omicron photos on Flickr

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

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.

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Alpha Omicron Pi Bid Day at TCU-3 by Raul Mosley

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

You can learn more about AOII here:

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

Please follow the Fort Worth Portrait Project:

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

AOII Victory September 2014-25 by Raul Mosley

The Lambda Rho chapter of Alpha Omicron Pi posed for portraits at TCU's Frog Fountain prior to attending a Victory event on September 26, 2014.. (I don't have the first clue what this event was, but I'm assuming it was a formal dance of some sort.) You can learn more about the chapter at the following sites:

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

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

Shenandoah University Omicron Delta Kappa (ODK) Circle Inducts 46 Students and One Staff Member Into its Ranks by Shenandoah University

2-1-17 | SUN-e Picture of the Day: On Jan. 29, the Shenandoah University Omicron Delta Kappa (ODK) Circle inducted 46 students and one staff member into its ranks. This is is a record number of inductees since Shenandoah reactivated the organization in 2008. ODK is a national leadership honor society that recognizes and encourages superior scholarship, leadership and exemplary character. Congratulations to all of the new members of ODK! Congratulations to all the new members of ODK, including student inductees (listed in alphabetical order) Emily Boero, Courtney Michelle Bridges, Brianna Brophy, Christopher Castanho, Jeffrey W. Chuang, Cory Claytor, Meghan C. Clouspy, Alaina Grace Combs, Karen Cornejo Guillen, Ashlyn Elizabeth Drake, Josue Israel Duran, Mary L. Dyke, Casey Edsall, Antonio Ford, Thanveer Reddy Gadwal, Annabelle Garcia, Jessica Gardiner, Gabrielle Haas, Kriti Hada, Brooke Ann Heltzel, Jacqueline Hemler, Anne Hess, Daniel G. Hillgren, Melinda Hockaday, Matthew Hwang, Terria Trana Jones, Benjamin William Judy, Desiree Kardashian, Michelle Lynn Krause, Peyton Leigh Krevonick, Danielle LaBar, Rachel Nicole Levy, Anna Lopynski, Dani Maloney, Sarah H. Mann, Joselyn E. Mendoza, Sapana Ojha, Elizabeth Pardo, Heather L. Pollak, Silvino Resendiz, Shelby Rose Shrader, Justin Struyk, Cassandra R. Tabarini, Manuel J. Vasquez, Corrie Wernle and Alex Wessel, as well as Director of Advising and College of Arts & Sciences Instructor of Kinesiology Sarah “Salli” Hamilton, M.S., A.B.D., who was inducted as a staff member. (PHOTO: Jimmy Smith)

10/02/2023 Florianópolis, SC. Novas Vacinas contra COVID-19. by Governo Santa Catarina

10/02/2023 Florianópolis, SC. Novas Vacinas contra COVID-19. O estado de Santa Catarina recebeu novas doses das vacinas da Pfizer para diferentes faixa etárias além da bivalente que protege contra a variante Ômicron.

Para identificar os frascos :

A bivalente o frasco com tampa cinza, bebês e crianças entre 6 meses e 5 anos frasco tampa vermelha e crianças e adolescentes tampa laranja.

Foto Ricardo Wolffenbüttel /SECOM

20220128 by Guy M Wong

www.nature.com/articles/d41586-022-00215-2

Where did Omicron come from? Three key theories

The highly transmissible variant emerged with a host of unusual mutations. Now scientists are trying to work out how it evolved.

Little more than two months after it was first spotted in South Africa, the Omicron variant of the coronavirus SARS-CoV-2 has spread around the world faster than any previous versions. Scientists have tracked it in more than 120 countries, but remain puzzled by a key question: where did Omicron come from?

There’s no transparent path of transmission linking Omicron to its predecessors. Instead, the variant has an unusual array of mutations, which it evolved entirely outside the view of researchers. Omicron is so different from earlier variants, such as Alpha and Delta, that evolutionary virologists estimate its closest-known genetic ancestor probably dates back to more than a year ago, some time after mid-2020 (ref. 1). “It just came out of nowhere,” says Darren Martin, a computational biologist at the University of Cape Town, South Africa.

