Then came Omicron. The new lineage, which first appeared in South Africa last fall, is by far the most transmissible. Some experts described the earlier form of Omicron, the BA.1 sublineage, as the most contagious respiratory virus they’d ever seen, owing in part to key mutations on the spike protein, the part of the virus that helps it grab onto and infect human cells.
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China's New COVID Crisis Could Spawn the Worst Variant Yet - 0 views
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The BA.2 sublineage that soon replaced BA.1 is even worse: potentially 80 percent more contagious than BA.1. There’s also a very rare “recombinant” form of Omicron called XE that combines the qualities of BA.1 and BA.2 and might be 10 percent more transmissible than even BA.2.
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BA.1 and BA.2 shrugged off China’s strict social distancing. Even the most fleeting contact between family members, neighbors and coworkers was enough to ignite a viral firestorm in China starting in January.
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The virus kept spreading. By early April officials were logging an average of around 15,000 new cases a day. A spike in deaths followed. In Hong Kong alone, nearly 9,000 people have died since mid-February. To be clear, that’s a fraction of the infections and deaths that countries with fewer restrictions tallied during the worst of their own COVID surges. What’s so worrying in China is the trend—and the potential for cases, and deaths, to keep going up and up.
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“It could be that we are seeing the resurgences in China, including the emergence and spread of new sub-strains, primarily because the population there never achieved high levels of natural immunity,”
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You can’t build up natural antibodies across a large population if no one is ever exposed to the virus. That’s the downside of total lockdowns
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The antibodies in recovered COVID patients lend strong immunity that, combined with vaccinations across large groups of people, can help blunt the impact of a new lineage. Michael for one said he believes natural immunity is stronger and longer-lasting than immunity resulting from even the best messenger-RNA vaccines.
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“They also used inactivated viruses in their Sinovac and Sinopharm vaccines, which I had expected to be more robust than mRNA vaccines in terms of producing a more diversified immune response that could counter new mutants, et cetera,” Michael said, “but apparently it would seem that this response has waned, making people susceptible again to new strains.”
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even if they are reasonably effective, the vaccines are unevenly distributed in China. The government’s attacks on foreign jabs has had the effect of encouraging anti-vax attitudes, especially among older Chinese who might be less media-savvy than their younger counterparts.
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just half of the most vulnerable age group–over-80s–is fully vaccinated. That plus the lack of natural immunity has left millions of Chinese exposed to aggressive lineages that can punch right through lockdowns.
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. “Any place can be a source of new variants, but those places with low levels of population immunity and unchecked spread of the virus are the most likely,”
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Each individual infection, unchecked by antibodies, tends to produce two mutations every two weeks,
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“What if we had 50 million people pull slot-machine levers simultaneously at the same time?” Moshiri asked. “We would expect at least one person would hit the jackpot pretty quickly. Now, replace the slot machine with ‘clinically-meaningful SARS-CoV-2 mutation,’ and that’s the situation we're in.”
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All that is to say, the longer COVID rates remain high in the world’s most-populous country, the greater the chance that the next major lineage will be Chinese.
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New lineages are inevitable from one country or another, of course. The trick is to slow the rate of mutation so that fresh vaccine formulations, therapies and public-health policies can at least keep pace with major changes in the virus.
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billion people with uneven rates of vaccination by potentially low-quality jabs and very little natural immunity to back up the shots.
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COVID-19 Vaccines Won't Stop All Infections - The Atlantic - 0 views
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Breakthrough infections, which occur when fully vaccinated people are infected by the pathogen that their shots were designed to protect against, are an entirely expected part of any vaccination process. They’re the data points that keep vaccines from reaching 100 percent efficacy in trials; they’re simple proof that no inoculation is a perfect preventative.
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nearly 40 million Americans have received the jabs they need for full immunization. A vanishingly small percentage of those people have gone on to test positive for the coronavirus. The post-shot sicknesses documented so far seem to be mostly mild, reaffirming the idea that inoculations are powerful weapons against serious disease, hospitalization, and death.
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The goal of vaccination isn’t eradication, but a détente in which humans and viruses coexist, with the risk of disease at a tolerable low.
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“Being vaccinated doesn’t mean you are immune. It means you have a better chance of protection.”
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Immunity is not a monolith, and the degree of defense roused by an infection or a vaccine will differ from person to person, even between identical twins. Some people might have underlying conditions that hamstring their immune system’s response to vaccination; others might simply, by chance, churn out fewer or less potent antibodies and T cells that can nip a coronavirus infection in the bud.
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An ideal response to vaccination might create an arsenal of immune molecules and cells that can instantaneously squelch the virus, leaving no time for symptoms to appear. But sometimes that front line of fighters is relatively sparse
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Should the virus make it through, “it becomes a race [against] time,” Ellebedy told me. The pathogen rushes to copy itself, and the immune system recruits more defenders. The longer the tussle drags on, the more likely the disease is to manifest.
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The range of vaccine responses “isn’t a variation of two- to threefold; it’s thousands,”
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dislikes the term breakthrough case, which evokes a barrier walling humans off from disease. “It’s very misleading,” she told me. “It’s like the virus ‘punches’ through our defenses.”
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The number of post-vaccination infections is also contingent on “the ongoing transmission situation,” Omer told me. “It depends on how much people are mixing.”
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Vaccination is actually more like a single variable in a dynamic playing field—a layer of protection, like an umbrella, that might guard better in some situations than others. It could keep a lucky traveler relatively dry in a light drizzle, but in a windy maelstrom that’s whipping heavy droplets every which way, another person might be overwhelmed.
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under many circumstances, vaccines are still best paired with safeguards such as masks and distancing—just as rain boots and jackets would help buffer someone in a storm.
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Even excellent vaccines aren’t foolproof, and they shouldn’t be criticized when they’re not. “We can’t expect it’s going to be perfect, on day one, always,” Borio said.
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The numbers for asymptomatic infections are still crystallizing, but they’re likely to be lower.
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“Whenever someone tests positive, the real question is, are they sick, and how sick are they? That’s a big difference.”
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Efficacy, a figure specific to clinical trials, also doesn’t always translate perfectly to the messiness of the real world, where there’s immense variability in how, when, where, by whom, and to whom shots are administered
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The vaccine’s performance under these conditions is tracked by a separate measure, called effectiveness. Studies rigorously examining vaccine effectiveness are challenging, but early data suggest that the Pfizer-BioNTech and Moderna shots are living up to their initial hype.
