronavirus variants caused the Covid-19 cases in the data, but the researchers noted that the research was conducted at a time when Delta was the dominant circulating coronavirus variant.

 

Dr. Kathryn Edwards of Vanderbilt University Medical Center in Nashville called the study's findings "impressive evidence" regarding the vaccine's effectiveness in adolescents.

 

"These extremely encouraging data indicate that nearly all hospitalizations and deaths in this population could have been prevented by vaccination," Edwards wrote in an editorial published alongside the new study.

 

"However, it is distressing that less than 39% of the adolescents in the control group had been immunized against Covid-19, despite uniform eligibility and widespread vaccine access," Edwards wrote. "Vigorous efforts must be expended to improve vaccination coverage among all children and especially among those at highest risk for severe Covid-19."

 

CDC data shows that currently, about 13.7 million of the about 25 million 12- to 17-year-olds in the United States are fully vaccinated against Covid-19, representing about 55% of adolescents.

 

Early signs that Omicron is peaking in some places offer hope

 

The Omicron surge has driven Covid-19 cases and hospitalizations to record highs in the United States. This week, however, officials have started to call out very early signs that the wave is peaking – or at least plateauing – in the Northeast. But rates are still higher in this region than any other and it will be weeks before any change can be declared a trend.

 

On Tuesday, New York Gov. Kathy Hochul said that recent case trends are “a glimmer of hope.” She specifically noted an apparent plateau in average daily case rates in New York City.

 

The New York City health department’s data tracker indicates that while the test positivity rate is “stable,” case trends are “increasing,” as are hospitalizations and deaths. Also, data for the most recent 10 days is considered incomplete.

 

"We remain squarely within our Omicron wave in New York City, whether looking at cases, hospitalizations, or deaths due to COVID-19,” according to a statement from the city’s health department. “Although there are preliminary signs that the level of cases may be plateauing, we need to continue following the data closely in the coming days to discern the trend.”

 

In a briefing Tuesday, Philadelphia Health Commissioner Dr. Cheryl Bettigole said that judging from a collection of metrics, the city “may be at peak right now.” Data from the city shows that the test positivity rate dropped for the first time in months, from 45% positive in the last week of December to 36% in the first week of January.

 

But she noted that the trends remain in flux.

 

“The thing about watching things like this is you’re watching a graph, you’re doing your best to project, and there’s no certainty to any of this,” she said. “I think we’re going to see it wiggle over the next few days, and then it’s just a question of whether we can hold it together and manage not to expose ourselves.”

 

In New Jersey, average daily cases have dropped slightly in recent days, but weekly tallies are still up about 6% compared to a week ago, according to data from Johns Hopkins University.

 

“We’ve had two days of a slight downturn, so we’re looking at a silver lining,” New Jersey Health Commissioner Judith Persichilli said on Monday. “That’s why I keep telling everybody it’s a prediction. Omicron is a funny variant that shoots way up and then, for example in South Africa came down just as quickly. We can only hope that that occurs.”

 

New Jersey state epidemiologist Dr. Christina Tan said that the Northeast region may see cases peak before other parts of the US.

 

In addition to New Jersey, only four other states – Maryland, Ohio, Delaware and Georgia – as well as Washington, DC, have seen case rates hold relatively steady compared to last week, changing less than 10% in either direction, according to data from JHU. But only in DC has this plateau held for more than a week.

 

Some more context: Overall, the US is reporting an average of more than 747,000 Covid-19 cases each day, about triple the peak from last winter, according to JHU data. Cases are up 34% compared to a week earlier. A record number of people are hospitalized with Covid-19 – more than 151,000, which has about doubled in two weeks, according to data from the US Department of Health and Human Services. And deaths are now starting to trend up, too, jumping 40% over the past week, according to JHU data.

 

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Research finds latest omicron variant BA.4.6 is better at evading immune system than BA.5, as scientists say COVID will be with us for a long time

 

Emerging research suggests the latest omicron variant to gain ground — BA.4.6, which accounted for about 8% of new U.S. cases last week — is even better at evading the immune system than BA.5, the Associated Press reported.

 

The research was published in preprint form by bioRxiv, an open access repository for research hosted by the Cold Spring Harbor Laboratory, meaning it has not been peer-reviewed. But the study, conducted by Chinese researchers, found that omicron subvariants and especially BA.4.6 “exhibit substantial growth advantages compared to BA.4 and BA.5.”

 

The fact that each new strain is more infectious than the previous one is one reason to expect that the virus will last far into the future, having already lasted longer than the 1918 flu pandemic. Scientists are concerned that the virus will keep evolving in ways that may prove worrisome.

 

White House COVID coordinator Dr. Ashish Jha said on Tuesday that the illness will be here for the rest of our lives.

 

Living with COVID “should not necessarily be a scary or bad concept,” since people are getting better at fighting it, Jha said during a recent question-and-answer session with U.S. Sen. Bernie Sanders of Vermont. “Obviously if we take our foot off the gas — if we stop updating our vaccines, we stop getting new treatments — then we could slip backward.”

 

Eric Topol, head of Scripps Research Translational Institute, told the AP the world is likely to keep seeing repetitive surges until “we do the things we have to do,” such as developing next generation vaccines and rolling them out equitably.

 

Topol is also skeptical about the government’s plan to move to annual COVID boosters, similar to the seasonal flu shot, until more research has been conducted.

 

Vaccines and boosters still offer the best protection against severe disease and death. And the more people get vaccinated, the greater the level of immunity for all humans, which will also help slow the emergence and spread of new variants.

 

The World Health Organization said Wednesday the global tally of COVID cases fell 12% in the week through Aug. 29 from the previous one, with just under 4.2 million infections counted. The number of fatalities fell 5% to just over 13,700, according to the agency’s weekly epidemiological update.

 

U.S. known cases of COVID are continuing to ease, although the true tally is likely higher given how many people are testing at home, where the data are not being collected.

 

The daily average for new cases stood at 75,359 on Tuesday, according to a New York Times tracker, down 18% from two weeks ago. Cases are still rising in six states, namely Georgia, South Carolina, Vermont, Rhode Island, Colorado, and Ohio. They are falling everywhere else, the tracker shows.

 

The daily average for hospitalizations was down 12% at 34,864 while the daily average for deaths is down 10% to 420.

 

Dr. Anthony Fauci said on Tuesday that Covid-19 shots are likely to be offered on an annual basis, similar to flu shots. He said the shots would likely be matched to the circulating strain of a given year.

 

Other Covid-19 news you should know about:

 

• The death toll from the earthquake in western China has jumped to 74 with another 26 people still missing, the government reported Wednesday, as frustration rose with uncompromising Covid-19 lockdown measures that prevented residents from leaving their buildings after the shaking, the AP reported. The 6.8 magnitude quake that struck just after noon Monday in Sichuan province caused extensive damage to homes in the Ganze Tibetan Autonomous Region and shook buildings in the provincial capital of Chengdu, whose 21 million citizens are under a strict Covid-19 lockdown.

 

Rescue workers in southwestern China cleared roads and dug through rubble to search for survivors after Monday’s 6.8-magnitude earthquake. Sichuan province is already reeling from a heat wave, drought and Covid-19 outbreak.

 

• The German government is planning to scrap a face mask mandate on flights to and from the country, though the health minister said Tuesday that it could be reimposed if coronavirus cases rise sharply, the AP reported separately. The rules run through Sept. 23, and the smallest party in the coalition government, the libertarian Free Democratic Party, has pressed for an end to them. The initial draft for this fall’s rules foresaw an obligation to wear N95-type masks on planes as well as long-distance trains and buses.

 

• For the first time since COVID brought air travel to a standstill, the number of people streaming through U.S. airport-security checkpoints over a holiday weekend exceeded pre-pandemic levels, the AP reported. The summer travel season ended on a busy note as more than 8.7 million people passed through security in the last four days, topping the Labor Day weekend of 2019. United Airlines Holdings Inc. confirmed the trend on Wednesday, raising its third-quarter revenue growth outlook, citing continued “strong” demand exiting a “robust” summer. Online travel company Sabre Corp. said that net air bookings and passengers boarded reached their highest levels for us in the last week of August since the beginning of the pandemic.

 

• The U.K. Health Security Agency said children who had not turned five by the end of last month would not be offered a vaccination, the Guardian reported. The news has sparked an outcry from parent groups and academics. The move is in line with advice published by the UK’s Joint Committee on Vaccination and Immunization in February 2022, the paper reported. UKHSA said the offer of Covid jabs to healthy five to 11-year-olds was always meant to be temporary.

 

Here’s what the numbers say

 

The global tally of confirmed cases of Covid-19 topped 606.6 million on Wednesday, while the death toll rose above 6.5 million, according to data aggregated by Johns Hopkins University.

 

The U.S. leads the world with 94.9 million cases and 1,048,470 fatalities.

 

The Centers for Disease Control and Prevention’s tracker shows that 224.1 million people living in the U.S. are fully vaccinated, equal to 67.5% of the total population. But just 108.8 million have had a booster, equal to 48.5% of the vaccinated population, and just 22 million of the people 50 and over who are eligible for a second booster have had one, equal to 34% of those who had a first booster.

 

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A Key to Long Covid Is Virus Lingering in the Body, Scientists Say

Virus remaining in some people’s bodies for a long time may be causing longer-term complications, recent research suggests

 

The virus that causes Covid-19 can remain in some people’s bodies for a long time. A growing number of scientists think that lingering virus is a root cause of long Covid.

 

New research has found the spike protein of the SARS-CoV-2 virus in the blood of long Covid patients up to a year after infection but not in people who have fully recovered from Covid. Virus has also been found in tissues including the brain, lungs, and lining of the gut, according to scientists and studies

 

The findings suggest that leftover reservoirs of virus could be provoking the immune system in some people, causing complications such as blood clots and inflammation, which may fuel certain long Covid symptoms, scientists say.

 

A group of scientists and doctors are joining forces to focus research on viral persistence and aim to raise $100 million to further the search for treatments. Called the Long Covid Research Initiative, the group is run by the PolyBio Research Foundation, a Mercer Island, Wash., based nonprofit focused on complex chronic inflammatory diseases.

 

“We really want to understand what’s at the root of [long Covid] and we want to focus on that,” says Amy Proal, a microbiologist at PolyBio and the initiative’s chief scientific officer. Dr. Proal has devoted her career to researching chronic infections after developing myalgic encephalomyelitis/chronic fatigue syndrome, an illness that shares similar symptoms with long Covid, in her 20s. She has mostly recovered now but has symptoms she manages.

 

Three long Covid patients, frustrated at the lack of answers and treatments, have helped connect researchers.

 

“Long Covid is this really incredible emergency,” says Henry Scott-Green, one of the patients, a 28-year-old in London who says brain fog, extreme fatigue and other debilitating long Covid symptoms prevented him from resuming full-time work as a product manager, though he plans to return soon. “We’re really trying to run really efficiently and cut out as many layers of bureaucracy as possible.”

 

So far, the group says it has received a pledge of $15 million from Balvi, an investment and direct giving fund established by Vitalik Buterin, the co-creator of the cryptocurrency platform Ethereum.

 

Among the strongest evidence of viral persistence in long Covid patients is a new study by Harvard researchers published Friday in the journal of Clinical Infectious Diseases. Researchers detected the spike protein of the SARS-CoV-2 virus in a large majority of 37 long Covid patients in the study and found it in none of 26 patients in a control group.

 

Patients’ blood was analyzed up to a year after initial infection, says David R. Walt, a professor of pathology at Brigham and Women’s Hospital in Boston and Harvard Medical School and lead researcher of the study. Dr. Walt isn’t currently involved with the long Covid initiative.

 

A year after infection, some patients had levels of viral spike protein that were as high as they did earlier in their illness, Dr. Walt says. Such levels long after initial infection suggest that a reservoir of active virus is continuing to produce the spike protein because the spike protein typically doesn’t have a long lifetime, he adds.

 

Dr. Walt plans to test antivirals such as Paxlovid or remdesivir to see if the drugs help clear the virus and eliminate spike protein from the blood. He says it’s possible that for some people, the normal course of medication isn’t enough to clear the virus. Such cases may require “a much longer exposure to these antivirals to fully clear,” says Dr. Walt.

 

One of the research group’s goals is to find a way for people to identify whether they continue to have the virus in their bodies. There is no easy way to determine this now.

 

Long Covid patients experience such a wide range of long-term symptoms that scientists think there is likely more than one cause, however. Some cases may be fueled by organ damage, for instance.

 

Yet consensus is growing around the idea that lingering virus plays a significant role in long Covid. Preliminary research from immunologist Akiko Iwasaki’s laboratory at Yale University documented T or B cell activity in long Covid patients’ blood, suggesting that patients’ immune systems are continuing to react to virus in their bodies. Dr. Iwasaki is a member of the new initiative.

 

In a 58-person study published in the Annals of Neurology in March, University of California, San Francisco researchers also found SARS-CoV-2 proteins circulating in particles in long Covid patients’ blood, especially in those with symptoms such as fatigue and trouble concentrating.

 

Now, the group is completing a study using imaging techniques and tissue biopsies to detect persistent virus or reactivation of other viruses in tissue. It also is looking at T-cell immune responses in tissues and whether they correlate with symptoms.

 

Some people may harbor the virus and don’t have long-term symptoms, says Timothy Henrich, an associate professor of medicine at UCSF involved with the study and a member of the long Covid initiative. For others, lingering virus may produce problems.

 

“I think there’s a real amount of mounting evidence that really suggests that there is persistent virus in some people,” says Dr. Henrich.

 

Write to Sumathi Reddy at Sumathi.Reddy@wsj.com

AERO Friedrichshafen, 18 April 2018

Day 17 (v 5.0) - more Sam Raimi than H. P. Lovecraft

 

 

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California’s new coronavirus wave is disrupting lives, even with less severe illness

 

A new surge of coronavirus cases is taking shape, as California slogs into a third pandemic summer with far fewer hospitalizations and deaths but still significant disruptions.

 

There are fewer cases of serious illness than occurred during other waves, underscoring the protection imparted by vaccinations, therapeutic drugs and, for some, partial natural immunity stemming from a previous infection.

