View allAll Photos Tagged omicron
www.sfchronicle.com/opinion/article/covid-omicron-paxlovi...
Omicron finally got me after two years of being a COVID hermit. Then, doctors made it worse
BA.5 just wiped me out for 12 days. Why did doctors let me get sick instead of giving me Paxlovid?
I knew right away that it was going to be bad.
It was a hot, humid night — almost 90 degrees — but my body was freezing. Putting on a sweatshirt and diving under a blanket couldn’t warm me up. My head, on the other hand, was on fire. I had a temperature over 100 degrees and needed ice packs piled on my forehead to cool down. The coughing wouldn’t stop.
I didn’t need a test to tell me that I had finally caught COVID.
For more than two years I basically lived like a hermit to avoid just this scenario. Sure, after getting vaxxed and boosted I didn’t think COVID would kill me. But I don’t exactly have a gold medal immune system; even a common cold gives me a rough time. I imagined COVID would lay me out with symptoms that could drag on for weeks or possibly months. So I stayed away from the office, indoor gatherings and restaurants. The gym? No thanks. Fifteen extra pounds was worth it to avoid getting sick.
But this summer was my sister’s 40th birthday. She and the rest of my family live on the East Coast and were throwing a big party. So I decided to leave my cave and fly to see them.
Sure enough, someone else showed up to the festivities quietly sucking cough drops, assuring anyone who asked that her unusually nasal intonation was just a cold.
It wasn’t. And I was dumb enough to sit right next to her.
As soon as the first symptoms hit, I knew I was in trouble. So I decided to do my damnedest to get a prescription for Paxlovid, the antiviral drug cocktail that can prevent the coronavirus from replicating in your body during the early stages of infection. I wasn’t technically eligible because I’m under 65 without any serious comorbidities. But having chills, a brutal cough and a sky-high fever had to count for something, right?
Apparently not.
Local pharmacists wouldn’t have anything to do with me. Neither would urgent care. I called my health care provider back in San Francisco for a prescription, but it too told me I wasn’t eligible for Paxlovid and had to rest and ride it out.
So ride it out I did for the next 12 days coughing, sweating, snotting and sleeping up to 16 hours a day. Instead of spending time with my family, I had to avoid them at all costs to keep them from getting sick — other than to beg for food and supplies; there are no delivery services in the rural community they live.
After a wasted vacation, a changed flight and a few extra sick days, I finally got home a couple of weeks ago.
That same day, my partner started showing symptoms of COVID.
She too was ineligible for Paxlovid and spent the next 10 days hacking away in isolated misery. She just finally tested negative, but neither of us are back even close to full speed. A mildly hilly walk in Golden Gate Park the other day had me huffing like I just ran a marathon. I was in bed by 8:30 that night.
I don’t know for sure which variant laid us out, but, based on infection data, it was almost certainly BA.5. Now, as BA.4.6 gains ground — and future variants follow — are we going to have to go through all this again if we want to live freely like we did before the pandemic? Because I don’t have the sick days or the stomach for that. And I can’t be the only one.
I’m hopeful the new omicron booster can break this cycle. But what if it doesn’t?
This begs the question: if an antiviral drug like Paxlovid exists that could potentially ease people’s COVID symptoms by preventing the virus from replicating in our bodies before it spreads, why are we being so precious about who we give it to? A pharmacist in Canada recently refused to fill a Paxlovid prescription for a 20-year-old with Down syndrome and a history of respiratory infections. How is that sensible public health policy?
I asked UCSF infectious disease specialist Monica Gandhi why those of not wanting to feel like garbage for weeks at a time, and who need to work or see vulnerable family members, can’t get easy access to the drug? We give antivirals widely to ease flu symptoms, why not COVID?
She replied that Paxlovid is currently being used to prevent death and hospitalizations, and that studies of people in my age range have shown no discernible benefits in this regard to taking the drug.
However, “there are other benefits of Paxlovid,” she said. “You were likely to have felt better sooner if your viral load was brought down more quickly. But there just have not been any studies on this in vaccinated people.”
My read on this is that even as public health guidance is evolving to tell us COVID is now endemic and we can start getting back to normal, in many unhelpful ways it still treats the virus like a deadly disease.
We can’t have it both ways.
Many doctors, Gandhi said, recognize the obvious utility in giving people the chance to recover faster. Given that the known side effects of Paxlovid are few and mild, some doctors are comfortable bending the rules to prescribe the drug to those who might not technically meet the public health guidance. That works in America because the feds are currently footing the bill — and they aren’t rigorously checking who does or doesn’t have dire comorbidities. But Paxlovid is expensive. And as the federal government cuts off funds and insurance companies start taking on the cost of the drug, you can expect those eligibility requirements to lock in tighter than they are now.
What happens then if the omicron booster shots prove ineffective at preventing breakthrough infections like the one that waylaid me? Are we willing to let perpetual sickness be the cost of normalcy?
Based on America’s COVID response thus far, I’m fairly certain the answer to that is yes — unless folks start agitating. Are we going to rely on insurance company actuaries and the power of positive thinking to guide us back to normal, with all the attendant consequences? Or are we going to insist that public health officials study all tools in the arsenal that could get us there with as little misery as possible?
Matthew Fleischer is The San Francisco Chronicle’s editorial page editor. Email: matt.fleischer@sfchronicle.com
www.usatoday.com/story/news/health/2022/08/24/paxlovid-pf...
Paxlovid, Pfizer's COVID pill, showed no measurable benefit in adults 40 to 65, study says
WASHINGTON — Pfizer's COVID-19 pill appears to provide little or no benefit for younger adults, while still reducing the risk of hospitalization and death for high-risk seniors, according to a large study published Wednesday.
The results from a 109,000-patient Israeli study are likely to renew questions about the U.S. government's use of Paxlovid, which has become the go-to treatment for COVID-19 due to its at-home convenience. The Biden administration has spent more than $10 billion purchasing the drug and making it available at thousands of pharmacies through its test-and-treat initiative.
The researchers found that Paxlovid reduced hospitalizations among people 65 and older by roughly 75% when given shortly after infection. That's consistent with earlier results used to authorize the drug in the U.S. and other nations.
But people between the ages of 40 and 65 saw no measurable benefit, according to the analysis of medical records.
The study has limitations due to its design, which compiled data from a large Israeli health system rather than enrolling patients in a randomized study with a control group — the gold standard for medical research.
The findings reflect the changing nature of the pandemic, in which the vast majority of people already have some protection against the virus due to vaccination or prior infection. For younger adults, in particular, that greatly reduces their risks of severe COVID-19 complications. The Centers for Disease Control and Prevention recently estimated that 95% of Americans 16 and older have acquired some level of immunity against the virus.
“Paxlovid will remain important for people at the highest risk of severe COVID-19, such as seniors and those with compromised immune systems,” said Dr. David Boulware, a University of Minnesota researcher and physician, who was not involved in the study. “But for the vast majority of Americans who are now eligible, this really doesn’t have a lot of benefit."
A spokesman for Pfizer declined to comment on the results, which were published in the New England Journal of Medicine.
The U.S. Food and Drug Administration authorized Paxlovid late last year for adults and children 12 and older who are considered high risk due to conditions like obesity, diabetes and heart disease. More than 42% of U.S. adults are considered obese, representing 138 million Americans, according to the CDC.
At the time of the FDA decision there were no options for treating COVID-19 at home, and Paxlovid was considered critical to curbing hospitalizations and deaths during the pandemic's second winter surge. The drug's results were also far stronger than a competing pill from Merck.
The FDA made its decision based on a Pfizer study in high-risk patients who hadn't been vaccinated or treated for prior COVID-19 infection.
“Those people do exist but they’re relatively rare because most people now have either gotten vaccinated or they’ve gotten infected,” Boulware said.
Pfizer reported earlier this summer that a separate study of Paxlovid in healthy adults — vaccinated and unvaccinated — failed to show a significant benefit. Those results have not yet been published in a medical journal.
More than 3.9 million prescriptions for Paxlovid have been filled since the drug was authorized, according to federal records. A treatment course is three pills twice a day for five days.
A White House spokesman on Wednesday pointed to several recent papers suggesting Paxlovid helps reduce hospitalizations among people 50 and older. The studies have not been published in peer-reviewed journals.
“Risk for severe outcomes from COVID is along a gradient, and the growing body of evidence is showing that individuals between the ages of 50 and 64 can also benefit from Paxlovid,” Kevin Munoz said in an emailed statement.
Administration officials have been working for months to increase use of Paxlovid, opening thousands of sites where patients who test positive can fill a prescription. Last month, U.S. officials further expanded access by allowing pharmacists to prescribe the drug.
The White House recently signaled that it may soon stop purchasing COVID-19 vaccines, drugs and tests, shifting responsibility to the private insurance market. Under that scenario, insurers could set new criteria for when they would pay for patients to receive Paxlovid.
Omicron VT-AFM XA: Variable-temperature, ultra-high-vacuum, atomic force microscope/scanning tunneling microscope at Argonne's Center for Nanoscale Materials.
Photo courtesy of Argonne National Laboratory.
www.thelancet.com/journals/lanres/article/PIIS2213-2600(22)00101-1/fulltext
Durability of BNT162b2 vaccine against hospital and emergency department admissions due to the omicron and delta variants in a large health system in the USA: a test-negative case–control study - The Lancet Respiratory Medicine
Summary
Background
The duration of protection against the omicron (B.1.1.529) variant for current COVID-19 vaccines is not well characterised. Vaccine-specific estimates are especially needed. We aimed to evaluate the effectiveness and durability of two and three doses of the BNT162b2 (Pfizer–BioNTech) mRNA vaccine against hospital and emergency department admissions due to the delta (B.1.617.2) and omicron variants.
Methods
In this case–control study with a test-negative design, we analysed electronic health records of members of Kaiser Permanente Southern California (KPSC), a large integrated health system in California, USA, from Dec 1, 2021, to Feb 6, 2022. Vaccine effectiveness was calculated in KPSC patients aged 18 years and older admitted to hospital or an emergency department (without a subsequent hospital admission) with a diagnosis of acute respiratory infection and tested for SARS-CoV-2 via PCR. Adjusted vaccine effectiveness was estimated with odds ratios from adjusted logistic regression models. This study is registered with ClinicalTrials.gov (NCT04848584).
Findings
Analyses were done for 11 123 hospital or emergency department admissions. In adjusted analyses, effectiveness of two doses of the BNT162b2 vaccine against the omicron variant was 41% (95% CI 21–55) against hospital admission and 31% (16–43) against emergency department admission at 9 months or longer after the second dose. After three doses, effectiveness of BNT162b2 against hospital admission due to the omicron variant was 85% (95% CI 80–89) at less than 3 months but fell to 55% (28–71) at 3 months or longer, although confidence intervals were wide for the latter estimate. Against emergency department admission, the effectiveness of three doses of BNT162b2 against the omicron variant was 77% (72–81) at less than 3 months but fell to 53% (36–66) at 3 months or longer. Trends in waning against SARS-CoV-2 outcomes due to the delta variant were generally similar, but with higher effectiveness estimates at each timepoint than those seen for the omicron variant.
Interpretation
Three doses of BNT162b2 conferred high protection against hospital and emergency department admission due to both the delta and omicron variants in the first 3 months after vaccination. However, 3 months after receipt of a third dose, waning was apparent against SARS-CoV-2 outcomes due to the omicron variant, including hospital admission. Additional doses of current, adapted, or novel COVD-19 vaccines might be needed to maintain high levels of protection against subsequent waves of SARS-CoV-2 caused by the omicron variant or future variants with similar escape potential.
Funding
Pfizer.
fortune.com/2022/04/23/when-will-covid-end-meet-the-russi...
Will COVID ever end? A forgotten pandemic from the late 1800s might offer some clues – Fortune
With long-haul sufferers and symptoms like lost of taste and smell, the "Russian Flu" may have been a coronavirus like COVID, some experts say
Patients suffering from respiratory and neurological symptoms, including loss of taste and smell.
Long-haul sufferers who struggle to muster the energy to return to work.
A pandemic with a penchant for attacking the elderly and obese with particular force.
Sounds a lot like COVID, right?
It’s not.
Rather, it’s the “Russian Flu,” the world’s first well-documented pandemic, occurring as modern germ theory rose to prominence and miasma theory dispelled, ushering in the era of modern medical science and public health.
A quick check of the textbooks—the few that actually mention the thing—will inform you that the pandemic, which killed an estimated 1 million worldwide, lasted from 1889 to 1890.
Experts will tell you it likely hung around much longer—and might still lurk, in some form, today.
Predating the now oft-discussed “Spanish Flu” pandemic of 1918, which killed an estimated 50 million worldwide, the Russian Flu likely wasn’t a flu at all, some contend.
Instead, its symptoms more closely resemble a coronavirus—a category of viruses named for their crown-like appearance under a microscope, of which COVID-19 is a member.
Coronaviruses typically cause mild to moderate upper-respiratory infections in humans and are responsible for a handful of common colds. But some have turned deadly, including COVID-19; SARS (Severe Acute Respiratory Syndrome), an epidemic that emerged in 2002 and killed hundreds; and MERS (Middle Eastern respiratory syndrome), another epidemic that emerged in 2012 and killed hundreds.
“The epidemiology and clinical symptoms of the Russian Flu are much more in line with COVID than what we know about influenza pandemics,” said Dr. Harald Bruessow, editor of Microbial Biotechnology and a guest professor at KU Leuven in Belgium who has studied and published extensively on the esoteric ailment.
“You have respiratory infection, but at the same time there are strong neurologic symptoms,” he said of both the Russian Flu and COVID. “There’s also something like Long COVID that was observed following the Russian Flu pandemic. These people were incapacitated for a really long time, with an increase in suicide rate and an inability to return to full work capacity.
“All this stuff makes one think that one is dealing with a coronavirus infection in the 1880s.”
Let’s say the so-called “Russian Flu” was a coronavirus. Does it serve as a better lens through which to view the current pandemic than the Spanish Flu? What lessons can we learn? Does it offer any clues to how the COVID-19 pandemic might end—or linger, rather, as viruses tend to?
“If we say maybe the Russian Flu went extinct by a deus ex machina event, the odds are much lower for COVID,” Dr. Arijit Chakravarty, Fractal Therapeutics CEO and COVID researcher, told Fortune.
“We’re past that point.”
The forgotten ‘flu’
When “nobody really dared to predict the trajectory of the COVID pandemic, how it will develop or end”—frustrated by short-term computer simulations with a tendency toward inaccuracy—and looking to glimpse into a COVID-19 crystal ball, Bruessow turned to the past.
What pandemic might serve as the best paradigm for COVID? He first examined the Spanish Flu—but that was a different virus, he reasoned. Traveling backward in history from there, his options were limited, with the Russian Flu being the next chronological option—and, ironically, the first pandemic for which data was collected en masse.
As it turns out, it was a great fit.
“The Russian Flu was actually the best case I could figure out of a respiratory pandemic of a comparable size to COVID that was sufficiently medically documented,” Bruessow said of the disease, thought to have originated in cattle in Turkestan before enveloping the Russian empire and sweeping the world.
While considered a flu at the time, scientists did not yet have a solid grasp on what caused disease, with germ theory arising nearly simultaneously and duking it out with the miasma theory, the pre-scientific notion that disease was caused by “bad air” rising from the ground.
In one of his articles on the ailment, Bruessow refers to a 344-page doctors’ report from 1891 London, which describes Russian Flu patients as suffering from a “hard, dry cough,” fevers of 100-105 degrees, “frontal headache of special severity,” “pains in the eyeballs,” “general feeling of misery and weakness, and great depression of spirits,” and “weeping, nervous restlessness, inability to sleep, and occasional delirium.”
As with COVID, children seemed relatively spared, often only mildly affected, if they fell ill at all. Those who were elderly—in addition to those with pre-existing conditions like heart disease, tuberculosis, or diabetes—were more apt to take a fatal course, Bruessow wrote.
And there’s more: Nearly 10% of cases saw continued symptoms, referred to by European doctors of the time as “long enduring evil effects.”
As with COVID, it was noted that patients were likely infectious before developing symptoms, and were occasionally reinfected, as was the case with a patient who fell ill with the “flu” in December 1889 in France, and then again a month later in January 1890 in England.