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he circumstances of exposure to any version of the coronavirus will also make a difference. If vaccinated people are spending time with groups of unvaccinated people in places where the virus is running rampant, that still raises their chance of getting sick. Large doses of the virus can overwhelm the sturdiest of immune defenses, if given the chance.
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A vaccine with a recorded efficacy of 95 percent, for example, doesn’t give everyone who’s vaccinated a 5 percent chance of getting sick. Not all of those people will even encounter the virus
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The key is how vaccination changes the outcome for those who are meaningfully exposed: Among 100 individuals who might have fallen ill without the vaccine, just five symptomatic cases might appear.
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1 in 4 Americans Don't Want A Vaccine, Putting Herd Immunity At Risk : Shots - Health N... - 0 views
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A recent NPR/Marist poll found that one in four Americans said they would refuse a coronavirus vaccine outright if offered. Another 5% are "undecided" about whether they would get the shot.
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there were still a significant number of people across all ages and demographic groups who claim they will say "no."
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Now some researchers are increasingly worried that this reticence will be enough to prevent the nation from reaching what's known as herd immunity, the point at which the coronavirus can no longer spread easily through the population and transmission peters out.
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"Vaccine hesitancy is a big problem for all of us,"
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Up until now, the nationwide vaccine campaign has seen demand outstrip supply, but Mokdad says he believes that will soon change. By May, he believes, "We will have more vaccines than people willing to take the vaccine."
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The numbers who may refuse the vaccine remain potentially too high to contain a respiratory virus such as SARS-CoV-2, which requires a large segment of the population to be immune.
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But the fall and winter could be a different story. Scarpino says he believes that more contagious variants such as the one first reported in the U.K. will dominate the fall and winter COVID-19 season, raising the herd immunity threshold. Variants with higher transmissibility may require a larger share of the population to be immune before they can be contained.
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"What most of us want is a safe return to something that looks more normal," says Samuel Scarpino, who models the coronavirus outbreak at Northeastern University. "That to me means 80% to 85%, probably, vaccinated."
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And roughly 20% of the population are children under the age of 16, who are not yet eligible to receive a vaccine — making it even more crucial that adults do get vaccinated.
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Nobody knows exactly how large, but based on other diseases, researchers believe it is far above the current 32% of the U.S. population that's gotten at least one shot to date.
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"It's very hard to convince people to take the vaccine in summer, when everything is going good,"
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Scarpino and Mokdad say the problem will not be immediately apparent. Both scientists expect COVID-19 cases to drop over the summer months when a combination of vaccinations and warm weather will dramatically slow the virus down. Mokdad says he thinks the improved conditions will paradoxically make vaccination more difficult.
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Moderate rates of vaccination will prevent a nationwide crisis such as that seen during the winter of 2020 and 2021, he says. But he worries regional outbreaks could still overwhelm hospitals, close schools and force local governments to reinstitute restrictions in different parts of the United States, especially in areas where vaccination rates are low.
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The reasons for saying "no" to a vaccine are often complex.
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"I don't think there's one particular group," says Tara Kirk Sell, a senior scholar at the Johns Hopkins Center for Health Security. "I don't think that it works to classify people who are vaccine hesitant all having the same reason for being vaccine hesitant."
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Koltai says that misinformation is proliferating right now, often tailored to different groups with different grievances
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"You need to speak to these different groups: the minority groups, the Republicans and the other people who feel like they have some distrust in science," she says. Often the best way to do so, she says, is through groups and leaders at a local level who are in favor of vaccination.
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Last week, the Biden administration launched a major initiative to try and encourage vaccination by enlisting faith groups, unions and even NASCAR to promote getting vaccinated. It's the kind of broad, grassroots effort experts say can help.
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The question is, will it be enough? "We need to vaccinate as much as possible right now, stop the circulation of this virus in the U.S. and elsewhere," Mokdad says. "Then we can control it."
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Scientists Race To Develop More Convenient And Potent COVID Vaccines : Shots - Health N... - 0 views
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The three COVID-19 vaccines available in the United States are safe and effective and were made in record time. But they aren't ideal.
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Such a vaccine would be "administered in a single shot, be room temperature stable, work in all demographics and, even pushed beyond that, ideally be self-administered," she says.
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Now, researchers are racing to develop the next generation of COVID-19 vaccines, utilizing a variety of innovative technologies to produce more convenient and more potent options.
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The COVID-19 vaccine that Vaxart is developing is similar to Johnson & Johnson's in that it uses a harmless virus to deliver instructions to cells to make proteins that will prompt an immune response to the coronavirus.
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But instead of putting the delivery virus in a liquid, Vaxart freeze-dries it, turning into a powder that can be formulated into a pill that can be stored at room temperature.
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Another vaccine that could be self-administered is a nasal spray vaccine.
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By contrast, an intranasal vaccine induces two kinds of immunity, Lund says. You still get the systemic protection, she says, "but you will also get immunity directly at the site where you put that vaccine." That makes it harder for the coronavirus to sneak in through the nose.
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Lurie says it's virtually certain the world will face new and dangerous microbes that will necessitate vaccines that are "safe and effective, fast, easy to use, preferably a single dose."
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Another possible improvement is the way the spike protein is packaged for delivery in a vaccine.
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The immune system of the person receiving the vaccine will react as if it has encountered the real virus when actually it has encountered a harmless mimic. That's the whole trick behind vaccines — getting the body's immune system ready if the real thing comes along.
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He says there's some evidence that starting with one kind of vaccine and then switching to another may give better immunity than a single vaccine could do on its own.
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In the end, among the most important qualities a new vaccine should have are that it should be able to be made and modified quickly in response to variants, as well as be distributed quickly.
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One way of doing that is to modify something called the spike protein, which prompts the immune response to the coronavirus.
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That way, she says, "when the next one comes, we're much closer to the starting gate than we even were for this one."
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U.K. Delays Second Covid-19 Vaccine Dose as Europe Ponders How to Speed Up Immunization... - 0 views
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The U.K. will focus on giving as many people as possible a first dose of a coronavirus vaccine, even if this delays administering a second one, the government said Tuesday, despite a lack of data about the extent of the immunity conferred by a single dose.
