Covid-19 Updates & Info

[Deuce]

Voted, but I'm not really sure what "back to normal" really means anymore.
I am planning to retire in a couple months and haven't seen any of my co-workers in 2 years. Intent is to do some travelling for the next few years, but will likely start domestically as it's still complicated to plan international travel with all the different requirements in play. It may sound crazy but 2 years into this, I have yet to take a Covid test. (knocking on wood)

I haven't been tested, either. I never really saw the purpose...
Firstly, I've never had any symptoms at all. Secondly, I'm very careful about not being exposed to the virus. Thirdly, the result of a test (PCR) is only good for that specific moment in time. If you test negative, it means only that you were negative at that precise moment. Three hours later, you could be positive. And so, a negative result is essentially useless unless you get tested every day. A positive result could help, I suppose, by telling you that you should isolate yourself... but there are far more negative results than positive ones, and it's rather evident that many, many people don't understand what a result of negative means. Many seem to believe that a result of negative means that they are negative for a month or more - and so they're not careful. They don't realize that it means only that you were negative at the exact moment you were tested - it does not mean that you're still negative an hour after the test.

I have a box of rapid tests at home. Because their accuracy is reportedly far less than 100%, they are essentially useless. Any test which tells you that you MIGHT have COVID means nothing. The only reason I got the box of rapid tests is in case they realize at some future point that these tests are 98% accurate. Until that happens, though (and it likely never will), I don't see myself using them, even if I have symptoms - because I'll be completely unsure if the result is accurate or not. If I have symptoms, I'll assume I have COVID and simply stay home for a week or so.

[ponchi101]

I have started a poll because I am truly at odds with what to do with the pandemic, and I am hoping for some TAT2.0 wisdom to help me through.
Vote will be anonymous. Your name will not show. I will vote only after some people have done so, to avoid prompting others.
Comments are, of course, welcome.

Clarification. In the third option, does "drop some mandates" mean get rid of some mandates or impose some mandates? And do you view restrictions differently than mandates in option 2? I'm assuming Option 2 is more lenient than Option 3 just based on the order of the choices.

Get rid of some mandates.
I truly asked these questions because I am truly unsure of what to do. To the point that I even had a hard time figuring out what to ask.
For example: I would give restaurants and entertaining places the option to decide whether they will enforce vaccination or not, as long as it is CLEARLY STATED AT THE ENTRANCE. Then the patrons can decide if they go in or not.
Txs to all for the votes.
To Atlpam: Indeed, what does back to normal mean? Again, I know I am asking half-baked questions here.

[ti-amie]

Dr. Hotez ( MD & PhD) is apparently being attacked by the fully vaxxed and boosted folks at Faux.

[dryrunguy]

Here's the latest Situation Report. My apologies for being a day late in posting it.

::

WASTEWATER SURVEILLANCE The US CDC has added wastewater surveillance of SARS-CoV-2 RNA to its COVID Data Tracker, as virus levels in sewage water may be capable of providing an early warning signal for transmission surges. The tool comprises data from more than 400 testing sites in 37 states, with more than 34,000 samples representing 53 million US residents collected so far. Hundreds of additional testing sites are expected to begin submitting data to the system in coming weeks. The CDC initiated the National Wastewater Surveillance System (NEWS) in September 2020, and it has become a critical tool for public health officials since it can show where viral loads are changing, which communities are at risk of a surge in cases, and where medical supplies should be deployed.

An additional benefit of the COVID wastewater tracking system is the identification of novel and “cryptic” variants of SARS-CoV-2. Cryptic variants are lineages of SARS-CoV-2 that contain mutations never before observed in humans. A number of cryptic lineages have been detected in the New York City sewer system. The origin of these out-of-the-ordinary lineages, which also have been detected in Missouri and California, has not yet been determined, but the most popular hypothesis is the mutations arose simultaneously in similar animal hosts, such as rodents that live in the sewer systems. Whatever the source, the new surveillance system could be critical in identifying and tracking the next major variant of concern.

US CDC ACIP MEETING The US CDC's Advisory Committee on Immunization Practices (ACIP) met on February 4 to provide updates to clinical considerations for utilization of COVID-19 vaccines. Topics of discussion included the FDA-approved Spikevax SARS-CoV-2 vaccine from Moderna, vaccination recommendations specific to immunocompromised individuals, and lengthening the gap between the first two doses of mRNA COVID-19 vaccines.

ACIP voted unanimously to recommend the use of a 2-dose primary series of Spikevax among US adults aged 18 years and older, and CDC Director Dr. Rochelle Walensky endorsed the recommendation later that day. ACIP members also discussed concerns regarding the risk of myocarditis following vaccination. Results of investigations into 13 deaths from myocarditis following mRNA vaccination found that the myocarditis was not caused by vaccination, and most other myocarditis cases among mRNA vaccine recipients were resolved within 90 days with no reported impact on quality of life. Additional discussions centered on potentially widening the time interval between initial mRNA vaccine doses from the current 21-28 days to 8 weeks apart. The change might reduce the risk of myocarditis among some recipients and increase vaccine effectiveness. However, no official vote was taken on the suggestion.

Officials also presented anticipated changes to vaccine guidance for certain immunocompromised individuals. The proposed revised guidance notes that people who are moderately or severely immunocompromised should receive a booster dose at least 3 months—instead of the current 5 months—after the last dose of a 3-dose primary series of mRNA SARS-CoV-2 vaccine. For immunocompromised individuals who received the single-dose J&J-Janssen vaccine, the guidance likely will change from the current recommendation—a primary dose followed by a booster 2 months later—to a 3-dose schedule of an additional mRNA dose at least 28 days after the initial dose and then an mRNA booster dose 2 months after the second dose. The guidance was expected to be updated on February 7 but the new recommendations are not yet published on the CDC’s website.

