Covid-19 Updates & Info

[ti-amie]

The first paragraph is so disheartening.

[dryrunguy]

Life expectancy in the U.S. continues to decline--in large part due to COVID. But there's been a shift from 2020 to 2021. Life expectancy fell the most among Native American and White populations. The year before that, which aligns with the first year of COVID, life expectancy fell the most among Black and Hispanic populations.

https://www.npr.org/sections/health-sho ... y-covid-19

[ponchi101]

White populations that maybe, just maybe, vote for a certain guy and believe C19 is a hoax and are therefore unvaccinated?
A testable hypothesis.

[dryrunguy]

Here's the latest Situation Report. It includes an explanation and defense for fast tracking the updated vaccines.

::

EPI UPDATE The WHO COVID-19 Dashboard reports nearly 600 million cumulative cases and 6.47 million deaths worldwide as of August 31. Global weekly incidence decreased for the third consecutive week, down 15% from the previous week. Global weekly mortality decreased for the second consecutive week, down 13% from the previous week.

Regional trends in weekly incidence and mortality also are declining. All regions reported decreases in weekly incidence, ranging from -13% to -36.5% from the previous week. Notably, incidence in the Western Pacific appears to have peaked, with weekly incidence down 15% after a slight increase (+1.6%) the week of August 15. Weekly mortality is declining in all regions except the Western Pacific (+3.5%) and South-East Asia (+15.5%). The Eastern Mediterranean region appears to have peaked, with weekly mortality down 35% over the previous week.

UNITED STATES
The US CDC is reporting 94.3 million cumulative cases of COVID-19 and 1,040,314 deaths. Average daily incidence continues to decline, down from the most recent high of 129,363 new cases per day on July 21 to 88,286 on August 30—the lowest average since May 12. Average daily mortality continues to decline, down to 383 on August 30 from a recent high of 486 on August 12.**
**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.

Both new hospital admissions and current hospitalizations continue to decline, down 2.9% and 6.3%, respectively, over the past week. Both trends peaked around the last week of July, similar to trends in daily incidence.

The BA.5 sublineage is projected to account for 88.7% of sequenced specimens in the US. While BA.5 remains the overwhelmingly dominant Omicron subvariant, its growth has reversed as the prevalence of the BA.4.6 sublineage is increasing. BA.4.6 remains the #2 subvariant nationwide, now accounting for 7.5% of sequenced cases, while BA.4 now accounts for 3.6% of cases. It remains unclear whether BA.4.6 is capable of usurping BA.5 nationwide, but it appears to be outpacing BA.5 in certain areas, particularly HHS Region 7 (Iowa, Kansas, Missouri, Nebraska), where it accounts for 17.2% of sequenced cases. Collectively, the remaining variants account for only 0.2% of cases nationally. All variants reported here are sublineages of the Omicron variant of concern (VOC).

PANDEMIC VIGILANCE Senior WHO officials are warning that although the overall numbers of COVID-19 cases and deaths are decreasing globally, those numbers could rise as northern nations head into colder months. WHO Director-General Dr. Tedros Adhanom Ghebreyesus on August 31 urged more people—particularly healthcare workers and older adults—to get vaccinated and stay up to date on vaccinations by getting booster doses, where available; wear masks in crowded indoor spaces; and maximize air flow when possible. Dr. Tedros warned that people must remain vigilant against the virus, even if already vaccinated, saying that pretending the pandemic is over is "a huge risk."

In an interview with STAT News, Dr. Maria Van Kerkhove, the WHO’s Technical Lead for COVID-19, echoed these sentiments. She recognized the world is facing many threats—including flooding, war, famine, and several significant disease outbreaks—and acknowledged a global desire for the COVID-19 pandemic to be over. But, instead of forgetting about the deadly disease, Dr. Van Kerkhove said the international community must optimize its response at this point in the pandemic, when we have the tools, knowledge, and, to some degree, immunity to be in a better position against circulating Omicron subvariants and prepare for those that might come next. She too warned that governments and individuals must remain laser-focused on sustaining the actions, systems, and workforce put in place to address the COVID-19 emergency, as those same systems can be used for other disease threats, which appear to be becoming more common as the climate warms.