Dr. Tom Ewing, a history professor and associate dean at Virginia Tech who has published extensively on the topic, considered the Russian Flu an apt comparison during the first three months of the COVID pandemic due to its quick spread and global efforts to track symptoms.
He now considers the Spanish Flu to be a better comparison due to the body count: It’s thought to have killed about 650,000 people in the U.S. in eight months, and COVID has killed nearly a million in the U.S. in a little over two years. In contrast, the Russian Flu is thought to have killed a million worldwide, in sum.
“I think where the useful comparisons are is, how do people react?” Ewing said. “How do they respond to first reports? How do physicians deal with a new threatening scale of disease? What we’re all living with right now—at what point do you say it’s all over?
Is the ‘Russian Flu’ still a killer?
The Russian Flu is typically considered to have lasted from 1889 through 1890, but in reality, it lasted much longer—through 1894, according to the U.S. National Institutes of Health National Library of Medicine—and nearly a decade, depending on whom you talk to. Major mortality peaks, as seen in public health data from the United Kingdom, continued through 1899 or 1900, Bruessow said, adding that the mortality peaks in England during that period are nearly as high as they were during what was likely the first phase of the Russian Flu.
It is unknown if later deaths were from additional waves of the Russian Flu or something else. But reports of symptoms from potential later waves, found in The Lancet and other British medical journals, are “strikingly similar,” and contemporary researchers were “formulating the suspicion” of an up-flair, he said.
All this “makes me think that we should consider the possibility that the Russian Flu agent was evolving and hanging around and even causing a major mortality peak in the United Kingdom and elsewhere,” he concluded.
While it’s unknown if the Russian Flu was indeed a coronavirus, some believe it lives on today as OC43, a common human coronavirus that often causes upper-respiratory track illness, according to the U.S. Centers for Disease Control and Prevention. While its presentation is often mild, the pathogen is known to cause bronchitis, bronchiolitis, and pneumonia in children and the elderly, as well as immunosuppressed patients, and its presentation may be easily confused with that of COVID-19, according to a 2021 article in The Southwest Respiratory and Critical Care Chronicles.
The thought that the Russian Flu endures as OC43 is a “fascinating hypothesis,” developed when scientists realized how genetically similar OC43 is to bovine coronavirus and projected a common ancestor arising around 1890—the Russian Flu era, and a time of major cattle pandemics that may have spread to humans.
www.thelancet.com/journals/lanres/article/PIIS2213-2600(22)00101-1/fulltext
Durability of BNT162b2 vaccine against hospital and emergency department admissions due to the omicron and delta variants in a large health system in the USA: a test-negative case–control study - The Lancet Respiratory Medicine
Summary
Background
The duration of protection against the omicron (B.1.1.529) variant for current COVID-19 vaccines is not well characterised. Vaccine-specific estimates are especially needed. We aimed to evaluate the effectiveness and durability of two and three doses of the BNT162b2 (Pfizer–BioNTech) mRNA vaccine against hospital and emergency department admissions due to the delta (B.1.617.2) and omicron variants.
Methods
In this case–control study with a test-negative design, we analysed electronic health records of members of Kaiser Permanente Southern California (KPSC), a large integrated health system in California, USA, from Dec 1, 2021, to Feb 6, 2022. Vaccine effectiveness was calculated in KPSC patients aged 18 years and older admitted to hospital or an emergency department (without a subsequent hospital admission) with a diagnosis of acute respiratory infection and tested for SARS-CoV-2 via PCR. Adjusted vaccine effectiveness was estimated with odds ratios from adjusted logistic regression models. This study is registered with ClinicalTrials.gov (NCT04848584).
Findings
Analyses were done for 11 123 hospital or emergency department admissions. In adjusted analyses, effectiveness of two doses of the BNT162b2 vaccine against the omicron variant was 41% (95% CI 21–55) against hospital admission and 31% (16–43) against emergency department admission at 9 months or longer after the second dose. After three doses, effectiveness of BNT162b2 against hospital admission due to the omicron variant was 85% (95% CI 80–89) at less than 3 months but fell to 55% (28–71) at 3 months or longer, although confidence intervals were wide for the latter estimate. Against emergency department admission, the effectiveness of three doses of BNT162b2 against the omicron variant was 77% (72–81) at less than 3 months but fell to 53% (36–66) at 3 months or longer. Trends in waning against SARS-CoV-2 outcomes due to the delta variant were generally similar, but with higher effectiveness estimates at each timepoint than those seen for the omicron variant.
Interpretation
Three doses of BNT162b2 conferred high protection against hospital and emergency department admission due to both the delta and omicron variants in the first 3 months after vaccination. However, 3 months after receipt of a third dose, waning was apparent against SARS-CoV-2 outcomes due to the omicron variant, including hospital admission. Additional doses of current, adapted, or novel COVD-19 vaccines might be needed to maintain high levels of protection against subsequent waves of SARS-CoV-2 caused by the omicron variant or future variants with similar escape potential.
Funding
Pfizer.
fortune.com/2022/04/23/when-will-covid-end-meet-the-russi...
Will COVID ever end? A forgotten pandemic from the late 1800s might offer some clues – Fortune
With long-haul sufferers and symptoms like lost of taste and smell, the "Russian Flu" may have been a coronavirus like COVID, some experts say
Patients suffering from respiratory and neurological symptoms, including loss of taste and smell.
Long-haul sufferers who struggle to muster the energy to return to work.
A pandemic with a penchant for attacking the elderly and obese with particular force.
Sounds a lot like COVID, right?
It’s not.
Rather, it’s the “Russian Flu,” the world’s first well-documented pandemic, occurring as modern germ theory rose to prominence and miasma theory dispelled, ushering in the era of modern medical science and public health.
A quick check of the textbooks—the few that actually mention the thing—will inform you that the pandemic, which killed an estimated 1 million worldwide, lasted from 1889 to 1890.
Experts will tell you it likely hung around much longer—and might still lurk, in some form, today.
Predating the now oft-discussed “Spanish Flu” pandemic of 1918, which killed an estimated 50 million worldwide, the Russian Flu likely wasn’t a flu at all, some contend.
Instead, its symptoms more closely resemble a coronavirus—a category of viruses named for their crown-like appearance under a microscope, of which COVID-19 is a member.
Coronaviruses typically cause mild to moderate upper-respiratory infections in humans and are responsible for a handful of common colds. But some have turned deadly, including COVID-19; SARS (Severe Acute Respiratory Syndrome), an epidemic that emerged in 2002 and killed hundreds; and MERS (Middle Eastern respiratory syndrome), another epidemic that emerged in 2012 and killed hundreds.
“The epidemiology and clinical symptoms of the Russian Flu are much more in line with COVID than what we know about influenza pandemics,” said Dr. Harald Bruessow, editor of Microbial Biotechnology and a guest professor at KU Leuven in Belgium who has studied and published extensively on the esoteric ailment.
“You have respiratory infection, but at the same time there are strong neurologic symptoms,” he said of both the Russian Flu and COVID. “There’s also something like Long COVID that was observed following the Russian Flu pandemic. These people were incapacitated for a really long time, with an increase in suicide rate and an inability to return to full work capacity.
“All this stuff makes one think that one is dealing with a coronavirus infection in the 1880s.”
Let’s say the so-called “Russian Flu” was a coronavirus. Does it serve as a better lens through which to view the current pandemic than the Spanish Flu? What lessons can we learn? Does it offer any clues to how the COVID-19 pandemic might end—or linger, rather, as viruses tend to?
“If we say maybe the Russian Flu went extinct by a deus ex machina event, the odds are much lower for COVID,” Dr. Arijit Chakravarty, Fractal Therapeutics CEO and COVID researcher, told Fortune.
“We’re past that point.”
The forgotten ‘flu’
When “nobody really dared to predict the trajectory of the COVID pandemic, how it will develop or end”—frustrated by short-term computer simulations with a tendency toward inaccuracy—and looking to glimpse into a COVID-19 crystal ball, Bruessow turned to the past.
What pandemic might serve as the best paradigm for COVID? He first examined the Spanish Flu—but that was a different virus, he reasoned. Traveling backward in history from there, his options were limited, with the Russian Flu being the next chronological option—and, ironically, the first pandemic for which data was collected en masse.
As it turns out, it was a great fit.
“The Russian Flu was actually the best case I could figure out of a respiratory pandemic of a comparable size to COVID that was sufficiently medically documented,” Bruessow said of the disease, thought to have originated in cattle in Turkestan before enveloping the Russian empire and sweeping the world.
While considered a flu at the time, scientists did not yet have a solid grasp on what caused disease, with germ theory arising nearly simultaneously and duking it out with the miasma theory, the pre-scientific notion that disease was caused by “bad air” rising from the ground.
In one of his articles on the ailment, Bruessow refers to a 344-page doctors’ report from 1891 London, which describes Russian Flu patients as suffering from a “hard, dry cough,” fevers of 100-105 degrees, “frontal headache of special severity,” “pains in the eyeballs,” “general feeling of misery and weakness, and great depression of spirits,” and “weeping, nervous restlessness, inability to sleep, and occasional delirium.”
As with COVID, children seemed relatively spared, often only mildly affected, if they fell ill at all. Those who were elderly—in addition to those with pre-existing conditions like heart disease, tuberculosis, or diabetes—were more apt to take a fatal course, Bruessow wrote.
And there’s more: Nearly 10% of cases saw continued symptoms, referred to by European doctors of the time as “long enduring evil effects.”
As with COVID, it was noted that patients were likely infectious before developing symptoms, and were occasionally reinfected, as was the case with a patient who fell ill with the “flu” in December 1889 in France, and then again a month later in January 1890 in England.
Dr. Tom Ewing, a history professor and associate dean at Virginia Tech who has published extensively on the topic, considered the Russian Flu an apt comparison during the first three months of the COVID pandemic due to its quick spread and global efforts to track symptoms.
He now considers the Spanish Flu to be a better comparison due to the body count: It’s thought to have killed about 650,000 people in the U.S. in eight months, and COVID has killed nearly a million in the U.S. in a little over two years. In contrast, the Russian Flu is thought to have killed a million worldwide, in sum.
“I think where the useful comparisons are is, how do people react?” Ewing said. “How do they respond to first reports? How do physicians deal with a new threatening scale of disease? What we’re all living with right now—at what point do you say it’s all over?
Is the ‘Russian Flu’ still a killer?
The Russian Flu is typically considered to have lasted from 1889 through 1890, but in reality, it lasted much longer—through 1894, according to the U.S. National Institutes of Health National Library of Medicine—and nearly a decade, depending on whom you talk to. Major mortality peaks, as seen in public health data from the United Kingdom, continued through 1899 or 1900, Bruessow said, adding that the mortality peaks in England during that period are nearly as high as they were during what was likely the first phase of the Russian Flu.
It is unknown if later deaths were from additional waves of the Russian Flu or something else. But reports of symptoms from potential later waves, found in The Lancet and other British medical journals, are “strikingly similar,” and contemporary researchers were “formulating the suspicion” of an up-flair, he said.
All this “makes me think that we should consider the possibility that the Russian Flu agent was evolving and hanging around and even causing a major mortality peak in the United Kingdom and elsewhere,” he concluded.
While it’s unknown if the Russian Flu was indeed a coronavirus, some believe it lives on today as OC43, a common human coronavirus that often causes upper-respiratory track illness, according to the U.S. Centers for Disease Control and Prevention. While its presentation is often mild, the pathogen is known to cause bronchitis, bronchiolitis, and pneumonia in children and the elderly, as well as immunosuppressed patients, and its presentation may be easily confused with that of COVID-19, according to a 2021 article in The Southwest Respiratory and Critical Care Chronicles.
The thought that the Russian Flu endures as OC43 is a “fascinating hypothesis,” developed when scientists realized how genetically similar OC43 is to bovine coronavirus and projected a common ancestor arising around 1890—the Russian Flu era, and a time of major cattle pandemics that may have spread to humans.
If they’re correct, the Russian Flu is still circulating, and it’s still occasionally deadly—a 2021 study published in Nature found a 9.1% mortality rate for those hospitalized with confirmed cases of OC43, though it only tracked 77 patients between 2012 and 2017 at one Korean hospital.
The Russian Flu may indeed be “still killing people off, and we’re just not paying attention to it, which is totally plausible,” Chakravarty said. “We used to think the Epstein-Barr Virus was harmless,” and now we know it raises the risk of developing multiple sclerosis by more than 30 times.
“There’s a lot of sort of ‘dark matter’ in the infectious disease world that we haven’t fully mapped out.”
Such a future may await COVID, Bruessow contends.
“This is what virologists working in the viral evolution field are thinking we should expect from SARS-CoV2,” he said regarding the potential of COVID to persist well into the future. “Some people think the Omicron variant that dominates now is already going a bit in this direction, because this variant is much less affecting the lung and much more targeting the upper respiratory tract.”
Bruessow hopes Omicron is “the last hoorah” of COVID-19’s acute phase—the Russian Flu’s lasted about three years—but he’s well aware this may not be the case.
“Personally, I would be a bit skeptical” that Omicron would be the end of this, he said. “The virus will still occupy our societies for a while.”
Even if the Russian Flu eventually became less severe, there’s no reason to necessarily think COVID-19 will go the same route, Bruessow cautions, nor is the Russian Flu’s presumed attenuation necessarily permanent.
“Viral evolution is really neutral with respect to virulence,” he said. “The indication is that [COVID-19] will try to escape from the immune response, simply to infect the maximum number of people, and the virus with the highest efficiency will replace less efficient viral types.
“This is the dynamic we are seeing, of increasing transmission. There’s no guarantee that the next wave won’t be a virus that has, once again, increased virulence, like Delta.”
‘Pandemic-era’ life for more than a century
Among Chakravarty’s take-aways from the Russian Flu: “The body count can still pile up” over several years, even if a disease isn’t incredibly transmissible and has a relatively low fatality rate, as was the case with the Russian Flu.
Even so, “mortality bounced around,” he said. “There wasn’t a steady decrease toward endemicity.”
Regardless, COVID is “much more contagious” than the Russian Flu was, Chakravarty cautions—and the world is much better connected than it was in the industrial era, allowing for greater ease of disease spread.
COVID has a “screamingly high” transmission rate—one person with Omicron infects, on average, eight to nine others, making it nearly as infectious as mumps—and the duration of immunity is low, he cautioned.
“You can sneeze in Wuhan in the morning and someone can be really ill the next day in Frankfurt.”
The potential Russian Flu wave of 1900 is the last mention of the illness Bruessow sees in medical literature. There seem to have been seasonal, legitimate influenza outbreaks up until the onset of the Spanish Flu in 1918, after which major respiratory pandemics “were all influenza related.”
“After that, there’s no indication of a coronavirus causing a major epidemic in the 20th century,” he said.
It’s possible that a “very mild” coronavirus continued to circulate throughout the 20th century but was less impactful due to improvements in public health and quality of life, Ewing said.
During the early 20th century “health was getting better, mortality rates were decreasing, life expectancy was going up.” This, in addition to tuberculous public health campaigns encouraging people to beware of coughing, sneezing, and spitting in public, may have blunted any circulating coronaviruses, he said.
While the Spanish Flu may not be the best lens through which to view COVID-19, it does contain pertinent lessons, Bruessow contends.
While the Spanish Flu is generally thought to have subsided in 1919 after three waves, later waves occurred periodically in the late 1920s into the 1940s—some as virulent as the initial Spanish Flu, with even higher mortality, he contends.
As U.S. COVID czar Dr. Anthony Fauci and colleagues pointed out in a 2009 New England Journal of Medicine article, “It is not generally appreciated that descendants of the H1N1 influenza A virus that caused the catastrophic and historic pandemic of 1918-1919 have persisted in humans for more than 90 [now 100] years and have continued to contribute their genes to new viruses, causing new pandemics,” including the 2009 H1N1 “swine flu.”
“We are living in a pandemic era that began around 1918,” they wrote 13 years ago—long before the advent of COVID-19.
Bruessow agrees with Fauci and his colleagues that “viruses do not simply disappear.”
“They change and hopefully they adapt and behave,” Bruessow said. “But there are still some escapes, and we might see a return with higher virulence. Vigilance is indicated.”
