Covid-19 Updates & Info

[JazzNU]

[dryrunguy]

Here's the latest Situation Report.

::

OMICRON POSES “VERY HIGH” RISK As nations worldwide brace for predicted COVID-19 case surges due to the Omicron variant of concern (VOC), the WHO has warned Omicron poses a “very high” global risk. The VOC has been reported in more than 70 countries, and while new data are helping to clarify initial impressions of the variant’s transmissibility, severity, and ability to evade immunity, many uncertainties remain.

The UK continues to experience a surge in COVID-19 cases—in England, new cases are doubling every 2.5 days—and health officials there expect that Omicron will soon overtake Delta to become the most prevalent SARS-CoV-2 variant. A recent technical brief from the UK Health Security Agency estimates that someone infected with Omicron is about 3 times as likely as a person with Delta to pass the virus on to a close contact. On December 12, the UK government raised its official COVID-19 alert level, and on December 13 UK Prime Minister Boris Johnson confirmed the country’s first-known death of a patient from Omicron. He cautioned putting too much emphasis on initial reports of Omicron possibly causing less severe symptoms, instead focusing on the speed with which the variant is spreading. He also announced vaccine booster doses will be made available to anyone over age 18 who is at least 3 months from their last vaccine. Early analyses are showing 2 doses of the AstraZeneca-Oxford or Pfizer-BioNTech vaccines have a substantial fall in neutralizing antibodies against Omicron compared with other variants, and a third dose is expected to help boost immune response. Authorities across Europe are warning of the variant’s quick spread; the European Centre for Disease Prevention and Control today reported an additional 441 confirmed Omicron cases in the region in the past day, bringing the region's total number to 2,127 since the variant’s emergence.

In South Africa, where early cases of Omicron were first detected, the VOC has caused a faster surge in test positivity than previous variants. The 7-day average number of daily new confirmed COVID-19 cases has more than doubled since December 5. South Africa President Cyril Ramaphosa tested positive for SARS-CoV-2 on December 12, several days after returning from a trip to 4 West African nations, and is showing mild symptoms. South African doctors say most patients with Omicron are recovering at home within the 10- to 14-day isolation period, including older patients and those with preexisting conditions. Still, the volume of new COVID-19 cases has the potential to overwhelm the healthcare system and strain hospitals, a scenario that could result in more severe cases and deaths.

The US CDC last week released its first report on Omicron, discussing 43 cases detected in 25 states between December 1 and December 8. Since then, Omicron cases have been detected in at least 5 more states and Washington, DC. Nearly 80% (34) of the patients were fully vaccinated and one-third (14) had received a booster dose, although 5 of those were not 2 weeks from their last dose. Additionally, 6 of the patients were previously infected with SARS-CoV-2, and nearly all cases experienced mild cold-like symptoms, including congestion, cough, and fatigue. Only 1 patient was hospitalized. State-level community transmission is listed as high across nearly the entire country, which does not bode well in the face of what appears to be the more infectious Omicron variant. As the US nears 50 million cumulative COVID-19 cases and 800,000 related deaths, the CDC predicts the weekly number of COVID-19 related deaths will rise from 8,800 last week to 10,000 next week and to more than 11,000 in 4 weeks. The full impact of Omicron in the US, and around the world, will become more apparent as we enter 2022, the third year of the pandemic.

VACCINE EFFECTIVENESS AGAINST OMICRON Preliminary studies of the Omicron variant of concern (VOC) are revealing lower vaccine effectiveness compared with previous SARS-CoV-2 variants. While still under review, full doses of current vaccines* appear to be around 30-40% effective in preventing infection against Omicron. With booster doses, that estimate increases to between 70-75%. A recent study out of South Africa involving 78,000 persons infected with Omicron indicated that the Pfizer-BioNTech vaccine was about 33% effective in preventing infection but about 70% effective in preventing severe disease. Another study from the UK estimated that a full course of the Pfizer-BioNTech vaccine resulted in around 40% effectiveness in preventing infection.

The decreases in vaccine effectiveness can be attributed to significant changes in the S gene of the Omicron variant compared to previous SARS-CoV-2 variants. The S gene codes for the spike protein, which sits on the outside of the virus and contributes to its ability to infect host cells. Omicron’s totality of mutations in its S gene have resulted in a variant that is different enough from previous variants to be less recognizable by vaccine-induced immunity or by previously acquired immunity following recovery from infection. An Oxford preprint study examined blood sera from 43 fully vaccinated individuals and reported significant decreases in neutralization titers against Omicron. Neutralization titers refer to the ability of neutralizing antibodies to detect and inactivate the virus when it enters the body. All of the studied serum samples showed greatly decreased neutralization capability against Omicron compared to previous variants; some samples showed no neutralization capability at all. With decreased ability of previously vaccinated individuals’ immune systems to recognize and rapidly eliminate Omicron, more breakthrough infections are expected compared with previous VOCs.

