Covid-19 Updates & Info

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Re: Covid-19 Updates & Info

#2131

Post by ponchi101 »

Flew into the States today. I did get an antigen test yesterday, and then I did upload it into the UNITED.COM site.
But still, nobody asked me for it today at the airport. Then again, it was Houston. So no good to rely on the Colombian authorities for enforcement (which they did).
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Re: Covid-19 Updates & Info

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Post by dryrunguy »

Here's the latest Situation Report. They hadn't issued one in a while, so much of this falls into "we already knew this" territory.

But there were a few items that raised my eyebrows: 1) the Delta-based study that examined the risk of COVID-related hospitalization or severe illness based on previous infection, vaccination status, etc.; 2) the section on racial and ethnic differences in COVID treatments by treatment type and ethnicity; and 3) I had no idea that Tonga has recorded only one official case of COVID and is considered a COVID-free zone--that has significant implications as relief workers come into the country to provide much-needed aid and assistance, but without the usual 21-day quarantine period.

::

EPI UPDATE The WHO COVID-19 Dashboard reports 332.6 million cumulative cases and 5.55 million deaths worldwide as of January 19. Global weekly incidence increased again last week, up 29.77% over the previous week. This is the 13th consecutive week of increasing weekly incidence, setting another new record with 20.32 million new cases. All WHO regions except Africa (-27.24%) reported increases last week. The Omicron variant drove the greatest percentage increases in South-East Asia (+144.58%), Eastern Mediterranean (+68.25%), and the Western Pacific (+38.49%), followed by the previous leaders of the Americas (+32.46%) and Europe (+17.01%).

Global weekly mortality increased for the second week, up 10.88% from the previous week with 48,911 total deaths. Cumulative global mortality passed 5.5 million the week ending January 10, up from 5 million on November 1, 2021. The true global death toll of the pandemic is estimated to be much higher, with models from the Institute for Health Metrics and Evaluation and The Economist suggesting COVID-19-related deaths to be between 2 and 4 times higher.

Global Vaccination
The WHO reported 9.57 billion cumulative doses of SARS-CoV-2 vaccines administered globally as of January 11. A total of 4.7 billion individuals have received at least 1 dose, and 4.0 billion are fully vaccinated. Analysis from Our World in Data indicates that the overall trend in global daily vaccinations increased from mid-October (21.36 million doses per day) through late-December (38.87 million). However, daily vaccinations continue to decrease, down to 30.15 million on January 19.* Our World in Data estimates that there are 4.73 billion vaccinated individuals worldwide (1+ dose; 60.11% of the global population) and 4.05 billion who are fully vaccinated (51.59% 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
The US CDC is currently reporting 67.9 million cumulative cases of COVID-19 and 853,230 deaths. The US is averaging 755,095 new cases and 1,669 deaths per day.* Some models estimate that the cumulative number of deaths could rise above 1 million by mid-March, when the Omicron wave is expected to subside.
*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.

COVID-19 hospitalizations in the US set another record high this week, with a 7-day average of 21,086 new hospitalizations per day. The CDC is also reporting a surge in the number of current hospitalizations, up from an average of 125,106 hospitalized COVID-19 patients on January 10 to 142,595 on January 17, an increase of 14% over that period. The current average is the highest since the beginning of the pandemic.

US Vaccination
The US has administered 530.4 million cumulative doses of SARS-CoV-2 vaccines. The trend in daily vaccinations continues to decline, down from a recent high of 1.74 million doses per day on December 6 to 1.04 million on January 14.*

A total of 249.7 million individuals have received at least 1 vaccine dose, equivalent to 75.2% of the entire US population. Among adults, 87.1% have received at least 1 dose, as well as 24.7 million children under the age of 18. A total of 209.5 million individuals are fully vaccinated**, which corresponds to 63.1% of the total population. Approximately 73.6% of adults are fully vaccinated, as well as 19.3 million children under the age of 18. Since August 13, 81.7 million fully vaccinated individuals have received an additional or booster dose. An estimated 39% of fully vaccinated individuals have received a booster, including 62.3% 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.

COVID-19 IMMUNE LANDSCAPE With cases of COVID-19 continuing to surge worldwide due to the Omicron variant of concern (VOC), scientists are looking to recent experiences with the Delta variant to shed insight into what the immune landscape might look like for individuals who are unvaccinated and have recovered from previous SARS-CoV-2 infection, those who are vaccinated, and those who are both recovered and vaccinated. The world will be in a significantly different place after Omicron subsides, with millions of people having at least short-term immune memory of its distinct S-gene mutations. More people than ever before will have some form of natural immunity against SARS-CoV-2, but it is unclear the extent to which recent infection might protect against future infection or hospitalization. In a new report published in the US CDC’s Morbidity and Mortality Weekly Report (MMWR), researchers examined case and hospitalization rates in New York and California during the surge of the Delta VOC. They describe a complex immune landscape through the beginning of Delta’s takeover to the time when it became the predominant global variant.

Initially, in May 2021, vaccinated persons with no prior infection had the lowest rates of hospitalization, but as Delta began to infect more people and cause breakthrough cases, individuals with previous infection were less likely to be hospitalized compared to unvaccinated persons with no prior infection. From May 2021 to June 2021, vaccinated persons with no prior infection had the lowest hospitalization rates of any other group at 27.7-fold lower compared with unvaccinated persons with no prior infection. But from October 2021 to November 2021, hospitalization rates among vaccinated persons with prior infection were 57.5-fold lower and 55.3-fold lower among unvaccinated individuals with prior infection, compared with unvaccinated individuals with no prior infection. By comparison, hospitalization rates in vaccinated persons with no prior infection were 19.8-fold lower. These data suggest that natural immunity from prior infection can play an important role in preventing severe consequences of subsequent SARS-CoV-2 infections, even among those who have not been fully vaccinated.