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A vaccine made by Pfizer Inc. and BioNTech SE was the first to be authorized in the West. It is now being unrolled globally after emergency authorizations by various regulators on the basis of a successful monthslong trial that involved giving two shots to more than 20,000 volunteers. The second injection was administered 21 days after the first.
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While the trial data shows that the vaccine conferred immunity to over 50% of the participants after the first dose, marketing only one shot would require a new study in which only one dose would be administered to another set of volunteers, said BioNTech Chief Executive Uğur Şahin.
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A vaccine developed by Moderna Inc., which was authorized in the U.S. and could be given a green light by the European Union regulator in January, also consists of two doses. A third vaccine, developed by Oxford University and AstraZeneca PLC and authorized by the U.K. Wednesday, similarly has two doses.
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Most scientists agree that well over 60% of a population would need to be immunized to achieve herd immunity, in which enough people are immune, either through vaccination or by contracting the disease, to stop the spread of a pathogen.
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Pierre Van Damme, a senior member of the task force, said Monday that using only one shot would allow for the vaccination of the majority of Belgium’s 11.5 million inhabitants before the summer. A government spokesman said a decision would be made in the next two weeks
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Can You Get Covid-19 Twice? - WSJ - 0 views
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More than 160 South Koreans tested positive a second time for the novel coronavirus last month, weeks after being discharged from medical supervision. Some symptom-free Americans have been barred from donating their blood plasma to help treat others because they are still testing positive.
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The revelations are generating concern that people who have had Covid-19 are getting infected anew—something scientists say current evidence doesn’t support.
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Here is what we know, and don’t know, about the possibility of becoming sick with the virus more than once.
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ost scientists say that people who have had Covid-19 gain some immunity to the virus that causes it. What they don’t know is whether that protection lasts a few months, a few years or a lifetime.
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The immune system wards off infections by producing antibodies that fight invaders. A range of hereditary and environmental factors, including diet and sleep patterns, typically affect the strength and longevity of those defenses.
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Immunity also depends on the pathogen. For example, infection by the virus that causes measles confers lifelong immunity. Others, like the influenza virus, can mutate so rapidly that protective antibodies might not recognize them during a reinfection.
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The novel coronavirus mutates more slowly than the influenza virus. That gives researchers hope that any natural immunity, or vaccine, would offer more lasting protection. Even if someone gets sick again, researchers believe a second infection might be milder than the first.
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Data are scant, but preliminary research shows antibodies can emerge within days or several weeks of the onset of symptoms. A study involving 34 hospitalized cases in China found that two patients, both in their 80s, produced antibodies within three days of symptom onset. The rest produced them two weeks after symptoms first surfaced.
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A group of Chinese researchers reported in March that they had infected four rhesus macaques, allowed them to recover and then tried to reinfect two of them with the same strain of the virus. Neither became sick again.
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Then why are some people testing positive again? South Korean health officials are refraining from labeling them as “reinfections.” Korean doctors involved in a continuing government review believe that those patients likely harbored low levels of the virus that diagnostic polymerase chain reaction, or PCR, tests failed to pick up. In later stages of the disease, the virus settles into the lungs where it can elude detection. The virus, they say, hadn’t been fully cleared from the body.
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ow do I know I’ve fully recovered? Clinicians have mixed views on what constitutes recovery because long-term data aren’t yet available. Guidelines vary across the globe, and even within countries. In a peer-reviewed study published last month, researchers in Hong Kong detected the virus in the feces of Covid-19 survivors even as their respiratory samples tested negative. Viral fragments can linger in the body after symptoms disappear, but it doesn’t mean that a person is infectious, or that the disease will make a comeback.
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Who Is Protected Against Monkeypox? - The New York Times - 0 views
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Older people who received smallpox vaccinations may yet have some immunity, researchers say. Healthy children and adults generally do not become severely ill.
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The answer is reassuring. Most children and adults with healthy immune systems are likely to dodge severe illness, experts said in interviews. But there are two high-risk groups.
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One comprises infants younger than six months.
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“We can’t guarantee that a person who was vaccinated against smallpox is still going to be protected against monkeypox,” Dr. Fauci said.
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In the United States, routine immunization for smallpox ceased in 1972. The military continued its vaccination program until 1991 as a precaution against a bioterrorism attack.
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And many older adults, the group most likely to succumb to the monkeypox virus, are at least somewhat protected by decades-old smallpox vaccinations, studies suggest.
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Monkeypox takes up to 12 days to cause symptoms, giving doctors a window of at least five days after exposure to vaccinate and forestall disease. (The approach, called post-exposure prophylaxis, is not an option for Covid patients because the coronavirus can start to ravage the body just a couple days after exposure.)
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The agency is working to expand that capacity, she said, adding: “We’ve been preparing for this type of outbreak for decades.”
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Each pustule contains live virus, and a ruptured blister can contaminate bed linens and other items, putting close contacts at risk. Infected people should also be very careful about rubbing their eyes because the virus can destroy sight.
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“We’re lucky to have vaccines and therapeutics — things that can mitigate all that,” said Anne Rimoin, an epidemiologist at the University of California, Los Angeles, who has studied monkeypox in Africa. “We do have the ability to stop this virus.”
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In the United States, the Centers for Disease Control and Prevention is tracking nine cases in seven states, not all of which have a history of travel to countries where monkeypox is endemic. That suggests that there may already be some level of community transmission, Dr. Rochelle Walensky, the agency’s director, told reporters on Thursday.
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A majority of those infected currently are men under 50, and many identify as gay or bisexual, which may reflect the outbreak’s possible origins at a Gay Pride event in the Canary Islands. (The outbreak could just as easily have started among heterosexual people at a large event, experts said.)
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No deaths have been reported. But experts are particularly concerned about close contacts who are children, older adults or who have weak immune systems for other reasons.
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“Until we know more, we will be using available vaccine stocks for people who’ve had close contact with known cases, and people at highest risk for exposure through their jobs, like health care workers treating monkeypox patients,” he said.
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Many of the most vulnerable groups may already be protected. In one study, Dr. Slifka and his colleagues drew blood from 306 vaccinated volunteers, some of whom had been immunized decades earlier, including one who had been immunized 75 years before. Most of them maintained high levels of antibodies to smallpox.
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“We wouldn’t want to take the chance that somebody was left unprotected,” she said.
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Laboratory evidence of antibodies does not prove that smallpox vaccination can protect against monkeypox. But answering that question would require that study participants be deliberately infected with smallpox or a related virus, an obviously unethical experiment.