Most studies do appear to reinforce the need for booster doses, which are posited to significantly increase protection against Omicron. However, with very little of the world having access to booster doses, or even first doses, Omicron likely will result in another large wave of infections over the next several months. While overall infections are currently on the rise, fully vaccinated persons still appear less likely to be hospitalized with infections due to Omicron. The variant also appears to cause less severe disease than its predecessor variants; however, given the apparent high transmissibility of Omicron, healthcare facilities are still likely to undergo severe strain to remain on top of the wave of incoming patients.
*Full original course of the vaccine, not including additional or booster doses.

GLOBAL VACCINE ACCESS Low- and middle-income countries (LMICs) continue to wait for vaccine supply, as wealthier nations and those producing the supply retain vaccine doses. Despite donations to COVAX, vaccine hoarding has negatively impacted supply to those countries, including COVAX’s mission to equitably distribute vaccines. Experts note that there is a global supply chain risk of reverting to higher-income countries holding on to vaccines for boosters as the Omicron situation, and the potential of future variants, is assessed. Some argue there is a need for some sort of rule against vaccine hoarding, as well as more transparency among manufacturers. WHO warns vaccine hoarding is a detriment to the global targets of vaccinating 40% of the population in each country this year and 70% by mid-2022, leading to a prolongation of the pandemic.

The Duke Global Health Innovation Center and the COVID Collaborative estimate that 11 billion doses of SARS-CoV-2 vaccine will have been manufactured by the end of 2021, which should cover 70% of those 5 and older around the world, but doses are not being equitably distributed. Globally, 8.5 million doses have been distributed, with 56% of the world population having received at least 1 dose of SARS-CoV-2 vaccine; however, only 7.2% of people in low-income countries have received at least 1 dose. Some countries are utilizing most of their supply but still have low vaccination rates because supplies are not adequate to cover the population. Other nations face challenges with delivery capacity and logistics, cold-chain requirements, and vaccine hesitancy. COVAX aimed to deliver 800 million doses by the end of this year, down from its initial 2.3 billion dose goal, but now estimates that less than half of that figure will be delivered. GAVI last week announced a new agreement with Moderna for an additional 150 million doses to be delivered next year to COVAX and priced in the lowest-tier. GAVI and Moderna also agreed to advance access to 20 million doses that will now be available in Q4 of 2021, rather than Q1 of 2022.

ORAL ANTIVIRALS Oral antivirals could transform the treatment of COVID-19, allowing some patients to take medicines while recovering at home instead of having to visit health clinics or be admitted to hospital to receive injections or infusions of currently available therapies. Pfizer this morning released final analysis of its oral antiviral candidate PAXLOVID (the protease inhibitors nirmatrelvir and ritonavir, taken together), showing the treatment retained its 89% efficacy in preventing hospitalization and death among 2,246 high-risk COVID-19 patients. The results were released in a press release and have not yet been peer-reviewed. The data are similar to an interim analysis released in November, which included about 1,200 patients. The company also released interim results from a different study testing PAXLOVID in standard-risk patients and fully vaccinated patients* with 1 or more risk factors. The primary endpoint of self-reported symptom alleviation for 4 consecutive days was not met, but a secondary endpoint showed a 70% reduction in hospitalization and no deaths. Notably, patients in the treatment groups of both studies showed a significant reduction in viral load when compared with patients in the placebo groups. A lower viral load could help lower the risk of transmission. Because PAXLOVID works to inhibit the protease enzyme the virus uses to reproduce—instead of working to inhibit the virus itself—scientists feel the treatment could be effective against Omicron and other variants.

Over the past month, excitement over Merck and Ridgeback Biotherapeutic’s oral antiviral COVID-19 treatment molnupiravir has waned, after full clinical trial data showed the therapy’s efficacy in reducing hospitalization was much lower than initially anticipated based on preliminary data. On November 30, a US FDA advisory panel voted 13-10 to recommend the investigational drug for emergency authorization. The narrow endorsement came after hours of spirited debate centered on several concerns, including whether molnupiravir—which hinders the ability of SARS-CoV-2 to properly replicate its genetic material—could lead to the development of new viral variants, increase the risk of birth defects if used in pregnant individuals, or cause other DNA mutations in humans. The concerns over variants and birth defects are resurfacing just as Britain launches a national clinical trial examining molnupiravir and other COVID-19 treatments, known as PANORAMIC. The trial aims to recruit more than 10,000 people aged 50 and older or who are classified as clinically vulnerable because of pre-existing conditions and who have been infected for less than 5 days. Britain became the first country to approve molnupiravir (Lagevrio) in early November, but the government then said the drug would be rolled out as part of a clinical trial. The results of the trial, as well as other research into the drug, will be useful in showing its real-world effectiveness and evaluating the risks. We expect the FDA to make decisions on emergency use authorization (EUA) applications for both PAXLOVID and molnupiravir in the coming weeks.
*Full original course of the vaccine, not including additional or booster doses.