Some important context to these findings is that the shift in protection from vaccine-alone to vaccine-plus-prior infection occurred during a time of known waning immunity from initial rounds of vaccination. Additionally, people who were fully vaccinated with an additional booster dose were not evaluated as a separate group in this study. All of these data point to having high levels of antibodies—whether vaccine-induced, naturally acquired, or a combination—as vital in protecting against hospitalization and severe COVID-19 outcomes. It is still unclear whether these patterns will hold for the Omicron VOC, which has a greatly different viral profile compared with previous variants. Hospitals are still reporting that the unvaccinated have the highest risk of severe COVID-19, while the group with the lowest risk of severe COVID-19 are those who are fully vaccinated and boosted, underscoring the continuing need for vaccines and booster doses.

A word of caution: Some might interpret these findings as a “green light” to ignore all COVID-19 precautions and take unnecessary risks for themselves and others. Even if natural immunity does confer protection for an extended time, the consequences of contracting and recovering from COVID-19 cannot be overstated; it is estimated that 15-80% of people recovering from illness will experience “long COVID,” or prolonged symptoms including brain fog, dizziness, loss of taste and smell, and other symptoms which can alter daily life for those affected. While those who might get COVID-19 twice do seem fortunate in that their bodies are better able to fight off the newest infection, it is still better never to become infected with SARS-CoV-2 because of the uncertainties of long-term sequelae. Vaccines, masks, and physical distancing are all still vital tools in bringing an end to the pandemic with as few deaths as possible.

US RESPONSE Beginning next week, the administration of US President Joe Biden will supply 400 million “high-quality” masks at no cost to the US population through community health centers and pharmacies. The N95 respirators, which will come from the Strategic National Stockpile, offer the highest level of protection from SARS-CoV-2, according to new guidance from the US CDC, filtering out 95% of all airborne particles. It is not clear yet how many masks will be available to each person at one time, and recipients will not be prioritized based on vulnerability, income, or other criteria.

Late last week, the CDC updated its guidance on the types of masks and respirators recommended for use during the COVID-19 pandemic, removing concerns related to shortages of N95 or KN95 respirators and saying “people can choose” those respirators. The agency clarified that some types of masks and respirators provide more protection to the wearer than to others and that “surgical N95s”—respirators that provide additional protection against certain hazards present during medical procedures, such as blood splatter—should be reserved for healthcare professionals. Overall, the CDC continues to encourage people to “wear the most protective mask you can that fits well and that you will wear consistently.” Nearly 150 manufacturer applications to sell N95 masks are backlogged at the CDC, which is being criticized for taking months to review the applications.

The US government on January 18 quietly launched its new website, COVIDtests.gov, that allows 4 at-home SARS-CoV-2 tests to be shipped to “valid residential addresses” at no cost. According to the site, orders usually will ship within 7-12 days—meaning they are not appropriate for people who need to be tested immediately—and will be delivered by the US Postal Service. The website’s launch comes 1 month after US President Joe Biden announced the government will obtain an additional 500 million free tests and 1 week after he doubled that number to 1 billion tests. White House officials noted a telephone hotline to request tests is also being established, with more information available at the end of this week. Additionally, most US residents with private insurance are now eligible to purchase tests online or in stores and have them covered at the time of purchase or be reimbursed by submitting a claim to their insurer. Only tests bought on or after January 15 are eligible, and insurers are required to pay for up to 8 tests per covered individual per month. Tests available for purchase online or in stores remain difficult to find in many areas of the country, and the Biden administration’s efforts to distribute tests and masks to millions are being viewed by some as a push to regain the trust of the American public in the federal pandemic response.

US VACCINE REQUIREMENTS The US Supreme Court last week issued opinions in response to 2 sets of cases involving federal SARS-CoV-2 vaccine requirements. In one unsigned opinion, the court halted the Biden administration’s enforcement of the Occupational Safety and Health Administration’s (OSHA) Emergency Temporary Standard (ETS) that would have required all workers at firms with 100 or more employees to either get vaccinated or be tested weekly and wear a mask to work (National Federation of Independent Business v. Department of Labor, No. 21A244). In a 6 to 3 decision, the justices concluded that OSHA overstepped its authority in issuing the requirement covering 84 million workers and issued a stay pending a decision from the US Court of Appeals for the Sixth Circuit. The stay undercuts one of US President Joe Biden’s most significant efforts to encourage widespread vaccination and leaves states and companies responsible for making their own policies. For example, Starbucks—which employs 228,000 people in the US—will no longer require employees to be vaccinated following the Supreme Court’s ruling. President Biden expressed disappointment over the court’s decision, saying that the “common sense life-saving requirements” are “grounded squarely in both science and the law.”

In a separate unsigned opinion, the Supreme Court allowed the Biden administration to continue enforcing a Centers for Medicare and Medicaid Services (CMS) regulation issued by the US Department of Health and Human Services (HHS) requiring vaccination for nearly all workers at hospitals, nursing homes, and other medical facilities that receive federal funds through Medicare and Medicaid (Biden v. Missouri, No. 21A240). The vote in that case was 5 to 4, with Chief Justice John G. Roberts Jr. and Associate Justice Brett M. Kavanaugh joining the liberal justices to form a majority. They concluded that the rule is necessary to protect the safety of patients and “is consistent with the fundamental principle of the medical profession: first, do no harm.” The court’s ruling overturns lower federal court injunctions in 2 dozen states, requiring that facilities participating in federally funded programs vaccinate their employees. Some concerns remain that the mandate will exacerbate existing staffing shortages, especially at some long-term care facilities and smaller rural hospitals.