Chakravarty is of a similar mindset but cautions that one can’t draw too many inferences from any particular pandemic, regardless of similarities.
“Each new pandemic, new plague is a new chapter in the history books,” he said. “Your mileage may vary.”
But one thing remains constant.
“There’s no two-year timeline for pandemics,” he warned.
Me ha costado hacer esta imagen. Conjunción de Saturno y Marte en la constelación de Leo, con la bahía de Sydney al fondo (Sydney Opera House y Harbour Bridge). Imagen tomada desde los Botanic Gardens el viernes 11 de julio, hacia las 6 de la tarde hora local (sobre las 8:00 UT). Es una combinación de 35 imágenes independientes de 15 segundos, ISO 400, F9.0 y 18mm de focal (equivalente a 32mm objetivos convencionales) con cámara CANON EOS 400. Todas las tomas contenían tanto la constelación como la ciudad. Combiné de forma independiente las estrellas y la ciudad (así, todas las luces de barcos y aviones fueron eliminadas) usando DeepSkyStacker, luego las combiné usando Photoshop, tocando también los niveles, contrastes y algo de color. Fue más difícil de que parece porque para ver las estrellas necesitaba un cielo brillante, mientras que para tener una toma de la ciudad necesitaba un cielo muy oscuro. Además, las estrellas casi ni se veían, por lo que tuve que usar un desenfoque gaussiano en esa imagen (por eso parecen algo artificiales). La superposición la hice usando la última imagen como referencia, de forma que se puede ver la constelación (boca abajo) más cerca de la ciudad. Pasa el ratón sobre la imagen para identificación de los objetos más destacados. Crédito imagen: Á.R. L.-S. (CSIRO/ATNF, Agrupación Astronómica de Córdoba). Agradezco la ayuda y la compañía de Attila Popping; juntos soportamos durante una hora el frío de Sydney en el invierno austral (unos 5º-6º a esa hora ese día).
We’re easily sidetracked, it appears. One half of id-iom had ventured out into the cold to scrape and blank out our previous wall as the weather was just about sunny enough. After an hour or so out there I head out to see how he’s getting on and rather than paint over the previous wall he’d decided to adapt it into something else entirely. Then I got involved. Then it got dark and we had to come back the next day to finish what we were doing. And it’s still not ready to be painted on again. Like I said, easily sidetracked.
Anyway, if at first glance you thought this was 90’s cartoon legend Johnny Bravo then you’d be very much mistaken. For this is his second cousin twice removed Johnny Omicron. He’s twice as chatty but half as much fun. Now he’s got to go. The wall will be blanked out…
Cheers
id-iom
www.science.org/doi/10.1126/sciimmunol.abq2427
Omicron BA.1 breakthrough infection drives cross-variant neutralization and memory B cell formation against conserved epitopes
Abstract
Omicron is the evolutionarily most distinct SARS-CoV-2 variant of concern (VOC) to date. We report that Omicron BA.1 breakthrough infection in BNT162b2-vaccinated individuals resulted in strong neutralizing activity against Omicron BA.1, BA.2 and previous SARS-CoV-2 VOCs, but not against the Omicron sublineages BA.4 and BA.5. BA.1 breakthrough infection induced a robust recall response, primarily expanding BMEM cells against epitopes shared broadly amongst variants, rather than inducing BA.1-specific B cells. The vaccination-imprinted BMEM cell pool had sufficient plasticity to be remodeled by heterologous SARS-CoV-2 spike glycoprotein exposure. While selective amplification of BMEM cells recognizing shared epitopes allows for effective neutralization of most variants that evade previously established immunity, susceptibility to escape by variants that acquire alterations at hitherto conserved sites may be heightened.
INTRODUCTION
Containment of the COVID-19 pandemic requires the generation of durable and sufficiently broad immunity to provide protection against current and future variants of SARS-CoV-2. The titer of neutralizing antibodies to SARS-CoV-2, and the binding of antibodies to the spike (S) glycoprotein and its receptor-binding domain (RBD) are considered correlates of protection against infection (1, 2). Currently available vaccines are based on the S glycoprotein of the ancestral Wuhan-Hu-1 strain and induce antibodies with a neutralizing capacity that exceeds the breadth elicited by infection with the Wuhan strain, or with variants of concern (VOCs) (3). However, protective titers wane over time (4–7) and routine booster vaccinations are thought to be needed to trigger recall immunity and maintain efficacy against new VOCs (8–11).
Long-lived memory B (BMEM) cells are the basis for the recall response upon antigen re-encounter either by infection or booster vaccination. They play an important role in the maintenance and evolution of the antiviral antibody response against variants, since low-affinity selection mechanisms during the germinal center reaction and continued hypermutation of BMEM cells over several months following antigen exposure expand the breadth of viral variant recognition (12, 13).
To date, over 1 billion people worldwide have been vaccinated with the mRNA-based COVID-19 vaccine BNT162b2 and have received the primary 2-dose series or further boosters (14). Thus, BNT162b2 vaccination is contributing substantially to the pattern of population immunity in many regions of the world.
How vaccine-mediated protective immunity will evolve over time and will be modified by iterations of exposure to COVID-19 vaccines and to infections with increasingly divergent viral variants remains poorly understood, and is of particular relevance with the emergence of antigenically distinct VOCs. Omicron is the evolutionary most distant reported VOC to date, with a hitherto unprecedented number of amino acid alterations in its S glycoprotein, including at least 15 amino acid changes in the RBD and extensive changes in the N-terminal domain (NTD) (15). These alterations are predicted to affect most neutralizing antibody epitopes (16–20). In addition, Omicron is highly transmissible, has outcompeted Delta within weeks to become the dominant circulating VOC, and has given rise to multiple sublineages, starting with BA.1 and BA.2, that are spreading rapidly across the globe (21, 22). New Omicron sublineages that harbor further alterations in the S glycoprotein continue to arise, with BA.4 and BA.5 deemed VOCs by the European Centre for Disease Prevention and Control (ECDC) on the 12th May 2022 (23).
To characterize the effect of Omicron breakthrough infection on the magnitude and breadth of serum neutralizing activity and BMEM cells, we studied blood samples from individuals that were double- or triple-vaccinated with BNT162b2, including cohorts that experienced breakthrough infection between November 2021 and mid-January 2022, a period when the BA.1 lineage was dominant in Germany (24). As an understanding of the antigen-specific B cell memory pool is a critical determinant of an individual’s ability to respond to newly emerging variants, our data will help to guide further vaccine development.
RESULTS
Cohorts and sampling
Blood samples were sourced from the biosample collection of BNT162b2 vaccine trials, and a biobank of prospectively collected samples from vaccinated individuals with subsequent SARS-CoV-2 Omicron breakthrough infection experienced in a period of Omicron sublineage BA.1 dominance, and we therefore refer to “BA.1 breakthrough infection” herein. Samples were selected to investigate biomarkers in four independent groups, namely individuals who were (i) double- or (ii) triple-vaccinated with BNT162b2 without a prior or breakthrough infection at the time of sample collection (BNT162b22, BNT162b23) and individuals who were (iii) double- or (iv) triple-vaccinated with BNT162b2 and who experienced breakthrough infection with the SARS-CoV-2 Omicron variant after a median of approximately 5 months or 4 weeks, respectively (BNT162b22 + Omi, BNT162b23 + Omi). Median ages of the cohorts were similar (32-39 years), except for the BNT162b22 cohort, which had a mildly increased median age of 52, albeit with only two individuals >65 yrs of age. Immune sera were used to characterize Omicron infection-associated changes to the magnitude and the breadth of serum neutralizing activity. PBMCs were used to characterize the VOC-specificity of peripheral BMEM cells recognizing the respective full-length SARS-CoV-2 S glycoprotein or its RBD.
Omicron BA.1 breakthrough infection after BNT162b2 vaccination induces broad neutralization against Omicron BA.1, BA.2 and other VOCs, but not against BA.4 and BA.5
To evaluate the neutralizing activity of immune sera, we used two orthogonal test systems: a well-characterized pseudovirus neutralization test (pVNT) (25, 26) to investigate the breadth of inhibition of virus entry in a propagation-deficient set-up, as well as a live SARS-CoV-2 neutralization test (VNT) designed to evaluate neutralization during multicycle replication of authentic virus with the antibodies maintained throughout the entire test period. For the former, we applied pseudoviruses bearing the S glycoproteins of SARS-CoV-2 Wuhan, Alpha, Beta, Delta, Omicron BA.1, BA.2, and of the recently emerged Omicron sublineages BA.4 and BA.5 to assess neutralization breadth. As BA.4 and BA.5 share an identical S glycoprotein sequence, including key alterations L452R and F486V, we herein refer to them as BA.4/5. In addition, we assayed SARS-CoV (herein referred to as SARS-CoV-1) to detect potential pan-sarbecovirus neutralizing activity (27).
As reported previously (25, 28, 29), in Omicron-naïve double-vaccinated individuals 50% pseudovirus neutralization (pVN50) geometric mean titers (GMTs) of Beta and Delta VOCs were reduced, and neutralization of Omicron BA.1, BA.2 and BA.4/5 was virtually undetectable. In Omicron-naïve triple-vaccinated individuals, pVN50 GMTs against all tested VOCs were substantially higher with robust neutralization of Alpha, Beta and Delta. While GMTs against Omicron BA.1 and BA.2 were already considerably lower as compared with Wuhan (GMT 160 and 211 vs 398), neutralizing activity against Omicron BA.4/5 was even further reduced (GMT 74), corresponding to a 5-fold lower titer as compared to the Wuhan strain.
Omicron BA.1 breakthrough infection had a marked effect on magnitude and breadth of the neutralizing antibody response of both double- and triple-vaccinated individuals, with slightly higher pVN50 GMTs observed in the triple-vaccinated individuals (Fig. 2a, fig. S1b, Table S6). The pVN50 GMT of double-vaccinated individuals with breakthrough infection against Omicron BA.1, BA.2 and BA.4/5 was more than 100-fold, 35-fold and 15-fold above the GMTs of Omicron-naïve double-vaccinated individuals. Immune sera from double-vaccinated individuals with BA.1 breakthrough infection had broad neutralizing activity against Omicron BA.1, BA.2 and previous SARS-CoV-2 VOCs, with higher pVN50 GMTs against Beta and Delta than observed in Omicron-naïve triple-vaccinated individuals (GMT 740 vs. 222 and 571 vs. 370). In contrast, Omicron BA.1 breakthrough infection had only a minor boost effect on neutralization of BA.4/5 with pVN50 GMTs against Omicron BA.4/5 being significantly below those against Wuhan (GMT 135 vs. 740).
We observed a similar pattern when studying the neutralization of these variants with BA.1 convalescent and control sera from triple-vaccinated individuals. BA.1 convalescent sera exhibited high pVN50 GMTs against the previous SARS-CoV-2 VOCs, including Beta (1182), Omicron BA.1 (1029), and BA.2 (836) that were close to the Wuhan reference (1182). Omicron BA.1 breakthrough infection only moderately increased neutralization of BA.4/5 in triple-vaccinated individuals with pVN50 GMTs of 197, remaining 6-fold lower than against the Wuhan strain.
Of note, in all cohorts, neutralizing titers against BA.4/5 were closer to the low level observed against the phylogenetically more distant SARS-CoV-1 than that seen against Wuhan (Fig. 2a, Table S4 to S6). Looking at the ratios of SARS-CoV-2 VOC and SARS-CoV-1 pVN50 GMTs normalized against Wuhan, it is remarkable that breakthrough infection with Omicron BA.1 does not lead to more efficient cross-neutralization of Omicron BA.4/5 in double- and triple-vaccinated individuals as compared with triple-vaccinated Omicron-naïve individuals.
Authentic live SARS-CoV-2 virus neutralization assays conducted with Wuhan, Beta, Delta and Omicron BA.1 confirmed the observation that BA.1 breakthrough infection boosted broad immunity against BA.1 and previous SARS-CoV-2 VOCs (Fig. 2c, fig. S1c, d, Tables S7 to S9). In BNT162b2 double- and triple-vaccinated individuals, Omicron BA.1 breakthrough infection was associated with a strongly increased neutralizing activity against Omicron BA.1, with 50% virus neutralization (VN50) GMTs in the same range as against the Wuhan strain (Fig. 2c; GMT 493 vs. 381 and GMT 538 vs. 613). Similarly, BA.1 convalescent double- and triple-vaccinated individuals showed comparable levels of neutralization against other variants as well (e.g., GMT 493 and 729 against Beta), indicating a wide breadth of neutralizing activity, a finding further supported by the calculated ratios of SARS-CoV-2 VOC VN50 GMTs normalized against the Wuhan strain (Fig. 2d). While double- and to a lesser extent also triple-BNT162b2 vaccinated Omicron-naïve individuals displayed reduced neutralization proficiency against VOCs, neutralization activity of Omicron BA.1 convalescent subjects reached almost the same range of high performance against all live SARS-CoV-2 variant strains tested. Likewise, Omicron BA.1 breakthrough infection similarly augmented broad neutralization in individuals vaccinated with other approved COVID-19 vaccines or heterologous regimens, but with significantly reduced potency against Omicron BA.4/5 (fig. S2, Table S11). In aggregate, these data demonstrate that Omicron BA.1 breakthrough infection of vaccine-experienced individuals mediates broadly neutralizing activity against BA.1, BA.2 and several previous SARS-CoV-2 variants, but not for BA.4/5.
BMEM cells of BNT162b2 double- and triple-vaccinated individuals broadly recognize VOCs and are further boosted by Omicron BA.1 breakthrough infection.
Next, we investigated the phenotype and quantity of SARS-CoV-2 S glycoprotein-specific B cells in these individuals. To this aim, we employed flow cytometry-based B cell phenotyping assays for differential detection of variant-specific S glycoprotein-binding B cells in bulk PBMCs. We found that all S glycoprotein- and RBD-specific B cells in the peripheral blood were of a BMEM phenotype (BMEM; CD20highCD38int/neg, fig. S3a). Antigen-specific plasmablasts or naïve B cells were not detected. The assays allowed us to identify BMEM cells recognizing the S glycoprotein (fig S3b) or RBD (fig S3c) of SARS-CoV-2 Wuhan, Alpha, Delta and Omicron BA.1 variants.
As expected, the overall frequency of antigen-specific BMEM cells varied across the different groups. Consistent with prior reports (30), the frequency of BMEM cells in Omicron-naïve double-vaccinated individuals was low at an early time point after vaccination and increased over time: At 5 months as compared to 3 weeks after the second BNT162b2 dose, S glycoprotein-specific BMEM cells almost quadrupled, and RBD-specific ones tripled across all VOCs thereby reaching quantities similar to those observed in Omicron-naïve triple-vaccinated individuals.
Double or triple BNT162b2-vaccinated individuals with a SARS-CoV-2 Omicron BA.1 breakthrough infection exhibited a strongly increased frequency of S glycoprotein-specific BMEM cells, which was higher than those of Omicron-naïve triple-vaccinated individuals.
In all groups, including Omicron-naïve and Omicron BA.1 infected individuals, BMEM cells against Omicron BA.1 S glycoprotein were detectable at frequencies comparable to those against Wuhan and other tested VOCs (Fig. 3b, d), whereas the frequency of BMEM cells against Omicron BA.1 RBD was slightly lower compared to the other variants (Fig. 3c, e, fig. S4f-j, m, n). We then compared the ratios of RBD- to S glycoprotein-binding BMEM cells within the different groups and found that they are biased toward S glycoprotein recognition for the Omicron BA.1 VOC, particularly in the Omicron-naïve groups (Fig. 3f). In the Omicron BA.1 convalescent groups this ratio was higher, indicating that an Omicron BA.1 breakthrough infection improved Omicron BA.1 RBD recognition.
Omicron BA.1 breakthrough infection after BNT162b2 vaccination boosts BMEM cells against epitopes broadly conserved across S glycoproteins of Wuhan and other VOCs.