J&J-JANSSEN WHO EUL The WHO on December 9 updated its emergency use listing (EUL) for the J&J-Janssen SARS-CoV-2 vaccine, saying countries can choose to use the vaccine as a single or 2-dose regimen given at least 2 months and up to 6 months apart. The agency noted that clinical trials show that 2 doses of the vaccine have higher efficacy than 1 dose but also stated that an initial J&J-Janssen vaccine followed by a dose of an mRNA vaccine as a second dose induces higher neutralizing antibody concentrations than a second dose of the J&J-Janssen vaccine. Single-dose administration remains efficacious and optimal in some circumstances, such as in hard-to-reach populations, but countries can consider a second dose among higher-risk populations, including healthcare workers, older individuals, or people with comorbidities, and as vaccine supplies and accessibility increase. The recommendations could help some countries use their excess supplies of the J&J-Janssen vaccine. For example, South Africa last month requested J&J and Pfizer-BioNTech delay further deliveries of the companies’ vaccines due to oversupply. But the country on December 9 announced booster doses of both vaccines will soon become more widely available.

HEALTHCARE WORKER VACCINE MANDATE The US Supreme Court refused to block New York’s vaccine mandate for healthcare workers in a 6-3 vote on December 13. In a previous and similar order, the court allowed Maine’s vaccine requirements for healthcare workers to stay in force. In the New York case, the unsigned order included no reasoning, which is common in response to emergency requests. However, Justice Neil M. Gorsuch filed a 14-page dissent, joined by Justice Samuel A. Alito Jr., saying the majority had betrayed the court’s commitment to religious liberty because the mandate does not include allowance for religious exemption. New York’s vaccine mandate for healthcare workers only allows a narrow medical exemption for those who have had a severe allergic reaction to a previous dose of the SARS-CoV-2 vaccine or a component of the vaccine. Justice Clarence Thomas also dissented, although he gave no reasoning. Challenges to mandates for federal contractors, healthcare workers, and companies of more than 100 employees are pending in lower courts, and additional challenges against federal vaccine requirements or other state mandates could soon reach the Supreme Court.

PANDEMIC HEALTH COSTS The COVID-19 pandemic is set to dismantle nearly 2 decades of global progress toward Universal Health Coverage and increase the number of people pushed into extreme poverty due to out-of-pocket healthcare costs, already at more than half a billion people prior to the pandemic, according to 2 new reports from the WHO and the World Bank. In 2020, the pandemic disrupted health services, caused immunization rates to drop for the first time in 10 years, spurred increases in tuberculosis and malaria deaths, and sparked the worst economic crisis since the 1930s, the agencies said, warning that further financial hardships are likely as governments and households face tighter fiscal constraints. WHO Director-General Dr. Tedros Adhanom Ghebreyesus called on governments to “immediately resume and accelerate” efforts to rebuild and strengthen healthcare and social support systems so that every person can access services without financial consequences. The reports were released to mark International Universal Health Coverage Day on December 12.

[ponchi101]

I gather I can take my 4th dose sometime around... May?

[ti-amie]

FAFO

[ti-amie]

Interesting conversation here...

[JazzNU]

GLOBAL VACCINE ACCESS Low- and middle-income countries (LMICs) continue to wait for vaccine supply, as wealthier nations and those producing the supply retain vaccine doses. Despite donations to COVAX, vaccine hoarding has negatively impacted supply to those countries, including COVAX’s mission to equitably distribute vaccines. Experts note that there is a global supply chain risk of reverting to higher-income countries holding on to vaccines for boosters as the Omicron situation, and the potential of future variants, is assessed. Some argue there is a need for some sort of rule against vaccine hoarding, as well as more transparency among manufacturers. WHO warns vaccine hoarding is a detriment to the global targets of vaccinating 40% of the population in each country this year and 70% by mid-2022, leading to a prolongation of the pandemic.

I understand what WHO's mission is, so I get that there is some framing here that they do intentionally, but many people rely on their reports as objective information. The shaming of wealthy nations has gotten rather interesting and I feel like I'm missing something. Did the low-to-middle income nations suddenly get a ton of cold storage and logistical support and I just missed it?