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The other three vaccinated individuals had no symptoms at all. “They didn’t even know they had been infected,” Dr. Slifka said.
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The eradication of smallpox, while one of the greatest achievements in public health, has left populations vulnerable to the virus and to its cousins.
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“If monkeypox were to establish itself in a wildlife reservoir outside of Africa, the public health setback would be enormous,” Dr. Rimoin said. “That, I think, is a legitimate concern.”
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I'm an epidemiologist. When I heard about Britain's 'herd immunity' coronavirus plan, I... - 0 views
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My colleagues here in the US, even as they are reeling from the stumbling response of the Donald Trump administration to the crisis, assumed that reports of the UK policy were satire – an example of the wry humour for which the country is famed. But they are all too real.
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The stated aim has been to achieve “herd immunity” in order to manage the outbreak and prevent a catastrophic “second wave” next winter
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the reasoning goes that even though in a perfect world we’d not want anyone to take the risk of infection, generating immunity in younger people is a way of protecting the population as a whole.
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We talk about vaccines generating herd immunity, so why is this different? Because this is not a vaccine. This is an actual pandemic that will make a very large number of people sick, and some of them will die
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Even though the mortality rate is likely quite low, a small fraction of a very large number is still a large number.
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There might well be a second wave, I honestly don’t know. But vulnerable people should not be exposed to a virus right now in the service of a hypothetical future
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This virus is capable of shutting down countries. You should not want to be the next after Wuhan, Iran, Italy or Spain. In those places, the healthcare systems have broken down. In Italy, the choices of whom to save and whom to allow to die are real
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You should instead look to the example of South Korea, which, through a combination of intense surveillance and social distancing, appears to have gained some semblance of control over the virus. We can learn from South Korea, Singapore, Hong Kong and Taiwan, all of which have so far done a good job mitigating the worst outcomes despite having reported cases early in the pandemic, and in the case of South Korea, suffering a substantial outbreak.
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The UK should not be trying to create herd immunity, that will take care of itself. Policy should be directed at slowing the outbreak to a (more) manageable rate. What this looks like is strong social distancing.
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If you hear any talking head on TV explain that kids don’t get sick, remember that doesn’t mean kids cannot be infected and transmit. It’s probably a good idea to hold off on visits to Nana and Grandpa.
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The most fundamental function of a government is to keep its people safe. It is from this that it derives its authority, the confidence of the people and its legitimacy
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Nobody should be under the illusion that this is something that can be dodged through somehow manipulating a virus that we are only beginning to understand. This will not pass you by; this is not a tornado, it is a hurricane.
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Don’t panic, but do prepare. If your government won’t help you, do it yourself.
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Opinion | The Covid-19 Pandemic Ends With Exponential Decay - The New York Times - 0 views
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Reaching herd immunity is a key goal. It drives cases toward zero by slowing the spread of the virus through a combination of vaccination and infection-acquired immunity to maintain exponential decay — even as society resumes normal activities.
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But contrary to popular belief, reaching herd immunity doesn’t prevent all outbreaks, at least not initially. It simply means so few people are susceptible to infections that any outbreaks that do happen tend to be snuffed out and case counts decline. Over time, outbreaks themselves become less and less common.
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It is possible to bring Covid-19 case numbers down quickly via exponential decay even before vaccination rates reach herd immunity. We just need to keep transmission rates below the tipping point between exponential growth and exponential decay: where every person with Covid-19 infects fewer than one other person, on average
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Every single thing people can do to slow transmission helps — including wearing masks, getting tested and avoiding crowded indoor spaces — especially given concerns about current and future variants, since it could be what gets us past the threshold into exponential decay.
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As more and more people get vaccinated, people can gradually ease precautions while cases continue to decline. Keeping cases down gets easier over time until — and this is the beauty of vaccine-driven herd immunity — it’s almost effortless, once enough people are vaccinated, to keep cases sustainably low. That’s the power of exponential decay.
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US coronavirus: America is at a crossroads in this pandemic as Covid-19 deaths near 500... - 0 views
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On the brink of a devastating milestone -- 500,000 US Covid-19 deaths -- the US is at a crossroads in the course of this pandemic.
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And while vaccinations slowly increase, some Americans say they won't get a Covid-19 vaccine -- hurting the chances of herd immunity and hindering a return to normal life.
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More than 43.6 million Americans have received at least one dose of their two-dose vaccines, according to the US Centers for Disease Control and Prevention. close dialogCovid-19Your local resource.Set your location and log in to find local resources and information on Covid-19 in your area.Please enter aboveSet Locationclose dialog/* effects for .bx-campaign-1191325 *//* custom css .bx-campaign-1191325 *//* custom css from creative 50769 */.bx-custom.bx-campaign-1191325 .bx-row-validation .bx-input {border-color: white !important;border-width: 1px !important;background-color: white !important;box-shadow: 0px 2px 8px 1px rgba(0,0,0,0.12) !important;}.bx-custom.bx-campaign-1191325 .bx-row-validation .bx-vtext { color: #e53841 !important; font-size: 11px !important; position: absolute !important; bottom: -1.8em !important;} @media screen and (max-width:736px) { .bx-custom.bx-campaign-1191325 .bx-row-validation .bx-vtext {font-size: 10px !important; }}.bx-custom.bx-campaign-1191325 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About 18.8 million have been fully vaccinated. That's about 5.7% of the US population -- far less than the estimated 70% to 85% of Americans who would need to be immune to reach herd immunity.
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To speed up vaccinations, some experts have suggested delaying second vaccine doses to get more first doses into people's arms.
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Both vaccines on the US market -- developed by Pfizer-BioNTech and Moderna -- require two doses, the second of which are intended to be administered 21 days and 28 days after the first, respectively.
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Nationwide, the rates of new Covid-19 cases, hospitalizations and deaths are declining.The number of patients hospitalized with Covid-19 has fallen for the 40th day in a row, according to the COVID Tracking Project.
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Fauci hopes that doesn't happen, he said, adding it's "possible" people may be wearing masks in 2022.
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And daily new cases have dropped 23% over the same time period, according to Johns Hopkins. (But testing is also down by 17%, according to the COVID Tracking Project.)
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About 1,700 cases of variant strains first spotted in the UK, South Africa and Brazil have been reported in the US, according to the Centers for Disease Control and Prevention.