US BOOSTER CAMPAIGN The US FDA on August 31 granted emergency use authorization (EUA) for 2 Omicron-specific vaccine boosters, one from Pfizer-BioNTech and one from Moderna. Pfizer-BioNTech’s booster is authorized for people aged 12 years and older, and Moderna’s booster is authorized for adults only. The US CDC's Advisory Committee for Immunization Practices (ACIP) is expected to vote today on recommendations for the boosters, and once CDC Director Dr. Rochelle Walensky gives the final approval, the doses can start to be rolled out to states, likely after the Labor Day holiday. The new bivalent boosters target both the original virus strain and the BA.4/BA.5 subvariants, with the hopes that the shots can provide at least some additional protection against currently dominant subvariants as the nation enters colder months. Notably, under the new EUA, the monovalent mRNA COVID-19 vaccines are not authorized as booster doses for individuals 12 years of age and older. The older boosters will be phased out as the updated boosters become more readily available.

However, public health officials face challenges in rolling out the new boosters, including general pandemic fatigue and low uptake of the current boosters. There is also confusion about who should get these newer boosters, particularly among those who were recently boosted for the first or second time with original vaccine formulations. On this question, experts recommend people wait 3 to 6 months after their last immunization or most recent infection to receive the maximum benefit from the new boosters. Otherwise, recently activated immune systems may neutralize the booster components too quickly for the body to develop immune memory for later protection.

Although some people have expressed concern over the rapid timeline with which the new boosters were developed and authorized, public health officials note that annual flu vaccines are updated in much the same manner. Neither shot completed human trials, but experts maintain that safe, effective vaccine formulations with updated antigen profiles are routinely produced using a fast-track model. Therefore, while the targeted strains of SARS-CoV-2 are different, the manufacturing and safety profiles behind these updated boosters remain the same. Additionally, Dr. Walensky said last week that waiting to conduct those trials could potentially risk authorizing an outdated vaccine and that Omicron-adapted vaccines are necessary to help prevent an expected fall and winter surge. Still, data on the boosters’ ability to prevent hospitalizations and deaths will be collected. Now, public health officials must thoughtfully advocate that individuals, especially those at greatest risk of adverse outcomes, choose to receive the updated boosters, just as many in the US and around the world are growing indifferent to COVID-19 in their communities.

US LIFE EXPECTANCY Life expectancy in the US fell for the second year in a row in 2021, representing the first time life expectancy dropped 2 years in a row in 100 years. The Vital Statistics Rapid Release published by the US CDC provides life expectancy estimates calculated using complete period life tables based on provisional death counts for 2021. Someone born in the US in 2019 had a life expectancy of 79 years. But in 2020, life expectancy fell to 77 years, falling further in 2021 to 76.1 years. Notably, there is a 5.9 year gap in life expectancy between males and females. Life expectancy for males born in 2021 was 73.2 years and 79.1 years for females.

The analysis also provides life expectancies by Hispanic origin and race, where the greatest decline between 2020 and 2021 was for non-Hispanic American Indian and Alaska Native (AIAN) males, whose life expectancy declined from 63.8 to 61.5 years, followed by non-Hispanic AIAN females at 70.7 to 69.2 years. Dr. Robert Anderson, Chief of Mortality Statistics at CDC's National Center for Health Statistics, said the type of loss experienced since 2019 is similar to the decline in US life expectancy after the 1918 influenza pandemic. Asian Americans saw the smallest decline in life expectancy from 2020 at 83.1 years, a decline of 0.1 years, and Black Americans lost 0.7 years. COVID-19 accounts for about half of the decline in life expectancy, while accidents and unintentional injuries, including drug overdoses, account for another 16%. COVID-19’s impact on mortality and morbidity, as well as healthcare systems, likely will continue long after the emergency phase of the pandemic ends, as researchers become more aware of the virus’s lasting health implications.

COMMERCIALIZATION PLANNING On August 30, US health officials announced plans to begin shifting COVID-19 vaccine coverage to the commercial market as soon as January 2023. A blog post by US HHS Assistant Secretary for Preparedness and Response Dawn O’Connell noted that while the US government has supported no-cost access to vaccines and therapeutics since the beginning of the pandemic, the ability to do so always had a limited timeframe. However, the timeline to transition to the private market has been accelerated, as the US Congress has shown continued reluctance to authorize additional funds to purchase more medical countermeasures. Assistant Secretary O’Connell advocated for additional funding in order to support an “orderly wind down” of the federal programs, as well as to ensure equitable distribution and coverage for the under- and uninsured.