This is a serious question, because I knew they've increased it, but I feel like I missed where they got a substantial amount, enough to almost vaccinate their entire populations. Because I don't know how Astra Zeneca is stored, but Pfizer and Moderna were never the vaccines that were going to vaccinate the globe. J&J and Novavax, easy to store and cheap to make, were the ones that were supposed to do that (besides whatever China and Russia are doing) and Novavax's bizarre 8 month delay from "we're almost ready" to actually applying for official approval was the real reason along with J&J health concerns for the slow rollout in many of the poorer regions of the world. Did something change?

For instance, with Omicron, there's been a lot of South Africa coverage with a "had vaccines been shared with Africa." I'm in total agreement that more of Africa should be vaccinated by now, but South Africa is a very poor example. They have many more vaccines available than they have people willing to take the shots, same as the so-called wealthier nations. They've delayed receiving some shipments since they don't run out of their existing vaccines supply, falling well short of their vaccination goals. These facts seems to be left out of many of the articles I've seen for Omicron even though most are talking specifically about South Africa and not Africa as a whole.

So what am I missing here? Is it just the bad optics that has fueled the wealthy nation narrative with little mention of the other issues? When did "we know that J&J and Novavax are the vaccines that will get us out of the global pandemic" and problems associated with both those vaccine rollouts turn into just "wealthy nations are constantly hoarding the vaccines?" Not saying they don't have many more than they need, but they've been donating hundreds of millions of doses as well funds to manufacture more doses and there are quite a few other issues and just wondering why they rarely get mentioned anymore. Feel like if you weren't paying close attention at the beginning of the year then you'd have no idea now because only one thing gets blamed.

[ponchi101]

Colombia has been getting vaccines. Venezuela has been using Russian Sputnik V and Sinovax (for the younger population).
And, mixing narratives. Colombia is currently negotiating a package of jet fighters (and support crafts) to modernize its Air Force for when they go to war with... Venezuela, Panama, Ecuador, Peru or Brazil? What TF do they need these planes for?
Plans to open and start operating factories to manufacture vaccines (which they wiped out ten years ago)? Nah, we can buy those from the USA. Or beg for them.
Sorry, but this subject always pissed me off. It is the same narrative I always hear when things go wrong in S. America; It is NEVER our fault, it is always the gringos or our European colonizers, or the transnationals or the IMF or the World Bank. It is never us.

[ti-amie]

Covid deaths in the United States surpass 800,000.

Coronavirus deaths in the United States surpassed 800,000 on Wednesday, according to a New York Times database, as the pandemic neared the end of a second year and as known virus cases in this country rose above 50 million.

The new death toll — the highest known number of any country — comes a year after vaccines against the coronavirus began rolling out in the United States. It also comes at a tenuous moment in the pandemic: Cases are rising once again, hospitals in some parts of the country are stretched to their limits with Covid patients and the threat and uncertainties of a new variant loom.

More than 1,200 people in the United States are dying from Covid-19 each day.

The last 100,000 deaths occurred in less than 11 weeks as the pace of death has picked up, moving faster than at any time other than last winter’s surge. The current uptick is being driven by the Delta variant. It is not yet known how the Omicron variant, which continues to emerge in more states, might affect those trends in the coming weeks and months.

Naoko Muramatsu, a professor at the University of Illinois at Chicago’s School of Public Health, said that from the beginning of the pandemic in 2020, older people have suffered disproportionately.

“Early on, Covid was considered to be an older people’s problem,” she said. Nearly two years later, those difficulties have persisted, whether in the form of a high death rate or isolation, which in many cases already existed but expanded significantly as the months wore on. Older people steered clear of crowded public gatherings and younger relatives stayed away, fearful of exposing those more vulnerable to the virus.

Some 75 percent of the 800,000 Covid-19 deaths have involved people 65 or older. One in 100 older Americans has died. Countless others have found themselves isolated.

“Covid really made something visible that was already going on for older adults,” she said. “Older people were so vulnerable.”

After the first known coronavirus death in the United States in February 2020, the virus’s death toll in this country reached 100,000 people in only three months. The pace of deaths slowed throughout summer 2020, then quickened throughout the fall and winter, and then slowed again this spring and summer.

Throughout the summer, most people dying from the virus were concentrated in the South. But the most recent 100,000 deaths — beginning in early October — have spread out across the nation, in a broad belt across the middle of the country from Pennsylvania to Texas, the Mountain West and Michigan.

The benchmark of 800,000 deaths in the United States occurred despite the wide availability of vaccines for most of 2021.