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Experts with the University of Washington's Institute for Health Metrics and Evaluation said over the weekend that while the B.1.1.7 strain likely accounts for less than 20% of current infections in the US, that number will likely soar to 80% by late April.
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"Managing the epidemic in the next four months depends critically on scaling up vaccination, trying to increase the fraction of adults willing to be vaccinated above three-quarters, and strongly encouraging continued mask use and avoiding situations where transmission is likely, such as indoor dining, going to bars, or indoor gatherings with individuals outside the household," the team wrote.
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"With new, more contagious variants of the virus circulating throughout the U.S., now is not the time to let your guard down and scale back on the measures that we know will work to prevent further illness and deaths -- wearing masks, practicing physical distancing, and washing hands," a joint statement said.
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Daily deaths have declined 24% this past week compared to the previous week
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"I do think we're looking at some new normals. I think the handshake, for example, is probably going away," she said."I do think masks in the cough/cold/flu season in the winter months would make a lot of sense. That clearly, really insulated the Southeast Asian countries from some of the worst of this, understanding the importance of wearing masks."
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"It's estimated that about 70% of Americans must be vaccinated before we get to herd immunity through vaccination," CNN medical analyst Dr. Leana Wen said. "That's the point where enough people have the immune protection that the virus won't spread anymore."
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"The evidence was pretty compelling by last March or April that uniform wearing of masks would reduce transmission of this disease," National Institutes of Health Director Dr. Francis Collins told Axios on HBO on Sunday.
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"A mask is nothing more than a life-saving medical device, and yet it got categorized in all sorts of other ways that were not factual, not scientific and frankly, dangerous," he added. "And I think you can make a case that tens of thousands of people died as a result."
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shared by carolinehayter on 17 Dec 20
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Some Vials Of COVID-19 Vaccine Contain Extra Doses, Expanding Supply, FDA Says : Corona... - 0 views
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Science politics us trump culture policy pandemic vaccine
shared by carolinehayter on 17 Dec 20
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The Food and Drug Administration says that some of the vials of Pfizer-BioNTech COVID-19 vaccine being distributed throughout the U.S. contain extra doses and the agency is encouraging hospitals and clinics to use the additional shots to speed up the nationwide immunization campaign.
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The agency issued the guidance Wednesday after health care workers reported throwing out the excess vaccine, fearing it would be against the rules to use it. "At this time, given the public health emergency, FDA is advising that it is acceptable to use every full dose obtainable
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As health care workers prepared for the vaccine's arrival, they expected to receive vials holding five doses. That left many surprised by the overfilled containers.
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Permission to use the additional portions means the limited supply could increase by up to 40%, Politico reported.
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Leading health experts say that even if all goes well, the vaccine will not be available to the general public until the end of March or beginning of April.
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Inoculations began in the U.S. on Monday with health care workers and the elderly being the first in line to get it.
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Meanwhile, The New York Times reported that a second allotment of the Pfizer-BioNTech vaccine may not be available to the U.S. until next June, given the combination of short supply and global demand.
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"It's pretty unusual to have a full extra dose or more though — but it does seem to be there!" Erin Fox, a pharmacist at University of Utah who monitors drug shortages, told the news outlet.
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However, because there are no preservatives in the vaccines, partial doses from separate vials shouldn't be combined.
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There are conflicting reports about when the U.S. is poised to receive another batch of the medicine from Pfizer.
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A vaccine developed by Moderna is expected to get emergency use authorization from the FDA as early as this week. Clinical data shows it is nearly as effective as the Pfizer injections.
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Dr. Anthony Fauci, the nation's senior official for infectious diseases, told NPR this week that half of all Americans would need to be vaccinated before seeing an impact on the spread of the virus, and that 75% to 85% of the population would need to be vaccinated to create herd immunity. He predicted the U.S. could begin to see early stages of herd immunity by late spring or summer.
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Never Had Covid? Omicron BA.4 and BA.5 May End Your Luck - Bloomberg - 0 views
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Covid virginity is becoming more special now that it describes a shrinking minority. The lucky few, like weight-loss gurus, are only too happy to share their secrets to success.
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Some sound quite reasonable, such as virologist Angela Rasmussen, who tweeted that despite resuming travel to scientific conferences, she’s remained uninfected by wearing high quality masks when warranted, skipping the hotel gym, eating outdoors and walking instead of cabbing if possible.
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Others are more extreme, such as the expert who Tweeted that, among other measures, he sealed his N95 tightly on his face for the entire trip from the U.S. to Australia. He never removed it even to take a sip of water.
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My high level of vaccine antibodies probably explains my success more than my behavior. I make some effort to avoid Covid, but have been far from perfect. And I’ve been potentially exposed at least twice: Once last December, when someone at a small holiday gathering I’d attended developed symptoms the next day, and more recently, when I shared a large indoor space with two people who later tested positive. But according to my lab work, I’ve never had even a silent infection.
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But one piece of advice almost no one is giving? Be lucky. Pediatrician Neil Stone says that there’s no “secret” for staying Covid-19 free because there’s just too much luck involved.
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As for me, I have some data that can, to an extent, quantify and explain my own good luck in avoiding Covid so far. I’m participating in a study on immunity which allowed me to learn that my blood still carries loads of antibodies induced by my vaccine and December booster shot, and no signs of any prior infection. Not everyone’s antibodies wane at the same rate, and in some people, the antibodies don’t wane much at all. (At some point it should become routine to collect this information to help people decide whether to get additional booster shots.)
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It’s possible I was protected by my high antibodies, or that some quirk of air flow meant I never breathed in enough virus to get sick. Or perhaps I benefited from a different form of luck. There’s another facet to immunity called the innate immune system, which acts as a first line of defense and sometimes knocks out a virus or other pathogen before it replicates enough to elicit the production of antibodies. Good innate immunity might help explain something many of us have experienced — not getting a cold or flu even when sleeping in the same bed with the sick person through the whole illness.
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Stress, diet, general health and even sunlight might all affect innate immunity. So could other factors. There’s so much we still don’t know about the immune system. And that’s one reason we talk about “luck.”
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understanding how the luck works could help other people avoid Covid, whether for the first time or for the second or third time. Taking a closer look at what passed for luck helped researchers like Gary Taubes discover that public health had obesity all wrong, and the standard high carb/low fat diets were causing people to gain weight.