OMICRON-ONLY VACCINES As noted in previous briefings, both Moderna and Pfizer are pursuing the development and testing of Omicron variant-specific vaccines. Some health officials, such as those from the European Medicines Agency, support the efforts. However, research from the US National Institutes of Allergy and Infectious Diseases' (NIAID) Vaccine Research Center posted on February 3 to the preprint server bioRxiv suggests that an Omicron variant-specific booster developed by Moderna might not provide additional or greater protection beyond the company’s already authorized mRNA vaccine booster dose. The research, which is not yet peer-reviewed, tested the boosters in primates. These findings mirror the results of other small animal studies testing vaccines targeting other individual variants. But predicting the future emergence or dominance of SARS-CoV-2 variants is difficult, with scientists uncertain if a new dominant variant might evolve from Omicron, a past variant, or have mutations very different from either Omicron or other past variants. This concern has led some scientists and health officials to advocate publicly for broad protection in future vaccines—to multiple variants, all betacoronaviruses, or even all coronaviruses. Several NIAID researchers recently published a commentary in the New England Journal of Medicine (NEJM) calling for a universal coronavirus vaccine to help mitigate the impacts of any future coronavirus pandemic.

LONG COVID/PASC Long COVID, or post-acute sequelae of COVID-19 (PASC), are both terms that represent a broad range of symptoms that individuals with SARS-CoV-2 infection can develop days to months after initial infection. Some public health experts are warning that the most recent surge in Omicron cases could lead to a different type of public health crisis, with extended burdens on patients and the healthcare system long after the pandemic ends. Some studies suggest that convalescent COVID-19 patients, especially those who had more severe disease or certain symptoms during acute infection, could be at higher risk of long-term cardiovascular complications or abnormal brain changes. Many patients experiencing long COVID already are waiting months for care, as physicians and clinics try to determine the best way to treat the huge constellation of symptoms that characterize the condition. Research continuously suggests that vaccination could blunt the development of long-term symptoms.

A new cohort study published February 4 in JAMA Network Open sought to better understand certain new symptoms and their prevalence among individuals who test positive and negative for SARS-CoV-2 infection, stratified by age and disease severity. New-onset shortness of breath, heart rhythm abnormalities, and type 2 diabetes were more common 31 to 150 days after testing positive than among those with negative results. Among positive individuals over 20 years old, fatigue, shortness of breath, and sleep disorders were the most common new symptoms, whereas change in bowel habits, fatigue, and shortness of breath were the most common new symptoms for positive individuals under 20. The researchers also found that new symptoms—such as anxiety, depression, neuromuscular disorders, peripheral nerve disorders, and uncoordinated movements—were more common among hospitalized and ventilated patients. They called for healthcare providers to be aware of symptoms that might develop among patients after SARS-CoV-2 infection, particularly those who required hospitalization.

ANTIBODY DURABILITY Researchers are continuing to gain insight into SARS-CoV-2 immune responses—and the durability of antibody production—following infection. A study published February 3 in JAMA Network Open suggests that antibodies targeting the receptor-binding domain (RBD) of the spike protein can persist for up to 20 months in unvaccinated individuals who reported test-confirmed COVID-19. While the data are encouraging, it remains unclear how the antibody levels correlate to protection against future infections, especially with new variants. Another study, published February 7 in Nature Microbiology, had similar results, with researchers finding the magnitude of persistent antibody responses were correlated with COVID-19 severity in unvaccinated individuals. They note that while the neutralizing antibody (nAb) response seen in most individuals in the study would be sufficient to provide protection against reinfection and severe infection at 480 days from disease onset, people who had asymptomatic or mild infections likely would need to be vaccinated to maintain antibody-mediated protection against future SARS-CoV-2 infection. With more people becoming infected with SARS-CoV-2 and recovering from COVID-19, the future of the pandemic may see surges of infections due to new variants, but hopefully those cases will result in fewer hospitalizations and deaths. Vaccination remains the most reliable way to help prevent infection, severe disease, and death.

NOVAVAX Novavax on January 7 said it has received expanded US government funding to support late-stage clinical trials for its 2-dose SARS-CoV-2 vaccine among adolescents aged 12 to 17, including a booster component. The company has filed with the US FDA for Emergency Use Authorization (EUA) of its vaccine among adults, and the vaccine has received clearances for use in adults in Great Britain and Germany, as well as endorsement in New Zealand. Israel recently signed a deal to purchase 5 million doses of the protein-based vaccine, and Australia this week received its first shipment of a total order of 51 million doses. Some experts hope that Novavax’s use of protein-based technology will help win over individuals who are reluctant to be vaccinated with shots using newer mRNA technology.

SOUTH AFRICAN VACCINE REPLICATION Scientists at South Africa’s Afrigen Biologics and Vaccines announced last week that they have used publicly available information to produce a close copy of Moderna’s SARS-CoV-2 mRNA vaccine, without the company’s support. The effort—which is backed by the WHO-supported mRNA technology transfer hub launched in June 2021—represents the first mRNA vaccine designed, developed, and produced in an African lab. Scientists are using Moderna-patented technology because the company has vowed to not enforce its COVID-19-related patents against those making vaccines intended to combat the pandemic. However, without the involvement of an mRNA vaccine producer, the process to bring the new vaccine to market could take up to 3 years, instead of about 1 year with support from an outside company, according to the WHO’s Initiative for Vaccine Research. Human clinical trials using the Moderna mimic are expected to begin in the fourth quarter of this year after production is scaled up. Though the long timeline for vaccine production and testing does not address Africa’s urgent need for vaccines, many scientists are enthusiastic that the effort will lay the groundwork for the future development and production of mRNA vaccines on the continent.