 

Still, officials are deciding how best to respond now that cases are rapidly rising after plunging in the spring.

 

The extent of infection has prompted some schools, including UCLA, Cal Poly San Luis Obispo and Berkeley’s K-12 public schools, to reinstitute indoor mask mandates and has reignited concerns that hospitals may soon be asked to care for larger numbers of coronavirus-positive patients.

 

“If we continue on the current trajectory, we could find that cases and hospitalizations end up exerting stress on our healthcare system within just a few weeks,” Los Angeles County Public Health Director Barbara Ferrer said during a recent briefing.

 

Some observers say there’s no sign that California is nearing a peak, as the latest variant’s exceptional contagiousness is thought to be approaching that of measles. State modeling suggests that the spread of COVID-19 is likely still increasing in Southern California, and could be ticking up in the San Joaquin Valley and Greater Sacramento, as well.

 

Even if hospitals don’t become burdened, there’s concern that climbing rates of transmission could keep people at home for a week or more, ruining plans for graduations, weddings and vacations and making it difficult for businesses to maintain adequate staffing.

 

Other worry that unlike in previous waves, people tired of the pandemic will be less willing to wear masks or take other measures to reduce coronavirus spread, potentially threatening the health of vulnerable people at higher risk of severe complications and increasing the chance of people suffering from long COVID.

 

In the San Francisco Bay Area, some businesses and institutions are taking care to avoid greater spread, including the Golden State Warriors, whose coach, Steve Kerr, was briefly out with a coronavirus infection as the team marched through the NBA playoffs, and Apple, which reportedly postponed a three-day-a-week return-to-work plan.

 

Statewide, officials are reporting nearly 15,000 new coronavirus cases a day, a rate nearly as high as during last summer’s Delta surge. The latest wave was spawned by the highly infectious Omicron strains.

 

San Francisco has one of the state’s highest coronavirus case rates, reporting more than 400 a week for every 100,000 residents as of Thursday. Los Angeles County was reporting 308 cases a week for every 100,000 residents as of Tuesday. A rate of 100 or more is considered high.

 

“It’s now a big-time surge,” Dr. Robert Wachter, chair of UC San Francisco’s Department of Medicine, tweeted Monday. “No longer just cases … also major uptick in hospitalizations. … If you’re trying to stay well, time to up your game.”

 

While the daily census of coronavirus-positive patients in hospitals has risen lately, it has done so at a much slower pace than in previous surges. On the whole, the patient count remains far lower than in the past.

 

Statewide, 2,281 coronavirus-positive patients were hospitalized as of Tuesday — up 41% from two weeks ago. By comparison, daily hospitalizations surpassed 8,300 during the height of the Delta wave and topped 15,400 at the peak of the first Omicron surge.

 

Additionally, some hospital officials in recent weeks have noted that most of the coronavirus-positive patients are not being treated for COVID-19; they may have been admitted for other reasons and tested positive while in the hospital.

 

“We are not seeing COVID pneumonia. We’re seeing flu-like illnesses,” tweeted Dr. Brad Spellburg, chief medical officer of L.A. County-USC Medical Center, noting that patients are going home after being seen in the emergency room.

 

Of about 10 coronavirus-positive patients at his public hospital, only one was admitted primarily for COVID-19, Spellburg said.

 

However, Ferrer noted that coronavirus-positive patients take up hospital resources, in part to keep them isolated.

 

“The more cases you have — even if it’s just a small fraction of people who get infected and need to be hospitalized — the greater the strain will be on the healthcare system,” she said.

 

In L.A. County, there were 502 coronavirus-positive patients in public and private hospitals as of Tuesday. That’s up 38% from two weeks before. In San Francisco, there were 96 patients, up 26% over the same period.

 

“The rate of increase in hospital admissions are of concern,” said Ferrer, who characterized the increase as occurring at a “modest pace.”

 

Computer models posted to the state’s COVID-19 forecasting website indicate increasing hospitalizations in the weeks to come — with coronavirus-positive intensive care patients projected to almost quadruple from 242 to close to 950 by the end of June. That’s not as high as the winter Omicron peak of about 2,600 but would represent a significant increase from the post-winter low of 112.

 

State modeling also projects that the overall daily number of hospitalized coronavirus-positive patients could approach 5,000 by the end of June.

 

Nationwide, COVID-19 deaths have started to increase. The U.S. was reporting an average of 301 COVID-19 deaths a day for the seven days ending Monday, up 5% from the previous week. The U.S. Centers for Disease Control and Prevention is now forecasting that daily COVID-19 deaths will increase through at least mid-June, possibly doubling to more than 750 a day.

 

California is averaging 33 COVID-19 deaths a day, a level that has remained stable.

 

Some medical experts have recently pushed back against what they consider an overly optimistic sentiment that increases in coronavirus cases don’t really matter, because immunization rates have lowered the risk of hospitalization and death.

 

“There is no way to get around the reality that surges of COVID-19 are problematic — they result in people being sick enough to be out of work; others sick enough to be in the hospital; others sick enough to have longer term issues,” tweeted Dr. Abraar Karan, an infectious-diseases expert at Stanford University. “Normalizing surges is bad public health.”

 

A coronavirus infection brings with it the risk of developing long COVID, in which symptoms like fatigue, difficulty breathing and brain fog can persist for years.

 

A report published last week in the journal Nature Medicine analyzed health records of veterans and found that vaccinated people who were infected with the coronavirus have some risk of experiencing long COVID. The study reviewed records prior to Dec. 1, before the Omicron wave accelerated in the U.S.

 

“The findings suggest that vaccination before infection confers only partial protection in the post-acute phase of the disease,” the study said. Reliance on vaccines alone and not using other strategies to reduce risk “may not optimally reduce long-term health consequences” from a coronavirus infection, the report said.

 

A separate report, published last week by the CDC, said roughly 1 in 5 adults who survived COVID-19 have a health condition that might be related to their infection, such as problems affecting the heart or lungs.

 

It’s “wishful thinking” to imagine that recurrent COVID-19 illnesses “aren’t a big deal,” Wachter tweeted. The truth, he said, is that risks of getting long COVID from “recurrent cases of COVID aren’t yet clear.”

 

www.sfchronicle.com/health/article/Bay-Area-s-spring-COVI...

 

As Bay Area cases swell again, it’s ‘very hard right now to avoid getting COVID’

 

Coronavirus cases blew up across the Bay Area in May, as the region became entrenched in a sixth surge that is likely many times larger than what reported infections show and may even be approaching the magnitude of this past winter’s massive omicron wave, health experts say.

 

COVID hospitalizations are climbing in the Bay Area too — they’ve nearly doubled since the start of the month — though they remain at a relatively low and manageable level compared to prior surges, experts said. The number of patients with COVID needing intensive care in the region has more than doubled over the past month, but ICU capacity is not tapped out.

 

Deaths also remain far below the levels seen in earlier waves; the Bay Area has reported on average three deaths a day for almost all of May.

 

The mix of variants fueling this surge makes it tough to speculate when cases will level off, experts said — cases could have already peaked and will soon start dropping, or they may keep climbing for longer. Plus, subvariants that have yet to get a foothold in the region could further prolong this wave or a drive a new one later in the summer.

 

Regardless of where this current surge is headed, health experts said people who want to avoid becoming infected should be resuming aggressive COVID precautions by now, if they haven’t already, including wearing masks indoors and avoiding crowded spaces — from busy restaurants and movie theaters to graduation parties.

 

“My sense is that it’s very hard right now to avoid getting COVID. It is so prevalent,” said Dr. John Swartzberg, an infectious disease expert with UC Berkeley.

 

“That’s the bad news. But we really dodged the bullet with this surge in terms of the variants causing it,” he said. “It’s apparent they don’t cause as severe disease in people. It’s mostly upper respiratory stuff.”

 

As of the end of last week, the Bay Area was reporting between 4,000 and 4,500 new coronavirus cases a day — roughly double the daily reports from the start of the month. Health officials have said for many weeks that reported cases are lower than the actual number of infections, in large part due to increased reliance on home testing and a significant number of asymptomatic cases.

 

But some experts now believe infections are likely many times higher than the reported cases — one preprint study estimated as much as thirtyfold higher in New York City. At the peak of the omicron surge, the Bay Area was reporting roughly 20,000 cases a day — also an undercount, though probably not as much as now, since home tests were harder to find in the winter. It’s possible, some experts say, that cases now are much closer to the omicron peak than the official counts would seem to show.

 

“I think those numbers are probably not that far off from each other,” said Dr. Robert Wachter, chief of medicine at UCSF. “Certainly I know more people with it now than in January.”

 

Wachter said he believes many people who were cautious earlier in the pandemic have been caught by this latest surge because they were lulled into complacency by the relatively slow-building case counts. And they may simply be tired, too — even, or perhaps especially, in the Bay Area, where residents generally adopted more protective measures than in other parts of the country.

 

“Because people seem to have psychologically moved on, it seems like they’re not treating the level of cases with the same respect that we might have previously,” said Wachter, noting that his wife became infected for the first time in this surge, after attending an in-person conference.

 

Wachter added that hospitalizations, though increasing in recent weeks, remain well below the height of the winter omicron surge. Nearly 600 people are currently hospitalized with COVID in the Bay Area, including 67 in intensive care as of Monday. At the omicron peak in late January, more than 2,000 people were hospitalized, with 366 in the ICU.

 

Wachter said the lower hospitalization numbers likely are “a reflection of vaccination, boosting and prior infection” providing protection, as well as improved access to Paxlovid, an antiviral given to prevent severe illness.

 

He said UCSF — as with other Bay Area hospitals — is not yet strained by the number of patients with COVID, but there’s some stress on capacity due to large numbers of health care providers being out sick. “It’s more about having enough doctors or nurses than having 40 or 45 patients in the hospital,” Wachter said.

 

Predicting where this surge is headed, and whether the Bay Area may be hit by yet another wave later this summer, is complicated for now because more than one variant is circulating, experts said. As of the end of last week, two omicron subvariants — known as BA.2 and BA.2.12.1 — were making up the bulk of cases in the southwestern part of the United States, including California, according to the Centers for Disease Control and Prevention.

 

BA.2.12.1 was notable for driving a recent Northeast surge; it now makes up roughly half of cases in the Southwest, according to the CDC. It’s believed to be 20% to 30% more infectious than the original omicron.

 

Adding further complexity could be the arrival of the subvariants BA.4 and BA.5, which have been detected in the Bay Area but are not yet widely circulating. Those subvariants drove recent surges in South Africa and parts of Europe, and Bay Area experts said there is some concern they could cause a new swell of illness here.

 

Early reports suggest those subvariants may be more infectious and better able to evade immunity than the currently circulating strains, but experts don’t anticipate they’ll cause much more damage.

 

“My guess is if BA.4 and BA.5 do come here, and start to take over, it’s just going to cause a prolonged problem of what we’re experiencing now, as opposed to something catastrophic,” Swartzberg said.

 

Dr. Lee Riley, also an infectious disease expert at UC Berkeley, agreed that emerging subvariants could extend this surge or trigger a new one. He’s more concerned about what this fall or winter will bring, though.

 

“At some point, we’re going to start seeing variants that are really not as susceptible to our immunity,” Riley said. “These surges could get even worse, maybe by this fall.”

A nice double star and good calibration here, no vignette!

 

Full calibration achieved with:

 

10x 1600 ISO @ 40s each

5x Darks

5x Bias

5x Flats

 

Processed in Deep Sky Stacker

Adjusted slightly in GIMP 2.8 (Windows)

 

Skywatcher 200P

Canon 1100D

 

Taken in Taunton, Somerset

 

www.webmd.com/lung/news/20211222/monoclonal-antibody-for-...

 

Monoclonal Antibody for Omicron in Short Supply

 

Of the three monoclonal antibody treatments available in the United States to keep people infected with COVID-19 from becoming seriously ill, only one is effective against the surging Omicron variant – and that medicine is in short supply, The New York Times reported.

 

That shortage has created problems at hospitals filling up with COVID patients. About 73% of the new COVID cases in the U.S. are caused by the rapidly spreading Omicron variant, up from about 12% the week before, the U.S. Centers for Disease Control and Prevention says.

 

The antibody treatment that works against Omicron is, made by GlaxoSmithKline and Vir Biotechnology. It received government approval last spring.

 

Two antibody treatments approved earlier, made by Eli Lilly and Regeneron, worked against the Delta variant and other forms of COVID, but are not as effective against Omicron, The Times said.

 

The Times said the federal government ordered 450,000 doses of sotrovimab and began shipments in the fall. But shipments were halted when Omicron emerged because health authorities wanted to preserve the supply until they knew how seriously to take the threat of the new variant, The Times said.

 

When it became clear that Omicron was not going away, the government allocated 55,000 doses to states, The Times said. Shipments should arrive as soon as this week.

 

The manufacturer is expected to make and deliver 300,000 more doses to the United States. GSK spokesperson Kathleen Quinn said more doses will be manufactured with another production facility and accelerated production plans.

 

Meanwhile, hospitals are deciding whether or not to keep giving the Eli Lilly and Regeneron treatments to patients, because they’re not effective against Omicron.

 

Administrators at NewYork-Presbyterian, N.Y.U. Langone and Mount Sinai hospitals said the hospitals will stop giving the Eli Lilly and Regeneron treatments, The Times reported, citing memos obtained and unnamed health system officials.

 

Regeneron and Eli Lilly say they’re developing monoclonal antibodies that will work against Omicron, though they won’t be available for months.

 

One bright spot is that the U.S. Food and Drug Administration on Wednesday gave emergency authorization for an antiviral produced by Pfizer called Paxlovid – the first oral monoclonal antibody.

 

Pfizer says preliminary lab studies also suggest the pill will hold up against the Omicron variant.

 

“Today’s authorization introduces the first treatment for COVID-19 that is in the form of a pill that is taken orally — a major step forward in the fight against this global pandemic,” Patrizia Cavazzoni, M.D., director of the FDA’s Center for Drug Evaluation and Research, said in a news release. “This authorization provides a new tool to combat COVID-19 at a crucial time in the pandemic as new variants emerge and promises to make antiviral treatment more accessible to patients who are at high risk for progression to severe COVID-19.”