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Opinion | Could 'Innate Immunology' Save Us From the Coronavirus? - The New York Times - 0 views
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n a 2018 study, Dr. Netea and his colleagues vaccinated volunteers with either B.C.G. or a placebo and then infected them all with a harmless version of the yellow fever virus. Those who had been given B.C.G. were better able to fight off yellow fever.
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Research by Dr. Netea and others shows that live vaccines train the body’s immune system by initiating changes in some stem cells. Among other things, the vaccines initiate the creation of tiny marks that help cells turn on genes involved in immune protection against multiple pathogens.
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This area of innate immunity “is one of the hottest areas in fundamental immunology today,”
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Dr. Gallo is leading the charge to test the O.P.V. live polio vaccine as a treatment for coronavirus.
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B.C.G. may actually be able to ramp up the body’s initial immune response in ways that reduce the amount of virus in the body, such that an inflammatory response never occurs.
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Opinion | As pediatricians, we say please don't use precious coronavirus vaccines on he... - 0 views
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As vaccination programs work their way through younger cohorts, the number of people needed to be vaccinated to prevent a death rapidly climbs. By the time young children are being considered, there are almost no deaths to prevent and only very small numbers of hospitalizations.
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At that point, the rationale behind mass immunization shifts increasingly toward indirect protection, or herd immunity. With growing evidence that coronavirus vaccines prevent asymptomatic infection and onward transmission, an argument used to justify immunizing young children is that it would mean reaching herd immunity faster.
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That approach can be useful with influenza or pneumonia, because children play a large role in their transmission. But young children do not appear to be important transmitters of covid. Population-based studies in Iceland showed that children younger than 10 were far less likely to be infected with the virus or transmit it to others. Similar results were found in Israel.
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Consider that in Israel, more than 60 percent of the adult population had received the Pfizer vaccine by last month, and covid had been virtually eradicated. There was a 98 percent reduction of covid in all age groups, yet no child under age 16 had been vaccinated.
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Much discussion has focused on the percentage of individuals needed to be vaccinated to reach herd immunity, with most estimates in the range of 60 to 70 percent. Instead, the focus should be on those who are the most likely to transmit the virus; in the United States, with much of the elderly population vaccinated, that means young adults.
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The universal vaccination of healthy children 2 to 11 years old simply shouldn’t be a priority and may ultimately prove unnecessary.
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shared by Javier E on 31 Jan 12
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Gains in DNA Are Speeding Research Into Human Origins - NYTimes.com - 0 views
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dna research human origins neanderthal denisovan interbreeding
shared by Javier E on 31 Jan 12
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genetic analysis shows, modern humans encountered and bred with at least two groups of ancient humans in relatively recent times: the Neanderthals, who lived in Europe and Asia, dying out roughly 30,000 years ago, and a mysterious group known as the Denisovans, who lived in Asia and most likely vanished around the same time.
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Their DNA lives on in us even though they are extinct. “In a sense, we are a hybrid species,
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A third group of extinct humans, Homo floresiensis, nicknamed “the hobbits” because they were so small, also walked the earth until about 17,000 years ago. It is not known whether modern humans bred with them because the hot, humid climate of the Indonesian island of Flores, where their remains were found, impairs the preservation of DNA
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Comparing genomes, scientists concluded that today’s humans outside Africa carry an average of 2.5 percent Neanderthal DNA, and that people from parts of Oceania also carry about 5 percent Denisovan DNA. A study published in November found that Southeast Asians carry about 1 percent Denisovan DNA in addition to their Neanderthal genes.
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as few as six couplings all those tens of thousands of years ago might have led to the current level of ancient immune alleles.
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This means that our modern era, since H. floresiensis died out, is the only time in the four-million-year human history that just one type of human has been alive,
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Were they romantic couplings? More likely they were aggressive acts between competing human groups, Dr. Stringer said. For a model, he pointed to modern hunter-gatherer groups that display aggressive behavior among tribes.
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The value of the interbreeding shows up in the immune system, Dr. Parham’s analysis suggests. The Neanderthals and Denisovans had lived in Europe and Asia for many thousands of years before modern humans showed up and had developed ways to fight the diseases there
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When modern humans mated with them, they got an injection of helpful genetic immune material, so useful that it remains in the genome today. This suggests that modern humans needed the archaic DNA to survive. The downside of archaic immune material is that it may be responsible for autoimmune diseases like diabetes, arthritis and multiple sclerosis, Dr. Parham said, stressing that these are preliminary results.
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little is known about the Denisovans — the only remains so far are the pinky bone and the tooth, and there are no artifacts like tools. Dr. Reich and others suggest that they were once scattered widely across Asia, from the cold northern cave to the tropical south. The evidence is that modern populations in Oceania, including aboriginal Australians, carry Denisovan genes.
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How to evaluate and eventually ease coronavirus restrictions - The Washington Post - 0 views
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restrictions pandemic strategies trump policy response
shared by Javier E on 29 Mar 20
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In recent days, epidemiologists and infectious disease specialists, as well as former top agency officials, have rushed to put out their own plans — by publishing preprint papers online and sharing ideas on Twitter and in op-eds
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a consensus of sorts has begun to coalesce around several key ingredients for an American strategy to move forward while minimizing human and economic casualties. They include mounting a large-scale contact tracing effort, widespread testing, building up health care capacity before easing restrictions, making future quarantines more targeted, and allowing those who have recovered and have some immunity to go back to work.
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While overall the peak of the epidemic may occur in late April or early May, the timing may be different in different states.
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The plan was published Sunday by the American Enterprise Institute. Its lead author — Scott Gottlieb, former Food and Drug Administration commissioner in the Trump administration
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“The goal is to outline a plan that will allow a gradual return to a more normal way of life without increasing the risk” that the epidemic will resurge.
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Most economists and health experts say there is no way to restart the economy without addressing the underlying problem of the coronavirus. As long as the pandemic continues to spread, the markets will be in turmoil and any businesses will struggle to stay open, they say.
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instead of giving false reassurances and deadlines, the White House should tell people the hard truth about the current situation and a coherent strategy they can work toward. “The social distancing, being stuck at home, the deaths we’re going to be seeing. People want to know what it’s for. That there’s a plan.”
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the road map Gottlieb’s group outlined stresses the need to move away from the current decentralized system and “toward more coordinated execution of response.”