TREATMENT DISPARITIES New research published in the US CDC’s Morbidity and Mortality Weekly Report (MMWR) examines racial and ethnic disparities in the use of medications to treat COVID-19 cases within the US. The researchers looked at patient electronic health record data collected between March 2020 and August 2021 at 41 US healthcare systems. They focused on 3 main countermeasures used to treat patients with confirmed SARS-CoV-2 infection during that time period: monoclonal antibodies (mAb) delivered through intravenous infusion or subcutaneous injection, the steroid dexamethasone, and the antiviral remdesivir. Overall, mAb were rarely used to treat individuals with SARS-CoV-2 infection, but when administered, Hispanic patients received mAb 58% less often than did non-Hispanic patients, and Black, Asian, or Other race patients received mAb 22%, 48%, and 47% less often, respectively, than did White patients during November 2020-August 2021. The disparities were different and less pronounced for the other 2 treatments, with Black inpatients receiving remdesivir 9% more often than other racial groups and Hispanic patients receiving dexamethasone 6% more often than non-Hispanic groups. The researchers stressed the importance of better understanding this data and addressing gaps to build more equitable healthcare systems.

In an attempt to bridge these gaps, some states—including New York, Utah, and Minnesota—updated guidance to include formulations offering race as a preferential factor for receiving mAb treatment. However, at least Minnesota has dropped the scoring system that took race into account after the threat of a lawsuit. A fact sheet from the FDA also lists race and ethnicity as potential risk factors that may put patients at high risk for progression to severe COVID-19. That language has drawn criticism from some conservative US lawmakers.

BEIJING WINTER OLYMPICS China this week announced that tickets to the Beijing Winter Olympics will no longer be sold to the general public, with the announcement coming less than 2 days after health authorities detected the city’s first case of the SARS-CoV-2 Omicron variant of concern (VOC). Ticket sales already were limited to domestic spectators, and now will be further limited to certain approved groups that will need to undergo strict screening and quarantining measures. In a statement, the International Olympic Committee said the new rules were intended to “help create an absolutely safe environment for the athletes.” In recent weeks, China has switched from a “zero tolerance” approach to COVID-19 to a new “dynamic clearing” policy, which accepts that cases will happen and empowers local authorities to implement strategies to deal with them. However, the thinking behind the previous approach continues to prevail, with authorities taking aggressive steps to quell a series of outbreaks and more than 20 million people across the country in some stage of lockdown.

The highly transmissible Omicron variant poses a significant test to the country’s policies, especially after several studies have shown that the Chinese-produced vaccines from Sinovac Biotech and Sinopharm produce significantly lower neutralizing antibodies against Omicron than other major vaccines. Additionally, some evidence suggests that prior natural immunity gained from previous infection plus vaccination provides the most robust immune response to protect from severe disease. With low levels of natural immunity among China’s population, as well as weak health systems in some areas, hospitals could become overwhelmed if Omicron were to spread. Pfizer-BioNTech has licensed its vaccine to Shanghai Fosun Pharmaceutical Group, allowing the company to domestically manufacture the shots and the government to roll out a booster program using them. In the meantime, companies worldwide are preparing for continuing supply chain disruptions as Chinese officials continue to impose community- and citywide lockdowns.

ENGLAND British Prime Minister Boris Johnson announced on January 19 that all COVID-19 mitigation measures implemented under the government’s “Plan B”—including mandatory mask-wearing on public transportation and in retail shops and the use of vaccine certificates—will be dropped in England late next week. The guidance to work from home and the need for students to wear masks at secondary schools both ended immediately. Prime Minister Johnson noted England is moving back to “Plan A” due to the successful rollout of booster doses and what appeared to be a peak in the Omicron surge. Notably, while the number of new COVID-19 cases is dropping, the level still remains well above the previous high peak in January 2021. Scotland and Wales have also announced similar easing of mitigation measures. While the news was welcomed by many businesses, some teaching and health unions and public health representatives raised concern over the loosening of restrictions. Teachers warned that COVID-19-related disruptions continue at schools; National Health Service (NHS) officials cautioned that nearly 20,000 COVID-19 patients remain in hospital and the system is stretched thin; and health groups said the abrupt switch could send the wrong message to the public as more of a political move than one grounded in science. Indeed, Prime Minister Johnson is facing political challenges over allegations that he held several large events at Downing Street that breached lockdown policies.

TONGA While more continues to be learned about the devastation in Tonga after a massive volcanic eruption on January 15, life is beginning to return to normal on the main island of Tongatapu after it was covered in a thick coating of ash and hit by a tsunami resulting from the blast. As many as 150 homes were damaged or destroyed and at least 3 people were killed as a result of the eruption and tsunami. UN humanitarian flights have been delayed as ash is cleared from the airport runway, and aid agencies are working to coordinate delivery of aid without direct contact with residents. Tonga is a COVID-free zone, logging only one COVID-19 case during the pandemic, and fears are high that outside assistance—without the nation's mandatory 21-day quarantine—could bring the virus to the country, complicating recovery efforts. UN officials have noted that they are taking action to follow necessary protocols for entry into the country.

https://covid19.who.int/
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Re: Covid-19 Updates & Info

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Post by ti-amie »

Once again, thanks for this Dry. As for the typo...

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Re: Covid-19 Updates & Info

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“Do not grow old, no matter how long you live. Never cease to stand like curious children before the Great Mystery into which we were born.” Albert Einstein
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Re: Covid-19 Updates & Info

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Post by JazzNU »

ti-amie wrote: Thu Jan 20, 2022 11:34 pm
Also rolled back the school mask mandate and the state employee vaccine mandate on his first day in office.

Avoidable sickness and death are fine though, cause these kids ain't got to learn anything about racism.
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Re: Covid-19 Updates & Info

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Post by ti-amie »

Nothing is ever real until it happens to them. And once it happens to them heaven help you if you ask why they're for Program A now. You'll get a word salad of "we have to look out for each other" and so on.

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Re: Covid-19 Updates & Info

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Well. Republicans have zero empathy. They are fairly sociopathic in that aspect. Unless it happens to them, directly, nothing matters.
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Re: Covid-19 Updates & Info

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Post by Deuce »

It's certainly not only Republicans. This is very common among all politicians. Unless they are directly affected by it - be it COVID, homelessness, drug abuse, alcoholism, spousal abuse, incest - what have you... until it becomes part of THEIR life, they simply don't care.