After the administration recently announced a pause to a program providing free, at-home testing kits, public health experts expressed concern over reduced coronavirus test accessibility for the uninsured or those who live in more remote areas, and others have highlighted the potential impacts that commercialization will have on global equity. HHS recently convened a group of more than 100 representatives from state and local governments, health care providers and insurers, pharmaceutical companies and vaccine manufacturers, patient advocates, and others to discuss first steps in how to move forward with the commercialization process, and the agency plans to continue partner engagement to better implement and communicate a plan.

VACCINATION AMONG US CHILDREN COVID-19-related hospitalizations among US children reached their second highest peak of the pandemic this summer, lower only than the initial Omicron surge earlier this year. Relaxed restrictions allowing for more socialization played a role, as did the more transmissible BA.5 Omicron subvariant, but experts say low vaccination rates also contributed. About 60% of children aged 12-17 are fully vaccinated, but only 30% of younger children, ages 5-11, have received 2 doses. Notably, the COVID-19 vaccination campaign for the youngest children, ages 6 months to 5 years, is off to a very slow start 10 months after the US FDA authorized the vaccines for use among this age group. As of August 16, only 3.4% of children under age 2 had received their first dose, and 5.7% of those aged 2-4 years had gotten their first shot, a significantly slower pace than among older kids and teens, according to US CDC data. Only about 1% of the these children are fully vaccinated.

Several factors are slowing the rate, including parental hesitation and more limited opportunities for vaccine administration. While the slow pace presents a much longer-term challenge to get this age group vaccinated, some of this trend was by design, with most vaccine doses going to pediatricians and community health centers, with the expectation that parents would look to get their children vaccinated by their healthcare providers in familiar, trusted settings. Federal officials said they hope childhood COVID-19 vaccination rates will rise as more children visit their doctors heading into the fall and winter seasons.

[ti-amie]

[ponchi101]

So. Loony friend sends Twitter about "NIH has approved the use of ivermectin for treating C19". In tweet, the person says that the NIH people should be tried for murder and crimes because they did not approve it earlier. Of course: "The people that wanted to make money from the vaccines already did. Criminals!" (Paraphrase).
Go online. I find three separate stories (AP, Newsweek, another one I can't recall) debunking the story. In each, they directly quote the same tweet I was sent. They clarify: the NIH has approved ivermectin FOR CLINICAL TRIALS; i.e. you can still test it as a possible treatment, but it is not approved as a treatment.
I send all this info.
I get back: "You did not read what I sent. This is new; it was finally approved".
I send back: "Debunks are from yesterday".
I feel sad.
---0---
I feel that there is no way that we can find a consistent epistemology, one that can lead to clarity. Items like these truly divide us; I like my loony friend but it is so hard to engage when we almost live in two parallel universes in which neither one of us is acceptable in the other's.

[dryrunguy]

IIRC, ivermectin has been studied in clinical trials for COVID treatment since 2021. What's different now?

[ponchi101]

There is no difference. The thing is that these people cannot understand that the NIH CANNOT stop you from testing an innocuous treatment; if you want to continue investigating Vitamin C as an effective treatment for the common cold, you are allowed to. If you have the grant money and want to keep testing Ivermectin, in a controlled trial, the NIH allows you.
They truly do not understand methodology in any sense. It is what makes me sad. They are constantly asking you to be "open minded" and, when you are and test the claim, and debunk it, you are still not receptive. They never think "am I applying the same process myself?".

[ti-amie]

[dryrunguy]

Here's the latest Situation Report. Haven't read it yet. BTW, I was over at the Wellspan Health Campus in Chambersburg, PA this morning. They had a sign by the pharmacy indicating that they have the new Moderna bivalent boosters available. I'm shocked they got them so soon. But in an interesting diversion from usual COVID vaccine practice, these will be administered by appointment only. So either they don't have that many doses available or there may be some provision requiring disclosure (e.g., that the bivalent boosters have not been tested in clinical trials?).