Older people have been vaccinated at a much higher rate than younger age groups and yet the brutal effects of the virus on them has persisted. The share of younger people among all virus deaths in the United States increased this year, but, in the last two months, the portion of older people has risen once again, according to data from the Centers for Disease Control and Prevention.

By now, Covid-19 has become the third leading cause of death among Americans 65 and older, after heart disease and cancer. It is responsible for about 13 percent of all deaths in that age group since the beginning of 2020, more than diabetes, accidents, Alzheimer’s disease or dementia.

— Julie Bosman, Amy Harmon

https://www.nytimes.com/live/2021/12/15 ... ass-800000

[JazzNU]

Found this article from a few days ago while searching for information about the vaccine shortage in Africa

Arrival of 1bn vaccine doses won’t solve Africa’s Covid crisis, experts say

With 1bn doses of Covid vaccines expected to arrive in Africa in the coming months, concern has shifted to a global shortage of equipment required to deliver them, such as syringes, as well as insufficient planning in some countries that could create bottlenecks in the rollout.

After a troubled start to vaccination programmes on the continent, health officials are examining ways to encourage take-up as some countries have had to throw away doses.

Critics have blamed hoarding of vaccine doses by a handful of western countries for a situation in which only 7.5% of people in African countries have been vaccinated – which some argue led to the emergence of the Omicron variant in southern Africa – but health experts point to a wider series of issues.

The World Health Organization says a shortage of syringes – in particular a 0.3ml syringe version required to deliver the Pfizer dose – may slow delivery, and it has stepped up technical assistance missions in 15 countries that have lagged behind.

Figures show a wide disparity in what has been achieved, with 15 countries reaching a target of 10% of the population vaccinated by the end of September, and more than half struggling to reach a third of that number.

Among the success stories have been some smaller island states, including Seychelles and Mauritius, which have vaccinated more than 60% of their populations, and Morocco has reached 48%.

The case of South Africa – which had vaccinated 40% of its population as of 3 December – highlights some of the complexities involved.

With sufficient doses for an estimated 150 days of vaccination, it has cancelled some vaccine shipments as it has tried to reinvigorate a campaign that had met resistance from some sections of the population, not least in the 18-34 age group.

Some of South Africa’s vaccine supply problems were self-inflicted, including being slow to initially secure stock. There have also been technological issues, with requirements to register using a phone or computer creating a digital barrier in a country where only 60% of people are internet users.

Dr Richard Mihigo, a WHO programme coordinator, said there had been a “start and stop” approach to vaccine drives in Africa in recent months.

“The first doses arrived in Ghana in March and there were a lot of promises from Covax [the global vaccine consortium] that countries would receive their allocations. But that delivery was stopped when India halted delivery from the Serum Institute [in the midst of its own outbreak] earlier this year,” he said.

“That start was not ideal. Since then, however, the situation has stabilised. Now the prospects through March 2022 looks very good with almost 1bn doses forecast to arrive, which in theory could cover 70% of the African population.”

Set against that, however, has been the struggle of some countries to deliver what doses they have – because of instability, for example in the Democratic Republic of the Congo and Nigeria; health systems with poor reach, especially outside big cities; and vaccine hesitancy around the Covid jab.

Nigeria’s underfunded health system lacks everyday supplies such as cotton swabs. Spotty power supply means fridges holding vaccines need to be kept on expensive fuel generators, and millions of citizens live in areas racked by banditry or Islamist insurgencies that medics cannot reach.

Nigeria’s health minister, Osagie Ehanire, said last week: “The foundation is not strong. And if you don’t have a strong foundation, there’s not much you can build on top.”

Hesitancy has been driven by a combination of factors on a continent that in general, studies suggest, has far higher rates of vaccine acceptance than the US. The huge amount of misinformation that has circulated globally is partly to blame, but there are also economic reasons.

David Harrison, the head of the nonprofit DG Murray Trust in South Africa, said some were reluctant to give up a day’s work or pay to travel to a vaccination site. “Twelve million people applied for an R350 (£16) emergency Covid-19 relief grant,” he said. “If you’re asking those people to pay R20 for a taxi fare to and from a vaccine site, it’s a significant trade-off.”

Mihigo, of the WHO, echoed this point. “To make sure more and more of the available vaccine can be put in arms of the people, we need to focus attention on providing additional incentives to people to get vaccinated without compromising their livelihoods.

“I was in DRC recently and I heard someone say precisely this. They can’t afford to travel and then wait in a vaccination centre for two hours.”

Writing in South Africa’s Mail and Guardian this week, Anand Madhvani, a co-founder of Covid Kenya – a group of volunteers that uses social media to create awareness about Covid-19 issues – raised local inequalities in vaccine access.