 

Paxlovid won’t be immediately available to help people infected with Omicron because current supplies are limited.

  

www.latimes.com/california/story/2021-12-26/jump-in-child...

 

Jump in child COVID hospitalizations in N.Y. sparks concerns in California amid Omicron

 

SAN FRANCISCO —

 

A jump in child COVID-19 hospitalizations in New York is being seen as a warning to get more children vaccinated in California and elsewhere as the Omicron variant continues to surge.

 

The Omicron wave hit New York before California, where cases have been spiking in the last week. California officials said they are monitoring the rise in child hospitalizations.

 

“Unfortunately NY is seeing an increase in pediatric hospitalizations (primarily amongst the unvaccinated), and they have similar [5 - to 11-year-old] vaccination rates,” California State Epidemiologist Dr. Erica Pan wrote on Twitter. “Please give your children the gift of vaccine protection as soon as possible as our case [numbers] are increasing rapidly.”

 

The increase is concentrated in New York City and the surrounding metro area. Officials described pediatric admissions quadrupling in New York City in recent weeks.

 

Half of the children being admitted to hospitals are younger than 5 and ineligible for vaccination. Three-quarters of those ages 12 to 17 who were admitted into hospitals for COVID-19 were not fully vaccinated, and 100% of those ages 5 to 11 who were admitted into hospitals were not fully vaccinated.

 

The warning about pediatric hospital admissions comes as California’s public health director and health officer, Dr. Tomás Aragón, warned that state modelers are predicting hospital surges for California.

 

“Why? Omicron is so contagious that it finds unvaccinated/non-immune people who are most vulnerable for hospitalizations and deaths,” Aragón wrote.

 

Aragón urged people to get vaccinated and boosted; test before risky events, as well as three to five days after them; and consider not attending or postponing high-risk indoor gatherings. Aragón also suggested improving ventilation and air filtration, and improving the fit and quality of masks.

 

Health experts have increasingly urged people to upgrade their masks from cloth masks alone. A more protective mask-wearing setup involves a cloth mask over a surgical mask, which improves the fit; an even more improved set-up involves wearing those that are higher-grade, like a KF94, KN95 or N95 mask.

 

Dr. Anthony Fauci, President Biden’s chief medical adviser, recently urged people to not go to the kinds of indoor parties attended by dozens of people whose vaccination status you don’t know. Fauci said it’s safer for people to gather in smaller-sized gatherings with family and friends in homes where everyone is known to be vaccinated and boosted, and even safer if people get rapid tests just before the event.

 

Fauci on Sunday told ABC that recent data from Britain shows that, in its Omicron wave, a lower percentage of newly infected people are needing hospitalization stays.

 

“Interestingly, the duration of hospital stay was lower, the need for oxygen was lower,” Fauci said on ABC’s “This Week.” Still, because Omicron is causing such a high volume of new infections, the variant could find many, many more people who haven’t been immunized, and could still result in hospitals that are overrun.

 

Unvaccinated people “are the most vulnerable ones when you have a virus that is extraordinarily effective in getting to people and infecting them the way Omicron is,” Fauci said in the televised interview. Omicron “might still lead to a lot of hospitalizations in the United States.”

 

While unvaccinated people are at highest risk of contracting the virus and suffering severe illness, the Omicron variant’s mutations enable it to increase the risk of breakthrough infections among those who are vaccinated. Still, vaccinated people, especially those who are boosted, are expected to be generally protected from severe illness and death, unless they have a weakened immune system.

 

New coronavirus cases dramatically increased through Christmas in Los Angeles County. On Tuesday, 3,052 new cases were reported; on Wednesday, 6,509; Thursday, 8,633; Friday, 9,988; Saturday, 11,930; and Sunday, 8,891. Officials warned coronavirus case counts over the weekend are actually an undercount due to delays in reports over the holiday.

 

At its peak during last winter’s surge, L.A. County was averaging about 16,000 new coronavirus cases a day. Officials have warned that L.A. County could be on track to see daily case numbers that could break that record, with as many as 20,000 new cases a day.

 

The percentage of coronavirus tests in L.A. County coming back positive has risen dramatically. For the seven-day period that ended Sunday, 10.8% of coronavirus tests had positive test results. By comparison, for the seven-day period that ended on Dec. 20, 3.4% of tests came back with positive results.

 

Los Angeles County’s COVID-19 hospitalizations have also increased significantly since Dec. 1, from 569 to 904 on Christmas, an increase of 59%. But the latest number is far less than it was a year ago, when vaccinations had just been introduced and were in sharply limited supply; in L.A. County on Dec. 25, 2020, there were 6,815 people with COVID-19 in L.A. County’s hospitals; up from 2,572 on Dec. 1, 2020. At its peak, L.A. County observed 8,098 COVID-19 hospitalizations on Jan. 5, a time that coincided with overwhelmed hospitals and overflowing morgues.

 

Southern California’s COVID-19 hospitalizations are increasing faster than the San Francisco Bay Area.

 

Since Dec. 1, the COVID-19 hospitalization rate in Southern California has risen by about 41%, from 7.7 hospitalizations for every 100,000 residents, to 10.8.

 

By contrast, the greater San Francisco Bay Area has seen its rate climb by 26%, from 3.8 to 4.8. Experts say it’s a sign of concern when the rate is 5 or greater.

 

The Inland Empire has among the highest COVID-19 hospitalization rates in Southern California; San Bernardino County’s rate is 20, and Riverside County’s is 15. San Diego County’s rate is 11; Los Angeles and Ventura counties, 9; and Orange County, 8.

 

Some experts are expressing hope that areas with high vaccination and masking rates will not be devastated by a surge in COVID-19 hospitalizations.

 

Dr. Robert Wachter, chair of the UC San Francisco Department of Medicine, wrote on Friday that while coronavirus case rates are rising fast in San Francisco, hospital numbers remain low.

 

The bad news, Wachter said, is that Omicron is spreading fast in San Francisco. The good news is that Omicron does appear to lead, generally speaking, to milder illness, particularly in vaccinated populations, Wachter wrote on Twitter.

 

Wachter said he’d be far less upbeat in areas with lower vaccination rates. San Francisco has one of California’s highest vaccination rates, with 88% of the population having received at least one dose; but other areas of the state have lower rates; L.A. County’s rate is 76%; Orange County, 75%; Ventura County, 74%; while Fresno County’s is 65%; Riverside County, 64%; San Bernardino County’s is 60% and Kern County’s is 56%.

 

“I’d be ... far more scared if I wasn’t vaxxed and boosted. The unvaxxed are playing a risky hand,” Wachter wrote.

 

In San Francisco, Wachter wrote he still expects a bump in hospitalizations but added it “seems unlikely it’ll be overwhelming here.”

 

In Los Angeles County, officials have expressed concerns about the rising case numbers.

 

“Very high case numbers can easily cause significant stress to our healthcare system if even a small percent of those infected experience and require hospital care,” Public Health Director Barbara Ferrer said. A COVID hospital surge can also compromise care for non-COVID patients, such as those suffering from accidents, heart conditions and cancer.

 

Still, L.A. County can manage rising case numbers without overwhelming the hospital system, Ferrer said, if more people get vaccinated and boosted, wear masks in indoor public settings and outdoor crowded areas, and avoid large indoor crowded gatherings.

 

Ferrer has also discouraged big indoor public gatherings in light of the Omicron surge.

 

“No matter what, the case numbers are going to go up. But we might be able to manage these case numbers in a way that doesn’t end up stressing out our healthcare system and prevents most people from experiencing severe illness and the tragedy of passing away,” Ferrer said.

 

Unvaccinated people have the highest chance of getting infected with the coronavirus and being hospitalized with COVID-19.

 

For the weeklong period that ended Dec. 11, for every 100,000 unvaccinated residents, there were 272 L.A. County residents who were newly infected with the coronavirus. By comparison, for every 100,000 residents who were considered fully vaccinated but hadn’t received a booster, 68 were infected.

 

Those who had received their booster had the lowest risk of infection. For every 100,000 residents who received a booster, only 12 were infected that week.

 

That means unvaccinated people were 23 times more likely to be infected with the coronavirus than vaccinated people who received a booster shot.

 

Vaccinated people were also far less likely to be hospitalized than unvaccinated people.

 

For every 100,000 unvaccinated L.A. County residents, 25 of them were hospitalized for the week that ended Dec. 11. By comparison, the hospitalization rate for people who were considered fully vaccinated was 1.

 

“Even with transmission shooting upward, vaccination continues to be highly protective against hospitalization,” Ferrer said.

(pequeno fragmento do texto do cartaz da exposição)

 

Curitiba.

  

Percebi nestas fotografias o quanto Curitiba se escondia por detrás de nossas vivências ordinárias, das contas a pagar, das dezenas de compromissos inadiáveis e do trânsito caótico. Percebi que a cada dia nos tornávamos mais distantes da cidade, menos íntimos dos espaços públicos, mais e mais ensimesmados. A cidade, em resposta a este desprezo, se esconde de nosso olhar que nada lhe traz. Desta forma, apartados, habitamos a cidade.

As fotografias aqui expostas buscam o extraordiário ao invés do olhar já calejado de tanto "não-ver". Assim, (...)

 

(o resto do texto você pode apreciar na abertura da exposição dia 03/08 às 19h.)

 

Osvaldo Santos Lima

Diretor Omicron Centro de Fotografia.

news.yahoo.com/how-strong-is-your-immunity-against-omicro...

 

How strong is your immunity against Omicron?

 

For months, scientists, public health officials, politicians and the general public have debated whether prior SARS-CoV-2 infection — touted as “natural immunity” — offers protection against COVID-19 that is comparable to vaccines.

 

The answer to that debate is complicated, but studies show the best way to protect yourself against the Omicron variant of the coronavirus is to get vaccinated and then boosted. An infection on top of that, while not desirable, offers even more protection.

 

Recent evidence suggests that “natural” COVID-19 protection depends on many factors, including when the infection happened, the variant involved, whether someone has been boosted or not, and the overall strength of their immune system.

 

“The question about natural versus vaccination immunity is an important one,” Monica Gandhi, an infectious disease specialist and professor of medicine at the University of California, San Francisco, told Yahoo News. “The CDC showed that up to the Delta surge, no doubt, natural immunity is likely as protective or more protective even than your two-dose vaccines,” she added.

 

Gandhi was referring to a study published two weeks ago in the Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report. It is the same study that GOP lawmakers pointed to this week when introducing the “Natural Immunity Transparency Act,” arguing that the CDC data “demonstrated natural immunity was 3-4 times as effective in preventing COVID-19 compared with vaccination.”

 

But this claim needs more context. The CDC study analyzed COVID-19 cases in California and New York in 2021, which together only account for about 18 percent of the U.S. population. The data was collected from May 30 to Nov. 20, 2021, a period before and during the Delta wave. The study showed that prior to Delta, which became predominant in late June and July 2021, case rates were lowest for people who were vaccinated and not previously infected with COVID-19. But by early October, when Delta was dominant, the picture changed. Case rates then were substantially lower among both unvaccinated and vaccinated people with previous infections, suggesting that natural immunity during this period was superior to vaccines.

 

However, it is important to note that the CDC research was conducted during a time when vaccine-induced immunity was waning for many people and before the emergence of the highly transmissible Omicron variant. Additionally, most U.S. adults were not yet eligible to receive booster shots, which are seen as offering the best protection against Omicron.

 

In general, studies conducted pre-Omicron do support the concept that infection-induced immunity and vaccine-induced immunity are pretty similar in terms of protection. However, Gandhi said there are many reasons vaccines are preferred. Notably, vaccines are free, safe and quick, while getting COVID-19 carries substantial risks, including long COVID, hospitalization and death. “It’s just safer,” Gandhi said.

 

She also said natural immunity can vary substantially from person to person, depending on many factors like age, the overall strength of the person’s immune system, how severe the COVID case was and the variant that infected them.

 

“What happens with natural infection is that if you have a mild infection, you may not mount the strong cellular immune response that you need to fight it in the future,” Gandhi said. On the other hand, vaccines were subject to rigorous trials and found to elicit a high immune response. Most experts agree that a vaccine is a more quantifiable, predictable and reliable way to protect the population.

 

Another downside to relying on natural immunity is that Omicron has replaced Delta as the dominant variant, and Omicron is both more transmissible and more capable of evading immune protection triggered by both vaccines and previous infections.

 

Shane Crotty, a virologist and professor at La Jolla Institute for Immunology, told Yahoo News that the Omicron variant changed everything. “Omicron is looking so different from the other variants that just infection alone might not be giving you great antibodies against the other variants because it looks so different,” he said. It is still unclear how much immunity one can expect to come out of an Omicron infection, including how long that protection lasts and whether it will apply to future variants.

 

Based on the epidemiological data available, Crotty said, those who are likely to be the most protected against both infection and hospitalization at the moment are people who have had a breakthrough infection. This means, individuals who have had an infection and then a vaccine, or vice versa.

 

“Data by tons of labs shows that those people make really broad neutralizing antibodies,” the professor said. “Their antibodies recognize every possible variant and even distant viral species, but they also make really high levels of those antibodies,” he added.

 

People in this category — both infection and vaccination — have what has become to be known as “hybrid immunity” or “super immunity.” According to a CDC study, those who get fully vaccinated after recovering from COVID-19 have twice the protection of those who do not get vaccinated after their recovery.

 

Experts warn, however, this doesn’t mean people should purposefully try to infect themselves with the coronavirus to achieve greater protection against COVID-19, since there are serious health risks involved.

 

People who are boosted also have an especially high level of protection against Omicron. “It’s pretty amazing three doses of the same vaccine, which is just against the ancestral strain. Your immune system is so clever. It’s seeing that old version of the spike protein basically, and the first two times it sees it, it makes neutralizing antibodies against the ancestral strain and a couple of variants, but not Omicron, but just seeing that same vaccine the third time, and now you make neutralizing antibodies against Omicron,” Crotty explained.