::

EPI UPDATE The WHO COVID-19 Dashboard reports nearly 603.7 million cumulative cases and 6.48 million deaths worldwide as of September 7. Global weekly incidence decreased for the fourth consecutive week, down 11% from the previous week. Global weekly mortality decreased for the third consecutive week, down 10.5% from the previous week.

Regional trends in weekly incidence and mortality also are declining. All regions reported decreases in weekly incidence, ranging from -9% to -29% from the previous week. Weekly mortality is declining in all regions except the Western Pacific (+4.5%) and Africa (+15.6%).

UNITED STATES
The US CDC is reporting 94.8 million cumulative cases of COVID-19 and 1,043,171 deaths. Average daily incidence continues to decline, down to 74,803 on September 6 from 88,286 on August 30—the lowest average since the beginning of May. Average daily mortality continues to decline, down to 336 on September 6 from a recent high of 495 on August 12.**
**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.

Both new hospital admissions and current hospitalizations continue to decline, down 6.6% and 7.4%, respectively, over the past week. Both trends peaked around the last week of July, similar to trends in daily incidence.

The BA.5 sublineage is projected to account for 88.6% of sequenced specimens in the US. While BA.5 remains the overwhelmingly dominant Omicron subvariant, the prevalence of the BA.4.6 sublineage is increasing. BA.4.6 remains the #2 subvariant nationwide, now accounting for 8.4% of sequenced cases, while BA.4 now accounts for 2.8% of cases. Collectively, the remaining variants account for only 0.2% of cases nationally. All variants reported here are sublineages of the Omicron variant of concern (VOC).

EMERGENCY SPENDING REQUEST The Biden administration on September 2 asked the US Congress to pass US$47.1 billion in new emergency spending as part of a continuing resolution to keep the government open beyond the end of the 2022 fiscal year on September 30. The request includes US$22.4 billion to address the ongoing COVID-19 pandemic, of which US$18.4 billion would go to the US HHS to purchase vaccines, treatments, and diagnostics and conduct research, and US$4 billion would support the global response. The federal government is running out of money for its COVID-19 efforts ahead of a potential fall surge, and Congress has been reluctant to authorize additional spending, with Republican lawmakers insisting that new funding be offset by budget cuts or come from transfers of unspent, previously approved US$5 trillion in pandemic relief funds. The new request is already facing opposition in Congress.

Last week, the White House Office of Science and Technology Policy (OSTP), in collaboration with other relevant government agencies, released the First Annual Report on Progress Towards Implementation of the American Pandemic Preparedness Plan, detailing the nation’s pandemic preparedness efforts, including areas for investment. Notably, the report calls the COVID-19 emergency a “moderate pandemic,” despite more than 1 million US deaths and nearly 6.5 million worldwide, and urges the US government to “seize the moment” to prepare for the likelihood of future pandemics and increasing frequency of biological threats.

UPDATED VACCINE BOOSTERS Last week, the US CDC recommended the use of updated COVID-19 booster vaccines for US residents over the age of 12 who have completed at least a 2-dose primary vaccination series. The recommendation was given to the Pfizer-BioNTech and Moderna mRNA bivalent vaccine boosters that are adapted to address both the original SARS-CoV-2 strain and the Omicron variant of concern, specifically targeting the BA.4 and BA.5 subvariants. The process the companies’ used to modify their vaccines is similar to that of the annual alteration of influenza vaccines. The nimbleness with which scientists can “plug-and-play” variant-specific components into the mRNA platform allowed the rapid updates. However, some individuals have expressed concern over a lack of human clinical data supporting the booster authorizations.

The bivalent boosters are already available for individuals looking to recharge their immune protection against currently circulating variants ahead of what some officials predict will be a surge of cases this fall and winter. Individuals aged 12 and older are eligible for the new booster at least 2 months after completing their 2-dose primary series or their most recent booster. Anyone who is vaccinated and recently recovered from COVID-19 should wait at least 3 months to get their next shot to maximize their immune response. The new boosters are being offered alongside influenza vaccines, with hopes that immunization coverage will increase for both flu and COVID-19. Countries in the southern hemisphere, including Australia, recently experienced a challenging flu season, prompting health officials to call for increased vaccine coverage before influenza activity increases in the United States. Many top US health officials are suggesting that COVID-19 booster shots will become annual vaccinations, similar to those for influenza. Scientists are still hopeful that future COVID-19 vaccines will enable a more durable immune response, but they also note that the current vaccines provide excellent protection from severe disease.