“In many African countries we have some existing systems for vaccinations, but these require massive expansion and support for mass adult campaigns – even once a steady supply of vaccines is available,” he wrote. “In Kenya, where I work, we needed high-profile local language vaccination campaigns. There is deep inequality within our countries. Relative elites in capitals quickly got themselves vaccinated but stopped pushing for everyone.”


https://www.theguardian.com/global-deve ... -doses-due

[ponchi101]

This is the current data for Colombia:

Screenshot 2021-12-16 103931.jpg

The numbers are a bit higher, proportionally, than the USA. Colombia has a population of about 48 MM, so, if you extrapolate to the USA's 360MM, we would get a death toll of 970,000, considerably higher than in the States.
Even though our vaccination seems to be slight ahead.
Starting Tuesday: no foreigners WITHOUT vaccination can enter the country. Not even with a negative PCR test. Residents and citizens need to show full vaccination schedule OR a PCR test.
2022, here we go, full deja vu.

[ti-amie]

[dryrunguy]

Here's the latest Situation Report. Haven't read it yet.

::

EPI UPDATE The WHO COVID-19 Dashboard reports 270.8 million cumulative cases and 5.32 million deaths worldwide as of December 15. Global weekly incidence increased for the eighth consecutive week, up 0.89% from the previous week. At 4.2 million new cases, last week was 75% of the highest weekly total (April 2021). Europe continues to account for the vast majority of the increase, especially as the Omicron variant of concern (VOC) spreads throughout the region. The UK reported a record number of 78,610 new COVID-19 cases on December 15, 16% higher than its previous record set in January. Weekly incidence in Africa has more than doubled over last week, up from 79,491 new cases the week of November 29 to 167,682 new cases last week. Global weekly mortality has held relatively steady at approximately 50,000 deaths per week since late October.

Global Vaccination
The WHO reported 8.2 billion cumulative doses of SARS-CoV-2 vaccines administered globally as of December 13. A total of 4.35 billion individuals have received at least 1 dose, and 3.47 billion are fully vaccinated. Analysis from Our World in Data indicates that the overall trend in global daily vaccinations has increased since mid-October, up from 21.3 million doses per week to 36.4 million on December 15.* Our World in Data estimates that there are 4.45 billion vaccinated individuals worldwide (1+ dose; 56.55% of the global population) and 3.67 billion who are fully vaccinated (46.4% of the global population).
*The average daily doses administered may exhibit a sharp decrease for the most recent data, particularly over the weekend, which indicates effects of reporting delays. In an effort to reflect the longer-term trends, the numbers reported here may not correspond to the most recent data.

UNITED STATES
On December 13, the US surpassed 50 million cumulative COVID-19 cases:
1 case to 10 million: 289 days
10 to 20 million: 54 days
20 to 30 million: 85 days
30 to 40 million: 162 days
40 to 50 million: 100 days

As of December 14, the US CDC reports 50.2 million cumulative COVID-19 cases and 797,877 deaths. Daily incidence has increased steadily since the most recent low on October 24, up from 64,152 new cases per day to 117,950 on December 14—+84% over that period. Daily mortality is currently 1,143 deaths per day and likely will rise as daily incidence continues to increase.*

At the current pace, the US likely will surpass 800,000 cumulative deaths today or tomorrow. More people have died of COVID-19 in the US than are estimated to have died in the Civil War, the nation’s deadliest conflict (750,000 deaths). And the official number of COVID-19-related deaths likely is an undercount. If the US surpasses this benchmark on December 16:
1 death to 100k: 87 days
100k to 200k: 111 days
200k to 300k: 88 days
300k to 400k: 35 days
400k to 500k: 33 days
500k to 600k: 121 days
600k to 700k: 105 days
700k to 800k: 78 days

*Changes in state-level reporting may affect the accuracy of recently reported data, particularly over weekends. In an effort to reflect the longer-term trends, the numbers reported here may not correspond to the most recent dates.

US Vaccination
The US has administered 488.3 million cumulative doses of SARS-CoV-2 vaccines. Daily vaccinations have remained relatively steady over the past week, but have increased steadily since early July, up from 446,000 doses per day to 1.53 million on December 10, which is higher than the average prior to the Thanksgiving holiday weekend.*

There are 240 million individuals who have received at least 1 vaccine dose, equivalent to 72.3% of the entire US population. Among adults, 84.6% have received at least 1 dose, as well as 21.5 million children under the age of 18. A total of 202.8 million individuals are fully vaccinated**, which corresponds to 61.1% of the total population. Approximately 72.2% of adults are fully vaccinated, as well as 16.4 million children under the age of 18. Since August 13, 56.1 million fully vaccinated individuals have received an additional or booster dose, including 42.3% of fully vaccinated adults aged 65 years or older.
*Due to delays in reporting, estimates for the average daily doses administered are less accurate for the most recent 5 days. The most current average provided here corresponds to 5 days ago.
**Full original course of the vaccine, not including additional or booster doses.