Our findings imply that Omicron BA.1 infection in vaccinated individuals boosts not only neutralizing activity and BMEM cells against Omicron BA.1, but broadly augments immunity against various VOCs. To investigate the specificity of antibody responses at a cellular level, we performed multi-parameter analyses of BMEM cells stained with fluorescently labeled variant-specific S or RBD proteins. By applying a combinatorial gating strategy, we sought to distinguish between BMEM cell subsets that could identify epitopes specific to a single variant only (either Wuhan, Alpha, Delta or Omicron BA.1) versus those that could identify epitopes shared by any given combination of these variants.
In a first analysis, we evaluated BMEM cell recognition of Wuhan and Omicron BA.1 S and RBD proteins (Fig. 4b-d). Staining with full length S glycoproteins showed that the largest proportion of BMEM cells from Omicron-naïve double-vaccinated individuals, and even more predominantly from triple-vaccinated individuals were directed against epitopes shared by both Wuhan and Omicron BA.1 SARS-CoV-2 variants. Consistent with the fact that vaccination with BNT162b2 can elicit immune responses against Wuhan epitopes that do not recognize the corresponding altered epitopes in the Omicron BA.1 S glycoprotein (Fig. 4b, c, fig. S5a), we found in most individuals a smaller but clearly detectable proportion of BMEM cells that recognized only Wuhan S glycoprotein or RBD. Consistent with the lack of exposure, almost no BMEM cells binding exclusively to Omicron BA.1 S or RBD protein were detected in these Omicron-naïve individuals.
In Omicron BA.1 convalescent individuals, frequencies of BMEM cells recognizing S glycoprotein epitopes shared between Wuhan and Omicron BA.1 were considerably higher than in the Omicron-naïve ones (Fig. 4b, c). This was particularly pronounced for double-vaccinated individuals. In most of these subjects, we also found a small proportion of exclusively Wuhan S glycoprotein-specific BMEM cells, as well as a moderately lower frequency of exclusively Omicron BA.1 variant S glycoprotein-specific BMEM cells.
A slightly different pattern was observed by B cell staining with labeled RBD proteins (Fig. 4b, d, Fig. S5b). Again, Omicron BA.1 breakthrough infection of double-/triple-vaccinated individuals was found to primarily boost BMEM cells reactive against conserved epitopes. A moderate boost of Wuhan-specific reactivities was observed; however, we detected only small populations of BMEM cells specific to the Omicron BA.1-RBD in the tested individuals.
Next, we employed the combinatorial gating approach to identify the subsets of S glycoprotein or RBD binding BMEM cells that either bind exclusively to Wuhan or Omicron BA.1, or to common epitopes conserved broadly throughout all four variants, Wuhan, Alpha, Delta and Omicron BA.1 (Fig. 4e). Across all four cohorts, we found that the frequency of BMEM cells recognizing S glycoprotein-conserved epitopes accounted for the largest fraction of the pool of S glycoprotein-binding BMEM cells (Fig. 4f, all 4+ve). The S glycoprotein of the Wuhan strain does not have an exclusive amino acid change that distinguishes it from the S glycoproteins of the Alpha, Delta, or Omicron BA.1 VOCs. Accordingly, we hardly detected BMEM cells exclusively recognizing the Wuhan S glycoprotein in any individual (Fig. 4f). In several individuals with Omicron BA.1 breakthrough infection, we detected a small proportion of BMEM cells that bound exclusively to Omicron BA.1 S glycoprotein (Fig. 4f), whereas almost none of the individuals displayed a strictly Omicron BA.1 RBD-specific response (Fig. 4 g). Our findings indicate that Omicron BA.1 breakthrough infection in vaccinated individuals primarily expands a broad BMEM cell repertoire against conserved S glycoprotein and RBD epitopes rather than inducing large numbers of Omicron BA.1-specific BMEM cells.
To further dissect the nuances of this response, we characterized the BMEM subsets directed against the RBD in both double- and triple-vaccinated Omicron BA.1 convalescent individuals. We used the combinatorial Boolean gating approach to discern BMEM cells with distinct binding patterns in the spectrum of strictly variant-specific and common epitopes shared by several variants. Multiple sequence alignment revealed that the Omicron BA.1 RBD diverges from the RBD sequence regions conserved in Wuhan, Alpha, and Delta by 13 single amino acid alterations (fig. S6). The most prominent BMEM cell population that we detected in BA.1 convalescent individuals recognized Wuhan, Alpha as well as the Delta RBDs, but not Omicron BA.1 RBD (Fig. 4h). Contrary to expectations, the population of BMEM cells exclusively reactive with Omicron BA.1 RBD was small in most of those individuals. We did not detect BMEM cells that exclusively recognized epitopes shared by both the Omicron BA.1 and Alpha RBDs, or by the Omicron BA.1 and Delta RBDs.
Furthermore, in all individuals we identified two additional subsets of RBD-specific BMEM cells, (in bold in Fig. 4h). One subset was characterized by binding to the RBDs of Wuhan, Alpha as well as Omicron BA.1, but not the Delta RBD. The other population exhibited binding to Wuhan and Alpha but not Omicron BA.1 or Delta RBD. Sequence alignment identified L452R as the only RBD alteration unique for Delta that is not shared by the other 3 variant RBDs (Fig. 4i top). Similarly, the only RBD site conserved in Wuhan and Alpha but altered in Delta and Omicron BA.1 was found to be T478K (Fig. 4i bottom). Both L452R and T478K alterations are known to be associated with the evasion of vaccine induced neutralizing antibody responses (31, 32). Position L452 is in fact mutated in the recently emerged SARS-CoV-2 Omicron sublineages BA.4 and BA.5 (33). Of note, only minor BMEM cell frequencies were detected in those combinatorial subgroups in which multiple sequence alignment failed to identify unique epitopes in the RBD sequence (e.g., Wuhan only or Wuhan and Omicron BA.1, but not Alpha, Delta). These observations indicate that the BMEM cell response against RBD is driven by specificities induced through prior vaccination with BNT162b2 and not substantially redirected against new RBD epitopes displayed by the infecting Omicron BA.1 variant.
DISCUSSION
SARS-CoV-2 Omicron BA.1 is a partial immune escape variant with an unprecedented number of amino acid alterations in the S glycoprotein at sites of neutralizing antibody binding (15). Neutralizing antibody mapping and molecular modeling studies strongly support the functional relevance of these alterations (20, 34), that is confirmed by the fact that double-vaccinated individuals have no detectable neutralizing activity against SARS-CoV-2 Omicron BA.1 (25, 35).
In line with concurrently published reports (36, 37), we show that Omicron BA.1 breakthrough infection of BNT162b2 vaccinated individuals augments broadly neutralizing activity against Omicron BA.1, BA.2 and previous VOCs to similar levels observed against the Wuhan strain. However, neutralization of the latest Omicron sublineages BA.4 and BA.5 was not enhanced, with titers rather comparable to those against the phylogenetically more distant SARS-CoV-1. While our study focused on individuals vaccinated with the BNT162b2 mRNA vaccine, in individuals vaccinated with CoronaVac similar observations suggest that Omicron BA.4/5 can bypass BA.1 infection-mediated boosting of humoral immunity (33).
Our study provides insights into how immunity against multiple variants is achieved and why Omicron BA.4 and BA.5 sublineages can partially escape neutralization. It suggests that initial exposure to the Wuhan strain S glycoprotein may have shaped the formation of BMEM cells and imprinted against novel BMEM cell responses recognizing epitopes distinctive for the Omicron BA.1 variant. Omicron BA.1 breakthrough infection in BNT162b2-vaccinated individuals primarily expands a broad BMEM cell repertoire against conserved S glycoprotein and RBD epitopes, rather than inducing strictly Omicron BA.1-specific BMEM cells. Similar observations have been reported from vaccinated individuals who experienced breakthrough infections with the Delta variant and with the Omicron BA.1 sublineage (3, 33).
As compared to the immune response induced by a homologous vaccine booster, an Omicron BA.1 breakthrough infection leads to a more substantial increase in antibody neutralization titers against Omicron and a robust cross-neutralization of many SARS CoV-2 variants. These effects are particularly striking in double-vaccinated individuals.
Three findings may point to potentially complementary and synergistic underlying mechanisms. The first is induction of broadly neutralizing antibodies. We found that the majority of sera from Omicron BA.1-convalescent but not from Omicron-naïve vaccinated individuals robustly neutralize previous SARS-CoV-2 VOCs including BA.1 and BA.2, and to a far lesser extent also SARS-CoV-2 Omicron BA.4/5 and SARS-CoV-1. This indicates that Omicron BA.1 infection in vaccinated individuals stimulates BMEM cells that produce neutralizing antibodies against S glycoprotein epitopes conserved in the SARS-CoV-2 variants up to and including Omicron BA.2, but that have mostly been lost in BA.4/5 and are for the most part not shared by SARS-CoV-1. Over the last two years, broadly cross-neutralizing antibodies have been isolated from both SARS-CoV-2 and SARS-CoV-1 convalescent and/or vaccinated individuals (20, 27, 38) and are known to target highly conserved S glycoprotein domains (39, 40). The greater antigenic distance of the Omicron BA.1 S glycoprotein from earlier SARS-CoV-2 strains may promote targeting of conserved subdominant neutralizing epitopes as recently described to be located, e.g., in cryptic sites within the RBD distinct from the receptor-binding motif (41, 42) or in the membrane proximal S glycoprotein subunit designated S2 (43–45).
The second finding is a bias toward RBD-specific BMEM cell responses. Omicron BA.1-infected individuals appear to have a significantly higher RBD/S glycoprotein-specific BMEM cell ratio as compared to vaccinated Omicron-naïve individuals. Omicron BA.1 carries multiple S glycoprotein alterations such as del69/70 and del143-145 in key neutralizing antibody binding sites of the NTD that dramatically reduce the targeting surface for memory B cell responses in this region. Although the Omicron BA.1 RBD harbors multiple alterations, there are some unaffected neutralizing antibody binding sites left (20). An expansion of BMEM cells that produce neutralizing antibodies against RBD epitopes that are not altered in Omicron BA.1, such as those at position L452 as indicated in our study, could help to rapidly restore neutralization of the BA.1 and BA.2 variants. Importantly, the strong neutralization of Omicron BA.1 and BA.2 should not mask the fact that the neutralizing BMEM immune response in Omicron BA.1 convalescent vaccinated individuals is driven by a smaller number of epitopes. The significantly reduced neutralizing activity against the Omicron BA.4/5 pseudovirus, which harbors the additional alterations L452R and F486V in the RBD, demonstrates the mechanism of immune evasion by loss of the few remaining conserved epitopes. Meanwhile, further sublineages with L452 alterations (e.g., BA.2.12.1) are being reported to evade humoral immunity elicited by BA.1 breakthrough infection (33).
The third finding is an overall increase of S glycoprotein-specific BMEM cells. Omicron BA.1-convalescent double-vaccinated individuals appear to have a higher frequency of BMEM cells and higher neutralizing antibody titers against previous VOCs as compared to triple-vaccinated individuals. Studies on other VOCs have not shown breakthrough infections in double-vaccinated individuals to be superior to a third vaccine dose in eliciting neutralizing activity (4, 36). This may be explained by poor neutralization of the partial escape Omicron BA.1 variant in the initial phase of infection, which may result in greater or prolonged antigen exposure of the immune system to the altered S glycoprotein.
In aggregate, our results suggest that despite potential imprinting of the immune response by previous vaccination, the preformed B cell memory pool can be refocused and quantitatively remodeled by exposure to heterologous S glycoproteins to allow neutralization of variants that evade a previously established neutralizing antibody response. However, our data also suggest that the immunity in the early stage of Omicron BA.1 infection in vaccinated individuals is based on recognition of conserved epitopes and is narrowly focused on a small number of neutralizing sites that are not altered in Omicron BA.1 and BA.2. Such a narrow immune response bears a high risk that those few epitopes may be lost by acquisition of further alterations in the course of the ongoing evolution of Omicron and may result in immune escape, as being experienced with sublineages BA.2.12.1, BA.4 and BA.5 (33, 46). Importantly, Omicron BA.1 breakthrough infection does not appear to reduce the overall spectrum of (Wuhan) S glycoprotein-specific memory B cells, as memory B cells that do not recognize Omicron BA.1 S remain detectable in blood at similar frequencies. We consistently detected Wuhan-specific (non-Omicron BA.1 reactive) BMEM cells in Omicron BA.1 breakthrough infected individuals at levels similar to those in Omicron-naïve double-/triple-vaccinated individuals. Our data therefore suggest an increase of the total BMEM cell repertoire by selective amplification of BMEM cells that recognize shared epitopes.
Our findings raise a number of questions, e.g., to what extent induced BMEM responses are functional and directed against neutralizing domains. A recent study examined more than 600 neutralizing antibodies isolated from triple-CoronaVac vaccinated individuals who subsequently experienced BA.1 breakthrough infection. Consistent with our findings, the study showed that BA.1 infection in vaccinated individuals primarily retrieves Wuhan S glycoprotein-induced B cell memory and elicits cross-reactive neutralizing antibodies against RBD epitopes that neutralize both the ancestral SARS-CoV-2 Wuhan as well as the Omicron BA.1 variant (33). Also, it is not yet clear whether the BMEM cells against conserved epitopes that we observed after Omicron BA.1 breakthrough infection are newly recruited cross-reactive naïve B cells, or rather expanded from the pre-existent memory B cell pool. A recent study investigating a third vaccine booster suggests that both mechanisms are relevant (47). Further, we cannot exclude that strictly Omicron-BA.1 specific BMEM cells are in fact being efficiently generated but had just not been exported from the germinal center at the time point of our analysis. These questions can be addressed by comprehensive studies of the B cell repertoire at later time points (> 3months) after breakthrough infection, including BCR repertoire analysis by single cell Ig gene sequencing of antigen-specific BMEM cells, extended to the cloning, expression and characterization of monoclonal antibodies with regard to specificity, functional properties, and affinity.
Our findings are based on retrospective analyses of samples derived from different studies. Therefore, the sample sizes were relatively small and cohorts were not fully adjusted with regard to immunization intervals, sampling time points and demographic characteristics such as age and sex of individuals. Another limitation is that the analysis was restricted to BMEM cells; long-lived bone marrow-derived plasma cells (BMPCs), which are known to be BNT162b2 vaccination induced (48), were not investigated as they cannot be cryopreserved.
A key motivation for our study was to inform our vaccine adaptation program. We expect that the currently ongoing vaccine adaptations to the Omicron BA.1 S glycoprotein, similar to the Omicron BA.1 breakthrough infection that we studied, may reshape the B cell memory repertoire and provide broad protection against previous VOCs. However, given the rapid evolution of SARS-CoV-2, other sublineages of Omicron that antigenically deviate from BA.1 even more than the immune escape variants BA.4/5, may have emerged by the time of potential authorization of those vaccines later this year. In a pandemic in which a highly transmissible VOC feeds dynamic and rapid evolution of altered variants, an effective strategy may be to leverage the full potential of mRNA vaccine technology, which allows production and release of new vaccines in less than three months. To enable adapted vaccines that truly reflect relevant VOCs at licensure, it would be prudent to build on decades of experience with seasonal influenza vaccines and implement timely, rapid licensure procedures that use the latest epidemiologic data to
select COVID-19 vaccine strains.
MATERIALS AND METHODS
Study design
The objective of this study was to investigate the effect of Omicron BA.1 breakthrough infection on the cross-variant neutralization capacity of human sera, and how repeat SARS-CoV-2 antigen exposure modulates BMEM cell specificity in individuals vaccinated with BNT162b2. We compared immune responses in Omicron-naïve individuals double- or triple-vaccinated with BNT162b2, to that of individuals double- or triple-vaccinated with BNT162b2 with a confirmed subsequent breakthrough infection with Omicron during a period of Omicron sublineage BA.1 dominance. Serum neutralizing capability was characterized using live and pseudovirus neutralization assays, and flow cytometry was used to detect and characterize SARS-CoV-2-specific B cells in bulk PBMCs. Cross neutralization of variants was further characterized in a cohort vaccinated with other approved COVID-19 vaccines or mixed regimens, that experienced subsequent Omicron breakthrough infection. All participants had no documented history of SARS-CoV-2 infection prior to vaccination.