Internationally, the UK has approved bivalent boosters targeting Omicron BA.1 from both Moderna and Pfizer-BioNTech for individuals aged 12 and older. Notably, the UK Health Security Agency (UKHSA) this week said healthy children between the ages of 5-11 years will no longer be offered vaccination against COVID-19, angering some parents and healthcare providers. The European Union has also backed both the Pfizer-BioNTech and Moderna Omicron BA.1-adapted boosters. With the rollout of the new boosters, questions are being raised about remaining stockpiles of old formulations. US officials are debating whether or how to use remaining doses, with some worrying that millions of doses might be wasted. International donations are under consideration, although officials are worried about depleting national stockpiles and falling global demand for the vaccines.

NEEDLE-FREE VACCINES Many scientists and health organizations, including the WHO, have suggested that vaccines delivered nasally or orally may be a crucial step in controlling COVID-19. While the current COVID-19 vaccines, which are administered via intramuscular injection, have shown prolonged effectiveness at preventing severe disease, they are less effective at limiting disease transmission. Many theorize that vaccines administered through nasal drops or oral inhalation may lead to heighted mucosal immunity, a factor that could prolong immunity.

Leading these efforts, both China and India this week approved new needle-free COVID-19 vaccine candidates. China approved the Convidecia Air vaccine made by CanSino Biologics as a booster dose for those who are already fully vaccinated. The vaccine, which is based on the same adenovirus platform as the company’s injected vaccine, is delivered orally via an inhaled mist produced by a nebulizer. India regulators approved a 2-dose primary series vaccine produced by Bharat Biotech, which is administered as drops in the nose. Neither CanSino nor Bharat Biotech have published clinical trial results on the vaccines in peer-reviewed journals, but in-country regulators used preliminary data for their approvals. It is unclear how successful these vaccines will be at preventing disease, but they are a sign of a potential next step for COVID-19 vaccines.

PAXLOVID REBOUND DATA A letter published September 7 in the New England Journal of Medicine provides new data on the occurrence of viral load rebound among COVID-19 patients taking Paxlovid. The data come from a phase 2/3 double-blind, randomized, controlled clinical trial involving nearly 2,250 unvaccinated individuals who had symptomatic COVID-19 infections and at least one risk factor for severe disease. Results regarding viral load rebound were similar in both the treatment and placebo groups, even after controlling for various factors. For those participants for whom viral load data were available, 2.3% of 990 who received Paxlovid experienced viral load rebound between baseline and 14 days after the start of treatment, and 1.7% of 980 patients in the placebo group had viral load rebound within the same timeframe. According to the researchers, the data reaffirm the effectiveness of Paxlovid at preventing severe disease and death, with little difference in instances of rebound between those who took Paxlovid and those who did not. However, Paxlovid remains out of reach for many people who reside in low- and middle-income countries (LMICs), further increasing global disparities in managing COVID-19 disease.

ANTIBODIES Vaccines against COVID-19 are effective at preventing severe illness and death among most individuals, but new SARS-CoV-2 variants are able to circumvent some immune protection induced by these vaccines, which has necessitated the development of new boosters. Additionally, monoclonal antibody therapies, or mAbs, that worked against earlier variants struggle against current variants. Most recently, data in a preprint study posted to bioXiv show that the 2 mAbs that comprise AstraZeneca’s Evusheld—the only therapeutic antibody combination available to protect immunocompromised people against COVID-19—may be less effective against the BA.4.6 subvariant, which is increasing in prevalence. Increased efforts to keep antibody treatments current and updated are important so that immunocompromised people can access reliable and effective treatments against COVID-19.