IMMUNITY AGAINST OMICRON Preliminary results from laboratory studies examining the durability of immune responses following SARS-CoV-2 vaccines, and particularly booster doses, or previous SARS-CoV-2 infections in the face of the Omicron variant of concern (VOC) are coming fast and furious. While it is clear that the quickly spreading variant can cause breakthrough infections in fully vaccinated individuals and those who have recovered from previous infections, questions remain over how well the vaccines and their boosters will help prevent severe disease, hospitalization, or death.

The WHO held a global consultation on December 15 to examine evidence about Omicron’s ability to evade immunity, and heard reports on several studies suggesting that T cells—a type of white blood cell that play an important role in the human immune system—in vaccinated people can mount a robust defense against the VOC. While it seems increasingly likely that Omicron’s immune evasion will lead to an increase in new infections, even in fully vaccinated and previously infected individuals, researchers predict that T cells will maintain their ability to perform at a high level to help prevent severe disease.

A preprint study—published on medRxiv and not yet peer-reviewed—from researchers working at Massachusetts General Hospital, Harvard University, and the Massachusetts Institute of Technology (MIT), reinforces the potential positive impact of booster doses. The research team explored how well the 3 vaccines authorized in the US (Moderna, Pfizer-BioNTech, and J&J-Janssen) withstood a pseudovirus that was built to imitate the Omicron VOC. The findings showed “low to absent” antibody neutralization from blood sera taken from people who received a complete regimen of vaccine. In positive results, individuals who had received booster doses of an mRNA vaccine exhibited potent neutralization of the Omicron pseudovirus, highlighting the potential importance of boosters in mounting stronger immune responses.

The idea of immune escape raises several questions about the future of currently available SARS-CoV-2 vaccines, with several schools of thought emerging. Some experts argue that individuals who have received full regimens of 2-dose SARS-CoV-2 vaccines will be sufficiently protected against severe outcomes of COVID-19, while others are pushing booster doses for fully vaccinated individuals based on several laboratory studies showing the extra dose might provide some additional protection. Other researchers are calling for a rapid investment into tailored vaccines specifically designed to address the Omicron variant. All 3 arguments have merits, and it remains unclear which direction the global community—at least those nations with sufficient vaccine access and capacity—will go. The conversation surrounding vaccine booster doses and SARS-CoV-2 variants will continue for the foreseeable future, changing as new data become available.

BREAKTHROUGH CASES With the proportion of COVID-19 cases caused by the Omicron variant of concern (VOC) expected to surge in the coming weeks in the US, more data are being collected on who is becoming infected, including people who are fully vaccinated.* According to US CDC data published last week, 34 of the 43 Omicron cases initially recorded were in fully vaccinated people, 14 of whom had received a booster.** While much is still unknown about Omicron’s ability to dodge vaccine-induced immunity, it appears Omicron is able to skirt at least some protection garnered from vaccination and cause breakthrough cases. A new report from the Peterson-KFF Health System Tracker—which was conducted prior to Omicron’s detection and is based primarily on COVID-19 cases caused by the Delta variant—suggests that COVID-19 breakthrough cases are highly correlated with age (more common among those aged 65 and older) and underlying health conditions. A recent Wall Street Journal analysis came to the same conclusions. According to CDC data posted on November 22, unvaccinated persons had 14 times the risk of dying in September compared to vaccinated persons, showing that vaccination continues to be the best way to reduce the risk of severe disease, hospitalization, and death from COVID-19.
*Full original course of the vaccine, not including additional or booster doses.
**Of those who had received a booster dose, 5 were within a 14-day window.

ASYMPTOMATIC CASES In a global meta-analysis published in JAMA Network Open, researchers from China found that 40.5% (95% CI, 33.50%-47.50%) of people who had confirmed positive tests for SARS-CoV-2 never became symptomatic. Although they represented only 0.25% (95% CI, 0.23%-0.27%) of the overall pooled tested population, the study highlights the potential transmission risk of asymptomatic cases in communities. The researchers included data from 95 individual studies covering 29,776,306 individuals undergoing testing. The pooled percentage of asymptomatic cases varied among different populations: 4.52% in nursing home residents or staff; 2.02% in air or cruise travelers; 2.34% in pregnant women; 1.46% in close contacts; 0.75% in healthcare workers or in-hospital patients; and 0.40% in community residents. Among confirmed cases, the pooled percentage of asymptomatic cases was notably highest among pregnant women (54.11%), followed by air or cruise travelers (52.91%), nursing home residents or staff (47.53%), community residents (39.74%), healthcare workers or in-hospital patients (30.01%), and close contacts (26.94%). In addition to the risk that an asymptomatic infected person could unwittingly pass the virus to others, infected asymptomatic individuals likely do not have robust immune responses and might not develop lasting neutralizing antibodies that could help ward off another infection. Additionally, people with asymptomatic COVID-19 still remain susceptible to post-acute sequelae of SARS-CoV-2 infection, or “long COVID.” The findings underline the importance of comprehensive, widespread testing and highlight the suspicion that many COVID-19 cases go undetected.