 

Underscoring the value of a third dose, recent studies by the CDC have shown a booster dose of the COVID-19 vaccine significantly reduces a person’s chance of hospitalization from the Omicron variant. One of the CDC reports, which looked at 259 hospitals and 383 emergency departments from late August through early January, found that a third dose of either the Pfizer or Moderna vaccine was 90 percent effective at preventing hospitalization and 82 percent effective at preventing emergency department and urgent care visits.

 

However, despite the evidence supporting the efficacy of a third dose, many Americans have been hesitant to receive their booster shots. Gandhi says this is unfortunate because boosters could be the ticket back to normal, and those who are unboosted or unvaccinated are more vulnerable to Omicron and future variants that could emerge. “What we need to get through this time is immunity ... so even if you’ve been actually infected, I really would recommend at least one dose of a vaccine,” Gandhi said.

 

www.vox.com/coronavirus-covid19/22841229/covid-19-us-canc...

 

Covid-19 created America’s next health care crisis: The cancers we didn’t catch early

 

The pandemic dramatically disrupted cancer screenings, and thousands of lives are now at stake.

 

Steve Serrao, chief of gastroenterology at a hospital in Moreno Valley, California, just lived through the fourth wave of Covid-19 with the omicron variant sweeping across the country. Patients in respiratory distress once again filled the hospital’s beds.

 

But it is another wave, one that’s starting to trickle in but is still a long way from cresting, that Serrao worries about most. He fears that the delayed diagnoses of various cancers and other chronic, life-threatening illnesses — the result of Covid-19’s disruption to routine checkups and screenings — will be the next crisis that overwhelms the US health system.

 

“Our next surge will be advanced chronic disease,” Serrao told me over the phone. “That’s going to be the next surge of patients who overwhelm our system. I don’t think our systems are ready.”

 

The Covid-19 pandemic dealt a crushing blow to the preventive services that can catch potential health problems before they become life-threatening. Screenings for several major cancers fell significantly during 2020, according to a study published in December 2021 in the journal Cancer. Colonoscopies dropped by nearly half compared to 2019, prostate biopsies by more than 25 percent. New diagnoses declined by 13 percent to 23 percent, depending on the cancer — not because there was less cancer in the world, but because less of it was being detected. The screening backlog was still growing by the end of 2020, according to this recent study, albeit at a slower rate.

 

“I think we are absolutely in uncharted territory,” Brian Englum, a University of Maryland surgeon who co-authored the new Cancer study, told me. “There are no examples I know of where we have seen numbers change this dramatically.”

 

The fear among doctors is that the pandemic’s disruption to cancer screenings and other preventive measures won’t just be a blip, although a blip would be bad enough on its own: When cancer gets diagnosed late, it’s less likely a patient’s doctors can successfully intervene, and the patient is more likely to die. Even a four-week delay in diagnosis is associated with a 6 to 13 percent higher risk of death.

 

But they also fear that the missed screenings will lead to a more permanent disconnect between patients and the health system. Research has found that when patients lose their primary care doctor, they tend to end up in the hospital more, with more serious health problems. People who have skipped appointments or didn’t get screenings or care may be less likely to seek it in the future, and the problems could compound.

 

It may take years for the consequences to become clear. Before the pandemic, some physicians questioned if the US might be conducting too many screenings. But the country is now being forced to undergo an unintended natural experiment in less screening, one with thousands of lives at stake. The collateral damage of a pandemic that has killed more than 900,000 Americans could grow even more.

 

“We could be years into this before we know there’s a problem,” Englum said, “and we’ve already lost a lot of people.”

 

“How many of these cases are out there? Nobody knows.”

 

Serrao described one of his patients as a Hispanic man in his 40s. When he first noticed bleeding in early 2020, the patient talked to his primary care doctor, who told him it might be hemorrhoids, Serrao said. The primary care doctor acknowledged that getting a cancer screening would be impossible on short notice because the local hospitals were so strained with Covid-19. And the patient feared he might get sick if he went to a hospital.

 

Ultimately, it was 18 months before the patient sought a colonoscopy. He was diagnosed with what was, by then, advanced rectal cancer, Serrao said.

 

If the man had come in right away, Serrao said, he might have been cancer-free after a simple polyp removal. Instead, the doctor and his team are now battling cancer that has moved into other parts of the patient’s body. His outlook is much worse than it would have been if the cancer had been caught sooner.

 

“How many of these cases are out there? Nobody knows,” Serrao said.

 

Serrao’s patient had the misfortune to notice symptoms amid the biggest disruption of medical care in US history — one that hit cancer screenings particularly hard. In April 2020, as many hospitals canceled services in order to prepare for the expected surge of Covid-19 patients, the number of colonoscopies plummeted 93 percent. Then, after a brief rebound, the late 2020 winter wave stretched hospitals and forced them to limit services. By the end of the year, there had been 133,231 fewer colonoscopies performed in 2020 compared to the 2019 baseline, 62,793 fewer chest CT scans, and 49,334 fewer fecal blood tests.

 

“The drop-off in screenings has made me born again on the importance of screening,” John Marshall, chief of oncology at Georgetown University Hospital, told me. “We’re seeing more advanced diagnoses, and people presenting at a stage where they no longer can be cured.”

 

It will take months for the backlog to be cleared. Carrie Saia, the CEO of a community hospital in Holton, Kansas, told me that one of her facility’s gastroenterologists had been recruited by a larger Kansas City hospital to “scope from 7 in the morning to whenever at night, doing nothing but scopes.”

 

“They’re 1,000 people behind and backlogged right now,” Saia said. “A certain percentage out of those patients are going to have cancer growing.”

 

And working to clear that backlog begets a new backlog. Patients who are just now seeking a screening are finding it harder to get appointments. Marshall said he knew of patients who first experienced symptoms in September, were recommended for a screening by their doctor, but still couldn’t get an appointment as of December because there are so many patients in need of colonoscopies, MRIs, and other screening procedures.

 

Covid-19 led to direct rationing in overwhelmed hospitals last summer; they were unable to take patients with acute medical emergencies and couldn’t find another facility to take them. But this more subtle kind of rationing — delaying necessary services for months because the backlog has grown so large — also takes its toll, forcing doctors to make hard choices about which patients to prioritize.

 

“Everything is harder,” Marshall said. “We’ve had to make trade-off and priority decisions about who’s getting the treatment before the other person, decisions we would never have had to make.”

 

Covid-19’s disruption of US health care is likely going to deepen disparities

 

Serrao practices at the Riverside University Health System in San Bernardino County, about an hour and a half drive from downtown Los Angeles. Roughly two-thirds of his patients are Black, Hispanic, or Asian/Pacific Islander. Almost all of them have government insurance, either Medicare or Medicaid.

 

Black Americans already experience a higher incidence of and a higher mortality from colorectal cancers than white Americans. Black and Hispanic patients also tend to be diagnosed with more advanced lung cancers than their white peers, they have higher mortality from breast cancer, and they receive fewer prostate exams. At each stage, from preventive screenings to death rates, disparities already existed.

 

“They already have health disparities on a good day,” Serrao told me. “These last couple of years have put them back multiple years. The setback is quite profound.”

 

Over the course of the pandemic, Serrao’s practice struggled to make a dent in the backlog. Just as they would gain some momentum, another surge of Covid-19 would interrupt their progress.

 

Last January, the GI unit at his hospital was converted to a recovery area for patients receiving radiation therapy and other cancer treatments because overflow Covid-19 patients were in the space usually reserved for oncology recovery patients. As a result, he and his team couldn’t perform any screenings.

 

It was a necessary step — the top priority was maintaining treatment for patients already diagnosed with cancer — but it required the postponement of screenings to identify new cancer cases. The backlog got bigger.

 

“I’m almost certain that there are population pockets out there that have high disparities with cancer that will show up in the next year, two years, three years with more advanced cancers,” Serrao said, “and that’s because of the disruption in health care.”

 

The US will be living with the fallout of delayed cancer screenings for years

 

That problem may only be getting worse over time. Englum told me that one of the more troubling implications of their findings is that cancer screenings did not return to their pre-pandemic normal by the end of 2020.

 

It wasn’t a two- or three-month blip during the worst of the outbreak. By the end of the year, the drop in screenings looked more and more like a permanent setback. It’s the same problem we’re seeing with routine vaccinations: people who missed their shots and aren’t catching up even as we enter a new post-Covid normal.

 

“What our study shows is not only did we not make up for the blip, we didn’t even get back to baseline by the end of 2020,” Englum said. “We kept losing ground.”

 

The US health system struggled before the pandemic with managing people’s care in a timely fashion. It requires having an established relationship with a primary care doctor — which fewer and fewer Americans do — and then staying on schedule with recommended preventive screenings like colonoscopies and mammograms. As of 2018, according to a federal study, only 8 percent of Americans were receiving all the preventive services that are recommended for them.

 

Americans have now lived through two years when their primary care practice might have been closed, permanently or temporarily. The hospitals where they would have gotten a colonoscopy were postponing those non-emergent procedures. Some of them may have been afraid to go to the doctor or hospital, knowing that a highly transmissible virus was on the loose.

 

That only makes the challenge of getting people to stay on top of their health care harder. Doctors worry that people’s habits may be permanently changed by the pandemic — and not for the better.

 

“I am fearful that once people got out of that habit, they didn’t see an immediate problem,” Englum told me. “Then they say, ‘Well, I haven’t seen my doctor for six months or a year and nothing happened. I feel fine.’ They’re just out of the habit. They lost the routine.”

 

That means the health system is flying blind. Unless people get back in the habit of getting their recommended screenings, doctors will lose ground every year in identifying patients with serious conditions or at risk of developing them. That would limit their ability to get ahead of emerging health problems before they become chronic or even life-threatening.

 

In theory, Englum pointed out, this also could be an opportunity to learn whether the current screening guidelines are actually appropriate. If 10 years were to pass and there were no appreciable increase in cancer mortality, for example, maybe we could revise our recommendations for colonoscopies from every 10 years to every 12. The pandemic would have provided evidence such a delay doesn’t present a big risk at the population level.

 

That kind of reevaluation is happening across the health system. Health insurers are monitoring the outcomes for patients who delayed kidney treatment because of Covid-19. They are watching for any negative effects, but also for countervailing evidence that might indicate the missed care was actually unnecessary.

 

At every level, the pandemic has forced a natural experiment in what a disruption to the usual treatment plan means for patient outcomes. We are going to learn a lot, like it or not. The risk is that those lessons will come at the cost of thousands of lives.

 

Because the flip side of the optimistic scenario is that in 10 years’ time, we will see cancer mortality increasing as a result of delayed screenings.

 

“By then,” Englum said, “you’ve lost the opportunity to treat however many thousands of people.”

29/11/2021. London, United Kingdom. Health Secretary Sajid Javid holds a call with his counterparts from the G7 to discuss the outbreak of the Omicron Covid-19 virus at the Department of Health and Social Care. Picture by Lauren Hurley / DHSC

A Home Energy LLC solar installation for Omicron Biochemicals of South Bend, Indiana. This is a 4.46 kilowatt system with 19 Schott, 235 watt, solar panels.

Alpha Omicron Pi-Tau Delta

 

The Omicron Delta Kappa inductee ceremony on April 27, 2023.

(Photo by Sabree Hill/ Dillard University Photographer)

Koni-Omega Microfilm Camera HK-35

Manufactured by Konishiroku Photo Industries (distributed by Berkey Photo) fitted with Omicron 70mm f/5.6

 

© Dirk HR Spennemann 2012, All Rights Reserved

Covid - 19 Public Manipulation Model

www.theatlantic.com/health/archive/2022/07/covid-vaccines...

 

New COVID Vaccines Will be Ready This Fall. America Won’t Be.

 

Respiratory-virus season starts soon, and our autumn vaccine strategy is shaky at best.

 

Not so long ago, America’s next COVID fall looked almost tidy. Sure, cases might rise as the weather chills and dries, and people flock indoors. But Pfizer and Moderna were already cooking up America’s very first retooled COVID vaccines, better matched to Omicron and its offshoots, and a new inoculation campaign was brewing. Instead of needing to dose up three, four, even five times within short order, perhaps Americans could get just one COVID shot each year, matched roughly to the season’s circulating strains. Fall 2022 seemed “the first opportunity to routinize COVID vaccines,” says Nirav Shah, the director of the Maine Center for Disease Control and Prevention, and simultaneously recharge the country’s waning enthusiasm for shots.

 

Now that fall is [checks notes] officially 10 weeks away, that once-sunny forecast is looking cloudier. The Biden administration could soon offer second booster shots to all adults—an amuse-bouche, apparently, for fall’s Omicron-focused vaccines, which may not debut until October at the earliest, by which time BA.5 may be long gone, and potentially too late to forestall a cold-weather surge. In April, the FDA’s leaders seemed ready to rally around a fall reboot; in a statement last month, Peter Marks, the director of the agency’s Center for Biologics Evaluation and Research, struck a more dispirited tone. The coming autumn would be just a “transitional period,” he said. Which checks out, given the nation’s current timetable. “I see this fall shaping up to be more incremental,” says Jason Schwartz, a vaccine-policy expert at Yale, “rather than that fresh start of let’s begin again.”

 

This, perhaps, is not where experts thought we’d be a year and a half ago, when the vaccines were fresh and in absurdly high demand. Since then, the tale of the U.S.’s COVID immunity has taken on a tragicomic twist: First we needed a vaccine; then we needed more people to take it. Now the problem is both.

 

Yes, fall’s vaccine recipe seems set. But much more needs to happen before the nation can be served a full immunization entrée. “It’s July, and we just heard that the FDA would like to see a bivalent vaccine,” with the spike of BA.4 and BA.5 mixed with that of the OG SARS-CoV-2, Schwartz told me. When, exactly, will the updated shots be ready? How effective will they be? How many doses will be available? We just started prepping for this new inoculation course, and are somehow already behind.

 

Then, once shots are nigh, what will be the plan? Who will be allowed to get one, and how many people actually will? Right now, America’s appetite for more shots is low, which could herald yet another round of lackluster uptake.