Two recent studies point to promising new antibodies that could potentially neutralize all SARS-CoV-2 variants and render boosters unnecessary. In a study published August 5 in Communications Biology, Israeli scientists at Tel Aviv University sequenced B cells from the blood of people who had recovered from COVID-19 in Israel and isolated 2 antibodies, TAU-1109 and TAU-2310, that neutralized 84-90% of the Omicron (B.1.1.529) variant and 90-97% of the Delta variant. These findings were successfully corroborated by researchers at the University of California San Diego and Bar-Ilan University. Researchers noted that monoclonal antibodies that prevent SARS-CoV-2 from binding to ACE2 receptors in human cells—a process that current vaccines target—are more susceptible to viral evolution. The 2 TAU antibodies, named after Tel Aviv University, bind to a different part of the virus’ spike protein than most other mAbs.

In another study, published August 11 in Science Immunology, researchers from Boston Children’s Hospital and Duke University modified a humanized mouse model to develop SP1-77, an antibody that can neutralize all currently known variants of SARS-CoV-2. This model initially was developed to look for antibodies that neutralize HIV, another RNA-based virus that mutates often. Instead of blocking SARS-CoV-2 from binding to ACE2 receptors in human cells, the SP1-77 antibody blocks the virus from fusing its outer membrane with human cell membranes. Though this work is in an early proof-of-concept stage, the researchers have applied for a patent for the SP1-77 antibody and mouse model used to create it.

LONG COVID/PASC Myriad questions remain over the long-term health implications of SARS-CoV-2 infection, with an estimated 16 million US residents of working age experiencing symptoms of COVID-19 lasting 4 or more weeks beyond acute infection—a condition often called post-acute sequelae of SARS-CoV-2 (PASC) or long COVID. An ad hoc collaboration of healthcare providers from at least 40 long COVID clinics are trying to fill the knowledge gaps, meeting regularly to compare their experiences treating patients who are often frustrated, and sometimes anxious and depressed, with being dismissed by primary care and specialist providers. The American Academy of Physical Medicine and Rehabilitation collaborative is concerned both the public and the Biden administration are losing focus on the pandemic and its potential long-term impacts. The Biden administration has published 2 reports on long COVID, and congressional lawmakers have introduced several bills on the issue, but until more money, research, guidance, and education is available for those treating the condition, healthcare providers worry the lack of attention will further expose the fragility of the nation’s healthcare system and cases will go undertreated or undiagnosed, particularly in underserved communities.

Few risk factors for long COVID have been identified, although many studies suggest conditions such as immunosuppression, hypertension, obesity or older age are associated with a higher risk of severe outcomes. A new study published September 7 in JAMA Psychiatry suggests that psychological distress prior to infection may be a risk factor for post-COVID-19 conditions. The prospective observational cohort study included nearly 55,000 survey respondents, mostly White and female, and examined whether pre-infection psychological distress early in the pandemic—such as depression, anxiety, loneliness, perceived stress, and worry—was associated with an increased likelihood of developing post-COVID-19 conditions among individuals who were later infected with SARS-CoV-2. The researchers found that all types of distress were significantly associated with an increased risk of long-lasting COVID-19 symptoms, even after adjusting for various demographic and health factors. The relationship was dose-dependent, meaning individuals who reported more types of distress were at higher risk of developing long COVID. The authors emphasized that the findings should not be taken to mean long COVID symptoms are psychological and suggested future research should look at biobehavioral mechanisms linking psychological distress with persistent symptoms.

ORPHANHOOD & CAREGIVER LOSS The COVID-19 pandemic has taken a significant toll on children, many of whom have lost parents and caregivers as a result of COVID-19-related mortality. A research letter published September 6 in JAMA Pediatrics analyzed excess COVID-19-related deaths, estimating that 10.5 million children lost their parents or caregivers to COVID-19 and 7.5 million children experienced orphanhood between January 1, 2020, and May 1, 2022. This is nearly double previous estimates. The study also concluded that the highest amount of orphanhood by primary and/or secondary caregiver loss was found in Southeast Asia (40.6%) and Africa (24.3%). The Imperial College London’s COVID-19 Orphanhood Calculator is updated daily to provide national, regional, and global estimates of children who have lost a parent or caregiver.