This is the rule for politicians everywhere. Sure, there are exceptions to every rule - but for all intents and purposes, no matter how they market themselves, politicians are extremely self-serving.
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Re: Covid-19 Updates & Info

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Post by JazzNU »

ponchi101 wrote: Sat Jan 22, 2022 10:36 pm Well. Republicans have zero empathy. They are fairly sociopathic in that aspect. Unless it happens to them, directly, nothing matters.
He's a Democrat FYI, that's why there was a mask mandate in the first place. With few exceptions (Jacksonville is one), bigger cities typically have Democratic mayors.

I think this was a very phrased poorly Tweet honestly after watching the video. The video doesn't draw a correlation between keeping the mandate and his kid having covid. I'm sure it strengthened his resolve, but not sure it's much more than that. The mask mandate in Kansas City schools has been there, Missouri's AG has been out for them.
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Re: Covid-19 Updates & Info

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Thanks for the correction. I assumed KC = GOP.
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Re: Covid-19 Updates & Info

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Like night follows day...
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Re: Covid-19 Updates & Info

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I find myself having the most un-Christian thoughts every time I see something new from him....
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Re: Covid-19 Updates & Info

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Post by dryrunguy »

Here's the latest Situation Report. The last section on shifts in vaccine hesitancy is interesting.

::

GLOBAL VACCINE & TREATMENT ACCESS The COVID-19 pandemic is at a critical stage, and it is dangerous for the world to assume “we are in the endgame,” WHO Director-General Dr. Tedros Adhanom Ghebreyesus warned at the opening of a WHO Executive Board meeting on January 24. The conditions are ideal for new variants to emerge, but the world can end the acute phase of the pandemic this year by achieving the target of vaccinating 70% of each nation’s population and improving testing and surveillance, Dr. Tedros encouraged. Globally, at least 5.6 million people have died of COVID-19 as the pandemic enters its third year, but only about 10% of people in low-income countries have received at least 1 dose of vaccine.

The global vaccine sharing scheme COVAX announced last week that it has delivered 1 billion SARS-CoV-2 vaccine doses to 144 countries, only half of its goal to deliver 2 billion doses by the end of 2021. The scheme was hampered by wealthier nations’ hoarding of the shots, export restrictions, and numerous changes within the organization. Gavi, the Vaccine Alliance and other partners in the initiative last week warned that COVAX is “basically out of money” and needs at least US$5.2 billion in new funding over the next 3 months to support the quick rollout of already-donated doses and to purchase more vaccines. Leading African public health authorities recently called for donated shots to have a shelf life of at least 3 to 6 months to allow countries time to plan distribution and avoid situations where the doses expire. According to the Africa Centres for Disease Control and Prevention (Africa CDC), approximately 0.5% of the 572 million doses delivered to the continent so far have expired before being administered. Efforts continue to increase vaccine manufacturing in Africa. Last week, South African-American businessman Dr. Patrick Soon-Shiong opened a new vaccine plant in Cape Town to address the lack of capacity.

The Africa CDC said it also is in talks with pharmaceutical companies to increase supplies of COVID-19 treatments. Merck and Ridgeback Biotherapeutics, which make the antiviral molnupiravir, last week said they will provide 3 million courses of the drug to UNICEF for use in low- and middle-income countries (LMICs) throughout the first half of this year. In another development, the Medicines Patent Pool announced agreements with 27 generic drug manufacturers in Africa, Asia, and the Middle East to produce low-cost versions of molnupiravir for use by LMICs. The consumer advocacy group Public Citizen sent a letter to Pfizer on January 24, asking the company to commit to reserve at least two-thirds of its annual supply of the COVID-19 treatment Paxlovid for LMICs, to be purchased at lower prices. Public Citizen said it is trying to discourage a repeat of vaccine inequity as newer treatments become available.

The Center for Health Security is hosting a webinar on Thursday, January 27 at 1pm on this topic. Please join us for Protecting U.S. National Security by Increasing Vaccination Globally.

BOOSTER DOSES Several new peer-reviewed studies provide additional evidence that SARS-CoV-2 vaccine booster doses elicit antibody responses that help protect against severe disease from the Omicron variant. Two of the studies were published in the US CDC’s Morbidity and Mortality Weekly Report (MMWR). The first study examined data on hospitalizations and emergency room and urgent care center visits in 10 states from August 2021 to January 2022, spanning both Delta- and Omicron-predominant periods. In that study, researchers found that vaccine effectiveness (VE) of the 2-dose mRNA vaccine regimens dropped around 6 months after the second dose, during both periods. However, VE increased following a third dose of mRNA vaccine during both waves and was highly protective against emergency room and urgent care encounters (94% during Delta and 82% during Omicron) and hospitalization (94% and 90%, respectively). A second study examined incidence and death rates between April and December 2021, again across both Delta- and Omicron-predominant periods, among unvaccinated and fully vaccinated adults with and without booster doses. In 25 US states, individuals who had received a booster dose of mRNA vaccine had the highest protection against SARS-CoV-2 infection across both periods when compared to unvaccinated and vaccinated but unboosted individuals.

Another study, published in the Journal of the American Medical Association (JAMA) and led by CDC researchers, examined data collected from 4,666 COVID-19 testing sites across 49 US states between December 10, 2021, and January 1, 2022. The findings show that individuals who had 3 doses of vaccine were better protected against both Omicron and Delta variants when compared with those who were unvaccinated and with those who received only 2 vaccine doses, although higher odds ratios for Omicron suggest less protection for Omicron than for Delta. Yet another study, published online in The Lancet, funded by the Brazil Ministry of Health, and conducted by researchers from Brazil and the University of Oxford, shows that a third booster dose of the Oxford-AstraZeneca, Pfizer-BioNTech, J&J-Janssen, or Sinovac (CoronaVac) SARS-CoV-2 vaccines induces a significant increase in antibody levels among individuals who previously received 2 doses of the Sinovac vaccine. The researchers note that the most robust responses were seen in those who received heterologous (mixed) boosters, a finding that could be most relevant to older populations.