Recruitment of participants and sample collection
Individuals from the SARS-CoV-2 Omicron-naïve BNT162b2 double-vaccinated (BNT162b22) and triple-vaccinated (BNT162b23) cohorts provided informed consent as part of their participation in a clinical trial (the Phase 1/2 trial BNT162-01 [NCT04380701] (29), the Phase 2 rollover trial BNT162-14 [NCT04949490], or as part of the BNT162-17 [NCT05004181] trial).
Participants from the SARS-CoV-2 Omicron convalescent double- and triple-vaccinated cohorts (BNT162b22 + Omi and BNT162b23 + Omi cohorts, respectively) and individuals vaccinated with other approved COVID-19 vaccines or mixed regimens with subsequent Omicron breakthrough infection were recruited from University Hospital, Goethe University Frankfurt as part of a research program that recruited patients who had experienced Omicron breakthrough infection following vaccination for COVID-19, to provide blood samples and clinical data for research. Omicron infections were confirmed with variant-specific PCR between November 2021 and mid-January 2022, at a time when sublineage BA.1 was dominant (24). The infections of 7 participants in this study were further characterized by genome sequencing, 5 of whom were in the BNT162b2-vaccinated cohorts, and 2 in the cohort with participants vaccinated with other approved COVID-19 vaccines or mixed regimens. In all 7 cases, genome sequencing confirmed Omicron BA.1 infection.
Participants were free of symptoms at the time of blood collection. The study protocol for this research program was approved by the Ethics Board of the University Hospital, Goethe University Frankfurt (No. 2021-560). Demographic and clinical information for all participants as well as sampling timepoints are provided in Tables S1-S3 and S10, and Fig. 1. Serum was isolated by centrifugation 2000 × g for 10 min and cryopreserved until use. Li-Heparin blood samples were isolated by density gradient centrifugation using Ficoll-Paque PLUS (Cytiva) and were subsequently cryopreserved until use.
Statistical analysis
The statistical method of aggregation used for the analysis of antibody titers is the geometric mean and for the ratio of SARS-CoV-2 VOC titer and Wuhan titer the geometric mean and the corresponding 95% confidence interval. The use of the geometric mean accounts for the non-normal distribution of antibody titers, which span several orders of magnitude. The Friedman test with Dunn’s correction for multiple comparisons was used to conduct pairwise signed-rank tests of group geometric mean neutralizing antibody titers with a common control group. Flow cytometric frequencies were analyzed with and tables were exported from FlowJo software (Version 10.7.1.). Statistical analysis of cumulative memory B cell frequencies was the mean and standard error of the mean (SEM). Statistical significance was tested for using the nonparametric Friedman test with Dunn’s multiple comparisons correction. All statistical analyses were performed using GraphPad Prism software version 9.
December 20, 2021 - New York City - Governor Kathy Hochul, joined by Jackie Bray, Acting Commissioner of New York State Department of Homeland Security and Emergency Services, and Director of State Operations Kathryn Garcia updates New Yorkers on the Covid-19 spread in New York State, particularly on the Omicron variant, during a press briefing Monday December 20, 2021 in New York City. (Kevin P. Coughlin / Office of the Governor)
The Lambda Rho chapter of Alpha Omicron Pi greeting new members during the chapter's second ever Bid Day at TCU. For those of you who don't know what Bid Day is...and I didn't either...all the sororities assemble on the Campus Commons. Then the newbies are released one chapter at a time to run toward their new sisters. It's kinda like a cattle drive, but with a much happier ending.
I also rolled about 90 seconds of video: www.youtube.com/watch?v=8qnt0kMEWWQ&list=UUlJLPNVzTQB...
You can learn more about AOII here:
www.facebook.com/AOIILambdaRho
This album is part of the event coverage for the Fort Worth Portrait Project. The project tells the story of Fort Worth from 2014 - 2044 one captioned portrait at a time, but I also enjoy covering events like this one too.
Please follow the Fort Worth Portrait Project:
www.redeemedexpressions.com/fort-worth-portrait-project/
www.facebook.com/fortworthportraitproject
www.twitter.com/FWPortraitProj
www.instagram.com/fortworthportraitproject
Do you want to be featured in the project? Just head to the following site with a photo and a caption:
Esta fotografia tiramos hoje durante a aula do curso intermediário do Omicron Centro de Fotografia. Técnica de flash de luz mista.
O trem, a luz no céu, tudo sorte! Mas lembro que a sorte encontrou nossa turma preparada para a situação. "Quando a sorte me bate a porta sempre me encontra trabalhando."
Para aqueles que querem aprender a fotografar, se aprofundar realmente na arte fotográfica, indico nosso curso anual de fotografia com início em agosto próximo.
saudações fotográficas,
Osvaldo Santos Lima
December 20, 2021 - New York City - Governor Kathy Hochul, joined by Jackie Bray, Acting Commissioner of New York State Department of Homeland Security and Emergency Services, and Director of State Operations Kathryn Garcia updates New Yorkers on the Covid-19 spread in New York State, particularly on the Omicron variant, during a press briefing Monday December 20, 2021 in New York City. (Kevin P. Coughlin / Office of the Governor)
December 20, 2021 - New York City - Governor Kathy Hochul, joined by Jackie Bray, Acting Commissioner of New York State Department of Homeland Security and Emergency Services, shown here, and Director of State Operations Kathryn Garcia updates New Yorkers on the Covid-19 spread in New York State, particularly on the Omicron variant, during a press briefing Monday December 20, 2021 in New York City. (Kevin P. Coughlin / Office of the Governor)
www.bbc.com/news/world-europe-59713503
Covid: Dutch go into Christmas lockdown over Omicron wave
The Netherlands has announced a strict lockdown over Christmas amid concerns over the Omicron coronavirus variant.
Non-essential shops, bars, gyms hairdressers and other public venues will be closed until at least mid-January. Two guests per household will be allowed - four over the holidays.
Prime Minister Mark Rutte said the measures were "unavoidable".
Countries across Europe have been tightening restrictions as the heavily mutated variant spreads.
The new rules in the Netherlands - the strictest to have been announced over Omicron so far - come into force on Sunday.
"I stand here tonight in a sombre mood. And a lot of people watching will feel that way too," Mr Rutte told a news conference on Saturday. "To sum it up in one sentence, the Netherlands will go back into lockdown from tomorrow."
Under the new rules, people are being urged to stay at home as much as possible. Strict limits will be placed on the number of people who can meet - a maximum of two guests aged 13 and over will be allowed in people's homes, and four on 24-26 December and on New Year's Eve and New Year's Day.
Events are not permitted other than funerals, weekly markets selling groceries and professional sports matches with no spectators.
All schools will be closed until at least 9 January, while other lockdown measures will remain in place until at least 14 January.
Restaurants can continue to sell takeaway meals, and non-essential shops can offer click and collect services.
The BBC's Anna Holligan in The Hague said the announcement was being met with disbelief and dismay.
"I can now hear the whole of the Netherlands sighing. This is exactly one week before Christmas, another Christmas that is completely different from what we would like," Mr Rutte said.
But, he added, a failure to act now would likely lead to "an unmanageable situation in hospitals".
Earlier on Saturday, people rushed to do their Christmas shopping amid reports that new measures were about to be introduced.
"It's too busy, but I'm coming before the Christmas holidays to pick up gifts, it seems like a new lockdown is coming," Ayman Massori told AFP news agency.
For weeks, curfews have been placed on hospitality and cultural venues in the Netherlands in an effort to limit the spread of Omicron.
The Dutch National Institute for Public Health has reported more than 2.9m coronavirus cases since the pandemic began, and over 20,000 deaths.
It says the Omicron variant currently still accounts for a minority of coronavirus cases in the Netherlands, but is spreading rapidly.
Officials say it is expected to become the dominant variant by the New Year.
The head of the Dutch outbreak management team, Jaap van Dissel, said the new measures would "buy time", allowing more people to get booster shots and for the healthcare system to prepare for a possible rise in infections.
"As a country we are best protected if as many people as possible get a booster vaccination," he said.
More than 85% of all adults in the Netherlands have been vaccinated, but so far fewer than 9% have had the booster shot.
Health Minister Hugo de Jonge said all adults would now get an invitation for a booster appointment by 7 January.
France, the Republic of Ireland and Germany have also announced measures designed to curb the infections.
The Omicron variant is "spreading at lightning speed" in Europe and will likely become dominant in France by the start of next year, French Prime Minister Jean Castex has warned.
France has imposed strict travel restrictions on those entering from the United Kingdom - the hardest hit country in the region, with nearly 25,000 confirmed Omicron cases on Saturday.
Europe has already seen more than 89 million cases and 1.5 million Covid-related deaths, according to the latest EU figures.
www.reuters.com/world/uk/london-declares-major-incident-h...
Omicron coronavirus cases surge in UK, scientists see bigger wave
■ Number of cases of Omicron coronavirus variant jump
■ London mayor declares "major incident" to help hospitals
■ Government scientific advisors say many cases unreported
■ Advisors say more action needed to prevent hospitalisation surge
■ Johnson faced anger from his own lawmakers to existing measures
LONDON, Dec 18 (Reuters) - Britain reported a surge in cases of the Omicron coronavirus variant on Saturday which government advisors said could be just the tip of the iceberg, and London's mayor declared a "major incident" to help the city's hospitals cope.
The number of Omicron cases recorded across the country hit almost 25,000 as of 1800 GMT on Friday, up by more than 10,000 cases from 24 hours earlier, the UK Health Security Agency (UKHSA) said.
Register now for FREE unlimited access to Reuters.com
Summary
Number of cases of Omicron coronavirus variant jump
London mayor declares "major incident" to help hospitals
Government scientific advisors say many cases unreported
Advisors say more action needed to prevent hospitalisation surge
Johnson faced anger from his own lawmakers to existing measures
LONDON, Dec 18 (Reuters) - Britain reported a surge in cases of the Omicron coronavirus variant on Saturday which government advisors said could be just the tip of the iceberg, and London's mayor declared a "major incident" to help the city's hospitals cope.
The number of Omicron cases recorded across the country hit almost 25,000 as of 1800 GMT on Friday, up by more than 10,000 cases from 24 hours earlier, the UK Health Security Agency (UKHSA) said.
Seven people believed to have had the Omicron variant had died as of Thursday, up from one death in the UKHSA's previous data which ran up to Tuesday. Admissions to hospital of people thought to have the variant increased to 85 from 65.
The government's Scientific Advisory Group for Emergencies (SAGE) said it was "almost certain" that hundreds of thousands of people were being infected with the variant every day and were not being picked up in the figures.
SAGE said without a further tightening of COVID-19 rules, "modelling indicates a peak of at least 3,000 hospital admissions per day in England," they said in minutes of a meeting on Dec. 16.
Last January, before Britain's vaccination campaign gathered speed, daily hospital admissions in the United Kingdom as a whole surged above 4,000.
Prime Minister Boris Johnson has faced a rebellion in his governing Conservative Party over some of the measures he has taken so far to try to curb COVID-19's latest spread. A newspaper said on Saturday that Johnson's Brexit minister, David Frost, had resigned in part because of the new rules.
The advisors said it was too early to assess the severity of disease caused by Omicron but if there was a modest reduction compared to the Delta variant, "very high numbers of infections would still lead to significant pressure on hospitals".
London Mayor Sadiq Khan declared a "major incident" - which allows for closer coordination between public agencies and possibly more central government support - as COVID-19 hospital admissions in the city rose by nearly 30% this week.
He said health worker absences had also increased.
"This is a statement of how serious things are," he said.
Mayor of London, Sadiq Khan visits a coronavirus disease (COVID-19) pop-up vaccination centre at Chelsea football ground, Stamford Bridge in London, Britain, December 18, 2021. REUTERS/David Klein
Khan, from the opposition Labour Party, also declared a major incident in January, when rising COVID-19 cases threatened to overwhelm hospitals.
The Omicron variant is estimated to account for more than 80% of new COVID-19 cases in London, officials said on Friday.
EMERGENCY MEETING
Johnson was due to chair an emergency committee meeting over the weekend with the devolved administrations in Scotland, Wales and Northern Ireland, which have their own powers over public health.
A report in The Times newspaper said officials were preparing draft rules which, if introduced, would ban indoor mixing in England -- except for work -- for two weeks after Christmas when pubs and restaurants would be limited to outdoor table service.
People would be able to meet in groups of up to six outdoors, the newspaper said, adding that ministers were yet to formally consider the plans.
Johnson said on Friday "we are not closing things down".
A government spokesperson said the government would continue to "look closely at all the emerging data and we'll keep our measures under review as we learn more about this variant".
The number of all new COVID-19 cases reported in official data fell to 90,418 from a record high of more than 93,000 on Friday, but that was still the country's second-highest daily toll. Figures typically dip at the weekend.
Cases were up 44.4% over the seven days to Dec. 18 compared with the previous week.
Police clashed with a group of protesters opposed to the latest COVID-19 restrictions near Johnson's Downing Street office and residence on Saturday. A number of officers were injured but so far no arrests had been made, police said.
www.reuters.com/business/healthcare-pharmaceuticals/hospi...
Omicron hospitalisation risk around one third of Delta, UK analysis shows
Reuters
LONDON, Dec 31 (Reuters) - The risk of hospitalisation with the Omicron variant of coronavirus is about one-third that of the Delta variant, according to British analysis of more than a million cases of both types in recent weeks.
Britain is experiencing a surge in COVID-19 cases driven by the highly-transmissible Omicron variant, with record daily infections of 189,846 reported on Friday.
While hospital admissions have started to rise, the government has said it believes the new variant is milder than the Delta variant.
The number of patients needing mechanical ventilation beds has also remained steady through December, unlike previous peaks in the pandemic.
The analysis was published by the UK Health Security Agency, after it worked alongside Cambridge University MRC Biostatistics unit to analyse 528,176 Omicron cases and 573,012 Delta cases.
It also found that vaccines can work well against Omicron.
"In this analysis, the risk of hospitalisation is lower for Omicron cases with symptomatic or asymptomatic infection after 2 and 3 doses of vaccine, with an 81% ... reduction in the risk of hospitalisation after 3 doses compared to unvaccinated Omicron cases," the UKHSA said.
Susan Hopkins, Chief Medical Adviser at UKHSA, said the analysis was in keeping with other encouraging signs on Omicron but said the health service could still struggle with such high transmission rates.
"It remains too early to draw any definitive conclusions on hospital severity, and the increased transmissibility of Omicron and the rising cases in the over 60s population in England means it remains highly likely that there will be significant pressure on the NHS in coming weeks," she said.
Friday's daily data update showed 12,395 patients in hospital in England with COVID-19, up from 11,542 on Thursday and continuing a steeply rising trend. However, the figure is well below a peak of more than 34,000 in January.
news.yahoo.com/experts-warn-omicron-blizzard-disrupt-1627...
Experts, governors warn of U.S. Omicron 'blizzard' in weeks ahead
WASHINGTON (Reuters) - U.S. health experts on Thursday urged Americans to prepare for severe disruptions in coming weeks as the rising wave of COVID-19 cases led by the Omicron variant threatened hospitals, schools and other sectors impacting their daily lives.
The warning came as the United States reached a record high in COVID-19 cases, while federal officials issued more travel warnings and reportedly prepared to authorize booster shots for 12 to 15-year-olds next week.
For the second day in a row, the United States had a record number of new reported cases based on the seven-day average, with more than 290,000 new infections reported each day, a Reuters tally showed.
At least 18 states and Puerto Rico have set pandemic records for new cases, according to the tally. Maryland, Ohio and Washington, D.C., also saw record hospitalizations as overall U.S. COVID-19 hospitalizations rose 27%.
The surge comes amid increased holiday travel, with New Year's celebrations still to come, and as schools grapple with students' return to classrooms following winter breaks.
"We are going to see the number of cases in this country rise so dramatically, we are going to have a hard time keeping everyday life operating," Dr. Michael Osterholm, an infectious disease expert at the University of Minnesota, told MSNBC.
"The next month is going to be a viral blizzard," he said. "All of society is going to be pressured by this."
Dr. Anthony Fauci, the nation's top infectious disease official, on Wednesday said cases will likely rise throughout January, a warning echoed by the governor of Louisiana, where hospitalizations have more than tripled in the past two weeks.