There has been a greater push to address the associated economic, social, mental, and health-related consequences that orphanhood and caregiver loss can have on children, particularly as a result of COVID-19-related mortality. In the regions most affected by parent and caregiver loss, aid workers have noticed an increase in issues like child trafficking, early marriage, and exploitative labor practices involving children. The study’s authors recommend the following to mitigate the toll of parent and caregiver loss on children: accelerating vaccination, containment, and treatment efforts to prevent caregiver loss; preparing families to provide safe and nurturing alternative care; and bolstering economic support, violence prevention, parenting support, and school access initiatives. Others recommend funding support programs, such as providing conditional cash transfers to families to ensure that bereaved children continue going to school and remain connected to community resources. Many experts recommend turning to previous research of children who experienced parent and caregiver loss due to the HIV/AIDS epidemic to help identify meaningful solutions.

The United States is one of few countries to have made national commitments to address parent and caregiver loss; the White House released a memorandum in April 2022 promising that families affected by parent and caregiver loss would be able to access necessary support programs and resources. However, there have been no federal efforts to address the needs of children who have lost parents and caregivers as a result of COVID-19.

PANDEMIC LOCKDOWNS Most researchers agree that the rapid onset of the COVID-19 pandemic gave governments little option but to restrict their population’s interactions in early 2020, and those lockdowns likely helped to curb related deaths. But the restrictions had clear costs, including losses in educational gains, and debate remains over the usefulness of lockdown measures implemented after the outbreak’s initial phase. Now, much of the cost-benefit analyses involve value judgments, making lockdowns difficult to study and leading to disagreements. In China, which continues to enforce its “dynamic zero COVID” policies with what is beginning to appear as endless cycles of strict lockdowns and testing measures, experts agree that the restrictions likely will lead to long-lasting political, economic, and social consequences. The country’s leadership seems committed to these highly disruptive methods in an attempt to eradicate COVID-19, while the rest of the world is learning to live with the novel virus. Currently, nearly every Chinese province has recorded infections in recent days, and more than 300 million residents have been placed under partial or full lockdown since the end of August, some indefinitely. These recent actions have left China’s residents scared, frustrated, and feeling helpless.

https://covid19.who.int/

[ponchi101]

I gather these new bivalent vaccines will be the way to go. But I will still wait until '23.

[JazzNU]

Highly disturbing

[Deuce]

So... the U.S. gets the vaccine that targets Omicron BA.4 and BA.5 - which are the variants currently infecting people... and Canada (and Europe) only get the vaccine which targets BA.1, which was circulating at the end of last winter before being replaced by BA.4 and BA.5.
Why?
What are we waiting for?

It seems that the vaccine targeting BA.1 is not much different than the original COVID-19 vaccines when it comes to taking on BA.4 and BA.5. So it's merely a move sideways, not an advancement. Why bother?

[JazzNU]

A childhood friend of my mom's passed away last week from covid pneumonia after a few weeks of ups and downs in the ICU. And she was vaccinated. So just a reminder that covid is still around, still kills, and it's not just stats in a news story.

We're well over 2 years into this, so not saying you shouldn't go about your life the way you see fit (within reason), but do hope you are respectful of those that are still scared, and don't make anyone feel uncomfortable that takes more precautions than others.

[dryrunguy]

Here's the latest. I skimmed it very quickly. Lots of interesting and lots of depressing stuff here.

::

US RESPONSE As the COVID-19 pandemic enters its third fall in the US, the White House has signaled it plans to slowly restructure its response efforts, including the phaseout of the White House COVID-19 Response Team mid-2023. With dwindling federal funds, responsibility for vaccinations and therapeutics is shifting to private industry and consumers within the next 6 months. Any remaining funds are largely being used for vaccination campaigns promoting this fall’s updated boosters and the purchase of at-home, rapid tests for the Strategic National Stockpile and Test-to-Treat locations. Officials are tentatively hopeful that the national public health emergency declaration for the pandemic may be allowed to expire in early 2023. While part of this transition can be attributed to fewer COVID-19 cases, deaths, and related hospitalizations, as well as the widespread availability of vaccinations and therapeutics, most response activities need to wind down due to a lack of new funding from the US Congress. Experts and officials emphasize that the pandemic is far from over, with COVID-19 on track to remain the third leading cause of death in the nation.