The studies released by the CDC represent the most comprehensive data to date on the impact of booster doses in the US during the pandemic. The data from these reports also indicate that booster doses of the mRNA vaccines provide the most benefit to adults older than 50 years. However, uptake of booster doses has started to slow since the initial days of the Omicron wave despite advice from public health officials to stay “up to date” on vaccinations and recent evidence showing the boosters help prevent severe disease caused by Omicron. In updated data on breakthrough cases, the CDC notes that in November 2021, unvaccinated adults had 13 times the risk of testing positive for SARS-CoV-2 and 68 times the risk of dying from COVID-19 compared with fully vaccinated adults with booster doses.

VACCINE FOR UNDER-5 CHILDREN Many in the US continue to eagerly wait for the authorization of a SARS-CoV-2 vaccine for children under age 5. White House Chief Medical Advisor Dr. Anthony Fauci said last week he hopes the US FDA will soon authorize a vaccine for the youngest children, perhaps within the next month. More than 250 physicians recently sent a letter to the FDA concerning the issue and suggesting 2 options to expedite the process, such as joint decision making for parents and physicians to immunize children with off-label use of the Pfizer-BioNTech 10 μg dose vaccine formulation or removing the age de-escalation barrier to vaccine approval. The letter also urges the FDA to review and authorize the Moderna vaccine for children aged 6 months to 5 years as soon as data become available showing the vaccine is safe and effective, arguing the Moderna vaccine offers better protection against the Omicron variant and severe disease than other vaccines. Pfizer-BioNTech in December announced their plans to submit data to the FDA on a 3-dose study in the first half of 2022, after initial trials of the 3 μg 2-dose regimen given to 2- to 4-year olds did not produce as much of an immune response as it did in other age groups.

The American Academy of Pediatrics reports that, based on state-level data, the number of pediatric cases during the Omicron surge has drastically risen to nearly 5 times the rate of the peak of last winter’s surge. Parents continue to struggle with efforts to keep their children safe, stuck in limbo between daycare closures and child care crises. According to an analysis from the Center for the Study of Child Care Employment, 110,00 fewer people are working in childcare now than in February 2020. Outside of COVID-19 fears, some parents might take solace knowing that the rates of pediatric hospitalizations for other types of infections fell dramatically during the pandemic in England, including a 94% reduction in influenza-related hospitalizations, 90% reduction in measles-related hospitalizations, and an 82% drop in bronchitis-related hospitalizations in children under 14 years of age from March 1, 2020 to June 30, 2021 compared to March 1, 2017 to February 20, 2020. The researchers at the University of Oxford attribute the decreases to a range of behavioral and societal changes implemented to reduce transmission of SARS-CoV-2 and urge continued monitoring of other infections as COVID-19 mitigation strategies evolve. It is not clear whether similar reductions occurred in the US.

OMICRON-SPECIFIC VACCINES Though current SARS-CoV-2 vaccines continue to offer protection against severe COVID-19 disease and death, vaccine manufacturers are working to update the shots to hopefully provide better protection against the Omicron variant. Pfizer and BioNTech announced today they have begun a study to evaluate a SARS-CoV-2 vaccine based on the Omicron variant among adults aged 18 to 55 years. The study will enroll up to 1,420 healthy adults to test the Omicron-based shot as an initial (third shot) or secondary (fourth shot) booster dose or as primary vaccinations in previously unvaccinated individuals.

According to reporting from STAT News, a senior US FDA official said that if the agency moves to update vaccines to better confront Omicron or other variants, it will likely participate in an internationally coordinated program with other regulatory agencies and the WHO to decide if, when, or how to update the shots. The program could operate in a similar way to the one already in place to decide which strains to include in influenza vaccines, the unnamed official said. Even with Pfizer-BioNTech expecting to apply for authorization of an Omicron-specific vaccine by the end of March, the current surge in cases is already waning in Africa, Europe, and the US, suggesting it could end within or close to that timeframe. And while Omicron might remain the globally predominant strain, it is possible future variants will emerge with potentially very different mutations. Already, scientists are tracking an Omicron subvariant called BA.2, which has some new mutations, including several on the spike protein. The variant is not viewed as a “gamechanger,” but it already accounts for most new cases in India, Sweden, and Denmark and has been detected in the US.

COVID-19 THERAPIES On January 24, the US FDA revised the emergency use authorizations (EUAs) for 2 monoclonal antibody treatments—bamlanivimab and etesevimab (administered together) and REGEN-COV (casirivimab and imdevimab)—to restrict their use to only when a patient is likely to have been infected with or exposed to a variant that is susceptible to these therapies. The treatments have been shown to be highly unlikely to be effective against the Omicron variant of concern (VOC), and because that VOC is currently responsible for more than 99% of COVID-19 cases in the US, “these treatments are not authorized for use in any US states, territories, and jurisdictions at this time,” the FDA said in a statement. As a result, the US Department of Health and Human Services (HHS) has halted distribution of the therapies. However, the therapies could be useful in certain geographic regions or against new variants in the future. The FDA noted other therapies are available and expected to work against Omicron, including the monoclonal antibody sotrovimab, and the antivirals Paxlovid, remdesivir (Veklury), and molnupiravir.