OTTAWA STATE OF EMERGENCY The mayor of Canada’s capital declared a state of emergency this week to help police and city staff obtain the resources they need to address a 12 day-long demonstration involving a convoy of truck drivers and other protestors who are blocking the streets of Ottawa, running their large vehicle engines, honking horns, and bringing the city to a standstill. The initial purpose of the “Freedom Convoy,” which arrived in the city on January 29, was to protest vaccine mandates for cross-border truckers, but it has since evolved into a broader demonstration against general COVID-19-related public health measures and now involves others with ties to far-right groups. Over the weekend, police began ticketing and arresting people who were caught bringing fuel, food, or other “material aid” to protestors and cautioned that demonstrators “exhibited extremely disruptive and unlawful behavior” that presents risks to public safety. Some residents reported being harassed for wearing masks.

Additionally, the crowdfunding platform GoFundMe is facing allegations of fraud from the Florida Governor and Texas State Attorney General after the fundraising platform froze nearly US$10 million in donations to the Freedom Convoy’s fundraiser and said it would redistribute the money to a different charity. After threats of investigations, GoFundMe said it instead will automatically issue refunds to donors, based on police determinations that what began as a peaceful protest has became an occupation. Donors are now using a Christian crowdfunding site called GiveSendGo, which has raised more than US$6 million as of today. The Ottawa demonstrations have become a rallying cry for far-right and anti-vaccine groups worldwide. In Australia today, hundreds of anti-vaccine demonstrators blocked the streets of the capital Canberra, as politicians and their staff return to the city for a week of parliamentary proceedings.

WHITE-TAILED DEER White-tailed deer infected with SARS-CoV-2 have been identified in at least 15 US states—Arkansas, Illinois, Iowa, Kansas, Maine, Massachusetts, Minnesota, New Jersey, New York, North Carolina, Ohio, Oklahoma, Pennsylvania, Tennessee, and Virginia—adding to concerns that the wild animals could become a potential source of new variants. Researchers looking at deer in Iowa found 1,200 of 2,000 lymph node samples collected from deer that were killed by hunters or car strikes tested positive for the virus. Additionally, white-tailed deer on Staten Island, New York, have been found to be carrying the Omicron variant, the first time the variant has been detected in wild animals. Researchers say it is likely deer are being infected through human contact, then spreading the virus to other deer, and so far there is no evidence that the animals have transmitted the virus back to humans. But more widespread infection among the estimated 30 million deer in the US raises the risk that the animals could become a viral reservoir, which could lead to spillover into humans or other animal species.

[ponchi101]

So we may have two reservoirs for C19: white tailed deer, and white nationalists.
Sounds about right.

[ti-amie]

In case you haven't seen this gem:

[JazzNU]

Here's the latest Situation Report. My apologies for being a day late in posting it.

WHITE-TAILED DEER White-tailed deer infected with SARS-CoV-2 have been identified in at least 15 US states—Arkansas, Illinois, Iowa, Kansas, Maine, Massachusetts, Minnesota, New Jersey, New York, North Carolina, Ohio, Oklahoma, Pennsylvania, Tennessee, and Virginia—adding to concerns that the wild animals could become a potential source of new variants. Researchers looking at deer in Iowa found 1,200 of 2,000 lymph node samples collected from deer that were killed by hunters or car strikes tested positive for the virus. Additionally, white-tailed deer on Staten Island, New York, have been found to be carrying the Omicron variant, the first time the variant has been detected in wild animals. Researchers say it is likely deer are being infected through human contact, then spreading the virus to other deer, and so far there is no evidence that the animals have transmitted the virus back to humans. But more widespread infection among the estimated 30 million deer in the US raises the risk that the animals could become a viral reservoir, which could lead to spillover into humans or other animal species.

I don't know enough about a few of those to be certain, but the majority of those states have deer hunting and it's not a small or insignificant hobby. The way this is phrased, it's like human contact is the only concern. Seems like they'd need to say very clearly whether eating venison from an infected deer is a possible way to transmit the virus.

[ponchi101]

On personal news:
The husband of a cousin here in the USA is in the hospital, tubed and with no hopes of making it.
Former cancer patient, unvaccinated because... well, you know who they voted for.
I don't know if to feel sorry or what.

[JazzNU]

On personal news:
The husband of a cousin here in the USA is in the hospital, tubed and with no hopes of making it.
Former cancer patient, unvaccinated because... well, you know who they voted for.
I don't know if to feel sorry or what.

Sorry to hear this. It's your family, so hard to not feel bad when it's more personal even if I'm generally done (so, so done) and unsympathetic to the unvaccinated. I'm not unmoved by (some) personal stories.

I also feel sorry for the doctors and nurses treating them and any family members that tried to prevent any of this from happening and have to deal with his care and anything that comes if he doesn't pull through.

[ponchi101]

And we received news today that he died overnight.
A totally preventable death. It is the thing that one really wonders about: how can't they see it?

[JazzNU]

And we received news today that he died overnight.
A totally preventable death. It is the thing that one really wonders about: how can't they see it?

Sorry for your family's loss. And it is very hard to understand how they don't see it, particular those with pre-existing conditions or age factors that make the risk higher.

[dryrunguy]

Here's the latest Situation Report. Haven't read it yet. Just way too many meetings today.

::

EPI UPDATE The WHO COVID-19 Dashboard reports 399.6 million cumulative cases and 5.76 million deaths worldwide as of February 9.