The question of Omicron’s origins is of more than academic importance. Working out under what conditions this highly transmissible variant arose might help scientists to understand the risk of new variants emerging, and suggest steps to minimize it, says Angela Rasmussen, a virologist at the University of Saskatchewan Vaccine and Infectious Disease Organization in Saskatoon, Canada. “It’s very difficult to try to mitigate a risk that you can’t even remotely wrap your head around,” she says.

The World Health Organization’s recently formed Scientific Advisory Group for the Origins of Novel Pathogens (SAGO) met in January to discuss Omicron’s origins. The group is expected to release a report in early February, according to Marietjie Venter, a medical virologist at the University of Pretoria in South Africa, who chairs SAGO.

Ahead of that report, scientists are investigating three theories. Although researchers have sequenced millions of SARS-CoV-2 genomes, they might simply have missed a series of mutations that eventually led to Omicron. Alternatively, the variant might have evolved mutations in one person, as part of a long-term infection. Or it could have emerged unseen in other animal hosts, such as mice or rats.

For now, whichever idea a researcher favours “often comes down to gut feeling rather than any sort of principled argument”, says Richard Neher, a computational biologist at the University of Basel in Switzerland. “They are all fair game,” says Jinal Bhiman, a medical scientist at the National Institute for Communicable Diseases in Johannesburg, South Africa. “Everyone has their favourite hypothesis.”

Craziest genome

Researchers agree that Omicron is a recent arrival. It was first detected in South Africa and Botswana in early November 2021 (see ‘Omicron takeover’); retrospective testing has since found earlier samples from individuals in England on 1 and 3 November, and in South Africa, Nigeria and the United States on 2 November. An analysis of the mutation rate in hundreds of sequenced genomes, and of how quickly the virus had spread through populations by December, dates its emergence to not long before that — around the end of September or early October last year2. In southern Africa, Omicron probably spread from the dense urban province of Gauteng, between Johannesburg and Pretoria, to other provinces and to neighbouring Botswana.

But because Johannesburg is home to the largest airport on the African continent, the variant could have emerged anywhere in the world — merely being picked up in South Africa because of the country’s sophisticated genetic surveillance, says Tulio de Oliveira, a bioinformatician at the University of KwaZulu-Natal in Durban and at Stellenbosch University’s Centre for Epidemic Response and Innovation, who has led South Africa’s efforts to track viral variants, including Omicron.

What stands out about Omicron is its remarkable number of mutations. Martin heard about it when he took a phone call from de Oliveira, who asked him to look at the craziest SARS-CoV-2 genome he had ever seen.

The variant has more than 50 mutations when compared with the original SARS-CoV-2 virus isolated in Wuhan, China (see go.nature.com/32utxva). Some 30 of these contribute to changes in amino acids in the spike protein1, which the coronavirus uses to attach to and fuse with cells. Previous variants of concern have had no more than ten such spike mutations. “That is a hell of a lot of changes,” says Neher (see ‘Most mutated’).

Researchers have seen many of these mutations before. Some were previously known to give the virus an increased ability to bind to the ACE2 receptor protein — which adorns host cells and is the docking point for SARS-CoV-2 — or to help it evade the body’s immune system. Omicron forms a stronger grip on ACE2 than do previously seen variants3. It is also better at evading the virus-blocking ‘neutralizing’ antibodies4 produced by people who have been vaccinated, or who have been infected with earlier variants. Other changes in the spike protein seem to have modified how Omicron enters cells: it appears to be less adept at fusing directly with the cell’s membrane, and instead tends to gain entry after being engulfed in an endosome (a lipid-surrounded bubble).

But more than a dozen of Omicron’s mutations are extremely rare: some have not been seen at all before, and others have popped up but disappeared again quickly, presumably because they gave the virus a disadvantage1.

Another curious feature of Omicron is that, from a genomic viewpoint, it consists of three distinct sublineages (called BA.1, BA.2 and BA.3) that all seem to have emerged at around the same time — two of which have taken off globally. That means Omicron had time to diversify before scientists noticed it. Any theory about its origins has to take this feature into account, as well as the number of mutations, notes Joel Wertheim, a molecular epidemiologist at the University of California, San Diego.