Late last week, the FDA expanded the EUA for the COVID-19 treatment remdesivir to include certain non-hospitalized adults and pediatric patients ages 12 and older with mild-to-moderate disease. Previously, the use of the intravenous antiviral was limited to hospitalized patients. Additionally, the FDA authorized the drug’s use for pediatric patients younger than 12 years of age who weigh at least 3.5 kg but under 40 kg who are at high risk for progression to severe COVID-19, including hospitalization or death. A 3-day course of the drug is recommended as a third option behind the oral antiviral Paxlovid and sotrovimab. A 5-day course of remdesivir is recommended for hospitalized patients who are not on mechanical ventilation or extracorporeal membrane oxygenation (ECMO), while critically ill hospitalized patients should receive a 10-day course.

US VACCINE REQUIREMENTS On January 21, a federal judge in Texas issued a nationwide injunction against US President Joe Biden’s SARS-CoV-2 vaccine requirements for federal government employees, saying the president had exceeded his executive authority in issuing the rule. US District Judge Jeffrey Vincent Brown cited a recent US Supreme Court opinion blocking a different federal rule that would have required employees of companies with 100 or more workers to be vaccinated or submit weekly testing. Notably, the Supreme Court allowed a separate vaccine rule pertaining to workers at medical facilities that receive Medicare or Medicaid funding to remain in force. The US Department of Justice immediately filed notice that it plans to appeal the decision to the US Court of Appeals for the 5th Circuit. The case likely will go to the Supreme Court. At the beginning of December 2021, the Office of Management and Budget said 97.2% of the federal workforce was compliant with the rule, including those who had pending or approved exemptions. The plaintiff in the case, a Nevada-based group called Feds for Medical Freedom, also asked the judge to enjoin the rule applying to federal contractors, but that executive order is already subject to a nationwide injunction. Over the weekend, thousands of anti-vaccination protestors gathered in Washington, DC, for a rally against vaccine mandates.

VACCINE HESITANCY The results of a survey of 1,200 US adults led by researchers from the Ohio State University and published in JAMA Network Open found that vaccine hesitancy has decreased more rapidly among Black individuals than White individuals since December 2020. Hesitancy rates were comparable at the start of the survey, but Black individuals experienced larger increases in intention to vaccinate than White individuals relative to baseline. The belief that vaccines were necessary for protection also increased more among Black individuals than White individuals. The new survey data showing declines in hesitancy among Black individuals suggest there may be other factors to consider, including barriers to access. The study’s discussion notes Kaiser Family Foundation surveys that document the substantial portion of Black individuals who worry about access barriers. For example, 55% of Black individuals (vs 41% of White individuals) are very or somewhat concerned about missing work if the vaccine makes them sick; 37% of Black individuals (vs 24% of White individuals) worry they will have to pay for the vaccine; 23% of Black individuals (vs 16% of White individuals) are concerned about taking time off of work to get vaccinated; and 17% of Black individuals (vs 9% of White individuals) worry about finding transportation to vaccination sites. Though the administration of US President Joe Biden has taken some steps to alleviate such barriers—including paid sick leave and free Uber and Lyft rides to vaccination sites—some people remain unaware of these programs.
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Re: Covid-19 Updates & Info

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Post by dryrunguy »

Here's the latest Situation Report. The big news? It turns out COVID infection likely decreases sperm quality--at least in the short term. This also marks the first time I have seen experts linking long COVID to the need to expand our thinking as to what constitutes long-term disability. I'm surprised it took so long.

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EPI UPDATE The WHO COVID-19 Dashboard reports 357 million cumulative cases and 5.61 million deaths worldwide as of January 26. Global weekly incidence increased again last week, up 11.03% over the previous week. This is the 14th consecutive week of increasing weekly incidence, setting another new record with 22.77 million new cases. The Omicron variant drove the greatest percentage increases in the WHO regions of Eastern Mediterranean (+38.58%), South-East Asia (+36.05%), Europe (+19.29%), and the Western Pacific (+1.26%). Both Africa (-31.04%) and the Americas (-2.01%) experienced declines in weekly incidence.

While there is optimism among some public health experts that the rapid rise and fall of the Omicron surge in some regions could usher in an end to the pandemic, the WHO determined last week that the COVID-19 pandemic continues to constitute a Public Health Emergency of International Concern (PHEIC). Other experts warn that as long as the threat of new variants exists, calls for reaching COVID-19 endemicity are misguided.

Meanwhile, global weekly mortality increased for the third week, up 8.49% from the previous week with 53,935 total deaths. The Pan American Health Organization (PAHO) on January 26 warned that the average number of COVID-19-related deaths is up 37% in the region over the previous week.

Global Vaccination
The WHO reported 9.68 billion cumulative doses of SARS-CoV-2 vaccines administered globally as of January 26. A total of 4.7 billion individuals have received at least 1 dose, and 4.0 billion are fully vaccinated. Analysis from Our World in Data indicates that the overall trend in global daily vaccinations continues to decrease, down to 25.08 million on January 26 from a recent high of 38.88 million on December 23.* Our World in Data estimates that there are 4.78 billion vaccinated individuals worldwide (1+ dose; 60.79% of the global population) and 4.12 billion who are fully vaccinated (52.3% 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
The US CDC is currently reporting 72.3 million cumulative cases of COVID-19 and 870,195 deaths. The US is averaging 627,294 new cases—down from 726,941 on January 20—and 2,246 deaths per day—up from 1,860 one week ago and at the highest level since mid-February 2021.*
*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.

COVID-19 hospitalizations in the US are down 7.7% this week over last, with a 7-day average of 19,640 new hospitalizations per day. The recent surge in current hospitalizations appears to have peaked around January 19, down 1.7% to an average of 142,194 for the week ending January 24. According to analysis from The New York Times, the overall downward trend in hospitalizations belies the reality in some regions, where the number of cases and hospitalizations continue to grow significantly.