 

There’s little time to address these issues. Fall “is, like, tomorrow,” says Jacinda Abdul-Mutakabbir, an infectious-disease pharmacist at Loma Linda University, in California. Autumn, the season of viral illnesses and packed hospitals, already puts infectious-disease experts on edge. “We dread fall and winter season here,” says Yvonne Maldonado, a pediatric-infectious-disease specialist at Stanford University. The system has little slack for more logistical mayhem. The world’s third COVID autumn, far from a stable picture of viral control, is starting to resemble a barely better sequel to the uncoordinated messes of 2020 and 2021. The coming rollout may be one of America’s most difficult yet—because instead of dealing with this country’s vaccination problems, we’re playing our failures on loop.

 

In an ideal version of this fall, revamped COVID vaccines might have been doled out alongside flu shots, starting as early as August or September, to prelude a probable end-of-year surge. But that notion may have always been doomed. At an FDA advisory meeting in early April, Marks told experts that the fall vaccine’s composition should be decided no later than June. The agency didn’t announce the new ingredients until the final day of last month. And it chose to include BA.4 and BA.5, the reigning Omicron subvariant—rather than the long-gone BA.1, which Pfizer and Moderna had been working with. That decision may further delay the shots’ premiere, punting the delivery of some doses into November, December, or even later, depending on how the coming months go. If the goal is preventing a spate of seasonal sickness, that’s “cutting it quite close,” says Wilbur Chen, an infectious-disease physician and vaccine expert at the University of Maryland.

 

Whenever the shots do appear, they could once again be hard to keep in stock. Coronavirus funds are still (still!) stalled in congressional purgatory, and may never make it out. Although the Biden administration has agreed to purchase more than 100 million doses of Pfizer’s revamped Omicron vaccine for the months ahead, federal officials remain worried that, as Ashish Jha, the nation’s top COVID-response coordinator, has said, “we’re not going to have enough vaccines for every adult who wants one” this fall.

 

Meanwhile, state and local leaders are awaiting marching orders on how much vaccine they’ll be getting, and who will be eligible for boosters—intel they may not receive until after the updated shots are authorized. With a year and a half of experience under their belts, health workers know how to roll out COVID shots, says Chrissie Juliano, the executive director of the Big Cities Health Coalition. But distribution could still get tangled if “we’re back to a situation of scarcity,” she told me. The government may allocate shots based on states’ populations. Or it could opt to dole out more doses to the regions with the highest vaccination rates, wasting fewer shots, perhaps, but widening gaps in protection.

 

More than two years into the pandemic, with the health-care system under constant strain and staff exhausted or frequently out sick, local communities across the nation may not have enough capacity to deploy fall shots en masse. In particular, pharmacies, a vaccination mainstay, will need to handle a simultaneous surge in demand for flu and COVID shots amid “a serious nationwide staffing shortage,” Michael Hogue, the dean of Loma Linda University’s pharmacy school, told me. A lack of funding only compounds these problems, by making it harder, for instance, to get doses to people who aren’t insured. For that reason alone, “some of the contractors we’ve used in the past have not been able to keep up the same services,” including vaccination drive-throughs, Phil Huang, the director of Dallas County Health and Human Services, told me. In Douglas County, Nebraska, pop-up vaccination sites are closing because not enough nurses can staff them. How do you get people vaccinated, Lindsay Huse, the county’s health director, asked me, “when nobody wants to work for what you’re paying, or they’re just burned out?”

 

Even if more resources free up, greater shot availability may not translate to greater protection: Less than half of eligible vaccinated Americans, and less than a third of all Americans, have received a first booster dose, a pattern of attrition that experts don’t expect to massively improve. And just how much of an immunity boost the updated shot will offer is still unclear. When the FDA recommended including BA.4/5’s spike, it had limited data on the proposed recipe, collected in mice by Pfizer’s scientists. And Pfizer and Moderna won’t have time to generate rock-solid efficacy data in humans before the shots are authorized, then roll out in the fall. “So when we get these vaccines cranking off the assembly line, the case public-health officials may be able to make will be tempered,” Schwartz told me. That these doses will offer big improvements on their predecessors is a decent bet. But believing that will, for the public, require a small leap of faith—at a time when Americans’ trust in public health is already low.

 

America has had its share of COVID-vaccination victories. Hundreds of millions of people have gotten at least one dose. Distribution and administration have been streamlined. Communities have come together to bring shots to people in all sorts of venues. The local experts I spoke with felt confident that they’d rise to the challenge of this autumn, too. But if the shots themselves are not in demand, an infusion of supply-side resources alone won’t be enough.

 

With two years of data on COVID vaccines’ safety and efficacy, the case for dosing up has only strengthened, scientifically. But the public’s interest and trust in the shots has fallen off as recommendations have shifted, often chaotically, and the number of necessary shots has ballooned. Even Americans who lined up for their first doses are now over the idea of rolling up their sleeves again. Abdul-Mutakabbir hears often: “I got the two doses; that’s what you told me I needed to do. I’m not doing anything else.” In Camden County, New Jersey, a team led by Paschal Nwako, the region’s health officer, has “knocked on doors, given out freebies and gift cards, visited people in all areas: grocery stores, shops, restaurants, schools, churches, shows,” he told me. “We have exhausted all the playbooks.” Still, people have refused.

 

The shifting culture around COVID in the U.S. has undoubtedly played a role. “We don’t have the same sense of desperation that we did in December of 2020,” Maldonado, of Stanford, told me. Americans are eager to put the pandemic behind them. And boosters are a tough sell in a nation that has dispensed with nearly all other COVID-prevention measures, and where political leaders are triumphantly declaring victory. “We start talking about COVID, and people’s eyes glaze over,” says Nathan Chomilo, a pediatrician and health-equity advocate in Minnesota. “The messaging will have to be fundamentally different, even, than last year’s conversation about boosters.”

 

When the vaccines were fresh, the popular narratives were tantalizing: The shots could permanently stop transmission in its tracks. But that was probably never going to pan out, says Luciana Borio, the FDA’s former acting chief scientist. “Everybody that worked in the vaccine space,” she told me, knew that the safeguards against infection “were not going to last. Their voices did not get listened to.” Instead, the more appealing story took root, setting “expectations that could not be sustained.” Disappointment ensued, fracturing public faith; mis- and disinformation seeped into the cracks. And no one, including the nation’s leaders, was able to offer a compelling enough counternarrative to put the matter to rest.

 

An upgraded shot could be enticing to some pandemic-weary folks. “I know a lot of people, including my family members, who say, ‘If it’s the same vaccine, why would I have to get it?’” Nwako told me. “They want something different.” Chomilo suggested that it may also be wise to stop counting how many shots people have gotten: “I hope no one 15 years from now is saying, I’m on my 15th booster.” But nothing about these new vaccines promises to unify Americans around the why of COVID vaccines. At April’s advisory meeting, Marks said the FDA knew that the U.S.’s current vaccination strategy couldn’t go on forever. “We simply can’t be boosting people as frequently as we are,” he said. And yet, the nation’s leaders now seem keen on okaying another round of original-recipe shots for adults under 50—without emphasizing other tactics to lower transmission rates.

 

Getting COVID shots, too, can be a chore. With so many brands, doses, schedules, and eligibility requirements in the matrix, it’s “the most complex vaccine we have,” says Erik Hernandez, the system director of clinical-pharmacy services at the University of Pittsburgh Medical Center. The fall will introduce even more snarls: Boosters are switching to an Omicron blend, but, contrary to what the FDA had initially planned, primary-series shots will be sticking with the original recipe. “That has massive operational implications,” Maine CDC’s Shah said, and could “increase the risk of errors.” Nor have federal officials offered clarity on how long people getting shots now will have to wait before they’re eligible for yet another this autumn. And Loma Linda University’s Hogue thinks that it’s very unlikely that children, especially the youngest ones, will be greenlit for bespoke Omicron doses this fall—another caveat to juggle. Some experts also worry that different states will once again select different rules on who can sign up for shots first. “You almost have to have a computer algorithm” to figure out what shots you need, Chen, of the University of Maryland, told me. Recommending an updated dose for everyone at once could be less confusing, but if shots are truly scarce, broad eligibility could simply put the privileged at the front of the queue.

 

Less funding already means less community outreach, and less support for the people most vulnerable to COVID’s worst. The country could easily default back to many of the failures of equity it’s rehearsed before. Abdul-Mutakabbir, who’s the lead clinician and pharmacist for the COVID-19 Equitable Mobile Vaccination Clinics, serving Black and Latino communities in San Bernardino County, says she’s “very nervous” that large swaths of the country will once again “end up in this place where people of minority groups are going to be those that suffer, and people of lower socioeconomic status are going to be those that suffer.”

 

An infusion of dollars would allow the government to purchase more vaccines; it would furnish states with the funds to hire more workers, expand their community clinics, and reach people who might otherwise never get their shots. But the underlying issue remains: The U.S. does not have a strong, coordinated vaccination plan. Experts still can’t agree on how many shots people need, how often we’ll need to update them, even what the purpose of a COVID vaccination should be: stopping just severe disease and death? Blocking as much infection as possible? “We don’t really have a grand unified theory of what we’re doing when we vaccinate,” Shah told me, at least not one that’s been properly messaged—a deficit that will keep hamstringing the country’s immunization efforts.

 

Without a clear plan, this fall, contra Marks’s prediction, may actually be a definitive one for COVID vaccines—just not in the way that the nation’s leaders once hoped. A bad precedent, too, could be set, and make Americans’ trust in these shots, and the people who offer them, even tougher to recoup.

Omicron VT-AFM XA: Variable-temperature, ultra-high-vacuum, atomic force microscope/scanning tunneling microscope at Argonne's Center for Nanoscale Materials.

 

Photo courtesy of Argonne National Laboratory.

omicron the cat

Me ha costado hacer esta imagen. Conjunción de Saturno y Marte en la constelación de Leo, con la bahía de Sydney al fondo (Sydney Opera House y Harbour Bridge). Imagen tomada desde los Botanic Gardens el viernes 11 de julio, hacia las 6 de la tarde hora local (sobre las 8:00 UT). Es una combinación de 35 imágenes independientes de 15 segundos, ISO 400, F9.0 y 18mm de focal (equivalente a 32mm objetivos convencionales) con cámara CANON EOS 400. Todas las tomas contenían tanto la constelación como la ciudad. Combiné de forma independiente las estrellas y la ciudad (así, todas las luces de barcos y aviones fueron eliminadas) usando DeepSkyStacker, luego las combiné usando Photoshop, tocando también los niveles, contrastes y algo de color. Fue más difícil de que parece porque para ver las estrellas necesitaba un cielo brillante, mientras que para tener una toma de la ciudad necesitaba un cielo muy oscuro. Además, las estrellas casi ni se veían, por lo que tuve que usar un desenfoque gaussiano en esa imagen (por eso parecen algo artificiales). La superposición la hice usando la última imagen como referencia, de forma que se puede ver la constelación (boca abajo) más cerca de la ciudad. Pasa el ratón sobre la imagen para identificación de los objetos más destacados. Crédito imagen: Á.R. L.-S. (CSIRO/ATNF, Agrupación Astronómica de Córdoba). Agradezco la ayuda y la compañía de Attila Popping; juntos soportamos durante una hora el frío de Sydney en el invierno austral (unos 5º-6º a esa hora ese día).

We’re easily sidetracked, it appears. One half of id-iom had ventured out into the cold to scrape and blank out our previous wall as the weather was just about sunny enough. After an hour or so out there I head out to see how he’s getting on and rather than paint over the previous wall he’d decided to adapt it into something else entirely. Then I got involved. Then it got dark and we had to come back the next day to finish what we were doing. And it’s still not ready to be painted on again. Like I said, easily sidetracked.

 

Anyway, if at first glance you thought this was 90’s cartoon legend Johnny Bravo then you’d be very much mistaken. For this is his second cousin twice removed Johnny Omicron. He’s twice as chatty but half as much fun. Now he’s got to go. The wall will be blanked out…

 

Cheers

 

id-iom

 

www.sfchronicle.com/opinion/article/covid-omicron-paxlovi...

 

Omicron finally got me after two years of being a COVID hermit. Then, doctors made it worse

BA.5 just wiped me out for 12 days. Why did doctors let me get sick instead of giving me Paxlovid?

 

I knew right away that it was going to be bad.

 

It was a hot, humid night — almost 90 degrees — but my body was freezing. Putting on a sweatshirt and diving under a blanket couldn’t warm me up. My head, on the other hand, was on fire. I had a temperature over 100 degrees and needed ice packs piled on my forehead to cool down. The coughing wouldn’t stop.

 

I didn’t need a test to tell me that I had finally caught COVID.

 

For more than two years I basically lived like a hermit to avoid just this scenario. Sure, after getting vaxxed and boosted I didn’t think COVID would kill me. But I don’t exactly have a gold medal immune system; even a common cold gives me a rough time. I imagined COVID would lay me out with symptoms that could drag on for weeks or possibly months. So I stayed away from the office, indoor gatherings and restaurants. The gym? No thanks. Fifteen extra pounds was worth it to avoid getting sick.

 

But this summer was my sister’s 40th birthday. She and the rest of my family live on the East Coast and were throwing a big party. So I decided to leave my cave and fly to see them.

 

Sure enough, someone else showed up to the festivities quietly sucking cough drops, assuring anyone who asked that her unusually nasal intonation was just a cold.

 

It wasn’t. And I was dumb enough to sit right next to her.

 

As soon as the first symptoms hit, I knew I was in trouble. So I decided to do my damnedest to get a prescription for Paxlovid, the antiviral drug cocktail that can prevent the coronavirus from replicating in your body during the early stages of infection. I wasn’t technically eligible because I’m under 65 without any serious comorbidities. But having chills, a brutal cough and a sky-high fever had to count for something, right?

 

Apparently not.

 

Local pharmacists wouldn’t have anything to do with me. Neither would urgent care. I called my health care provider back in San Francisco for a prescription, but it too told me I wasn’t eligible for Paxlovid and had to rest and ride it out.

 

So ride it out I did for the next 12 days coughing, sweating, snotting and sleeping up to 16 hours a day. Instead of spending time with my family, I had to avoid them at all costs to keep them from getting sick — other than to beg for food and supplies; there are no delivery services in the rural community they live.