Silent spread

Researchers have explained the emergence of previous variants of concern through a simple process of gradual evolution. As SARS-CoV-2 replicates and transmits from person to person, random changes crop up in its RNA sequence, some of which persist. Scientists have observed that, in a given lineage, about one or two single-letter mutations a month make it into the general viral circulation — a mutation rate about half that of influenza. It is also possible for chunks of coronavirus genomes to shuffle and recombine wholesale, adds Kristian Andersen, an infectious-disease researcher at Scripps Research in La Jolla, California. And viruses can evolve faster when there is selection pressure, he says, because mutations are more likely to stick around if they give the virus an increased ability to propagate under certain environmental conditions.

Some scientists think that person-to-person spread would not be conducive to accumulating as many changes as Omicron has since mid-2020. “It does seem like a year and a half is a really short period of time for that many mutations to emerge and to apparently be selected for,” says Rasmussen.

But Bhiman argues that enough time has elapsed. She thinks the mutation process could have occurred unseen, in a region of the world that has limited genomic sequencing and among people who don’t typically get tested, perhaps because they didn’t have symptoms. At some point in the past few months, she says, something happened to help Omicron explode, maybe because the progress of other variants — such as Delta — was gradually impeded by the immunity built up from vaccination and previous infection, whereas Omicron was able to evade this barrier.

Although researchers have submitted almost 7.5 million SARS-CoV-2 sequences to the GISAID genome database, hundreds of millions of viral genomes from people with COVID-19 worldwide have not been sequenced. South Africa, with some 28,000 genomes, has sequenced less than 1% of its known COVID-19 cases, and many nearby countries, from Tanzania to Zimbabwe and Mozambique, have submitted fewer than 1,000 sequences to GISAID (see ‘Missing genomes’).

Martin says that researchers need to sequence SARS-CoV-2 genomes from these countries to get a better sense of the likelihood of unobserved evolution. It is possible that the three sublineages of Omicron each separately arrived in South Africa from a region with limited sequencing capacity, he says.

But de Oliveira says the scenario that Omicron evolved unseen through person-to-person transmission is “extremely implausible”. Intermediate steps in Omicron’s evolution should have been picked up in viral genomes from people travelling from countries that do little sequencing to those that do a lot.

“This is not the nineteenth century, where you take six months to go from point to point by sailboat,” says Sergei Pond, a computational evolutionary biologist at Temple University in Philadelphia, Pennsylvania.

And Andersen adds that, because some of Omicron’s mutations haven’t been seen before, the variant might have evolved in an environment not involving person-to-person chains of transmission. Some of the changes in Omicron don’t match any seen even in the broader viral group of sarbecoviruses, which includes the virus that causes severe acute respiratory syndrome (SARS). For example, one particular site on the genomes of all known sarbecoviruses encodes a serine amino acid, but a mutation in Omicron means the variant has a lysine at that position1, which changes the biochemistry of that region, Andersen says.

However, says Jesse Bloom, a viral evolutionary geneticist at the Fred Hutchinson Cancer Research Center in Seattle, Washington, SARS-CoV-2 has not yet explored all of its possibilities in people. “The virus is still expanding in the evolutionary space.”

Chronic infection

An alternative incubator for fast-paced evolution is a person with a chronic infection. There, the virus can multiply for weeks or months, and different types of mutation can emerge to dodge the body’s immune system. Chronic infections give the virus “the opportunity to play cat and mouse with the immune system”, says Pond, who thinks it is a plausible hypothesis for Omicron’s emergence.

Such chronic infections have been observed in people with compromised immune systems who cannot easily get rid of SARS-CoV-2. For example, a December 2020 case report described a 45-year-old man with a persistent infection5. During almost five months in its host, SARS-CoV-2 accumulated close to a dozen amino-acid changes in its spike protein. Some researchers suggest Alpha emerged in someone with a chronic infection, because, like Omicron, it seems to have accumulated changes at an accelerated rate (see go.nature.com/3yj6kmh).