We expect the global cumulative incidence to surpass 400 million cases in the WHO’s next update. If that is the case:
1 case to 100 million- 389 days
100 to 200 million- 190 days
200 to 300 million- 155 days
300 to 400 million- 34 days

The global weekly incidence decreased for the first time since mid-October 2021, down 15% from the previous week. It appears that the global trend has passed the Omicron peak. If the global trend follows what we have observed at the national level in many countries, we expect the decline to be relatively steep. Notably, all WHO regions with the exception of the Eastern Mediterranean region (+35.6%) reported decreasing weekly incidence last week. Global weekly mortality increased for the fifth consecutive week, up 9.6% from the previous week. The weekly total of 70,718 deaths is the highest since the week of August 23, 2021—the peak of the previous wave. Based on trends observed over the course of the COVID-19 pandemic, we expect the weekly mortality to peak in the next 2-4 weeks.

Global Vaccination
The WHO reported 10.1 billion cumulative doses administered globally as of February 7. A total of 4.81 billion individuals have received at least 1 dose, and 4.16 billion are fully vaccinated. Analysis from Our World in Data indicates that the overall trend in global daily vaccinations continues to decline steadily from the most recent high of 37 million doses per day in early January 2022 to 18.1 million on February 8.* The global weekly average jumped to 26.2 million doses per day on February 9, corresponding to a large jump reported in Asia, although this may be a reporting error.** Our World in Data estimates that there are 4.85 billion vaccinated individuals worldwide (1+ dose; 61.6% of the global population) and 4.23 billion who are fully vaccinated (53.7% of the global population). A total of 1.17 billion booster doses have been administered globally.
*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.
**The OWID data show 18.9 million doses reported in Asia on February 8 and 71.6 million on February 9 (+52.8 million), but it is not immediately clear what country or countries accounted for that increase. Only 20 total countries and territories reported an increase in doses administered from February 8 to February 9, and the largest increase was China with +1.01 million doses.

UNITED STATES
The US CDC is currently reporting 77.0 million cumulative cases of COVID-19 and 906,603 deaths.

The US surpassed 900,000 cumulative deaths on February 6:
1 death to 100k- 87 days
100k to 200k- 111 days
200k to 300k- 88 days
300k to 400k- 35 days
400k to 500k- 33 days
500k to 600k- 121 days
600k to 700k- 105 days
700k to 800k- 78 days
800k to 900k- 52 days

Daily incidence continues its sharp decline, down from a record high of 806,176 new cases per day on January 15 to 230,602 on February 8, a 71% decrease over only 3 weeks. Daily mortality has largely leveled, holding relatively steady at approximately 2,300-2,400 deaths per day since January 24—with a slight decline since February 1.* Daily mortality has not yet exhibited a decrease commensurate with the decline in daily incidence, but if this represents a peak, it would correspond to a lag of approximately 3 weeks behind the daily incidence trend.
*Changes in state-level reporting may affect the accuracy of recently reported data, particularly over weekends. In an effort to reflect the longer-term trends, the numbers reported here may not correspond to the most recent dates.

US Vaccination
The US has administered 674 million cumulative doses of SARS-CoV-2 vaccines. Daily vaccinations continue to decline, down from the most recent peak of 1.77 million doses per day on December 6 to 479,000 on February 4.* A total of 251 million individuals have received at least 1 vaccine dose, which corresponds to 75.7% of the entire US population. Among adults, 87.3% have received at least 1 dose, as well as 26.0 million children under the age of 18. A total of 213 million individuals are fully vaccinated**, which corresponds to 64.2% of the total population. Approximately 74.4% of adults are fully vaccinated, as well as 21.0 million children under the age of 18. Since August 13, 90.5 million individuals have received an additional or booster dose. This corresponds to 42.5% of fully vaccinated individuals, including 65.2% 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 RESPONSE During the week ending February 6, the number of new COVID-19 cases decreased 17% globally compared to the prior week but the number of new deaths increased by 7%, according to the WHO. The situation varies widely depending upon the region, leading WHO Director-General Dr. Tedros Adhanom Ghebreyesus to warn that “COVID isn’t finished with us,” while appealing for more support from wealthy nations to bring equity to the distribution and administration of vaccines, tests, therapeutics, and personal protective equipment (PPE). To date, only 0.4% of the 4.7 billion SARS-CoV-2 tests administered globally have been used in low-income countries, and only about 11% of people in those countries have received at least one dose of vaccine.

The WHO, along with world leaders and high-level officials, on February 9 called for higher income countries to fund their “fair share” of financial support to the Access to COVID-19 Tools (ACT) Accelerator—including the COVAX initiative—to help end the pandemic by delivering necessary tools for pandemic response to low- and middle-income countries (LMICs). The ACT-Accelerator is budgeted to need US$23.4 billion through September 2022, of which it expects wealthy countries to donate US$16.8 billion. However, those nations so far have pledged only US$814 million—about 5% of the amount—leaving a US$16 billion gap. The remaining US$6.5 billion is expected to be self-financed by middle-income countries. Separately, US$6.8 billion is necessary for in-country resource delivery, which is anticipated to come from domestic resources, multilateral development bank support, and additional international grant financing support. In January, COVAX appealed for US$5.2 billion to continue operations over the next 3 months.