 

After a wasted vacation, a changed flight and a few extra sick days, I finally got home a couple of weeks ago.

 

That same day, my partner started showing symptoms of COVID.

 

She too was ineligible for Paxlovid and spent the next 10 days hacking away in isolated misery. She just finally tested negative, but neither of us are back even close to full speed. A mildly hilly walk in Golden Gate Park the other day had me huffing like I just ran a marathon. I was in bed by 8:30 that night.

 

I don’t know for sure which variant laid us out, but, based on infection data, it was almost certainly BA.5. Now, as BA.4.6 gains ground — and future variants follow — are we going to have to go through all this again if we want to live freely like we did before the pandemic? Because I don’t have the sick days or the stomach for that. And I can’t be the only one.

 

I’m hopeful the new omicron booster can break this cycle. But what if it doesn’t?

 

This begs the question: if an antiviral drug like Paxlovid exists that could potentially ease people’s COVID symptoms by preventing the virus from replicating in our bodies before it spreads, why are we being so precious about who we give it to? A pharmacist in Canada recently refused to fill a Paxlovid prescription for a 20-year-old with Down syndrome and a history of respiratory infections. How is that sensible public health policy?

 

I asked UCSF infectious disease specialist Monica Gandhi why those of not wanting to feel like garbage for weeks at a time, and who need to work or see vulnerable family members, can’t get easy access to the drug? We give antivirals widely to ease flu symptoms, why not COVID?

 

She replied that Paxlovid is currently being used to prevent death and hospitalizations, and that studies of people in my age range have shown no discernible benefits in this regard to taking the drug.

 

However, “there are other benefits of Paxlovid,” she said. “You were likely to have felt better sooner if your viral load was brought down more quickly. But there just have not been any studies on this in vaccinated people.”

 

My read on this is that even as public health guidance is evolving to tell us COVID is now endemic and we can start getting back to normal, in many unhelpful ways it still treats the virus like a deadly disease.

 

We can’t have it both ways.

 

Many doctors, Gandhi said, recognize the obvious utility in giving people the chance to recover faster. Given that the known side effects of Paxlovid are few and mild, some doctors are comfortable bending the rules to prescribe the drug to those who might not technically meet the public health guidance. That works in America because the feds are currently footing the bill — and they aren’t rigorously checking who does or doesn’t have dire comorbidities. But Paxlovid is expensive. And as the federal government cuts off funds and insurance companies start taking on the cost of the drug, you can expect those eligibility requirements to lock in tighter than they are now.

 

What happens then if the omicron booster shots prove ineffective at preventing breakthrough infections like the one that waylaid me? Are we willing to let perpetual sickness be the cost of normalcy?

 

Based on America’s COVID response thus far, I’m fairly certain the answer to that is yes — unless folks start agitating. Are we going to rely on insurance company actuaries and the power of positive thinking to guide us back to normal, with all the attendant consequences? Or are we going to insist that public health officials study all tools in the arsenal that could get us there with as little misery as possible?

 

Matthew Fleischer is The San Francisco Chronicle’s editorial page editor. Email: matt.fleischer@sfchronicle.com

 

www.usatoday.com/story/news/health/2022/08/24/paxlovid-pf...

 

Paxlovid, Pfizer's COVID pill, showed no measurable benefit in adults 40 to 65, study says

 

WASHINGTON — Pfizer's COVID-19 pill appears to provide little or no benefit for younger adults, while still reducing the risk of hospitalization and death for high-risk seniors, according to a large study published Wednesday.

 

The results from a 109,000-patient Israeli study are likely to renew questions about the U.S. government's use of Paxlovid, which has become the go-to treatment for COVID-19 due to its at-home convenience. The Biden administration has spent more than $10 billion purchasing the drug and making it available at thousands of pharmacies through its test-and-treat initiative.

 

The researchers found that Paxlovid reduced hospitalizations among people 65 and older by roughly 75% when given shortly after infection. That's consistent with earlier results used to authorize the drug in the U.S. and other nations.

 

But people between the ages of 40 and 65 saw no measurable benefit, according to the analysis of medical records.

 

The study has limitations due to its design, which compiled data from a large Israeli health system rather than enrolling patients in a randomized study with a control group — the gold standard for medical research.

 

The findings reflect the changing nature of the pandemic, in which the vast majority of people already have some protection against the virus due to vaccination or prior infection. For younger adults, in particular, that greatly reduces their risks of severe COVID-19 complications. The Centers for Disease Control and Prevention recently estimated that 95% of Americans 16 and older have acquired some level of immunity against the virus.

 

“Paxlovid will remain important for people at the highest risk of severe COVID-19, such as seniors and those with compromised immune systems,” said Dr. David Boulware, a University of Minnesota researcher and physician, who was not involved in the study. “But for the vast majority of Americans who are now eligible, this really doesn’t have a lot of benefit."

 

A spokesman for Pfizer declined to comment on the results, which were published in the New England Journal of Medicine.

 

The U.S. Food and Drug Administration authorized Paxlovid late last year for adults and children 12 and older who are considered high risk due to conditions like obesity, diabetes and heart disease. More than 42% of U.S. adults are considered obese, representing 138 million Americans, according to the CDC.

 

At the time of the FDA decision there were no options for treating COVID-19 at home, and Paxlovid was considered critical to curbing hospitalizations and deaths during the pandemic's second winter surge. The drug's results were also far stronger than a competing pill from Merck.

 

The FDA made its decision based on a Pfizer study in high-risk patients who hadn't been vaccinated or treated for prior COVID-19 infection.

 

“Those people do exist but they’re relatively rare because most people now have either gotten vaccinated or they’ve gotten infected,” Boulware said.

 

Pfizer reported earlier this summer that a separate study of Paxlovid in healthy adults — vaccinated and unvaccinated — failed to show a significant benefit. Those results have not yet been published in a medical journal.

 

More than 3.9 million prescriptions for Paxlovid have been filled since the drug was authorized, according to federal records. A treatment course is three pills twice a day for five days.

 

A White House spokesman on Wednesday pointed to several recent papers suggesting Paxlovid helps reduce hospitalizations among people 50 and older. The studies have not been published in peer-reviewed journals.

 

“Risk for severe outcomes from COVID is along a gradient, and the growing body of evidence is showing that individuals between the ages of 50 and 64 can also benefit from Paxlovid,” Kevin Munoz said in an emailed statement.

 

Administration officials have been working for months to increase use of Paxlovid, opening thousands of sites where patients who test positive can fill a prescription. Last month, U.S. officials further expanded access by allowing pharmacists to prescribe the drug.

 

The White House recently signaled that it may soon stop purchasing COVID-19 vaccines, drugs and tests, shifting responsibility to the private insurance market. Under that scenario, insurers could set new criteria for when they would pay for patients to receive Paxlovid.

 

December 20, 2021 - New York City - Governor Kathy Hochul, joined by Jackie Bray, Acting Commissioner of New York State Department of Homeland Security and Emergency Services, and Director of State Operations Kathryn Garcia updates New Yorkers on the Covid-19 spread in New York State, particularly on the Omicron variant, during a press briefing Monday December 20, 2021 in New York City. (Kevin P. Coughlin / Office of the Governor)

 

The Lambda Rho chapter of Alpha Omicron Pi greeting new members during the chapter's second ever Bid Day at TCU. For those of you who don't know what Bid Day is...and I didn't either...all the sororities assemble on the Campus Commons. Then the newbies are released one chapter at a time to run toward their new sisters. It's kinda like a cattle drive, but with a much happier ending.

 

I also rolled about 90 seconds of video: www.youtube.com/watch?v=8qnt0kMEWWQ&list=UUlJLPNVzTQB...

 

You can learn more about AOII here:

 

www.facebook.com/AOIILambdaRho

www.aoiitcu.com/

 

This album is part of the event coverage for the Fort Worth Portrait Project. The project tells the story of Fort Worth from 2014 - 2044 one captioned portrait at a time, but I also enjoy covering events like this one too.

 

Please follow the Fort Worth Portrait Project:

 

www.redeemedexpressions.com/fort-worth-portrait-project/

www.facebook.com/fortworthportraitproject

www.twitter.com/FWPortraitProj

www.instagram.com/fortworthportraitproject

 

Do you want to be featured in the project? Just head to the following site with a photo and a caption:

 

www.redeemedexpressions.com/be-part-of-the-project/

 

Esta fotografia tiramos hoje durante a aula do curso intermediário do Omicron Centro de Fotografia. Técnica de flash de luz mista.

O trem, a luz no céu, tudo sorte! Mas lembro que a sorte encontrou nossa turma preparada para a situação. "Quando a sorte me bate a porta sempre me encontra trabalhando."

Para aqueles que querem aprender a fotografar, se aprofundar realmente na arte fotográfica, indico nosso curso anual de fotografia com início em agosto próximo.

 

saudações fotográficas,

 

Osvaldo Santos Lima

 

I've now had four vaccination serums: J&J shot in March, two Pfizer doses in July, a Maderna booster in December, and the God vaccination: a positive COVID test in December. Thankfully, the vaccines did their job: no symptoms and none of my family were infected with the Omicron variant of the novel coronavirus

www.thelancet.com/journals/lanres/article/PIIS2213-2600(22)00101-1/fulltext

 

Durability of BNT162b2 vaccine against hospital and emergency department admissions due to the omicron and delta variants in a large health system in the USA: a test-negative case–control study - The Lancet Respiratory Medicine

 

Summary

Background

The duration of protection against the omicron (B.1.1.529) variant for current COVID-19 vaccines is not well characterised. Vaccine-specific estimates are especially needed. We aimed to evaluate the effectiveness and durability of two and three doses of the BNT162b2 (Pfizer–BioNTech) mRNA vaccine against hospital and emergency department admissions due to the delta (B.1.617.2) and omicron variants.

 

Methods

In this case–control study with a test-negative design, we analysed electronic health records of members of Kaiser Permanente Southern California (KPSC), a large integrated health system in California, USA, from Dec 1, 2021, to Feb 6, 2022. Vaccine effectiveness was calculated in KPSC patients aged 18 years and older admitted to hospital or an emergency department (without a subsequent hospital admission) with a diagnosis of acute respiratory infection and tested for SARS-CoV-2 via PCR. Adjusted vaccine effectiveness was estimated with odds ratios from adjusted logistic regression models. This study is registered with ClinicalTrials.gov (NCT04848584).

 

Findings

Analyses were done for 11 123 hospital or emergency department admissions. In adjusted analyses, effectiveness of two doses of the BNT162b2 vaccine against the omicron variant was 41% (95% CI 21–55) against hospital admission and 31% (16–43) against emergency department admission at 9 months or longer after the second dose. After three doses, effectiveness of BNT162b2 against hospital admission due to the omicron variant was 85% (95% CI 80–89) at less than 3 months but fell to 55% (28–71) at 3 months or longer, although confidence intervals were wide for the latter estimate. Against emergency department admission, the effectiveness of three doses of BNT162b2 against the omicron variant was 77% (72–81) at less than 3 months but fell to 53% (36–66) at 3 months or longer. Trends in waning against SARS-CoV-2 outcomes due to the delta variant were generally similar, but with higher effectiveness estimates at each timepoint than those seen for the omicron variant.

 

Interpretation

Three doses of BNT162b2 conferred high protection against hospital and emergency department admission due to both the delta and omicron variants in the first 3 months after vaccination. However, 3 months after receipt of a third dose, waning was apparent against SARS-CoV-2 outcomes due to the omicron variant, including hospital admission. Additional doses of current, adapted, or novel COVD-19 vaccines might be needed to maintain high levels of protection against subsequent waves of SARS-CoV-2 caused by the omicron variant or future variants with similar escape potential.

 

Funding

Pfizer.

 

fortune.com/2022/04/23/when-will-covid-end-meet-the-russi...

 

Will COVID ever end? A forgotten pandemic from the late 1800s might offer some clues – Fortune

 

With long-haul sufferers and symptoms like lost of taste and smell, the "Russian Flu" may have been a coronavirus like COVID, some experts say

 

Patients suffering from respiratory and neurological symptoms, including loss of taste and smell.

 

Long-haul sufferers who struggle to muster the energy to return to work.

 

A pandemic with a penchant for attacking the elderly and obese with particular force.

 

Sounds a lot like COVID, right?

 

It’s not.

 

Rather, it’s the “Russian Flu,” the world’s first well-documented pandemic, occurring as modern germ theory rose to prominence and miasma theory dispelled, ushering in the era of modern medical science and public health.

 

A quick check of the textbooks—the few that actually mention the thing—will inform you that the pandemic, which killed an estimated 1 million worldwide, lasted from 1889 to 1890.

 

Experts will tell you it likely hung around much longer—and might still lurk, in some form, today.

 

Predating the now oft-discussed “Spanish Flu” pandemic of 1918, which killed an estimated 50 million worldwide, the Russian Flu likely wasn’t a flu at all, some contend.

 

Instead, its symptoms more closely resemble a coronavirus—a category of viruses named for their crown-like appearance under a microscope, of which COVID-19 is a member.

 

Coronaviruses typically cause mild to moderate upper-respiratory infections in humans and are responsible for a handful of common colds. But some have turned deadly, including COVID-19; SARS (Severe Acute Respiratory Syndrome), an epidemic that emerged in 2002 and killed hundreds; and MERS (Middle Eastern respiratory syndrome), another epidemic that emerged in 2012 and killed hundreds.

 

“The epidemiology and clinical symptoms of the Russian Flu are much more in line with COVID than what we know about influenza pandemics,” said Dr. Harald Bruessow, editor of Microbial Biotechnology and a guest professor at KU Leuven in Belgium who has studied and published extensively on the esoteric ailment.

 

“You have respiratory infection, but at the same time there are strong neurologic symptoms,” he said of both the Russian Flu and COVID. “There’s also something like Long COVID that was observed following the Russian Flu pandemic. These people were incapacitated for a really long time, with an increase in suicide rate and an inability to return to full work capacity.

 

“All this stuff makes one think that one is dealing with a coronavirus infection in the 1880s.”

 

Let’s say the so-called “Russian Flu” was a coronavirus. Does it serve as a better lens through which to view the current pandemic than the Spanish Flu? What lessons can we learn? Does it offer any clues to how the COVID-19 pandemic might end—or linger, rather, as viruses tend to?