"We are still at the very beginning of this current surge," John Bel Edwards told a news conference on Thursday. "January is going to be very, very challenging."
U.S. health officials have said early data show Omicron appears less severe but have continued to push vaccinations, masks and physical distancing. The Centers for Disease Control and Prevention (CDC) has also issued new guidelines shortening isolation and quarantine periods, which have been criticized by some disease experts www.reuters.com/world/us/no-tests-no-problem-experts-ques... and health care workers.
U.S. health regulators plan to approve a third vaccine dose for 12 to 15-year-olds next week, according to media reports. Boosters are already approved for those 16 and older.
With testing shortages and breakthrough cases, experts warn the surge would stress hospitals and businesses, although some state and city leaders said on Thursday they would keep schools open for children returning from winter break next week.
"We are committed in Arkansas to in-class instruction," Arkansas Governor Asa Hutchinson said. "It’s so important to our future, to our students, to their mental health."
Rising hospitalizations as healthcare workers are sidelined with their own COVID-19 infections is also concerning, as are fewer effective therapeutics, Dr. Peter Hotez, an infectious disease expert at Baylor College of Medicine, told CNN.
A rise in in hospitalization of children across the United States has also fueled concerns.
Already, 825,663 people have died in the United States from COVID-19 since early 2020, data showed, with the latest wave of hospitalizations driven by those not vaccinated.
President Joe Biden this month announced new plans to combat Omicron, but some experts have criticized the measures as arriving too late.
'HUNKER DOWN'
Cruise operators took a hit on Thursday after the CDC warned people to avoid cruises regardless of their vaccination status due to onboard outbreaks, a potential drag on an economy that otherwise appears to be holding up.
While airline travel has been widely disrupted, holiday sales were strong, new claims for state unemployment benefits fell last week to their lowest level of the pandemic, and U.S. stocks hit record highs on Thursday.
How schools handle the surge is also key, especially for working parents. U.S. Education Secretary Miguel Cardona told MSNBC that schools should stay open and that federal funds were available for staffing and testing to help make that happen.
"We can't shut down our city again," New York City Mayor-elect Eric Adams said while unveiling his plan on Thursday to fight COVID-19 while keeping the country's most populous city -- including its schools -- open for business.
Conditions should improve after January, as testing shortages ease and recently-approved medicines become more widely available, experts said.
"We do have light at the end of the tunnel," said University of Minnesota's Osterholm. "But for right now, you're going to have to hunker down."
In Arkansas, which on Thursday reported a record high of 4,978 new cases, Hutchinson said the state would make 1.5 million at-home tests available to residents, a move he hoped would free up health care workers to staff hospitals.
West Virginia Governor Jim Justice urged the relatively high proportion of unvaccinated people in his state to get inoculated but said he was against mandates.
If the situation worsens "and a bunch more people die, you'll have a run on the bank as far as people running to get vaccinated or to get their booster shots," Justice said.
www.cnn.com/world/live-news/omicron-variant-coronavirus-n...
The latest on coronavirus pandemic and Omicron variant
The US reported a record seven-day average of new Covid-19 cases on Tuesday, according to Johns Hopkins University data, as a rapid acceleration of infections continues in the country.
Several European countries — including France, the UK, Italy and Portugal — are also seeing a large increase in cases, with several setting new pandemic records.
Meanwhile, organizers of the 2022 IIHF World Junior Championship have abruptly canceled the remainder of the men's hockey tournament due to coronavirus spread within teams.
The latest wave of Covid-19 cases is "unlike anything we’ve ever seen," doctor says
This latest wave of Covid-19 cases is “unlike anything we’ve ever seen,” Dr. James Phillips, chief of disaster medicine at George Washington University Hospital, said Wednesday.
The emergency departments, he said, are flooded with mostly mildly symptomatic patients who are there to get tested.
“It's part of that shortfall of national testing that's occurring, and it's all falling on the emergency department,” Phillips said.
The problems are compounded by the highly contagious nature of the Omicron variant.
“While many of us were able to stay safe from getting the Delta virus and the previous variants that have come our way, Omicron is affecting the staff at our hospitals in an unprecedented way,” Phillips said. “We're really struggling to maintain our workforce, particularly of nurses right now. And that makes wait times even longer in the waiting rooms, and it's very demoralizing for both the patients and our staff.”
Covid-19 cases will threaten critical infrastructure, scientist says
The US is in a “mess right now” due to the surge in Covid-19 cases, Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, said.
It’s clear that the Omicron variant of the coronavirus is highly infectious, but it is unclear how many people will get seriously sick and die, he said. Rather, the country is in “unknown territory.”
The Centers for Disease Control and Prevention predicts more than 44,000 new Covid-19 deaths over the next four weeks.
“If you look at those CDC data,” Osterholm said, “if you look at the confidence intervals, you can drive a whole semi load of information through there. There's a big hole in terms of, just what does the real number look like over the course of the next month? We don't know.”
Because scientists still are working with limited information, public health leaders have had to make a best guess about what will work to keep people safe. Osterholm thinks the CDC is being too harshly criticized for its decision to change its guidelines to allow certain people to leave isolation or quarantine after a shorter period of time.
“We don't know a lot of the things we wish we'd know, but what we do know and what is emerging here is that this country is going to be in the soup in just the next few weeks with so many cases and so many locations, that we're going to see critical infrastructure as well as health care challenged,” Osterholm added.
Osterholm predicts that with the rapid spread of the Omicron variant, there may not be enough people who are well enough to keep hospitals, grocery stores and gas stations working. The change in CDC guidelines is not just about helping the economy, he said: “It was to play to the very safety of our everyday lives.”
Skip indoor New Year's Eve parties to avoid Covid-19, doctor says
People should skip big indoor New Year’s Eve parties this year, said Dr. Jonathan Reiner, professor of medicine and surgery at George Washington University.
Reiner said a small celebration at a friend’s house should be OK if everyone is vaccinated and boosted and has tested negative before the party. Big outdoor parties are less risky unless they’re crowded.
People may be frustrated that they still have to be so careful with get-togethers, but this is a temporary situation, he said.
“This is not going to go on forever. And the important issues now are to maintain not just the health of the population, which is obviously our primary goal, but also to maintain the health of the people who are manning our hospitals,” Reiner said.
Omicron case at German nightclub during Christmas party puts hundreds into quarantine
A nightclub owner in northern Germany has informed at least 622 people that they must quarantine for 14 days after at least one Omicron infection was detected at a celebration over Christmas.
The "Joy" dance club was holding the event in the Segeberg district of Schleswig-Holstein state. Only people with proof of vaccination, those who recovered from Covid-19 in the past six months plus a negative test, were allowed to enter under Germany's so-called 2G-plus rule. No masks or social distancing were required.
At least one guest was confirmed to have a Covid-19 infection with the Omicron variant, Segeberg district officials said in a news release Wednesday. Officials added that the 2G-plus rules were correctly enforced.
Claussen informed 622 visitors with online tickets by email on Wednesday. Around 200 other guests bought their tickets at the box office. To locate these guests, the disco manager is asking the 622 contacted guests for help.
US pediatric Covid-19 hospital admissions only 2% below September peak, CDC and HHS data shows
US pediatric hospital admissions for Covid-19 are only 2.2% lower than their peak in early September, continuing a rapid increase since mid-December.
On average, 334 children have been admitted to the hospital with Covid-19 on any given day over the week that ended Dec. 27, according to data published Wednesday from the US Centers for Disease Control and Prevention and the US Department of Health and Human Services.
This is a more than 58% increase from the previous week and just 2.2% lower than the peak average of 342 children admitted to the hospital at the end of August and in early September.
Nearly 76,000 children up to age 17 have been hospitalized with Covid-19 since August 2020. They make up the lowest number of Covid-19 hospitalizations of all age groups, but hospitalizations in this population are rapidly increasing.
Currently, 0.46 children are hospitalized with Covid-19 for every 100,000 children in the United States. This is up from 0.26 two weeks earlier and near the record of 0.47 hospitalized children that was set Sept. 2.
Pediatric hospital admissions are up more than 50% in the past week in HHS regions 1, 2, 3, 4 and 8, which includes the East Coast and parts of the Midwest. Only region 7, in the central Midwest, saw hospital admissions decline compared with the previous week.
Reminds me of the Sac school board allowed students to smoke in designated area on the school ground because teachers complained they couldn't catch students students holding a lit cigarette inside the toilet in the '70's.
Now, because people wouldn't self quarantine for ten days, they just hope people would do five days.
www.politico.com/news/2021/12/29/cdc-defends-new-covid-gu...
On Wednesday, Walensky acknowledged that the CDC’s decision to alter the recommended isolation period “really had a lot to do with what we thought people would be able to tolerate.”
“We have seen relatively low rates of isolation for all of this pandemic. Some science has demonstrated less than a third of people are isolating when they need to,” Walensky told CNN. “And so we really want to make sure that we had guidance in this moment — where we were going to have a lot of disease — that could be adhered to, that people were willing to adhere to and that spoke specifically to when people were maximally infectious.”
Indeed, the U.S. on Tuesday logged its highest single-day total of new Covid-19 cases, with 441,278 infections surpassing the previous daily record by close to 150,000. The dire state of the pandemic across the country demanded a change in CDC guidance, Walensky said on Wednesday.
Pictured, Kathleen Gregar.
The Center for Nanoscale Materials (CNM) at Argonne National Laboratory is a joint partnership between the U.S. Department of Energy (DOE) and the State of Illinois, as part of DOE’S Nanoscale Science Research Center program.
Photo courtesy of Argonne National Laboratory.
The Lambda Rho chapter of Alpha Omicron Pi at TCU held their 2014 Big-Little Reveal on Friday, October 3.
Sierra, a student at USC, describes the Big-Little reveal this way in her blog: "The day every new member and to-be Big waits impatiently for all semester long is finally here, the day where Little has to wonder no more of which girl she would call Big from this day on for the rest of her life. It's the day of reveal and as all of the Bigs are stressing to get the final touches done and set up the activities for the day, the Little's wait anxiously, excited to finally be united with their one and only but nervous about what is in store for them until that point." For the rest of her post, see www.thisonelifeblog.com/blog/big-little-reveal-week-day-4....
You can learn more about the Lambda Rho chapter of AOII here:
www.facebook.com/AOIILambdaRho
This album is part of the event coverage for the Fort Worth Portrait Project. The project tells the story of Fort Worth from 2014 - 2044 one captioned portrait at a time, but I also enjoy covering events like this one too.
Please follow the Fort Worth Portrait Project:
www.redeemedexpressions.com/fort-worth-portrait-project/
www.facebook.com/fortworthportraitproject
www.twitter.com/FWPortraitProj
www.instagram.com/fortworthportraitproject
Do you want to be featured in the project? Just head to the following site with a photo and a caption:
Nurses hold national day of action Jan. 13 to demand employers, Biden administration protect RNs, health care workers
Registered nurse members of National Nurses United (NNU), the nation’s largest union of RNs, hold actions across the country on Thursday, Jan. 13 — including a candlelight vigil in Washington, D.C. for nurses who lost their lives to Covid-19, and a national virtual press conference — to demand the hospital industry invest in safe staffing, and to demand that President Biden follow through on his campaign promise to protect nurses and prioritize public health.
NNU nurses emphasize that in recent weeks, the Biden administration has ripped away critical protections from health care workers and the public, with the Centers for Disease Control (CDC) weakening Covid isolation guidelines and the Occupational Safety and Health Administration (OSHA) announcing that it intends to withdraw critical Covid protections for health care workers—right when the Omicron variant is exploding across the country and hospitalizations are skyrocketing. Nurses emphasize that being left unprotected by the government and by their profit-driven hospital employers which have failed to invest in safe staffing and provide critical health and safety protections, has created such unsafe working conditions that nurses are being driven away from the profession.
#ProtectNurses
Colorized scanning electron micrograph of a cell (orange) infected with the Omicron strain of SARS-CoV-2 virus particles (blue), isolated from a patient sample. Image captured at the NIAID Integrated Research Facility (IRF) in Fort Detrick, Maryland. Credit: NIAID
The Lambda Rho chapter of Alpha Omicron Pi at TCU held their 2014 Big-Little Reveal on Friday, October 3.
Sierra, a student at USC, describes the Big-Little reveal this way in her blog: "The day every new member and to-be Big waits impatiently for all semester long is finally here, the day where Little has to wonder no more of which girl she would call Big from this day on for the rest of her life. It's the day of reveal and as all of the Bigs are stressing to get the final touches done and set up the activities for the day, the Little's wait anxiously, excited to finally be united with their one and only but nervous about what is in store for them until that point." For the rest of her post, see www.thisonelifeblog.com/blog/big-little-reveal-week-day-4....
You can learn more about the Lambda Rho chapter of AOII here:
www.facebook.com/AOIILambdaRho
This album is part of the event coverage for the Fort Worth Portrait Project. The project tells the story of Fort Worth from 2014 - 2044 one captioned portrait at a time, but I also enjoy covering events like this one too.
Please follow the Fort Worth Portrait Project:
www.redeemedexpressions.com/fort-worth-portrait-project/
www.facebook.com/fortworthportraitproject
www.twitter.com/FWPortraitProj
www.instagram.com/fortworthportraitproject
Do you want to be featured in the project? Just head to the following site with a photo and a caption:
Lake Forest College chartered Omicron Delta Kappa and inducted 25 founding members during a ceremony in the Chapel on Sunday, April 27. Later that day, 20 new members were welcomed to the National Leadership Honor Society, too. The organization aims to recognize and bring together students who are highly involved in a variety of collegiate activities.
Both China and New Zealand adopted a zero Covid policy.
www.msn.com/en-us/news/world/new-zealand-to-ease-covid-me...
New Zealand to ease COVID measures this week despite Omicron threat - PM
WELLINGTON (Reuters) - New Zealand Prime Minister Jacinda Ardern said on Monday the country will move into a system of living with the COVID-19 virus later this week despite the new Omicron variant posing a fresh health threat to the world.
There were no cases of the Omicron variant in New Zealand at this stage but the developing global situation showed why a cautious approach was needed at the borders, she said.
"Omicron is a reminder of the risk that still exists at our borders," Ardern said at the news conference.
New Zealand has some of the toughest border controls in the world and plans to keep borders closed to most international travellers for a further five months.
It also introduced fresh border measures for travellers from nine southern African nation on the weekend, announcing that only citizens from these countries can travel to New Zealand and will have to stay in state quarantine for 14 days.
Ardern said a lot of evidence still needed to be gathered to know the impact of the Omicron variant.
"It may impact on our vaccines, but it may not. It may be more severe or it may be more mild than Delta ... we simply dont know," Ardern said.
Director General of Health Ashley Bloomfield said authorities were looking at whether more needed to be done at the borders to keep Omicron away.
"It's really just looking to keep it (Omicron) out while we learn more about it," Bloomfield told reporters at the news conference.
New Zealand moves into a new "traffic light" system from Friday that rates regions as red, orange or green depending on their level of exposure to COVID-19 and vaccination rates. Auckland, the epicentre of the country's Delta outbreak, will start at red, making face masks mandatory and putting limits on gatherings at public places.
New Zealand has had about 11,000 cases so far and 43 related deaths.
www.globaltimes.cn/page/202111/1240340.shtml
Strict control, vaccine research give China edge on Omicron
Inactivated vaccine better in dealing with variants than mRNA vaccine in theory: expert
With the world reporting more cases of Omicron variant on Tuesday and more Western countries hastening to close their doors, China, where so far only Hong Kong has reported cases, is calmly and confidently responding to possible challenges with vaccine research and the experience gained from China's dynamic zero-COVID policy.
Chinese observers said that China will benefit from its COVID-19 policy of preventing imported cases and domestic flare-ups which continues to show its unique advantages facing Omicron. In comparison, observers warned that Western countries are likely to be gripped by Omicron if the variant proves highly infectious, with their unscientific easing of epidemic control measures and overconfidence in vaccines.
On Tuesday, Scotland reported three additional cases of the Omicron variant, bringing the total number in the UK to at least 14, media reported.
Although the US has not announced any cases, US President Joe Biden said on Monday that it was "almost inevitable" that Omicron would be found in the US eventually, following cases reported in Canada.