A new analysis from the Center for Global Development lauds the global vaccine rollout during the COVID-19 pandemic as the fastest and most widespread in history. But the paper singles out low-income countries as the exception, noting that other vaccination efforts have provided more coverage more quickly. Both the US and the EU recently indicated they will shift their focus from increasing vaccine supplies flowing into low-income countries, particularly those in Africa, to increasing vaccination administration and uptake. A paper posted February 9 to the preprint server medRxiv presents model-based estimates of deaths averted and cost per life saved by scaling up mRNA vaccinations in low- and lower-middle-income countries. According to the paper, which is not yet peer-reviewed, if every person living in those countries received 2 doses of mRNA vaccine this year, the effort would avert 1.2 million deaths at a cost between US$7,400 and US$81,500 per life saved. Despite the broad range, the price per life saved is considerably lower than some had estimated, showing the overall cost effectiveness of vaccinating the entire world.

US STATE MASK MANDATES As the number of new COVID-19 cases continues to decline across the US, a growing number of states—including California, Connecticut, Delaware, Illinois, Massachusetts, New Jersey, New York, Oregon, and Rhode Island—have either dropped or announced plans to end certain mask mandates, including some for schools, and other COVID-19 restrictions meant to reduce transmission of the virus. The moves, made largely in states controlled by Democratic governors, have put pressure on the White House, which said it is working on plans to move into a “new normal.” US President Joe Biden’s Chief Medical Advisor Dr. Anthony Fauci cautioned that the pandemic remains unpredictable and urged leaders to take gradual steps to transition out of the current surge. US CDC Director Dr. Rochelle Walensky noted her agency is working on new guidance for states and expressed optimism that new cases are dropping. But she warned that hospitalization and death rates remain high and that the nation is not yet at a point to drop mask mandates for indoor public spaces. The CDC currently recommends wearing masks in schools and in localities where coronavirus transmission is high—with case rates higher than 50 cases per 100,000 or positive test rates exceeding 8%—which at present accounts for 99% of the country. The agency reportedly is considering changing the metrics on which it bases its masking guidance, possibly shifting from case rates to data on hospitalizations.

Some parents expressed concern over the end of mask mandates for schools, saying more students over age 5 should be vaccinated before masks come off. Currently, only about 23% of children ages 5 to 11 years old are fully vaccinated and only about 56% of older children, aged 12 to 17, are fully vaccinated. Experts remain divided over when and on what metrics school mask mandates should be removed. However, all agree that masking in schools should not last forever.

US VACCINE MANDATE FOR FEDERAL EMPLOYEES In a 2-1 vote, the 5th US Circuit Court of Appeals on February 9 declined to block a lower court injunction on US President Joe Biden’s mandate requiring federal employees be vaccinated against COVID-19. The ruling, which was unexplained, signals the court will conduct a full review of the case and potentially sets the stage for the case to head to the US Supreme Court. In a dissenting opinion, Judge Stephen A. Higginson noted that a single district judge issued an injunction after several district courts rejected requests to block the mandate, writing the Supreme Court was the “only court that can now provide timely relief.” According to the US Office of Management and Budget, 97.2% of the federal workforce is compliant with the mandate, including those who are vaccinated or have pending or approved exemptions.

In a similar case, Louisiana and 15 other states filed an amended complaint last week against the federal vaccine mandate for healthcare workers at facilities that receive funding through Medicare or Medicaid. While experts agree the changes likely will not impact the rule’s fate, the new arguments—which include that state surveyors were improperly added to covered employees and that the Omicron variant’s ability to cause breakthrough infections renders vaccination meaningless—could raise new questions. The Supreme Court upheld the mandate in a January 13 opinion.

VACCINE UPTAKE Since the onset of mass SARS-CoV-2 vaccination in the US, and even before, the federal government has struggled to communicate effectively about vaccination recommendations, benefits, and risks, particularly in the context of engaging with vulnerable populations. In an effort to improve engagement with racial and ethnic minorities and communities with low vaccination coverage, the Health Resources and Services Administration (HRSA) is distributing more than US$66 million to community groups across the country to support vaccine outreach and education efforts. The funding aims to build confidence in SARS-CoV-2 vaccines through trusted local leaders who know better how to effectively engage with communities. The funding is part of the US$1.9 trillion American Rescue Plan that was signed into law in March 2021.

A recent study published in Nature found significant racial and ethnic disparities in terms of SARS-CoV-2 vaccine hesitancy and uptake in the US and UK. The study included data collected via a smartphone-based COVID-19 symptom monitoring study from more than 2 million individuals between March 2020 and February 2021. Among US participants, vaccine hesitancy was significantly higher for Black, Hispanic, and multi-racial individuals, compared to White participants. Similar trends were found among individuals in the UK. In the US, Black participants reported significantly lower vaccine uptake, even among those who were willing to be vaccinated; however, this trend was not observed in any other racial or ethnic minority group in the US, nor in any group in the UK. The low uptake among Black participants who were willing to get vaccinated suggests that access was also a barrier to vaccination.

The US CDC COVID-19 Emergency Response Team published findings from a study on SARS-CoV-2 vaccine uptake among lesbian, gay, bisexual, and transgender (LGBT) communities, in the CDC’s Morbidity and Mortality Weekly Report (MMWR). The CDC notes that LGBT individuals are at elevated risk for severe COVID-19 and death as a result of higher prevalence of underlying health conditions. The CDC also was concerned about the “potential for low vaccine confidence and coverage” in LGBT communities due to long-standing mistrust of healthcare systems and numerous barriers to accessing health services. Data collected through the National Immunization Survey Adult COVID Module (NIS-ACM) between August 29 and October 30, 2021, indicate that vaccination coverage was actually higher among LGBT adults (85.4%) than heterosexual adults (76.3%). While overall coverage was higher, some racial and ethnic minority groups within the LGBT community reported lower coverage than corresponding heterosexual groups, including non-Hispanic Black women. In fact, vaccination coverage was the lowest among non-Hispanic Black LGBT individuals across all categories of sexual orientation. Notably, the study also found higher degrees of confidence in vaccine safety and protection among portions of the LGBT community than among heterosexual adults. A separate study by health officials in New York found that SARS-CoV-2 vaccination coverage among individuals diagnosed with HIV infection (63.5%) was lower than among the broader New York adult population (75.0%), including across all racial and ethnic, economic, and other demographic subgroups. The analysis was conducted by matching data from New York state’s HIV surveillance registry and immunization registries for New York state and New York City.