US Vaccination
The US has administered 537.2 million cumulative doses of SARS-CoV-2 vaccines. The trend in daily vaccinations continues to decline, down significantly from a recent high of 1.77 million doses per day on December 6 to 760,975 on January 21.*

A total of 251.5 million individuals have received at least 1 vaccine dose, equivalent to 75.8% of the entire US population. Among adults, 87.6% have received at least 1 dose, as well as 25.3 million children under the age of 18. A total of 210.9 million individuals are fully vaccinated**, which corresponds to 63.5% of the total population. Approximately 73.9% of adults are fully vaccinated, as well as 19.9 million children under the age of 18. Since August 13, 85.2 million fully vaccinated individuals have received an additional or booster dose. An estimated 43.5% of fully vaccinated individuals have received a booster, including 63.3% 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.

GLOBAL VACCINE GAP US officials announced on January 26 that the government has shipped a total of 400 million SARS-CoV-2 vaccine doses to 112 countries, part of its efforts to fulfill its pledge to donate 1.2 billion doses. At a briefing, White House COVID-19 Coordinator Jeff Zients noted that the US has donated 4 times more doses than any other country. Still, 5 billion to 6 billion doses are needed in low- and middle-income countries to help protect them against COVID-19, and vaccine access gaps in those areas create fertile grounds for the emergence of new, possibly more dangerous, SARS-CoV-2 variants, the WHO has warned. The divide is stark: about 78% of people in high- and upper-middle-income countries have received at least one dose of vaccine compared with about 10% in low-income nations. According to calculations from the International Monetary Fund (IMF), 86 of 206 countries had immunized less than 40% of their populations as of the end of 2021, far from the fund’s goal of vaccinating 70% of the world’s population in the first half of this year. Experts agree that vaccine inequities led to the emergence of the Omicron variant and warn of future variants if a concerted global effort is not undertaken to manufacture, distribute, and administer more vaccines to prevent the virus from circulating among the unvaccinated. A group of Democratic US lawmakers is calling for the government to immediately provide an additional US$17 billion for global vaccination delivery and infrastructure and to streamline federal efforts to coordinate the nation’s global COVID-19 strategy. Some experts say additional funding could be useful but drumming up international political will is more important. Others warn the next variant—if it is capable of immune evasion—could be like starting from scratch.

US HEALTHCARE UTILIZATION The Omicron variant of concern (VOC) has caused massive surges in COVID-19 cases and, subsequently, in people seeking healthcare. A recent study published in the US CDC’s Morbidity and Mortality Weekly Report (MMWR) examined hospital-associated disease severity markers, including ICU admissions, length of stay, and death. The study found that disease severity, measured by US healthcare utilization, appeared to be lower during the Omicron VOC surge compared to both the Delta VOC surge and the previous winter season. ICU admissions during the beginning of the Omicron surge were 26% lower and 29% lower than during the Delta and winter 2020-2021 surges, respectively. Mean length of hospital stay was also comparatively lower. However, due to the massive number of positive cases, overall staffed hospital bed usage was 7% higher than during Delta and 3% higher than during winter 2020-2021.

The study was not able to directly assess the impact that vaccines had on disease severity markers or hospital stay lengths, but the authors posit that decreased admissions to the ICU and lower overall hospital stays during the Omicron surge can likely be attributed to higher vaccine coverage as well as higher levels of infection-acquired immunity. Supporting this hypothesis, high relative increases in hospital admittance were only observed in children 0- to 4-years-old who are currently not eligible for vaccination. Although people infected with Omicron appeared to require less intensive care at the hospital level, the sheer number of cases and burden on the healthcare system overall required significant resources and resulted in severe strain. The authors state that this analysis “underscores the importance of national emergency preparedness, specifically, hospital surge capacity and the ability to adequately staff local health care systems.”

HEALTHCARE WORKER BURNOUT As the world enters its third year of response to the COVID-19 pandemic, burnout in the global healthcare workforce continues to grow. In the US, a rapid increase in the number of COVID-19 cases due to the Omicron variant of concern (VOC) has led to a record surge of individuals requiring medical attention across healthcare settings. In California, hospitals have canceled operations and other elective procedures and ambulances have experienced backlogs for patient delivery. Healthcare professionals warn that the continued high intensity of care, a limited amount of life-saving countermeasures, and a large number of staff out sick are creating a continuously stressful work environment. Notably, the country has experienced a mass exodus of healthcare workers. In the Southern US, this trend has hit nonprofit safety-net hospitals particularly hard, reducing the capacity of necessary resources for many throughout the region. Earlier this year, the US Department of Health and Human Services (HHS) announced that US$103 million of funding from the American Rescue Plan will be committed to strengthening resilience and addressing burnout in the domestic healthcare workforce. However, STAT reports that another fund meant to support hospitals and clinics during the pandemic has run out of money, after the Biden administration quietly redirected nearly US$7 billion from the fund and used it to buy SARS-CoV-2 vaccines and therapeutics.

Workforce mental health issues are not exclusive to the US. Researchers in Canada analyzed anonymous data from 34,000 physicians working in Ontario. The analysis found a 27% increase in the number of doctors seeking care for burnout or substance misuse in the first year of the pandemic compared with the prior year. Burnout of nurses and other healthcare professionals is a universal issue and has led to wealthier countries recruiting healthcare workers from other less-wealthy countries. This phenomenon has intensified during the Omicron surge, raising many questions about the ethics of the practice.

US VACCINE REQUIREMENTS FOR LARGE EMPLOYERS The US Department of Labor’s Occupational Safety and Health Administration (OSHA) on January 25 withdrew its emergency temporary standard (ETS) that called for employers with 100 or more workers to require their employees to be vaccinated for COVID-19 or undergo regular testing and wear face masks while at work. The withdrawal, which took effect January 26, follows the US Supreme Court’s January 13 opinion that halted enforcement of the rule. In a 6 to 3 decision, the justices concluded that OSHA overstepped its authority in issuing the requirement covering 84 million workers and issued a stay pending a decision from the US Court of Appeals for the Sixth Circuit. Though OSHA withdrew the requirement as an enforceable emergency regulation, the agency said it is maintaining the ETS as a proposed rule. On its website, OSHA stated it is “prioritizing its resources to focus on finalizing a permanent Healthcare Standard” and that it continues to “strongly encourage” workers to be vaccinated.