Biden said the country would not go back to lockdowns, and he would lay out his strategy on Thursday for combating the pandemic over the winter, Reuters said.
As of Tuesday, at least 14 countries and regions including Spain, Germany and Australia have detected the variant.
The spread of the Omicron variant to more countries and regions has increased pressure on China to prevent imported cases, Mi Feng, spokesperson of the National Health Commission (NHC), said at Tuesday's media briefing.
But the mutation sites of Omicron do not affect the sensitivity and specificity of mainstream nucleic acid testing reagents in China, indicating that Chinese mainstream testing reagents could cope with Omicron, said Xu Wenbo, director of the National Institute for Viral Disease Control and Prevention under the Chinese Center for Disease Control (CDC) and Prevention.
Xu said that China is technically preparing for the Omicron variant and has done preliminary research into different vaccines, including inactivated vaccines and recombinant protein vaccines, and some Chinese vaccine producers have started preliminary design.
Chinese vaccine producer CanSino told the Global Times on Sunday that the company has started working on vaccines against the new variant. Some Chinese bio-tech companies said their nucleic acid testing kits are upgraded and they are able to detect all prevailing variants, be it Delta, Gamma, Beta or Omicron.
The NHC said that apart from Hong Kong, no other places in China have detected the variant. China's current strategy of preventing imported cases and domestic flare-ups is still effective in fending off the variant.
Regarding concerns about Omicron's effect on the 2022 Beijing Winter Olympics, Zhao Lijian, spokesperson of the Chinese Foreign Ministry, said at Tuesday's media briefing that he is confident the event will proceed smoothly and successfully as China has experience in dealing with coronavirus.
Unique advantage
Lu Hongzhou, co-director of the Shanghai Public Health Clinical Center at Fudan University, told the Global Times on Tuesday that China's "dynamic zero policy" has proved the most successful with the smallest losses in the world. China has to stick to its strict policies and vaccination programs, especially when herd immunity has not yet been reached.
Calling China's current COVID-19 policy the country's "magic weapon," chief epidemiologist of the Chinese Center for Disease Control and Prevention (CDC) Wu Zunyou said at a Sunday conference that China has to stick to its policies, at least through winter and next spring.
In comparison, measures Western countries have taken to ease controls prematurely can lead to result as "a single spark that starts a prairie fire," as for infectious diseases to spread widely at speed, all it takes is "one fish to slip through the net," Lu said.
The US and some Western countries have adopted a purely vaccine-based epidemic prevention policy because of their over-confidence in their own vaccines, and they have been negligent in other aspects, which has to some extent led to the emergence and rapid spread of the new variant, an immunology expert told Global Times on Tuesday on condition of anonymity.
But to some Western media, China's policy means isolation. CNN said in a report on Monday that as much of the world started to learn to live with COVID-19, China "dug its heels and looked increasingly isolated by comparison."
Chinese observers said that the West's choice of COVID-19 response is to some extent a helpless action as they cannot possibly clear their domestic cases with large numbers of locally transmitted cases, and residents are reluctant to cooperate with governments. In some countries, even the leaders do not follow their own rules.
Biden on Monday urged Americans to wear masks, but he has come under fire for flouting his own rules. He was pictured without a mask covering his face over the Thanksgiving weekend in a shop that had a sign on the window requiring customers to wear face coverings, the BBC reported.
In theory, China's inactivated vaccines are better in terms of dealing with virus variants compared with mRNA vaccines, the immunologist said.
"Because inactivated vaccines are based on the principle of inactivating the complete virus sequence and then injecting it into the body, the body can recognize the complete virus sequence after receiving an inactivated vaccine. As long as the virus retains some of its original characteristics, it can be recognized by the body."
For mRNA vaccines that inject only part of the viral sequence into the body, it is easier for the virus to break through its immunity once a more serious mutation occurs, he explained.
"Nevertheless, specific conclusions will have to wait until the laboratory data are available," he said.
China should also speed up developing an inhaled vaccine that can produce effective antibodies in the respiratory tract after it is inhaled through the mouth, which can offer prolonged protection and prevent spread of the virus, Lu said.
Chinese vaccine producer CanSinoBIO and researchers from the Institute of Military Medicine under the Academy of Military Sciences led by Chen Wei have jointly developed China's first inhaled vaccine, which many experts seen as a promising candidate for booster shots of inactivated vaccines.
WHO's role
Observers pointed out that the WHO's role in leading the world's united fight against the epidemic will become even more important.
Zhao Lijian said on Tuesday that China supports the WHO in continuing to play a leading role in assisting countries in responding to the epidemic and promoting international cooperation against the epidemic.
This week, the World Health Assembly is gathering for a special session during which member states will consider the benefits of developing a WHO convention, agreement or other international instrument on pandemic preparedness and response, the WHO said.
In recent times, the WHO's voice has been influenced from time to time by some Western countries, such as the US which has also affected WHO's authority and leadership to some extent, the anonymous expert said.
"These politicians must be urged to respect and help promote the decisions of WHO scientists, and to reach consensus on the WHO as the international leader in the global fight against the epidemic, which is vital for today's world," he said.
December 20, 2021 - New York City - Governor Kathy Hochul, joined by Jackie Bray, Acting Commissioner of New York State Department of Homeland Security and Emergency Services, and Director of State Operations Kathryn Garcia updates New Yorkers on the Covid-19 spread in New York State, particularly on the Omicron variant, during a press briefing Monday December 20, 2021 in New York City. (Kevin P. Coughlin / Office of the Governor)
David Mitchell's Omicron model. Folded from six A4 sheets using my very own silver rectangle version of the folding procedure for the basic unit.
Size: 10.5 cm x 10.5 cm x 10.5 cm
Paper design: Minecraft birch, sandstone, and spruce
History & Glory
Galleria Storica
Anno: 1927 - 1936
Tara: 6,3 - 7,7 tonnellate
Lunghezza: 8300 - 9850 millimetri
Motore: Benzina
Cilindri: 6
Cilindrata: 7060 centimetri cubi
Potenza: 91,5 Cavalli (HP)
Velocità massima: 40 chilometri/orari
Anni 30 - Lo sviluppo del trasporto
Omicron é un autobus prodotto da Lancia tra il 1927 e il 1936, con la costruzione in totale di 601 modelli. E' stato sviluppato in diverse versioni con telaio corto o lungo per l'uso urbano, oltre ad una versione a due piani. Molto lussuoso per l'epoca, venne utilizzato anche per viaggi lunghi. Il telaio Omicron era disponibile in tre versioni, la C (versione corta) e L (versione lunga), entrambi con due assi, e un'opzione a tre assi. Il Omicron C aveva un passo di 8.300 millimetri e il Omicron L aveva un passo più lungo, di 9.530 o 9.850 millimetri. Il modello esposto venne utilizzato come officina mobile per gli autobus del trasporto pubblico a Roma. Rimase in servizio sino al 1956
www.factcheck.org/2022/09/scicheck-qa-on-omicron-updated-...
Q&A on Omicron-Updated COVID-19 Boosters
Earlier this month, the U.S. began administering the first COVID-19 booster vaccines that have been updated to better match the latest circulating coronavirus strains.
Many scientists expect the revised boosters will be more effective than their predecessors, but whether that’s the case and to what degree remains unknown.
The new vaccines, from mRNA vaccine makers Pfizer/BioNTech and Moderna, are bivalent, meaning that along with the original version of the coronavirus, or SARS-CoV-2, they also specifically target the BA.4 and BA.5 omicron subvariants. At the end of August, the Centers for Disease Control and Prevention estimated that together the two subvariants accounted for more than 90% of new COVID-19 cases in the U.S.
The Food and Drug Administration authorized the retooled boosters on Aug. 31, and the CDC signed off on the shots the following day, after the agency’s vaccine advisory committee voted 13 to 1 to recommend both boosters.
The authorizations mark a shift in American COVID-19 vaccination policy. In what’s being called a “fall booster ‘reset,’” people will no longer count the number of vaccine doses they’ve received. Instead, the guidelines are simple: If you’ve had your primary series (one dose of J&J or two doses Pfizer/BioNTech, Moderna or Novavax) and it’s been at least two months since your last dose, then you’re eligible for one omicron-updated booster.
We’ll explain how the new vaccines are different and what experts are saying about them.
How are the updated shots different from the original ones?
The revised boosters are essentially identical to the original ones, except for a tweak to some of the mRNA included in the shots.
For both Pfizer/BioNTech and Moderna, half of the mRNA in the vaccine includes the instructions used in the earlier vaccines for cells to make the spike protein of the original coronavirus strain. The other half includes the instructions for making the spike protein of the BA.4 and BA.5 strains, which is the same in the two subvariants. The spike proteins trigger a protective immune response in the body.
The dual components are why the boosters are referred to as “bivalent.” For the same reason, you may hear the original vaccines being called “monovalent.”
As before, the new Pfizer/BioNTech booster contains a total of 30 micrograms of mRNA, matching the dosage of the primary series shots, while the revamped Moderna booster contains a total of 50 micrograms, or half of the dosage of the primary series.
Who is eligible to get an updated booster?
People 12 years of age and older are eligible to receive Pfizer/BioNTech’s updated booster and adults 18 years or older are eligible to receive Moderna’s updated booster, two or more months after a previous COVID-19 vaccination.
It doesn’t matter if you’ve never been boosted or if you’ve received multiple boosters already — everyone who meets the age requirements and has had their primary vaccinations can get the updated booster as long as they are two months or more out from their last COVID-19 dose. (If you’re still not sure if you’re eligible, you can take an online quiz from the CDC to find out.)
The updated boosters are only authorized as booster shots, so they can’t be given to people as primary vaccinations. For the specified populations, the updated boosters are also replacing the earlier versions of the boosters, which are no longer authorized. As a result, all booster doses will be the bivalent ones — except for kids 5 to 11 years old, who are currently only eligible to receive Pfizer/BioNTech’s original booster dose for their age group.
What evidence supports the use of these omicron-updated boosters?
To authorize the updated boosters, the FDA borrowed its approach for influenza vaccines, which each year are modified to match the flu strains that are expected to circulate that season. Because the changes are only tweaks — and because it would be impractical if not impossible to test the vaccines in people prior to the flu season — flu vaccines are approved without doing clinical studies each year.
The omicron-updated boosters are similar in that they have not yet been evaluated in people, although there is other supporting evidence to suggest that they will work. For one, there is clinical data on a slightly different omicron-specific bivalent booster that targets the BA.1 subvariant that was dominant earlier this year.
Moderna tested this booster in about 600 adults who had received two primary doses and one original booster, and at least three months later were given a second original booster or a BA.1 bivalent booster. In blood tests, there was a stronger antibody response a month out in those who had received the BA.1 booster against both BA.1, BA.4/5 and the original virus, as well as against a variety of other variants.
The Pfizer/BioNTech BA.1 bivalent booster was tested in a similar way, in about 600 people over the age of 55, with a median of about six months in between the booster doses. At one month, the antibody responses to BA.1 were better in those who had received the BA.1 booster than the original, and the antibody responses to the original virus were similar in the two groups.
Although similar studies are being done in people for the BA.4/5 bivalent booster now, those results aren’t in yet. However, experiments from both companies show that mice previously vaccinated and then boosted with the bivalent BA.4/5 vaccines have higher BA.5 neutralizing antibody responses than those boosted with the original vaccine.
immune responses.
Still, some experts have been wary of moving forward with a new COVID-19 booster without human data on these specific vaccines. Dr. Pablo Sanchez, a professor of pediatrics at the Ohio State University and a member of the CDC’s vaccine advisory committee, ultimately voted against recommending the new boosters because of that concern.
“I voted no because I really feel that we need the human data,” he said during the meeting. “There’s a lot of vaccine hesitancy already. We need the human data.” Nonetheless, Sanchez said that, given his age, he was “almost sure” that he would take it.
The rest of the committee, though, felt comfortable enough, given the precedent with flu, to recommend the boosters.
Numerous other countries have opted to go with updated BA.1 bivalent vaccines, which do have clinical data (although the European Medicines Agency, which recommended BA.1-adapted boosters in early September, also recommended the BA.4/5 boosters on Sept. 12). The FDA, however, decided that the best strategy would be to target BA.4/5, since BA.1 is already no longer circulating.
The agency could have waited for the clinical data on BA.4/5, but thought that doing so would sacrifice too many lives. Estimates from the COVID-19 Scenario Modeling Hub suggest that delaying the booster campaign by a month would result in 137,000 more hospitalizations and 9,700 more deaths.
“We have to be a step ahead, or at least we have to try,” FDA chief Dr. Robert Califf explained in a press conference following the authorization of the new boosters. “Because if we waited for all the proof to come in, the wave will have already passed us by and the damage will have been done.”
E. John Wherry, an immunologist at the University of Pennsylvania, said the difference between BA.1- versus BA.4/5-targeted boosters was likely to be small, but given the choice, he would also opt for BA.5.
“This will not be the last version of the vaccine that we see,” he said. “Going with what’s here currently makes a lot of sense to me.”
As for when the human data on the bivalent BA.4/5 booster will be available, Dr. Peter Marks, the head of vaccines at the FDA, said on Aug. 31 that it would probably be at least until the end of September or October, “because of the time it takes to actually dose and then do the assays.”
How effective are the new boosters?
Scientists don’t know how well the redesigned shots will work. In theory, the omicron-updated boosters should be better than the original boosters in protecting against disease because they will more specifically target the coronavirus strains currently circulating — and some data suggest that will be the case.
It’s also possible the updated boosters will prevent more infections, although that protection will be short-lived.
But as the World Health Organization has said, “The full public health benefit of variant-updated vaccines and their value proposition over current vaccines can only be quantified once vaccine effectiveness data have been obtained.”
The real question is not whether the booster will increase protection — they will, scientists told us — but whether and to what degree the updated booster will be better than the original boosters.
Wherry said he thought the new boosters would be better, but the difference would likely be modest.
“I think it’s important to not give the false sense of hope that this new bivalent vaccine is going to be a magic bullet that stops all omicron viruses,” he said. “We should be expecting that they keep the most vulnerable people out of the hospital, but we should not be expecting them to completely protect from, say, mild disease.”
Dr. Paul A. Offit, a vaccine expert and pediatrician at the Children’s Hospital of Philadelphia, is not convinced that the updated boosters will be an improvement.
“I think they’re all going to be of value, I don’t think they’re necessarily going to be of any greater value than just boosting with the ancestral strain,” he said. “What worries me in all this is … that it’s sort of being oversold, being overpromised,” Offit added. “I just fear that people might be disappointed.”
How safe are the new boosters?
The exact formulation found in the new boosters has not yet been tested in people, but the revised vaccines are very similar to the original vaccines that have now been given hundreds of millions of times in the U.S. alone and have been shown to only very rarely result in serious side effects.
In addition, both companies tested the slightly different BA.1 omicron-specific bivalent booster in people, and found no new safety concerns. Vaccine recipients reported experiencing the same expected and temporary side effects as the original shots, including pain, redness and swelling at the injection site; fatigue; headache; muscle pain; and fever.
Given the similarity in design and manufacturing process as the original vaccines, the FDA felt very confident authorizing the boosters. Other experts also told us there is no reason to think that the revamped boosters will pose any new safety hazards. Offit, for example, said it was “extremely unlikely” that the new boosters would be any different in terms of safety.
Notably, Sanchez, the sole dissenter on the CDC’s advisory committee, explained after his “no” vote that while he felt there needed to be clinical data to be able to recommend the boosters, he was not that worried about safety.
“I am comfortable that the vaccine will likely be safe like the others,” he said, adding that he would almost certainly get the new booster himself.
Like the original vaccines, scientists do expect the updated shots will carry a small increased risk of myocarditis and pericarditis, or inflammation of the heart muscle and its surrounding tissue, particularly in young males. Most people who are affected by the rare side effect and are treated, the CDC says, feel better quickly.
Another issue being monitored by scientists is whether boosting could hurt a person’s ability to respond to a future variant, as we have written. But Wherry, who has been following this topic, said there is no indication that is a current risk. “From the data that exists, I see no concern about that whatsoever,” he said. Some animal studies suggest that giving an omicron-only vaccine as a first vaccine dose in animals could be detrimental, he added, but that’s not what is being given to people.