MATERNAL ANTIBODIES People who receive SARS-CoV-2 vaccinations during pregnancy pass along more durable antibodies to their newborns than do unvaccinated individuals who had COVID-19 during pregnancy, according to a research letter published February 7 in the Journal of the American Medical Association (JAMA). The small study examined 77 vaccinated pregnant women who completed their 2-dose mRNA vaccine series between weeks 20 and 32 of gestation and 12 women who had symptomatic SARS-CoV-2 infection during pregnancy. The infants of vaccinated mothers had significantly higher immunoglobulin G (IgG) antibodies in umbilical cord blood at delivery and in blood draws at 2 and 6 months postpartum than infants who received antibodies from their unvaccinated convalescent mothers. The researchers note that while the antibody titer necessary for protection against SARS-CoV-2 infection or severe disease is unknown in infants, the findings further support recommendations for pregnant individuals to be vaccinated and provide evidence that antibodies in newborns of vaccinated individuals could persist until the infant becomes eligible for vaccination at 6 months. The US FDA is expected to authorize the Pfizer-BioNTech vaccine for young children ages 6 months to under-5 later this month.

J&J-JANSSEN VACCINE PRODUCTION Johnson & Johnson (J&J) late last year temporary halted production of its SARS-CoV-2 vaccine at the only plant making usable batches of the shots, a facility run by J&J subsidiary Janssen in the Netherlands capable of manufacturing more than 50 million doses per month, according to a report in The New York Times. The single-dose vaccine, which does not need ultra-cold storage, is the first choice for many low- and middle-income countries (LMICs), and the move caught officials with the African Union and the COVAX initiative off guard when they learned about the production suspension from Times reporters. The facility where the vaccine was being produced is instead manufacturing an experimental vaccine against a different virus, which some noted could be a more profitable venture. A J&J representative said the company has millions of finished doses in inventory, continues to deliver vaccine to fill-and-finish facilities, and intends to deliver on its vaccine commitments to LMICs. Notably, the company failed to deliver on commitments made to COVAX last May. Last year, J&J ran into regulatory problems with Maryland-based contractor Emergent BioSolutions when it did not pass US FDA inspections. The Emergent facility continues to require FDA review of vaccine batches manufactured at the plant, and none have been cleared for distribution. J&J has plans to produce SARS-CoV-2 vaccine at 2 other plants, one in the US and another in India, but those facilities are not expected to be operational until late spring. The Dutch production plant is expected to begin producing the J&J-Janssen vaccine again next month, although those doses will not be shipped until May or June.

PFIZER-BIONTECH VACCINE Pfizer this week reported US$36.78 billion in 2021 direct sales from the SARS-CoV-2 vaccine it makes with BioNTech, making the vaccine the top-selling pharmaceutical product ever in a single year. The next highest—the drug Humira, which is used to treat rheumatoid arthritis and other autoimmune and inflammatory conditions—registered US$20.7 billion in 2021 sales. In its full-year results, Pfizer predicted it will sell US$32 billion of its vaccine, called Comirnaty, and US$22 billion of its antiviral COVID-19 treatment Paxlovid in 2022. Pfizer CEO Albert Bourla this week said he expects the US FDA to soon authorize a low-dose version of the Pfizer-BioNTech vaccine for young children aged 6 months to under-5 years under a fast-track review process. Data from clinical trials of the vaccine among this age group are expected to be published later this week in preparation for a February 15 meeting of the FDA Vaccines and Related Biological Products Advisory Committee. The US CDC has begun preparations to deliver the vaccine once it is authorized, telling state and local officials they could expect to start receiving shipments on February 21.

AUSTRALIA & NEW ZEALAND Several countries with the strictest closed border policies have announced they will reopen to international travelers. Australia announced it will allow fully vaccinated citizens, permanent residents, and visa holders into the country without a travel exemption beginning February 21; unvaccinated visa holders will still require a valid travel exemption. Notably, the Australian Technical Advisory Group on Immunisation (ATAGI) announced today that Australians will need 3 vaccine doses to be considered “up to date” on their shots. If an individual has gone more than 6 months from their second dose without a booster shot, they will be considered “overdue.” The new definition will only apply to COVID-19 management within Australia and will not affect rules for “fully vaccinated” people entering the country. However, each state will continue to set its own requirements for booster doses, which could impact visitors.

Neighboring New Zealand announced a phased reopening of its borders beginning at the end of this month. The country expects to welcome all international travelers from October. Everyone entering the country will be required to self-isolate at home for 10 days. Both nations’ borders have been closed for most of the past 2 years.

[dryrunguy]

Here's the latest Situation Report. Now they're suggesting that booster vaccines begin to wane in effectiveness after about 4 months. Oh, and all those firings of unvaccinated employees of the State of New York? The majority of them were employed by the Department of Education. EDUCATION. The U.S. has NO chance of making it to the 22nd century.