“The virus has to change to stick around,” says Ben Murrell, an interdisciplinary virologist at the Karolinska Institute in Stockholm. The receptor-binding domain, where many of Omicron’s mutations are concentrated, is an easy target for antibodies, and probably comes under pressure to change in a long-term infection.

But none of the viruses from individuals with chronic infections studied so far has had the scale of mutations observed in Omicron. Achieving that would require high rates of viral replication for a long time, which would presumably make that person very unwell, says Rasmussen. “It seems like a lot of mutations for just one person.”

Further complicating the picture, Omicron’s properties could stem from combinations of mutations working together. For example, two mutations found in Omicron — N501Y together with Q498R — increase a variant’s ability to bind to the ACE2 protein by almost 20 times, according to cell studies. Preliminary research by Martin and his colleagues suggests that the dozen or so rare mutations in Omicron form three separate clusters, in which they seem to work together to compensate for the negative effects of any single one1.

If this is the case, it means that the virus would have to replicate sufficiently in a person’s body to explore the effects of combinations of mutations — which would take longer to achieve than if it were sampling the space of possible mutations one by one.

One possibility is that multiple individuals with chronic infections were involved, or that Omicron’s ancestor came from someone with a long-term infection and then spent some time in the general population before being detected. “There are a lot of open questions,” says Rasmussen.

Proving this theory is close to impossible, because researchers would need to be lucky enough to find the particular person or group that could have sparked Omicron’s emergence. Still, more comprehensive studies of SARS-CoV-2’s evolution in chronic infections would help to map out the range of possibilities, says Neher.

Mouse or rat

Omicron might not have emerged in a person at all. SARS-CoV-2 is a promiscuous virus: it has spread to a wild leopard, to hyenas and hippopotamuses at zoos, and into pet ferrets and hamsters. It has caused havoc in mink farms across Europe, and has infiltrated populations of white-tailed deer throughout North America. And Omicron might be able to enter a broader selection of animals. Cell-based studies have found that, unlike earlier variants, Omicron’s spike protein can bind to the ACE2 protein of turkeys, chickens and mice.

One study found that the N501Y–Q498R combination of mutations allows variants to bind tightly to rat ACE2 (ref. 6). And Robert Garry, a virologist at Tulane University in New Orleans, Louisiana, notes that several other mutations in Omicron have been seen in SARS-CoV-2 viruses adapting to rodents in laboratory experiments.

The types of single-nucleotide substitution observed in Omicron’s genome also seem to reflect those typically observed when coronaviruses evolve in mice, and do not match as well with the switches that are observed in coronaviruses adapting to people, according to a study of 45 mutations in Omicron8. The study noted that, in human hosts, G to U substitutions tend to occur in RNA viruses at a higher rate than C to A switches do, but that Omicron does not show this pattern.

It is possible, then, that SARS-CoV-2 could have acquired mutations that gave it access to rats — jumping from an ill person to a rat, possibly through contaminated sewage — and then spread and evolved into Omicron in that animal population. An infected rat could later have come into contact with a person, sparking the emergence of Omicron. The three sublineages of Omicron are sufficiently distinct that, according to this theory, each would represent a separate jump from animal to human.

A large population of animals with infections lasting longer than in humans could give SARS-CoV-2 room to explore a wide diversity of mutations and “build up a large ghost population of viruses that no one knows about”, says Martin, who says he finds this ‘reverse zoonosis’ theory convincing. Changes that make the virus better at spreading in its animal host won’t necessarily affect its ability to infect people, he says.

An animal reservoir could also explain why some of the mutations in Omicron have been rarely seen before in people, says Andersen.

In the dark

But others say that even a single viral jump from an animal to a person is a rare event — let alone three. Meanwhile, the virus has had plenty of opportunities to slip between people. And although some of Omicron’s mutations have been seen in rodents, that doesn’t mean they can’t happen or haven’t occurred in people, too, and have simply been missed.

Murrell also points out that SARS-CoV-2 didn’t immediately go through a period of accelerated evolution after jumping to people for the first time. When it spread to mink and deer, it did pick up changes, but not as many mutations as Omicron has accumulated, says Spyros Lytras, an evolutionary virologist at the University of Glasgow, UK. This means that the evidence isn’t sufficient to suggest Omicron’s predecessor would have undergone rapid selection after finding a new home in the wild.