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The plan divides coming months into four phases and sets “triggers” for states to move from one phase to the next.
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The latest proposal is a 19-page plan with a step-by-step timeline, with clear benchmarks states and regions would need to meet to safely move forward to the next step
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With most of the nation now in phase one of the epidemic, the goal should be a sharp increase in hospital critical care beds and an increase of testing to 750,000 people a week to track the epidemic — a number Gottlieb said could be achieved in the next week or two.
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For a state to move to phase two, it should see a sustained reduction in new cases for at least 14 days, and its hospitals need to be able to provide care without being overwhelmed.
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“The reason we set it at 14 days is that’s the incubation period of the virus,” said Rivers of Johns Hopkins. “That way you know the downward trend is certain and not because of a holiday or blip or some other delay in reported cases.”
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States that have moved into phase two would begin gradually lifting social distancing measures and opening schools and businesses, while increasing surveillance.
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The key goals thereafter would be accelerating the development of new treatments and deploying tests to determine who has recovered from infection with some immunity and could rejoin the workforce.
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Phase 3 occurs when the nation has a vaccine or drugs to treat covid-19 in place and the government launches mass vaccinations
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For weeks, World Health Organization officials have stressed such lockdowns are only helpful for slowing down the virus and buying time to deploy more targeted and comprehensive measures, which the U.S. has not yet done.
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Trump has repeatedly returned to strategies of bans and movement restriction
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Phase 4 involves rebuilding the nation’s capacity to deal with the next pandemic by building up its scientific and public health infrastructure.
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Mike Ryan, WHO head of emergency programs, recently urged countries to focus on finding and isolating infected people and their contacts. “It’s not just about physical distancing, it’s not just about locking down,”
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Many experts’ recent proposals for a U.S. strategy have similar stressed the importance of large-scale contact tracing — because it was a cornerstone for successful efforts like South Korea and Singapore.
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as countries have shown success with it against this coronavirus, that thinking has changed.
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such contact tracing is “impractical now in many places but more practical once case numbers have been reduced and testing scaled up” and “could alleviate the need for stringent social distancing to maintain control of the epidemic.”
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Rapidly building up that capacity — either with community volunteers or short-term hires — will be crucial in coming months, said Rivers of Johns Hopkins. “If you build capacity up and bring cases down, it starts looking a lot more possible.”
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Many proposals tackle the problem of the tanking economy.
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Gottlieb-Johns Hopkins plan, for example, calls for widespread use of blood tests to identify people who have had the infection and now are immune — called serology testing
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People who are immune could return to work, or take on high-risk roles in the health care system and help people, especially the elderly, who are still quarantined at home.
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Such serology tests have not been deployed before like this on such a large scale
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during Ebola outbreaks in Africa, survivors were often the ones who provided care, watched over the children of sick patients and buried the dead.
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One challenge unaddressed by most proposals and op-eds, however, is how to get such detailed plans adopted by the White House, whose response has weighed down by infighting and unclear leadership ping-ponging in recent weeks among Trump, Pence and health advisers like Anthony S. Fauci and Deborah Birx and others.
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Health officials and scientists involved in the federal response, especially from the Centers for Disease Control and Prevention, have fought to be heard while straining to avoid offending Trump, who bristles at being publicly contradicted, undercut or overshadowed by praise for ideas or people beside himself, according to people who spoke on the condition of anonymity about sensitive deliberations.
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On Thursday, Trump unveiled a plan of his own, though scarce in detail. He said he planned to help communities ease their restrictions and reopen for business by using on “robust” surveillance and categorizing counties across America into three “risk levels” — low, medium and high. More details are likely in coming days, White House officials said.
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With Broad, Random Tests for Antibodies, Germany Seeks Path Out of Lockdown - The New Y... - 0 views
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Mr. Germann and his girlfriend joined 3,000 households chosen at random in Munich for an ambitious study whose central aim is to understand how many people — even those with no symptoms — have already had the virus, a key variable to make decisions about public life in a pandemic.
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The study is part of an aggressive approach to combat the virus in a comprehensive way that has made Germany a leader among Western nations figuring out how to control the contagion while returning to something resembling normal life.
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Other nations, including the United States, are still struggling to test for infections. But Germany is doing that and more. It is aiming to sample the entire population for antibodies in coming months, hoping to gain valuable insight into how deeply the virus has penetrated the society at large, how deadly it really is, and whether immunity might be developing.
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The government hopes to use the findings to unravel a riddle that will allow Germany to move securely into the next phase of the pandemic: Which of the far-reaching social and economic restrictions that have slowed the virus are most effective and which can be safely lifted?
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Other countries like Iceland and South Korea have tested broadly for infections, or combined testing with digital tracking to undercut the spread of the virus. But even the best laid plans can go awry; Singapore attempted to reopen only to have the virus re-emerge.
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President Trump is in a hurry to restart the economy in an election year, but experts warn that much wider testing is needed to open societies safely.
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Both Britain and the United States, where some of the first tests were flawed, virtually forfeited the notion of widespread testing early in their outbreaks and have since had to ration tests in places as they scramble to catch up
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Germany, which produces most of its own high-quality test kits, is already testing on a greater scale than most — 120,000 a day and growing in a nation of 83 million.
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Merkel, a trained scientist, said this week that the aim was nothing less than tracing “every infection chain.”
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Every 10 people infected with the virus now pass it to seven others — a sharp decline in the infection rate for a virus that has spread exponentially.
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The generosity and solidarity on such striking display inside of Europe’s largest and richest economy have been missing in Germany’s response to poorer European nations in the south, which were hit hardest by the virus.
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the chancellor’s mixture of calm reassurance and clear-eyed realism — as well as her ability to understand the science and explain it to citizens — has been widely praised and encouraged Germans to follow social distancing rules. Her approval ratings are now higher than 80 percent.
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That broad confidence in government has given Germany a tremendous advantage. It is much of the reason a knock on the door by a police officer and strangers dressed like aliens asking for blood can engender good will rather than alarm
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“We are leading the thinking of what to do next.”
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Its most ambitious project, aiming to test a nationwide random sample of 15,000 people across the country, is scheduled to begin next month.
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“In the free world, Germany is the first country looking into the future,”
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Nationally, the Robert Koch Institute, the government’s central scientific institution in the field of biomedicine, is testing 5,000 samples from blood banks across the country every two weeks and 2,000 people in four hot spots who are farther along in the cycle of the disease.