What do experts say about who should get the updated shots, and when?
There is broad agreement that older people and those at higher risk of developing severe COVID-19 should get the new boosters. But experts differ on whether young, healthy people should get another dose.
“I don’t think that a healthy young person who has already received three doses frankly needs another dose, because I think they are protected against serious illness,” Offit said. “After about six months after their last dose, they’re not going to be as protected against mild illness, but that’s true of all infections like this one, meaning short incubation period, mucosal infections.”
Offit still recommends that people over 75 years old, those with significant underlying health problems and those who are immunocompromised seek out the shots. Those are the groups, he said, that have benefited from the previous boosters.
But others think it’s reasonable to give the shots more widely, and that younger people should at least consider them.
“Most young, healthy people are protected from severe disease even after three doses and that protection is pretty durable,” Wherry said. The updated booster, he said, is primarily meant to protect the most vulnerable and to perhaps offer a little bit better protection from mild or moderate disease.
“If you’re over 65, everyone should get boosted,” he said. “If you have comorbidities or are immunosuppressed, absolutely get boosted.”
For younger people, Wherry said boosters are still a good idea, but there can be more individual choice — and that people shouldn’t think that the booster will make them impervious to infection.
“I would encourage people to think about their own behavior and when the right timing for the boost would be,” he said. “If you last got a dose of vaccine or were last infected three months ago and you’re a middle-aged, otherwise healthy individual, you may consider waiting a month or two and time your next dose closer to the holidays or closer to when there’s going to be more indoor activities so that peak level of antibodies coincides with when you’re going to be attending family gatherings or be inside more.”
Although two months is the minimum amount of time to wait since the last COVID-19 dose before getting the updated booster, many experts, including Offit and Wherry, suggest that people wait longer than that since last being vaccinated or being infected with SARS-CoV-2.
“The science really says for a young, healthy individual, you’re going to get the best boosting if you wait four to six months,” Wherry explained. “That allows for your memory B cells and memory T cells to mature a little bit, antibody levels to come down from their sort of max peak level after infection or vaccination.”
But for people who are older or have health problems, Wherry suggested consulting a doctor, because those individuals might need to get their doses sooner.
Is this the start of a shift to an annual COVID-19 vaccine?
Maybe. The Biden administration has presented this fall’s booster as the first of a once-a-year shot for COVID-19, similar to an annual seasonal flu vaccine. But while that could be a reasonable approach, it’s too early to truly know.
Some federal health officials have said as much, noting that new variants might disrupt those plans and that older or high-risk people might need more than one vaccine a year. Some experts, including Offit, are critical of the administration for getting ahead of itself on this question. Offit told us it was reasonable to target high-risk groups, but that young, healthy people may not need an annual boost.
Others are more comfortable with the concept. Wherry, for instance, said that given data that protection against severe disease begins to wane a little around nine months, the one-year time frame makes sense as “a benchmark for the average person” — and also is practical.
“A bit of aligning to traditional health care is an important part of this because it’s actually going to help with vaccine compliance, keeping up with what’s new,” he said, adding that there would remain flexibility for higher-risk people, who likely already interact more with the health care system, to get additional doses if needed.
Where can I get an updated booster?
You can find where the new boosters are available in your area by visiting Vaccines.gov. As with other COVID-19 vaccines, the reformulated boosters will be available at pharmacies, community health centers, and some clinics and doctor’s offices. But a lack of funding means they are less likely than the earlier shots to be available in various public health outreach efforts.
In some places, the boosters may be difficult to find at first. Certain locales have reported shortages of the Moderna vaccine in particular in the first weeks of the rollout, in part due to the delayed release of 10 million doses from a packaging plant in Indiana.
Again, the only booster available to people 12 years and older will be the updated one, so even if it’s not advertised as being new or bivalent, that’s what you will receive.
Are the shots still free?
Yes. The U.S. government has purchased more than 170 million doses of the updated boosters, and at this time, all COVID-19 vaccinations remain available to the public free of charge, regardless of immigration or insurance status.
The administration, however, has warned that without additional funding, it expects it will need to transition COVID-19 vaccine costs “to the commercial market” as early as January. When that occurs, the vaccines will likely be covered for most people with health insurance, similar to flu and other vaccines. People without insurance, however, would need to pay out of pocket.
Can I get my updated booster along with my flu shot?
Yes. Health officials are suggesting this pairing be offered to you this fall, since they know that getting both in one go is more convenient and increases the likelihood that you’ll get both vaccinations.
After one nearly nonexistent and one mild flu season — likely thanks to COVID-19 mitigation measures — some experts are concerned this flu season might be worse than normal. The relative lack of flu for two years running likely means there is less immunity in the population and more people will be susceptible. Clues from the Southern Hemisphere, which often presage flu severity in the North, have been mixed. Australia has had a bad flu season in terms of the number of cases, raising concerns — but other countries have not had particularly active seasons.
Regardless of how severe the flu season turns out to be, vaccination is still recommended. Several studies, along with surveillance data, indicate that getting a COVID-19 shot at the same time as a flu shot is safe and doesn’t reduce your immune response to either virus. The temporary, expected side effects of vaccination are usually on par with or only slightly worse in people getting both shots compared with those just getting a COVID-19 dose.
For some individuals, getting the shots together may make sense, but for others, the timing might not be ideal. The CDC recommends getting the flu shot in September or October, but many experts recommend October or later because vaccine protection against flu wanes and may not last the entire season if given too early. Still, getting the flu vaccine a bit early is better than not getting it at all.
If you opt for dual vaccination, you should get the two shots in different arms or in the same arm with the injections at least an inch apart.
This year, for the first time, the CDC is preferentially recommending that people over 65 years of age get a high dose or adjuvanted flu vaccine instead of a standard flu vaccine, given evidence that those shots may work better for this group.
When will kids be able to get updated shots?
Teens 12 and older are eligible for Pfizer/BioNTech’s omicron-updated booster, but the wait is likely to be at least a few more weeks for younger kids.
On Sept. 21, the head of vaccines at the FDA said that the agency was “only a matter of weeks away” from authorizing updated boosters for kids 5 to 11 years old and “a few months away” for children under 5. The day before, the CDC released a planning document saying it expected Pfizer/BioNTech’s booster for 5- through 11-year-olds and Moderna’s booster for 6- to 17-year-olds in “early to mid-October.”
Pfizer and BioNTech had previously said that they expect to submit their EUA application for updated boosters for children 5 through 11 years of age in early October and that they were pursuing an application for the youngest children down to 6 months.
As with the new boosters for those 12 and up, there may not be clinical data in children for the specific vaccine prior to authorization.
At the CDC’s advisory committee meeting, a Moderna representative said that the company would be completing its EUA submission for its original booster vaccine in kids 6 through 17 by mid-September. The company, she said, is currently conducting a study of primary series BA.1 bivalent vaccines and original and BA.1 bivalent boosters in children 6 months to 5 years old, which is expected to be finished by the end of 2022. She added that Moderna was “exploring” ways of testing BA.4/5 bivalent vaccines in children for use as primary vaccinations and boosters.
www.reuters.com/business/healthcare-pharmaceuticals/us-cd...
U.S. officials prepare for pandemic's next phase as Omicron wanes
WASHINGTON, Feb 16 (Reuters) - U.S. health officials said on Wednesday they are preparing for the next phase of the COVID-19 pandemic as Omicron-related cases decline, including updating CDC guidance on mask-wearing and shoring up U.S. testing capacity.
The plans come as a growing number of U.S. states have begun to ease COVID-19 restrictions as cases decline. The seven-day average of daily cases dropped 40% from the previous week, while the daily hospital admission average dropped 28% and the average daily deaths dropped 9%, according to CDC data.
"We're moving toward a time when COVID isn't a crisis, but is something we can protect against and treat. The president and our COVID team are actively planning for the future," White House COVID-19 Response Coordinator Jeff Zients told reporters.
"Our highest, first priority is fighting Omicron," Zients said. "At the same time, we are preparing for the future."
The U.S. Centers for Disease Control and Prevention is weighing new COVID-19 guidance, including on when to wear face masks, CDC Director Rochelle Walensky said at the same briefing, adding that hospital capacity will be a key metric.
The CDC expects many of the revised guidelines will be issued in late February or early March, around the same time mask mandates in several states are lifted, she said.
"We want to give people a break from things like mask- wearing when these metrics are better, and then have the ability to reach for them again should things worsen," said Walensky.
Walensky cautioned that people will still have to wear masks in certain situations such as when experiencing COVID-19 symptoms, during the ten days following a COVID-19 diagnosis, or following exposure to someone with COVID-19.
Tom Inglesby, the White House's adviser for COVID-19 testing, said the administration had issued a formal request for information to related companies about how to bolster the nation's testing capacity, including details about supply-chain challenges and market volatility.
The industry's response will help direct U.S. investment, he said at the briefing.
Around 50 million to 60 million people can currently obtain free at-home COVID-19 tests over-the-counter using their insurance cards and the administration is working with more insurers to create point-of-sale options, said Inglesby.
The government has already shipped 50 million orders, or 200 million individual tests, as part of its plan to deliver free tests, said Zients.
www.nbcnews.com/health/health-news/cdc-masks-cdc-expected...
How the CDC Abandoned Science
Mass youth hospitalizations, COVID-induced diabetes, and other myths from the brave new world of science as political propaganda
The main federal agency guiding America’s pandemic policy is the U.S. Centers for Disease Control, which sets widely adopted policies on masking, vaccination, distancing, and other mitigation efforts to slow the spread of COVID and ensure the virus is less morbid when it leads to infection. The CDC is, in part, a scientific agency—they use facts and principles of science to guide policy—but they are also fundamentally a political agency: The director is appointed by the president of the United States, and the CDC’s guidance often balances public health and welfare with other priorities of the executive branch.
Throughout this pandemic, the CDC has been a poor steward of that balance, pushing a series of scientific results that are severely deficient. This research is plagued with classic errors and biases, and does not support the press-released conclusions that often follow. In all cases, the papers are uniquely timed to further political goals and objectives; as such, these papers appear more as propaganda than as science. The CDC’s use of this technique has severely damaged their reputation and helped lead to a growing divide in trust in science by political party. Science now risks entering a death spiral in which it will increasingly fragment into subsidiary verticals of political parties. As a society, we cannot afford to allow this to occur. Impartial, honest appraisal is needed now more than ever, but it is unclear how we can achieve it.
Enter the CDC’s new study. Widely covered in news outlets, the January 2022 study claims that kids below the age of 18 who get diagnosed with COVID are 2.5 times more likely to be diagnosed with diabetes. “These findings underscore the importance of COVID-19 prevention among all age groups,” the authors write, “including vaccination for all eligible children and adolescents.” But a closer examination of the study again reveals problems.
First, it does not adjust for body mass index. Higher BMI is a risk factor for COVID, prompting hospitalization and diabetes, and yet the CDC analysis does not adjust for weight at all. Second, the absolute risks the study finds are incredibly low. Even if the authors’ finding is true, it demonstrates an increase in diabetes of up to 6 in 10,000 COVID survivors. Third, the CDC’s analysis uses billing record diagnoses as a surrogate for COVID cases, but many kids had and recovered from COVID without seeking medical care. Without a true denominator that conveys the actual number of COVID cases, the entire analysis might be artifact. As the former dean of Harvard Medical School Jeffrey Flier told The New York Times, “The CDC erred in taking a preliminary and potentially erroneous association and tweeting it to specifically create alarm in parents.” Some might view it as a mistake, but after observing these matters for almost two years, I believe it was the entire point of the study: Alarm might boost flagging vaccine uptake in kids. (Already, a better study out of the United Kingdom finds no causal link between COVID and diabetes in kids.)
Manufacturing alarm at the very moment an age or other demographic cohort is targeted for vaccination has become a pattern for the CDC. On May 10, 2021, the FDA granted Emergency Use Authorization for the 12- to 15-year-old cohort to receive the Pfizer vaccine. On June 11, the CDC published a study in MMWR claiming to demonstrate rising hospitalization among this age group; widespread media coverage of the study quickly followed. But the absolute rates for this age group were, in reality, amazingly low: Less than 1.5 per 100,000, which was lower than they had been in the previous December. Meanwhile, a safety signal was being investigated—myocarditis, or inflammation of the heart muscle—which was more common after the second dose, and reported to be as frequent as 1 in 3,000-6,000, according to the Israeli Ministry of Health. Other countries became reluctant to push two doses within the standard 21- to 28-day timeline for these ages. By July, the U.K. had decided against pushing vaccines for this cohort, a decision that was walked back only slowly.
The CDC was undeterred, and in recent weeks the agency’s director has started to push for more doses at these ages. Against the advice of an FDA advisory committee, Rochelle Walensky has moved forward with recommending boosters for 12- to 15-year-olds. This view differs from WHO guidance and that of other countries, including Canada, which is not authorizing boosters for healthy adolescents aged 12-17. But when it comes to vaccination, the CDC has a single policy: All Americans should get three doses, regardless of age or medical conditions. This is not science as such, but science as political propaganda.
If that sounds like an exaggeration, consider a final example: the CDC’s near-total dismissal of natural immunity. Many other countries consider recovery from prior infection as a vaccination equivalent or better, an assumption that makes both medical and intuitive sense, but the CDC has steadfastly maintained that everyone needs the same number of vaccinations whether they have recovered from a COVID infection or not. This view is countered by data showing that vaccinating people who have recovered from
COVID infection or not. This view is countered by data showing that vaccinating people who have recovered from COVID results in more severe adverse events than vaccinating people who have not had COVID.
In order to bolster the claim that people who have recovered from COVID benefit from vaccination as much as those who never had it, the CDC published a fatally flawed Kentucky-based analysis. The August 2021 study compared people who had contracted COVID twice against those who had it just once, and concluded that those who had it once were more likely to have had vaccination. But the study could have easily missed people who had two documented cases of COVID but might have had severe underlying medical conditions—such as immunosuppression—that predisposed them to multiple bouts of infection in a short period. In addition, people who had COVID once and then got vaccinated might not have sought further testing, believing themselves invulnerable to the virus. The study did not adequately address these biases. Months later, the CDC published a stronger, cohort study showing clearly that natural
immunity was more robust than vaccine-induced immunity in preventing future COVID hospitalizations, and moreover, that people who survived infection were massively protected whether vaccinated or not.
But to listen to Walensky tell it, none of these complications even exist. On Dec. 10, 2021, she told ABC News that the CDC had seen no adverse events among vaccine recipients, and denied seeing any cases of myocarditis among vaccinated kids between 5 and 11. On that same day, however, data from her own agency showed the CDC was aware of at least eight cases of myocarditis within that age group, making her statement demonstrably false.
So why does the supposedly impartial CDC push weak or flawed studies to support the administration’s pandemic policy goals? The cynical answer is that the agency is not in fact impartial (and thus not sufficiently scientific), but captured by the country’s national political system. That answer has become harder to avoid. This is a precarious situation, as it undermines trust in federal agencies and naturally leads to a trust vacuum, in which Americans feel forced to cast about in a confused search for alternative sources of information.
Once that trust is broken, it’s not easily regained. One way out would be to reduce the CDC’s role in deciding policy, even during a pandemic. Expecting the executive agency tasked with conducting the science itself to also help formulate national policy—which must balance both scientific and political concerns and preferences—has proven a failure, because the temptation to produce flawed or misleading analysis is simply too great. In order to firewall policymaking from science, perhaps scientific agency directors shouldn’t be political appointees at all.
Ultimately, science is not a political sport. It is a method to ascertain truth in a chaotic, uncertain universe. Science itself is transcendent, and will outlast our current challenges no matter what we choose to believe. But the more it becomes subordinate to politics—the more it becomes a slogan rather than a method of discovery and understanding—the more impoverished we all become. The next decade will be critical as we face an increasingly existential question: Is science autonomous and sacred, or a branch of politics? I hope we choose wisely, but I fear the die is already cast.
Vinay Prasad is a hematologist-oncologist, associate professor of epidemiology and biostatistics at the University of California, San Francisco, and author of Malignant: How Bad Policy and Bad Evidence Harm People with Cancer.
Watch his video on the same topic at youtu.be/2C6524soTnA.