To confirm this theory, researchers would need to find close relatives of Omicron in another animal, but they haven’t been looking — “something that has been horribly neglected”, says Martin. Since the pandemic began, researchers have sequenced fewer than 2,000 SARS-CoV-2 genomes isolated from other animals, mostly from mink, cats and deer.

Now that Omicron has taken off, how it evolves in people could offer more clues about its origins. It might, for instance, shed mutations that, in retrospect, are found to have helped it adapt to a different animal host, or in a person with a chronic infection. But it could also not change by much, leaving researchers in the dark.

The answer to Omicron’s emergence will probably be one or a combination of the three scenarios, says Bloom. But, he adds, researchers are far from explaining the processes that brought Omicron here, let alone predicting what the next variant will look like.

And many scientists say they might never find out where Omicron came from. “Omicron really shows us the need for humility in thinking about our ability to understand the processes that are shaping the evolution of viruses like SARS-CoV-2,” says Bloom.

Nature 602, 26-28 (2022)

doi: doi.org/10.1038/d41586-022-00215-2

Omicron Obsession by Hieu Nghi

*Omicron là chữ cái số 15 trong hệ ký tự Hy Lạp, gồm 2 chữ Oo được tổ chức y tế thế giới WHO đặt tên cho biến thể B1.1.529 virus Sars-cov-2 mới. nghe nói biến thể này lây gấp 500 lần biến thể Delta!!!

Breakthrough COVID-19 Omicron Infection by Wayan Vota

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

Omicron Biochemicals Solar System by HomeEnergyLLC

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 Bid Day at TCU-234 by Raul Mosley

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

You can learn more about AOII here:

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

Please follow the Fort Worth Portrait Project:

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

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

20221204 by Guy M Wong

www.msn.com/en-us/health/medical/the-fast-spreading-new-c...

The Fast-Spreading New COVID-19 Subvariant XBB Is Part of a ‘New Class’ of Omicron

For the past several months, Omicron subvariants BA.4 and BA.5 have dominated COVID-19 cases in the U.S. But now, there’s a class of new COVID subvariants on the rise and one in particular is getting plenty of attention. It’s called XBB—or Gryphon—and there’s a chance it could overtake everything else out there.

XBB is getting a lot of buzz because it spreads fast—and seems to be able to evade immunity that people have built up from having a previous COVID-19 infection or getting the vaccine, says William Schaffner, M.D., an infectious disease specialist and professor at the Vanderbilt University School of Medicine. Still, Dr. Schaffner says, “it’s early days and we have a lot to learn.”

Here’s what we know about XBB so far, and why doctors are keeping a close eye on it.

What is the XBB COVID variant?

XBB is one of the “new class” of Omicron variants that are spreading fast right now, says Thomas Russo, M.D., professor and chief of infectious disease at the University at Buffalo in New York. That includes BQ.1.1, BQ.1, BQ.1.3, BA.2.3.20, and XBB, he says.

“XBB is a hybrid version of two strains of the BA.2 form of Omicron,” explains Amesh A. Adalja, M.D., a senior scholar at the Johns Hopkins Center for Health Security. It’s currently “spreading efficiently in Singapore,” he adds.

The variant was first detected in August 2022 in India, and has been detected in more than 17 countries since then, including Australia, Bangladesh, Denmark, India, Japan and the U.S., per Singapore’s Ministry of Health.

XBB is thought to have the best ability to evade antibody protections of these newly emerged COVID variants, according to a pre-print study from researchers in China. That study said that the new strains of Omicron, and XBB in particular, “are the most antibody-evasive strain tested, far exceeding BA.5 and approaching SARS-CoV-1 level.” (SARS-CoV-1, in case you’re not familiar with it, is the strain of coronavirus that causes SARS, a respiratory virus that can cause severe illness.)

Meaning, the vaccine and having previously had COVID-19 are not thought to offer the same level of protection against XBB as they have with previous strains of COVID-19. Antibody drugs like Evusheld and bebtelovimab may also not be very effective against XBB, the pre-print study says.