 

“If we say maybe the Russian Flu went extinct by a deus ex machina event, the odds are much lower for COVID,” Dr. Arijit Chakravarty, Fractal Therapeutics CEO and COVID researcher, told Fortune.

 

“We’re past that point.”

 

The forgotten ‘flu’

When “nobody really dared to predict the trajectory of the COVID pandemic, how it will develop or end”—frustrated by short-term computer simulations with a tendency toward inaccuracy—and looking to glimpse into a COVID-19 crystal ball, Bruessow turned to the past.

 

What pandemic might serve as the best paradigm for COVID? He first examined the Spanish Flu—but that was a different virus, he reasoned. Traveling backward in history from there, his options were limited, with the Russian Flu being the next chronological option—and, ironically, the first pandemic for which data was collected en masse.

 

As it turns out, it was a great fit.

 

“The Russian Flu was actually the best case I could figure out of a respiratory pandemic of a comparable size to COVID that was sufficiently medically documented,” Bruessow said of the disease, thought to have originated in cattle in Turkestan before enveloping the Russian empire and sweeping the world.

 

While considered a flu at the time, scientists did not yet have a solid grasp on what caused disease, with germ theory arising nearly simultaneously and duking it out with the miasma theory, the pre-scientific notion that disease was caused by “bad air” rising from the ground.

 

In one of his articles on the ailment, Bruessow refers to a 344-page doctors’ report from 1891 London, which describes Russian Flu patients as suffering from a “hard, dry cough,” fevers of 100-105 degrees, “frontal headache of special severity,” “pains in the eyeballs,” “general feeling of misery and weakness, and great depression of spirits,” and “weeping, nervous restlessness, inability to sleep, and occasional delirium.”

 

As with COVID, children seemed relatively spared, often only mildly affected, if they fell ill at all. Those who were elderly—in addition to those with pre-existing conditions like heart disease, tuberculosis, or diabetes—were more apt to take a fatal course, Bruessow wrote.

 

And there’s more: Nearly 10% of cases saw continued symptoms, referred to by European doctors of the time as “long enduring evil effects.”

 

As with COVID, it was noted that patients were likely infectious before developing symptoms, and were occasionally reinfected, as was the case with a patient who fell ill with the “flu” in December 1889 in France, and then again a month later in January 1890 in England.

 

Dr. Tom Ewing, a history professor and associate dean at Virginia Tech who has published extensively on the topic, considered the Russian Flu an apt comparison during the first three months of the COVID pandemic due to its quick spread and global efforts to track symptoms.

 

He now considers the Spanish Flu to be a better comparison due to the body count: It’s thought to have killed about 650,000 people in the U.S. in eight months, and COVID has killed nearly a million in the U.S. in a little over two years. In contrast, the Russian Flu is thought to have killed a million worldwide, in sum.

 

“I think where the useful comparisons are is, how do people react?” Ewing said. “How do they respond to first reports? How do physicians deal with a new threatening scale of disease? What we’re all living with right now—at what point do you say it’s all over?

 

Is the ‘Russian Flu’ still a killer?

The Russian Flu is typically considered to have lasted from 1889 through 1890, but in reality, it lasted much longer—through 1894, according to the U.S. National Institutes of Health National Library of Medicine—and nearly a decade, depending on whom you talk to. Major mortality peaks, as seen in public health data from the United Kingdom, continued through 1899 or 1900, Bruessow said, adding that the mortality peaks in England during that period are nearly as high as they were during what was likely the first phase of the Russian Flu.

 

It is unknown if later deaths were from additional waves of the Russian Flu or something else. But reports of symptoms from potential later waves, found in The Lancet and other British medical journals, are “strikingly similar,” and contemporary researchers were “formulating the suspicion” of an up-flair, he said.

 

All this “makes me think that we should consider the possibility that the Russian Flu agent was evolving and hanging around and even causing a major mortality peak in the United Kingdom and elsewhere,” he concluded.

 

While it’s unknown if the Russian Flu was indeed a coronavirus, some believe it lives on today as OC43, a common human coronavirus that often causes upper-respiratory track illness, according to the U.S. Centers for Disease Control and Prevention. While its presentation is often mild, the pathogen is known to cause bronchitis, bronchiolitis, and pneumonia in children and the elderly, as well as immunosuppressed patients, and its presentation may be easily confused with that of COVID-19, according to a 2021 article in The Southwest Respiratory and Critical Care Chronicles.

 

The thought that the Russian Flu endures as OC43 is a “fascinating hypothesis,” developed when scientists realized how genetically similar OC43 is to bovine coronavirus and projected a common ancestor arising around 1890—the Russian Flu era, and a time of major cattle pandemics that may have spread to humans.

 

www.thelancet.com/journals/lanres/article/PIIS2213-2600(22)00101-1/fulltext

 

Durability of BNT162b2 vaccine against hospital and emergency department admissions due to the omicron and delta variants in a large health system in the USA: a test-negative case–control study - The Lancet Respiratory Medicine

 

Summary

Background

The duration of protection against the omicron (B.1.1.529) variant for current COVID-19 vaccines is not well characterised. Vaccine-specific estimates are especially needed. We aimed to evaluate the effectiveness and durability of two and three doses of the BNT162b2 (Pfizer–BioNTech) mRNA vaccine against hospital and emergency department admissions due to the delta (B.1.617.2) and omicron variants.

 

Methods

In this case–control study with a test-negative design, we analysed electronic health records of members of Kaiser Permanente Southern California (KPSC), a large integrated health system in California, USA, from Dec 1, 2021, to Feb 6, 2022. Vaccine effectiveness was calculated in KPSC patients aged 18 years and older admitted to hospital or an emergency department (without a subsequent hospital admission) with a diagnosis of acute respiratory infection and tested for SARS-CoV-2 via PCR. Adjusted vaccine effectiveness was estimated with odds ratios from adjusted logistic regression models. This study is registered with ClinicalTrials.gov (NCT04848584).

 

Findings

Analyses were done for 11 123 hospital or emergency department admissions. In adjusted analyses, effectiveness of two doses of the BNT162b2 vaccine against the omicron variant was 41% (95% CI 21–55) against hospital admission and 31% (16–43) against emergency department admission at 9 months or longer after the second dose. After three doses, effectiveness of BNT162b2 against hospital admission due to the omicron variant was 85% (95% CI 80–89) at less than 3 months but fell to 55% (28–71) at 3 months or longer, although confidence intervals were wide for the latter estimate. Against emergency department admission, the effectiveness of three doses of BNT162b2 against the omicron variant was 77% (72–81) at less than 3 months but fell to 53% (36–66) at 3 months or longer. Trends in waning against SARS-CoV-2 outcomes due to the delta variant were generally similar, but with higher effectiveness estimates at each timepoint than those seen for the omicron variant.

 

Interpretation

Three doses of BNT162b2 conferred high protection against hospital and emergency department admission due to both the delta and omicron variants in the first 3 months after vaccination. However, 3 months after receipt of a third dose, waning was apparent against SARS-CoV-2 outcomes due to the omicron variant, including hospital admission. Additional doses of current, adapted, or novel COVD-19 vaccines might be needed to maintain high levels of protection against subsequent waves of SARS-CoV-2 caused by the omicron variant or future variants with similar escape potential.

 

Funding

Pfizer.

 

fortune.com/2022/04/23/when-will-covid-end-meet-the-russi...

 

Will COVID ever end? A forgotten pandemic from the late 1800s might offer some clues – Fortune

 

With long-haul sufferers and symptoms like lost of taste and smell, the "Russian Flu" may have been a coronavirus like COVID, some experts say

 

Patients suffering from respiratory and neurological symptoms, including loss of taste and smell.

 

Long-haul sufferers who struggle to muster the energy to return to work.

 

A pandemic with a penchant for attacking the elderly and obese with particular force.

 

Sounds a lot like COVID, right?

 

It’s not.

 

Rather, it’s the “Russian Flu,” the world’s first well-documented pandemic, occurring as modern germ theory rose to prominence and miasma theory dispelled, ushering in the era of modern medical science and public health.

 

A quick check of the textbooks—the few that actually mention the thing—will inform you that the pandemic, which killed an estimated 1 million worldwide, lasted from 1889 to 1890.

 

Experts will tell you it likely hung around much longer—and might still lurk, in some form, today.

 

Predating the now oft-discussed “Spanish Flu” pandemic of 1918, which killed an estimated 50 million worldwide, the Russian Flu likely wasn’t a flu at all, some contend.

 

Instead, its symptoms more closely resemble a coronavirus—a category of viruses named for their crown-like appearance under a microscope, of which COVID-19 is a member.

 

Coronaviruses typically cause mild to moderate upper-respiratory infections in humans and are responsible for a handful of common colds. But some have turned deadly, including COVID-19; SARS (Severe Acute Respiratory Syndrome), an epidemic that emerged in 2002 and killed hundreds; and MERS (Middle Eastern respiratory syndrome), another epidemic that emerged in 2012 and killed hundreds.

 

“The epidemiology and clinical symptoms of the Russian Flu are much more in line with COVID than what we know about influenza pandemics,” said Dr. Harald Bruessow, editor of Microbial Biotechnology and a guest professor at KU Leuven in Belgium who has studied and published extensively on the esoteric ailment.

 

“You have respiratory infection, but at the same time there are strong neurologic symptoms,” he said of both the Russian Flu and COVID. “There’s also something like Long COVID that was observed following the Russian Flu pandemic. These people were incapacitated for a really long time, with an increase in suicide rate and an inability to return to full work capacity.

 

“All this stuff makes one think that one is dealing with a coronavirus infection in the 1880s.”

 

Let’s say the so-called “Russian Flu” was a coronavirus. Does it serve as a better lens through which to view the current pandemic than the Spanish Flu? What lessons can we learn? Does it offer any clues to how the COVID-19 pandemic might end—or linger, rather, as viruses tend to?

 

“If we say maybe the Russian Flu went extinct by a deus ex machina event, the odds are much lower for COVID,” Dr. Arijit Chakravarty, Fractal Therapeutics CEO and COVID researcher, told Fortune.

 

“We’re past that point.”

 

The forgotten ‘flu’

When “nobody really dared to predict the trajectory of the COVID pandemic, how it will develop or end”—frustrated by short-term computer simulations with a tendency toward inaccuracy—and looking to glimpse into a COVID-19 crystal ball, Bruessow turned to the past.

 

What pandemic might serve as the best paradigm for COVID? He first examined the Spanish Flu—but that was a different virus, he reasoned. Traveling backward in history from there, his options were limited, with the Russian Flu being the next chronological option—and, ironically, the first pandemic for which data was collected en masse.

 

As it turns out, it was a great fit.

 

“The Russian Flu was actually the best case I could figure out of a respiratory pandemic of a comparable size to COVID that was sufficiently medically documented,” Bruessow said of the disease, thought to have originated in cattle in Turkestan before enveloping the Russian empire and sweeping the world.

 

While considered a flu at the time, scientists did not yet have a solid grasp on what caused disease, with germ theory arising nearly simultaneously and duking it out with the miasma theory, the pre-scientific notion that disease was caused by “bad air” rising from the ground.

 

In one of his articles on the ailment, Bruessow refers to a 344-page doctors’ report from 1891 London, which describes Russian Flu patients as suffering from a “hard, dry cough,” fevers of 100-105 degrees, “frontal headache of special severity,” “pains in the eyeballs,” “general feeling of misery and weakness, and great depression of spirits,” and “weeping, nervous restlessness, inability to sleep, and occasional delirium.”

 

As with COVID, children seemed relatively spared, often only mildly affected, if they fell ill at all. Those who were elderly—in addition to those with pre-existing conditions like heart disease, tuberculosis, or diabetes—were more apt to take a fatal course, Bruessow wrote.

 

And there’s more: Nearly 10% of cases saw continued symptoms, referred to by European doctors of the time as “long enduring evil effects.”

 

As with COVID, it was noted that patients were likely infectious before developing symptoms, and were occasionally reinfected, as was the case with a patient who fell ill with the “flu” in December 1889 in France, and then again a month later in January 1890 in England.

 

Dr. Tom Ewing, a history professor and associate dean at Virginia Tech who has published extensively on the topic, considered the Russian Flu an apt comparison during the first three months of the COVID pandemic due to its quick spread and global efforts to track symptoms.

 

He now considers the Spanish Flu to be a better comparison due to the body count: It’s thought to have killed about 650,000 people in the U.S. in eight months, and COVID has killed nearly a million in the U.S. in a little over two years. In contrast, the Russian Flu is thought to have killed a million worldwide, in sum.

 

“I think where the useful comparisons are is, how do people react?” Ewing said. “How do they respond to first reports? How do physicians deal with a new threatening scale of disease? What we’re all living with right now—at what point do you say it’s all over?

 

Is the ‘Russian Flu’ still a killer?

The Russian Flu is typically considered to have lasted from 1889 through 1890, but in reality, it lasted much longer—through 1894, according to the U.S. National Institutes of Health National Library of Medicine—and nearly a decade, depending on whom you talk to. Major mortality peaks, as seen in public health data from the United Kingdom, continued through 1899 or 1900, Bruessow said, adding that the mortality peaks in England during that period are nearly as high as they were during what was likely the first phase of the Russian Flu.

 

It is unknown if later deaths were from additional waves of the Russian Flu or something else. But reports of symptoms from potential later waves, found in The Lancet and other British medical journals, are “strikingly similar,” and contemporary researchers were “formulating the suspicion” of an up-flair, he said.

 

All this “makes me think that we should consider the possibility that the Russian Flu agent was evolving and hanging around and even causing a major mortality peak in the United Kingdom and elsewhere,” he concluded.

 

While it’s unknown if the Russian Flu was indeed a coronavirus, some believe it lives on today as OC43, a common human coronavirus that often causes upper-respiratory track illness, according to the U.S. Centers for Disease Control and Prevention. While its presentation is often mild, the pathogen is known to cause bronchitis, bronchiolitis, and pneumonia in children and the elderly, as well as immunosuppressed patients, and its presentation may be easily confused with that of COVID-19, according to a 2021 article in The Southwest Respiratory and Critical Care Chronicles.