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In Gangelt, a small town of about 12,000 in northwest Germany, tests of a first group of 500 residents found that 14 percent had antibodies to the virus. Another 2 percent tested positive for the coronavirus, raising hopes that about 15 percent of the local population may already have some degree of immunity.
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“The process toward reaching herd immunity has begun,”
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t may hold valuable insights for places that lag behind as the pandemic runs its course.
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The mortality rate in the town, for example, turned out to be 0.37 percent, much lower than the national rate of 2.9 percent which is calculated based only on detected infections.
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“We are at a crossroads,” said Mr. Hoelscher, the professor. “Are we going the route of loosening more and increasing immunity in the summer to slow the spread of this in the winter and gain more freedom to live public life? Or are we going to try to minimize transmissions until we have a vaccine?
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“This is a question for politicians, not for scientists,” he added. “But politicians need the data to make an informed risk assessment.”
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“I thought to myself if we’re going into lockdown, we need to start working on an exit strategy now,”
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The next day, he said he wrote a short pitch to the Bavarian government. Six hours later, he had the green light. It took another three weeks until the test kits had arrived, a new lab was opened and teams of medics started fanning out across the city.
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Six days after they first rung his doorbell, a doctor and two medical students came back to Mr. Germann’s apartment, household number 420 out of 3,000.They put on disposable protection suits, gloves and goggles and one of them sat down on a plastic stool they had brought along to take a small vial of his blood. Then they removed and bagged their suits, disinfected the stool and any surface they had touched and left. It took all of 10 minutes.
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Italians Find Promise of Antibodies Remains Elusive, for Now - The New York Times - 0 views
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nfected people develop different quantities of antibodies, and researchers are still studying the level that offers protection, and for how long.“We don’t know how long they last,” Dr. Venturi said. ‘‘This is the central point.”
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Many businesses in the region have been paying for employees to get the tests, so that they could go back to work if they tested negative for the virus or positive for the antibodies.
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His Humanitas research hospital near Milan treated Italy’s first known coronavirus patient and has deep experience with the virus. It has been examining the 2 or 3 percent of people in the region who swab tests show are actively infected but whose blood also contains the antibodies — known as immunoglobulin G, or IgG, antibodies — that should neutralize the virus. In other words, these people are no longer contagious.
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Dr. Venturi said those tests were essentially “useless” because they did not describe whether a person had the right level of antibodies and because no one knew yet how long they lasted.
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Instead, he said, Italy’s reopening phase needs to rely on uninfected people, which he considered to be 90 percent of the population, and on social distancing and other protective measures.
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In theory, even those lucky few would not need to wait for two consecutive negative swab tests — which sometimes take months — before being released from quarantine and allowed back to work. “It would be like a negative test result,” he said.
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In the meantime, though, Dr. Venturi said it was impossible to consider a work force made up only of people showing neutralizing antibodies.
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Results will take weeks more, but if confirmed, he said, it would show that people who test positive for an adequate level of neutralizing IgG antibodies do not pose a danger of contagion.
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“I did it to free myself of this doubt,” said Mr. Passaggio, who last month showed Covid-19 symptoms, including a low fever. Unable to get tested for the virus, as swabs are generally reserved for the hospitalized, he took precautions to avoid contaminating others, including staying isolated for weeks.
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Last Tuesday he got the results: high levels of immunoglobulin G, or IgG, antibodies. Mr. Passaggio said he understood from doctors on television that it meant a degree of immunity, confidence he was not a danger to others and that he could possibly “go to work before someone else.”
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Mr. Francese said that a month ago, 50 people in the town showed clear symptoms of the virus, but that the health authorities failed to test them. They got sick, and then their relatives got sick and cases kept building.
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The town, out of desperation, tracked down serological tests offered by a Chinese factory that the mayor said had an 96 percent accuracy rate, and which he said Italy’s national research center had approved.
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Robbio has already tested about half of its residents and found and isolated many positive cases, about half of whom had symptoms, he said. He also said that the tests had shown 12 percent had IgG antibodies.
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He said he considered those people “immune and thus would be eligible” for an eventual immunity license, despite health experts’ doubts.
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Pfizer Begins Testing Its Vaccine in Young Children - The New York Times - 0 views
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Pfizer has begun testing its Covid-19 vaccine in children under 12, a significant step in turning back the pandemic. The trial’s first participants, a pair of 9-year-old twin girls, were immunized at Duke University in North Carolina on Wednesday.
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Moderna also is beginning a trial of its vaccine in children six months to 12 years of age. Both companies have been testing their vaccines in children 12 and older, and expect those results in the next few weeks.
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AstraZeneca last month began testing its vaccine in children six months and older, and Johnson & Johnson has said it plans to extend trials of its vaccine to young children after assessing its performance in older children.
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Immunizing children will help schools to reopen as well as help to end the pandemic, said Dr. Emily Erbelding, an infectious diseases physician at the National Institutes of Health who oversees testing of Covid-19 vaccines in special populations.
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Children under 18 account for about 23 percent of the population in the United States, so even if a vast majority of adults opt for vaccines, “herd immunity might be hard to achieve without children being vaccinated,” Dr. Erbelding said.
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Scientists will test three doses of the Pfizer vaccine — 10, 20 and 30 micrograms — in 144 children. Each dose will be assessed first in children 5 through 11 years of age, then in children ages 2 through 4 years, and finally in the youngest group, six months to 2 years.
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“It sounds like a good plan, and it’s exciting that another Covid-19 vaccine is moving forward with trials in children,” said Dr. Kristin Oliver, a pediatrician and vaccine expert at Mount Sinai Hospital in New York.
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More than 3.3 million children have tested positive for the virus, at least 13,000 have been hospitalized and at least 260 have died, noted Dr. Yvonne Maldonado, who represents the American Academy of Pediatrics on the federal Advisory Committee on Immunization Practices.
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Children often react more strongly to vaccines than adults do, and infants and toddlers in particular can experience high fevers.
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“But this is a little different, because we’ve already had experience with tens of millions of people with these vaccines,” Dr. Maldonado said. “So there’s a higher degree of confidence now in giving this vaccine to kids.”
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Parents will want to know how the companies and the F.D.A. plan to monitor and disclose side effects from the vaccines, and how long they will continue to follow trial participants after the vaccines’ authorization, Dr. Oliver said.