“These variants are evolving to evade protection,” Dr. Russo says. The bivalent booster is “likely going to be protective against severe disease” with XBB, but will be “imperfect against preventing infection," Dr. Russo says.

Don’t panic, though. “When it comes to evasion of vaccine protection, it’s important to recognize that vaccine protection is not all or none,” Dr. Adalja says. “Even with immune-evasive variants, vaccine protection against what matters most—severe disease—remains intact.”

XBB variant symptoms

So far, symptoms of XBB seem to be similar to what they’ve been with COVID-19 in general. According to the Centers for Disease Control and Prevention (CDC), those can include:

· Fever or chills

· Cough

· Shortness of breath or difficulty breathing

· Fatigue

· Muscle or body aches

· Headache

· New loss of taste or smell

· Sore throat

· Congestion or runny nose

· Nausea or vomiting

· Diarrhea

How contagious is the XBB subvariant?

Like other strains of Omicron, XBB is thought to be very contagious. Singapore’s Ministry of Health notes that the variant now makes up 54% of COVID-19 cases in the country, up from 22% the week before.

Singapore’s Ministry of health says that XBB is “at least as transmissible as currently circulating variants” but adds that “there is no evidence that XBB causes more severe illness.”

When will the XBB subvariant peak?

There are a lot of unknowns about XBB right now. While it’s been detected in the U.S., BA.5 and BA.4.6 continue to be the dominant variants in this country, per CDC data.

Other variants are also started to spread at the same time, Dr. Adalja says, and it’s unclear which will displace BA.4.6 and BA.5 in the U.S., if they will at all. “It’s likely to spread to some degree in the U.S. but unclear if it—or some other related variant such as BQ.1.1—will become dominant,” he says.

Dr. Schaffner says there is "some concern" about XBB and fellow variants on the rise. “Watching what happens over the next several weeks is important,” he says.

This article is accurate as of press time. However, as the COVID-19 pandemic rapidly evolves and the scientific community’s understanding of the novel coronavirus develops, some of the information may have changed since it was last updated. While we aim to keep all of our stories up to date, please visit online resources provided by the CDC, WHO, and your local public health department to stay informed on the latest news. Always talk to your doctor for professional medical advice.

O (Omicron) by Joanie Lemercier

A permanent installation directed by Romain Tardy & Thomas Vaquié

Hala Stulecia, Wroclaw, Poland.

More details: www.antivj.com/O/

20220907 by Guy M Wong

www.msn.com/en-us/travel/news/research-finds-latest-omicr...

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.

www.wsj.com/articles/a-key-to-long-covid-is-virus-lingeri...

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

Novel Coronavirus by Daniel Foster

A petri dish containing a model of novel coronavirus

www.cnn.com/world/live-news/omicron-variant-coronavirus-n...

Omicron Is For Necron by eddi_monsoon

4 5

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

20220112 by Guy M Wong

■ 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.

Omicron-Dokk Altus Concept HA-XDK [001] - AERO Friedrichshafen - 18APR2018 by Simon Brooke

AERO Friedrichshafen, 18 April 2018

Omicron Initiation by Kappa Sigma Delta-Delta

www.latimes.com/california/story/2022-06-01/second-omicro...

20220531 by Guy M Wong

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.”

AOII Bid Day 2014 by Kristina Tombrella

Alpha Omicron Pi-Tau Delta

Omicron Delta Kappa April 2023_0114 by Dillard University

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

(Photo by Sabree Hill/ Dillard University Photographer)

20220716 by Guy M Wong

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.

20220213 by Guy M Wong

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.”

Mecha Godzilla invades the Omicron Weekend by Andrew Becraft

5 3

Omicron 1 & 2 Cygni : Eclipsing Binary Stars by Ash.Cox

4 3

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

Omicron Biochemicals Solar System by HomeEnergyLLC

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.

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

20211225 by Guy M Wong

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.

Exposição de formatura do Curso Anual nesta terça, dia 03/08, às 19h. by Osvaldo Santos Lima

(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.