 

The thought that the Russian Flu endures as OC43 is a “fascinating hypothesis,” developed when scientists realized how genetically similar OC43 is to bovine coronavirus and projected a common ancestor arising around 1890—the Russian Flu era, and a time of major cattle pandemics that may have spread to humans.

 

If they’re correct, the Russian Flu is still circulating, and it’s still occasionally deadly—a 2021 study published in Nature found a 9.1% mortality rate for those hospitalized with confirmed cases of OC43, though it only tracked 77 patients between 2012 and 2017 at one Korean hospital.

 

The Russian Flu may indeed be “still killing people off, and we’re just not paying attention to it, which is totally plausible,” Chakravarty said. “We used to think the Epstein-Barr Virus was harmless,” and now we know it raises the risk of developing multiple sclerosis by more than 30 times.

 

“There’s a lot of sort of ‘dark matter’ in the infectious disease world that we haven’t fully mapped out.”

 

Such a future may await COVID, Bruessow contends.

 

“This is what virologists working in the viral evolution field are thinking we should expect from SARS-CoV2,” he said regarding the potential of COVID to persist well into the future. “Some people think the Omicron variant that dominates now is already going a bit in this direction, because this variant is much less affecting the lung and much more targeting the upper respiratory tract.”

 

Bruessow hopes Omicron is “the last hoorah” of COVID-19’s acute phase—the Russian Flu’s lasted about three years—but he’s well aware this may not be the case.

 

“Personally, I would be a bit skeptical” that Omicron would be the end of this, he said. “The virus will still occupy our societies for a while.”

 

Even if the Russian Flu eventually became less severe, there’s no reason to necessarily think COVID-19 will go the same route, Bruessow cautions, nor is the Russian Flu’s presumed attenuation necessarily permanent.

 

“Viral evolution is really neutral with respect to virulence,” he said. “The indication is that [COVID-19] will try to escape from the immune response, simply to infect the maximum number of people, and the virus with the highest efficiency will replace less efficient viral types.

 

“This is the dynamic we are seeing, of increasing transmission. There’s no guarantee that the next wave won’t be a virus that has, once again, increased virulence, like Delta.”

 

‘Pandemic-era’ life for more than a century

Among Chakravarty’s take-aways from the Russian Flu: “The body count can still pile up” over several years, even if a disease isn’t incredibly transmissible and has a relatively low fatality rate, as was the case with the Russian Flu.

 

Even so, “mortality bounced around,” he said. “There wasn’t a steady decrease toward endemicity.”

 

Regardless, COVID is “much more contagious” than the Russian Flu was, Chakravarty cautions—and the world is much better connected than it was in the industrial era, allowing for greater ease of disease spread.

 

COVID has a “screamingly high” transmission rate—one person with Omicron infects, on average, eight to nine others, making it nearly as infectious as mumps—and the duration of immunity is low, he cautioned.

 

“You can sneeze in Wuhan in the morning and someone can be really ill the next day in Frankfurt.”

 

The potential Russian Flu wave of 1900 is the last mention of the illness Bruessow sees in medical literature. There seem to have been seasonal, legitimate influenza outbreaks up until the onset of the Spanish Flu in 1918, after which major respiratory pandemics “were all influenza related.”

 

“After that, there’s no indication of a coronavirus causing a major epidemic in the 20th century,” he said.

 

It’s possible that a “very mild” coronavirus continued to circulate throughout the 20th century but was less impactful due to improvements in public health and quality of life, Ewing said.

 

During the early 20th century “health was getting better, mortality rates were decreasing, life expectancy was going up.” This, in addition to tuberculous public health campaigns encouraging people to beware of coughing, sneezing, and spitting in public, may have blunted any circulating coronaviruses, he said.

 

While the Spanish Flu may not be the best lens through which to view COVID-19, it does contain pertinent lessons, Bruessow contends.

 

While the Spanish Flu is generally thought to have subsided in 1919 after three waves, later waves occurred periodically in the late 1920s into the 1940s—some as virulent as the initial Spanish Flu, with even higher mortality, he contends.

 

As U.S. COVID czar Dr. Anthony Fauci and colleagues pointed out in a 2009 New England Journal of Medicine article, “It is not generally appreciated that descendants of the H1N1 influenza A virus that caused the catastrophic and historic pandemic of 1918-1919 have persisted in humans for more than 90 [now 100] years and have continued to contribute their genes to new viruses, causing new pandemics,” including the 2009 H1N1 “swine flu.”

 

“We are living in a pandemic era that began around 1918,” they wrote 13 years ago—long before the advent of COVID-19.

 

Bruessow agrees with Fauci and his colleagues that “viruses do not simply disappear.”

 

“They change and hopefully they adapt and behave,” Bruessow said. “But there are still some escapes, and we might see a return with higher virulence. Vigilance is indicated.”

 

Chakravarty is of a similar mindset but cautions that one can’t draw too many inferences from any particular pandemic, regardless of similarities.

 

“Each new pandemic, new plague is a new chapter in the history books,” he said. “Your mileage may vary.”

 

But one thing remains constant.

 

“There’s no two-year timeline for pandemics,” he warned.

 

Pentax 645Z + Paxar Omicron 6 inch f/2.8

 

Omicron Xi 40th Anniversary Brunch at the Oswego Country Club.

06/11/22

December 20, 2021 - New York City - Governor Kathy Hochul, joined by Jackie Bray, Acting Commissioner of New York State Department of Homeland Security and Emergency Services, shown here, and Director of State Operations Kathryn Garcia updates New Yorkers on the Covid-19 spread in New York State, particularly on the Omicron variant, during a press briefing Monday December 20, 2021 in New York City. (Kevin P. Coughlin / Office of the Governor)

www.bbc.com/news/world-europe-59713503

 

Covid: Dutch go into Christmas lockdown over Omicron wave

 

The Netherlands has announced a strict lockdown over Christmas amid concerns over the Omicron coronavirus variant.

 

Non-essential shops, bars, gyms hairdressers and other public venues will be closed until at least mid-January. Two guests per household will be allowed - four over the holidays.

 

Prime Minister Mark Rutte said the measures were "unavoidable".

 

Countries across Europe have been tightening restrictions as the heavily mutated variant spreads.

 

The new rules in the Netherlands - the strictest to have been announced over Omicron so far - come into force on Sunday.

 

"I stand here tonight in a sombre mood. And a lot of people watching will feel that way too," Mr Rutte told a news conference on Saturday. "To sum it up in one sentence, the Netherlands will go back into lockdown from tomorrow."

 

Under the new rules, people are being urged to stay at home as much as possible. Strict limits will be placed on the number of people who can meet - a maximum of two guests aged 13 and over will be allowed in people's homes, and four on 24-26 December and on New Year's Eve and New Year's Day.

 

Events are not permitted other than funerals, weekly markets selling groceries and professional sports matches with no spectators.

 

All schools will be closed until at least 9 January, while other lockdown measures will remain in place until at least 14 January.

 

Restaurants can continue to sell takeaway meals, and non-essential shops can offer click and collect services.

 

The BBC's Anna Holligan in The Hague said the announcement was being met with disbelief and dismay.

 

"I can now hear the whole of the Netherlands sighing. This is exactly one week before Christmas, another Christmas that is completely different from what we would like," Mr Rutte said.

 

But, he added, a failure to act now would likely lead to "an unmanageable situation in hospitals".

 

Earlier on Saturday, people rushed to do their Christmas shopping amid reports that new measures were about to be introduced.

 

"It's too busy, but I'm coming before the Christmas holidays to pick up gifts, it seems like a new lockdown is coming," Ayman Massori told AFP news agency.

 

For weeks, curfews have been placed on hospitality and cultural venues in the Netherlands in an effort to limit the spread of Omicron.

 

The Dutch National Institute for Public Health has reported more than 2.9m coronavirus cases since the pandemic began, and over 20,000 deaths.

 

It says the Omicron variant currently still accounts for a minority of coronavirus cases in the Netherlands, but is spreading rapidly.

 

Officials say it is expected to become the dominant variant by the New Year.

 

The head of the Dutch outbreak management team, Jaap van Dissel, said the new measures would "buy time", allowing more people to get booster shots and for the healthcare system to prepare for a possible rise in infections.

 

"As a country we are best protected if as many people as possible get a booster vaccination," he said.

 

More than 85% of all adults in the Netherlands have been vaccinated, but so far fewer than 9% have had the booster shot.

 

Health Minister Hugo de Jonge said all adults would now get an invitation for a booster appointment by 7 January.

 

France, the Republic of Ireland and Germany have also announced measures designed to curb the infections.

 

The Omicron variant is "spreading at lightning speed" in Europe and will likely become dominant in France by the start of next year, French Prime Minister Jean Castex has warned.

 

France has imposed strict travel restrictions on those entering from the United Kingdom - the hardest hit country in the region, with nearly 25,000 confirmed Omicron cases on Saturday.

 

Europe has already seen more than 89 million cases and 1.5 million Covid-related deaths, according to the latest EU figures.

 

www.reuters.com/world/uk/london-declares-major-incident-h...

 

Omicron coronavirus cases surge in UK, scientists see bigger wave

 

■ Number of cases of Omicron coronavirus variant jump

■ London mayor declares "major incident" to help hospitals

■ Government scientific advisors say many cases unreported

■ Advisors say more action needed to prevent hospitalisation surge

■ Johnson faced anger from his own lawmakers to existing measures

 

LONDON, Dec 18 (Reuters) - Britain reported a surge in cases of the Omicron coronavirus variant on Saturday which government advisors said could be just the tip of the iceberg, and London's mayor declared a "major incident" to help the city's hospitals cope.

 

The number of Omicron cases recorded across the country hit almost 25,000 as of 1800 GMT on Friday, up by more than 10,000 cases from 24 hours earlier, the UK Health Security Agency (UKHSA) said.

 

Register now for FREE unlimited access to Reuters.com

 

Summary

 

Number of cases of Omicron coronavirus variant jump

London mayor declares "major incident" to help hospitals

Government scientific advisors say many cases unreported

Advisors say more action needed to prevent hospitalisation surge

Johnson faced anger from his own lawmakers to existing measures

 

LONDON, Dec 18 (Reuters) - Britain reported a surge in cases of the Omicron coronavirus variant on Saturday which government advisors said could be just the tip of the iceberg, and London's mayor declared a "major incident" to help the city's hospitals cope.

 

The number of Omicron cases recorded across the country hit almost 25,000 as of 1800 GMT on Friday, up by more than 10,000 cases from 24 hours earlier, the UK Health Security Agency (UKHSA) said.

 

Seven people believed to have had the Omicron variant had died as of Thursday, up from one death in the UKHSA's previous data which ran up to Tuesday. Admissions to hospital of people thought to have the variant increased to 85 from 65.

 

The government's Scientific Advisory Group for Emergencies (SAGE) said it was "almost certain" that hundreds of thousands of people were being infected with the variant every day and were not being picked up in the figures.

 

SAGE said without a further tightening of COVID-19 rules, "modelling indicates a peak of at least 3,000 hospital admissions per day in England," they said in minutes of a meeting on Dec. 16.

 

Last January, before Britain's vaccination campaign gathered speed, daily hospital admissions in the United Kingdom as a whole surged above 4,000.

 

Prime Minister Boris Johnson has faced a rebellion in his governing Conservative Party over some of the measures he has taken so far to try to curb COVID-19's latest spread. A newspaper said on Saturday that Johnson's Brexit minister, David Frost, had resigned in part because of the new rules.

 

The advisors said it was too early to assess the severity of disease caused by Omicron but if there was a modest reduction compared to the Delta variant, "very high numbers of infections would still lead to significant pressure on hospitals".

 

London Mayor Sadiq Khan declared a "major incident" - which allows for closer coordination between public agencies and possibly more central government support - as COVID-19 hospital admissions in the city rose by nearly 30% this week.

 

He said health worker absences had also increased.

 

"This is a statement of how serious things are," he said.

 

Mayor of London, Sadiq Khan visits a coronavirus disease (COVID-19) pop-up vaccination centre at Chelsea football ground, Stamford Bridge in London, Britain, December 18, 2021. REUTERS/David Klein

 

Khan, from the opposition Labour Party, also declared a major incident in January, when rising COVID-19 cases threatened to overwhelm hospitals.

 

The Omicron variant is estimated to account for more than 80% of new COVID-19 cases in London, officials said on Friday.

 

EMERGENCY MEETING

 

Johnson was due to chair an emergency committee meeting over the weekend with the devolved administrations in Scotland, Wales and Northern Ireland, which have their own powers over public health.

 

A report in The Times newspaper said officials were preparing draft rules which, if introduced, would ban indoor mixing in England -- except for work -- for two weeks after Christmas when pubs and restaurants would be limited to outdoor table service.

 

People would be able to meet in groups of up to six outdoors, the newspaper said, adding that ministers were yet to formally consider the plans.

 

Johnson said on Friday "we are not closing things down".

 

A government spokesperson said the government would continue to "look closely at all the emerging data and we'll keep our measures under review as we learn more about this variant".

 

The number of all new COVID-19 cases reported in official data fell to 90,418 from a record high of more than 93,000 on Friday, but that was still the country's second-highest daily toll. Figures typically dip at the weekend.

 

Cases were up 44.4% over the seven days to Dec. 18 compared with the previous week.

 

Police clashed with a group of protesters opposed to the latest COVID-19 restrictions near Johnson's Downing Street office and residence on Saturday. A number of officers were injured but so far no arrests had been made, police said.

Alpha Omicron Pi holds its Second Rush Party of the year.

December 20, 2021 - New York City - Governor Kathy Hochul, joined by Jackie Bray, Acting Commissioner of New York State Department of Homeland Security and Emergency Services, and Director of State Operations Kathryn Garcia updates New Yorkers on the Covid-19 spread in New York State, particularly on the Omicron variant, during a press briefing Monday December 20, 2021 in New York City. (Kevin P. Coughlin / Office of the Governor)

Micro'd version of Mike Rutherford's Behemoth.

 

See more over at Ry's photostream and here