J&J-JANSSEN VACCINE CONTRAINDICATION The US FDA on December 14 updated its fact sheets on the J&J-Janssen SARS-CoV-2 vaccine for healthcare providers and the general public to include a contraindication for individuals with a history of thrombosis with thrombocytopenia following the vaccine or any other adenovirus-vectored vaccine for COVID-19, as well as updated information about the risk of thrombosis with thrombocytopenia syndrome (TTS) following vaccination. The risk of TTS after vaccination using the J&J-Janssen vaccine remains low, but about 15% of cases have been fatal, according to the FDA. The highest reporting rate is among females between the ages of 30 and 49 (about 1 case per 100,000 doses administered). The US CDC’s Advisory Committee for Immunization Practices (ACIP) is meeting today to discuss the data and possibly recommend limitations on the use of the J&J-Janssen vaccine. The clotting issues also have been linked to the AstraZeneca-Oxford vaccine, which is not authorized in the US, but have not been reported with the mRNA vaccines from Moderna or Pfizer-BioNTech.

VACCINE PASSPORTS Many nations, localities, and businesses are beginning to mandate proof of SARS-CoV-2 vaccination, or so-called vaccine passports, for entry onto public transportation and into venues such as restaurants, night clubs, and stadiums. Public health officials agree that vaccination is the best way to prevent COVID-19 or lower the risk of severe disease, but others question the utility of vaccine certificates, with some nations experiencing protests and riots. A modeling study published this week in The Lancet Public Health suggests that countries that required proof of vaccination, recent infection, or negative SARS-CoV-2 test to engage in activities or travel generally saw an increase in uptake of the vaccines. The researchers examined the effects of vaccine requirements in 6 countries and found that COVID-19 certifications lead to increased uptake of vaccines 20 days prior to implementation and up to 40 days following, with the highest increases among populations aged 49 and younger. More widespread vaccinations help to protect individuals from severe illness but also help curb the spread of SARS-CoV-2 in vulnerable communities and demographics, a critical issue amid the current Omicron variant of concern-associated surge. Policymakers should consider vaccine certification as part of their COVID-19 strategies to address vaccine complacency and hesitancy and potentially increase uptake but keep in mind ethical considerations, as the requirements will not work among all populations.

US COLLEGES & UNIVERSITIES The heightened transmissibility of the Omicron variant of concern (VOC) presents a number of new challenges for institutions that have returned to in-person or hybrid activities. US colleges and universities—which can be hotbeds for disease transmission given the frequency of large group gatherings and the existence of communal living spaces—are now revisiting their COVID-19 mitigation strategies to account for Omicron. Already, several schools have reported cases of the Omicron variant in addition to their weekly reports. Cornell University this week reported more than 900 new COVID-19 cases, with many suspected to be Omicron infections among fully vaccinated students, some of whom had received booster doses. Cornell decided to close in-person activity at its Ithaca branch in response to the outbreak. Other schools, including New York University, have begun to cancel nonessential gatherings and events and are requiring booster shots for students who plan to return to campus for the spring semester. While many colleges and universities are keeping their current mitigation strategies in place for the remainder of the fall semester, school officials are watching data closely to prepare for the larger challenge of what to do when students return in the new year.

https://covid19.who.int/

[ti-amie]

[dmforever]

My dentist told me yesterday that her brother's son (20 something) got Covid and was hospitalized for 5 days. Her brother and SIL still wouldn't get, and aren't, vaccinated. It defies all rational thought.

Kevin

[ponchi101]

I will go the other way. On Saturday, I went to play padel with friends. We were OUTDOORS, and the girl from the sport complex showed up and asked for our reservation and OUR VACCINE card. I had left mine in my other back pack and was about to be told "sorry, but you are out" (and, again, we were outdoors) when I remembered that I had scanned it and kept a PDF in my phone. I showed it to her, we could keep playing.
it is that simple here. No vaccines, no indoor anything. Or, in our case, not even outdoor playing.
(Private facility so they decide how to handle it).