::

VACCINE FOR <5 CHILDREN The US FDA on February 11 postponed an advisory committee meeting set for today to discuss data on the Pfizer-BioNTech SARS-CoV-2 vaccine for young children ages 6 months through 4 years. According to an FDA statement, Pfizer notified the agency of new data from an ongoing clinical trial, and the postponement will allow the FDA time to consider that data. As previously reported here, the companies originally tested the vaccine as a 2-dose regimen, with each dose containing 3 μg, one-tenth of the dose given to those ages 12 and older. However, the companies announced late last year that among children aged 2 to 4 years old, 2 doses generated only 60% of the antibody levels seen in individuals aged 16 to 25 years who received 2 doses. Notably, 2 doses did appear to elicit antibody levels among the youngest children aged 6 months to 23 months similar to those in the older individuals.

The FDA originally pushed Pfizer and BioNTech to request authorization for an initial 2-dose regimen while collecting data on a third dose, but Dr. Peter Marks, Director of the FDA Center for Biologics Evaluation and Research, implied the new data showed that 2 doses were not sufficient in protecting against symptomatic infection, particularly during the latest Omicron surge. Former FDA Administrator and current Pfizer Board Member Dr. Scott Gottlieb said the delay was due to a “low number of cases” in the trial, perhaps insufficient for data analysis. The companies expect data on the 3-dose regimen to be available in early April.

Efforts last week by the US CDC to open preordering of the vaccine indicated the decision to authorize a 2-dose regimen while waiting on further data on 3 doses was nearly a done deal, with the agency predicting shipments of the lower-dose version could begin the week of February 21. While some experts breathed a sigh of relief that the FDA is taking extra time to review the scientific evidence, some parents expressed dismay and frustration over what they say feels like a string of setbacks. Still, not all parents are eager to vaccinate their younger children. The Pfizer-BioNTech vaccine has been available for children aged 5 to 11 since early November 2021, yet only about one third of the 28 million children in that age group have received at least 1 dose so far. A recent survey from the Kaiser Family Foundation showed about 30% of parents of children younger than age 5 intend to get them vaccinated as soon as shots become available. Approximately 400 children under age 5 have died of COVID-19 since the beginning of the pandemic.

BOOSTER DOSE EFFECTIVENESS Booster doses of SARS-CoV-2 mRNA vaccines are strongly recommended by public health and medical professionals—even more so during the recent surge in cases caused by the Omicron variant of concern—to lower the risk of symptomatic COVID-19 and more severe cases requiring hospitalization. Emerging data continue to support booster doses as both safe and effective for these purposes. A recent study published in the US CDC’s Morbidity and Mortality Weekly Report (MMWR) found that vaccine effectiveness at preventing severe COVID-19 was higher after a booster dose than after the second dose of mRNA vaccine. The effectiveness of boosters wanes after about 4 months but remains highly protective against severe disease. These findings were consistent across both the Delta-dominant and Omicron-dominant periods. The findings support further consideration of additional booster doses that could be valuable against future outbreaks or variants.

Despite booster doses being highly effective in preventing emergency department visits and hospitalizations due to COVID-19, public uptake of booster doses has slowed in recent months in the US. A survey from the Kaiser Family Foundation found that 60% of vaccinated but not boosted respondents stated that the Omicron wave did not greatly impact their decision whether or not to get a booster. Only around 29% of respondents reported that the Omicron wave made them more likely to get a booster shot. Additional data from the CDC on hospitalizations and deaths show that booster doses are most beneficial to older adults. The argument for booster doses is strongest in those aged 65 years and older, for whom booster doses reduced the death rate per 100,000 cases by around 90 times. More work still needs to be done to better understand the durability of immunity following booster doses as well as to encourage more people, particularly those in higher-risk populations, to receive their booster doses.

COVID-19 THERAPEUTICS Late last week, the US FDA authorized a new monoclonal antibody (mAb) treatment that reportedly retains activity against the SARS-CoV-2 Omicron variant in laboratory experiments. The treatment—known as bebtelovimab and made by Eli Lilly—received Emergency Use Authorization (EUA) for adults and certain pediatric patients who are at high risk of severe COVID-19 outcomes but was not authorized for hospitalized COVID-19 patients or those requiring supplemental oxygen. Eli Lilly has signed a contract with the US government to supply up to 600,000 doses of the treatment by March 31, with the option for an additional 500,000 doses to be delivered later this year, at a cost of at least US$720 million. The company said it will immediately begin shipments to fulfill the agreement. Many providers expressed gratitude for the authorization, after the US government halted the use of 2 of the most common monoclonal antibody treatments due to a loss of effectiveness against Omicron.

Also late last week, the WHO prequalified a different mAb treatment, tocilizumab, that inhibits the interleukin-6 (IL-6) receptor. The prequalification includes 3 different presentations of the treatment and represents the first mAb to receive the designation. Tocilizumab—which is used primarily to manage arthritis and has been the subject of many COVID-19 clinical trials, including the large RECOVERY trial—is prequalified only for patients diagnosed with severe or critical COVID-19. The RECOVERY trial continues its work to establish an empirical baseline of effectiveness for other therapeutics. In a study published February 12 in The Lancet, the RECOVERY Collaborative Group summarized the results of evaluation of the monoclonal antibodies casirivimab and imdevimab used in combination. Between September 2020 and May 2021, the combination treatment reduced 28-day mortality in patients who were seronegative at baseline—meaning they had not mounted their own immune response—but not among individuals who were seropositive at baseline. However, when all patients were considered together, the treatments had no significant difference in outcomes. The results support the use of the combination therapy only among hospitalized individuals who are seronegative.