ISRAEL Israel’s Ministry of Health on January 25 said its vaccine advisory panel has recommended making all adults eligible to receive a fourth dose of SARS-CoV-2 vaccine. If the ministry approves the recommendation, it would be the first country in the world to make a fourth vaccine dose available to all adults. Israel already offers fourth doses to people aged 60 and older, healthcare workers, and people with compromised immune systems. About 600,000 Israelis have already received a fourth dose. Over the weekend, the health ministry shared preliminary data from its own researchers suggesting a fourth dose provides 3 to 5 times as much protection against severe disease in older adults when compared with those in the same age group who had received a booster dose at least 4 months prior. It is not clear when the ministry’s director-general will decide on the panel’s recommendation. Israel is in the midst of a surge in new COVID-19 cases driven by the Omicron variant.

POST-ACUTE SEQUELAE Researchers continue work to learn more about the clinical presentation and duration of persistent symptoms of SARS-CoV-2 infection, known as post-acute sequelae of COVID-19 (PASC) or “long COVID.” Prevalence of the condition—which is characterized by fatigue, shortness of breath, brain fog, stress and anxiety, and other symptoms that last for weeks or years after acute infection—is unknown but estimated to be between 7% to 80% of recovered patients. A study published this week in Cell suggests an association between the development of long COVID and 4 factors, including the presence of certain autoantibodies that mistakenly turn on the body’s own tissues, reactivation of previous Epstein-Barr virus infection, viral load levels in early infection, and having Type 2 diabetes. Because 2 of the factors are virus levels in the blood, the researchers speculate that antiviral administration early in SARS-CoV-2 infection might help lower the risk of longer-lasting symptoms in some people. However, authorized antivirals in the US are in very short supply and difficult to obtain. Additionally, preliminary data from Israel and the UK suggest that people who were fully vaccinated when infected were much less likely to report long COVID symptoms than people who were unvaccinated when infected. Other studies are looking at ways to predict who might be at risk of long COVID and underlying causes of the condition.

In the US, 2 Democratic lawmakers this week sent a letter to the US CDC requesting the agency release data on the number of Americans with long COVID, including information on race, gender, and age. The lawmakers, healthcare providers, and experts nationwide say more data are needed on how many people suffer from long-term symptoms in order to better target resources and provide a more equitable recovery from the pandemic. A recent article published in Nature Medicine examined inequities in understanding and addressing neurological complications of COVID-19 among marginalized US communities, with the authors calling for more equity in COVID-19 research and “a dismantling of structural barriers that perpetuate disparities in clinical care.” Advocates and health experts are pressuring the government for more attention on long COVID, including greater financial assistance, access to disability benefits, and improved healthcare. The US National Institutes of Health (NIH) early last year launched an initiative to identify the causes and means of prevention and treatment of long COVID, but the research is expected to take years. Some say the condition could be contributing to a worker shortage in the US, with a recent analysis from the Brookings Institution estimating that long COVID could account for 15% of the nation’s 10.6 million unfilled jobs.

VACCINATION & FERTILITY New research provides evidence that SARS-CoV-2 vaccination has no negative impact on reproduction—whether conception is achieved through heterosexual intercourse or in vitro fertilization—but men who become infected with the virus appear to have a short-term decline in fertility. In a study published in the American Journal of Epidemiology, researchers from the Boston University School of Public Health found no association between vaccination of males or females with any of the vaccines available in the US—Pfizer-BioNTech, Moderna, or J&J-Janssen—and the likelihood of conception, with fertility rates among female participants with at least 1 dose of vaccine almost identical to rates among unvaccinated female participants. In the same study, researchers report that men who tested positive for SARS-CoV-2 within 60 days of a woman’s menstrual cycle had reduced fertility when compared with men who never tested positive or who tested positive at least 60 days prior to the cycle. Previous research has linked COVID-19 in men to poor sperm quality and other reproductive dysfunction. A separate study, published in Obstetrics & Gynecology, showed that IVF patients who were vaccinated had similar fertilization rates compared with unvaccinated patients after undergoing controlled ovarian hyperstimulation, single frozen-thawed embryo transfer, and other procedures such as egg or mature oocyte retrieval. Additionally, both groups had similar rates of early pregnancy loss. These studies provide further evidence that SARS-CoV-2 vaccination is safe for people who are trying to conceive. The CDC and other medical groups recommend all people trying to become pregnant to get vaccinated.

Separate studies—including one conducted in the US and another in Norway—showed that vaccination can change menstruation cycles, but the impacts are short-lived and small when compared to natural variation. All of the data should be reassuring to pregnant people and those trying to become pregnant as well as the approximately two-thirds of US parents who cite future fertility as a concern when it comes to vaccinating younger children ages 5 to 11. The vaccination rate among this latter cohort remains quite low in the US and the rates vary widely among US states.

OMICRON-SPECIFIC VACCINES Moderna announced on January 26 it has begun a Phase 2 clinical trial testing an Omicron variant-specific booster candidate. The study will evaluate the booster in 2 cohorts of participants: individuals who received the 2-dose primary series of the company’s mRNA vaccine and individuals who received the primary series plus a 50 µg booster dose. Moderna also announced the publication of neutralizing antibody data against the Omicron variant 6 months after receipt of the authorized booster dose. The study, published in the New England Journal of Medicine (NEJM), shows that the authorized 50 µg booster dose increased Omicron neutralizing titers to 20-fold higher than peak Omicron titers post-dose 2. However, 6 months later, Omicron neutralization declined 6.3-fold from peak titers at day 29 post-boost but remained detectable in all participants. Neutralizing titers against Omicron declined faster after the booster than for the wild-type virus.

https://covid19.who.int/
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