Questions remain over how well mAb treatments work against Omicron, as well as its BA.2 sublineage. Vir, the producer of the mAb sotrovimab, published a press release last week stating that its treatment retains neutralizing activity against the BA.2 sublineage of Omicron. The laboratory data, which are expected to be posted to a preprint server this week, are not yet peer-reviewed. Conversely, a separate study posted to bioRxiv (also not yet peer-reviewed) found BA.2 exhibited resistance to sotrovimab. Other therapies, including the antivirals Paxlovid and remdesivir, remain effective at reducing the risk of COVID-19-associated hospitalization or severe disease, but supply constraints and administration challenges are limiting access to only the highest-risk patients.

US VACCINE MANDATES New York City last week fired 1,430 municipal employees—less than 1% of the city’s workforce—for not complying with the city’s SARS-CoV-2 vaccination mandate. About 95% of the city’s 370,000 workers have received at least 1 dose of vaccine. Approximately 9,000 workers remain unvaccinated and are seeking exemptions but still could face termination. A majority of the fired employees, about 900, worked at the Department of Education. On February 11, the US Supreme Court denied a request from a group of New York City public school teachers, administrators, and staff seeking to block the mandate for employees who were not granted religious exemption. Those involved in the lawsuit were told they would be fired if they did not get vaccinated by February 14.

In compliance with the US Department of Defense vaccine mandate for military personnel, the US Navy and US Army announced they have begun discharging unvaccinated soldiers. The US Air Force last week said it has granted 9 religious exemptions and continues to process 2,556 pending requests and 732 pending appeals. Overall, the Air Force has turned down more than 3,200 requests for exemptions and approximately 440 appeals. The US Navy has not yet granted any religious exemptions.

CANADIAN PROTESTS After being closed for nearly a week because of demonstrations against COVID-19 vaccine mandates and restrictions, the Ambassador Bridge—the busiest US-Canada border crossing—reopened late February 13 after police made more than 2 dozen arrests, towed 7 vehicles, and seized 5 others. The bridge, which links Ontario to Detroit, is a major artery for the transport of vehicle parts from Canada to automotive plants in the US. Protests continue to block border crossings between Emerson, Manitoba, and Pembina, North Dakota, and Coutts, Alberta, and Sweet Grass, Montana. Additionally, demonstrations that began January 29 continue in the Canadian capital of Ottawa, disrupting transportation and daily activity. On February 14, Canada Prime Minister Justin Trudeau announced he is invoking the Emergencies Act, allowing the government the authority to “restore order.” The unusual move is meant to counter acts of lawlessness seen during the protests, according to Canada Public Safety Minister Marco Mendicino, who called the move “very careful and deliberate.”

Earlier on February 14, TD Bank—short for Toronto-Dominion Bank—froze approximately US$1.1 million that was intended to go to groups supporting the “Freedom Convoy” leading the Ottawa demonstrations, most of which came from a GoFundMe account that was shut down. TD Bank has said it wants the courts to decide where the money should go. After the GoFundMe account was shuttered, a crowdsourcing site on GiveSendGo began to raise money. Late last week, an Ontario Superior Court decision to grant the Canadian government authority to freeze access to any money raised to back the blockade. Meanwhile, GiveSendGo said it could continue to deliver money to protestors, but the site was hacked late on February 13, with hackers releasing the names of donors. Also on February 14, Ontario Premier Doug Ford announced the province will no longer require proof of vaccination to enter indoor spaces as of March 1 due to a decreasing number of COVID-19 cases and hospitalizations. He clarified that the restrictions were not being lifted in response to the demonstrations.

ASIA Several nations and regions in Asia have experienced increases in new COVID-19 cases following Lunar New Year celebrations held early this month, with governments grappling with how to respond to the Omicron variant that has found its way through strict border controls. Hong Kong is experiencing a record surge in cases, reporting more than 2,000 new cases on February 14. The outbreak is overwhelming hospitals, forcing schools to remain closed, and necessitating help from China to address what Hong Kong Chief Executive Carrie Lam called an “aggravating situation.” Hong Kong has been following the mainland’s zero-COVID strategy by isolating all patients in hospitals to suppress transmission, but this outbreak is testing the limits of that policy. For now, there are no plans for a strict lockdown in Hong Kong, although a more-intrusive contact-tracing app is being used to restrict the movements of unvaccinated individuals.

China is continuing to enforce its zero-COVID policy, shutting down entire cities and holding the Beijing Winter Olympics in a strict “closed-loop” bubble that some have criticized as excessive. A paper published last week in the weekly bulletin of the China Center for Disease Control and Prevention (CCDC) estimated that if the global vaccination rate was 95% and population mobility returned to 2019 levels, zero-COVID regions would see more than 234 million new cases in 1 year, including 2 million deaths. Without the development of more effective and durable vaccines, a constellation of public health mitigation measures will need to be continued to stave off further crises, although most experts agree that China’s widespread lockdowns are extreme.

[Suliso]

Swiss government has decided to "cancel" covid from tomorrow. All regulations are overturned except masks in hospitals, retirement homes and public transport (till the end of March). Covid certificates will be no longer in use within the country and government's covid task force will be disbanded at the end of the March.

Not sure if individual businesses and municipalities will play any role or how quickly my company will follow. Interesting times...

[Deuce]

^ I used to do something similar when I was 3 years old... I believed that others couldn't see me if I closed my eyes.

Apparently, 2 years is all humans can tolerate of a potentially deadly virus. At that point, they begin to believe they can simply wish it away.
"We don't want to deal with COVID-19 anymore, so if we pretend hard enough that it no longer exists, it will surely disappear."
Protective measures are being lifted in many countries - despite many medical professionals saying that doing so is ill-advised. These decisions to lift protective measures have a far more political foundation than a medical one.