At the state level, New York Governor Kathy Hochul allowed the COVID-19 state disaster emergency declaration to expire last night, leaving only 10 states with emergency orders in place—California, Connecticut, Delaware, Illinois, Kansas, New Mexico, Rhode Island, Texas, West Virginia, and Washington. The 10 states with the lowest vaccination rates in the country (Wyoming, Alabama, Mississippi, Louisiana, Idaho, Tennessee, Arkansas, Georgia, North Dakota, Indiana) have yet to vaccinate 60% of their populations with the 2-dose primary series, far below the nationwide total of 67.6% and evidence that an updated booster may have a limited impact in the face of continued unwillingness to get vaccinated.

US WORKFORCE According to a recent Gallup poll, one-third of adults are concerned about COVID-19 exposure in the workplace, a proportion that is relatively unchanged since November 2021. The percentage of people “not concerned at all” has increased from 23% in 2020 to a record high of 39%. The recent survey also shows significant gaps in results by gender—41% of working women are concerned about on-the-job exposure compared with 26% of working men—and political party affiliation—51% of Democrats expressed at least moderate concern compared with 14% of Republicans. Two-thirds of workers said they expect new COVID-19 cases to increase during the colder months, although the poll was conducted prior to the approval of updated booster doses.

Additionally, recent research conducted by economists from Stanford University and Massachusetts Institute of Technology estimates that the labor force shrunk by about 500,000 people due to COVID-19 illness. Millions of people left the workforce for various reasons, including lack of childcare, fear of COVID, and retirement. But this research examines the direct impact of COVID-19 illness, estimating that workers with week-long COVID-19-related work absences are 7 percentage points less likely to be in the labor force one year later compared to otherwise-similar workers who do not miss a week of work for health reasons. In August, the total size of the labor force reached 164.7 million people, exceeding prepandemic levels for the first time. However, workforce recovery is experiencing slow-growth compared to prepandemic numbers, and economic recovery will depend on an expanded workforce in the long term.

BRAIN FOG When the COVID-19 pandemic first began, brain fog was not included in the list of possible symptoms. However, many COVID-19 patients report experiencing the condition, both during acute infection and lasting 3 or more months after recovery. Brain fog symptoms appear to be independent of initial disease severity. According to one review of multiple studies, about 22% of individuals report cognitive impairment 12 or more weeks following their initial diagnosis. Brain fog is often described as a disorder of executive function, the set of abilities that includes holding attention, remembering and recalling information, and blocking out distractions. Cognitive tasks that once seemed simple become excruciatingly difficult, and in some cases, impossible. Some people have had to leave their jobs due to an inability to perform their tasks, and many have faced frustration in obtaining medical care, often being dismissed as having anxiety or depression. Complicating the matter is that few clinicians are aware that many viral infections, not only COVID-19, can lead to brain fog and there are few reliable diagnostic tools.

Other neurological complications have been reported following COVID-19 infection, including stroke, delirium, and encephalitis. A recent study published in the journal Brain showed that patients hospitalized with COVID-19 had elevated levels of sera markers of brain injury, neurofilament light (NfL) and glial fibrillary acidic protein (GFAP). However, no specific pathogenic mechanism was determined responsible. Researchers continue to investigate what leads to brain fog—with possible causes including neuro-inflammation, autoimmune responses, or microclots that inhibit blood flow, and therefore oxygen supply—and are hopeful treatments can be developed.

GENETIC MUTATIONS For years, scientists have known that specific genetic mutations can make certain people less susceptible to infection with HIV, norovirus, or the parasite that causes malaria. Now, scientists worldwide are searching for similar mutations or immune system variations that might explain why some people with known exposures to COVID-19 either never become infected or never show symptoms of SARS-CoV-2 infection. The hope is that if researchers can identify a genetic or immune response explanation for resistance, they can use that knowledge to manufacture treatments or vaccines, which possibly could provide cross-protection from other coronaviruses in the future.

EUROPEAN BOOSTER AUTHORIZATIONS Following recommendations made earlier this month by the European Medicines Agency (EMA), the European Commission (EC) on September 12 approved the expanded conditional marketing authorization (CMA) of the Novavax COVID-19 vaccine, marketed as Nuvaxovid, in the EU as a homologous and heterologous booster for adults aged 18 and older. The protein-based vaccine is now available as a primary series or booster in EU Member States, Japan, Australia, and New Zealand, and is under review in other markets, including as a booster in the US. Only 4,872 people in the US have received the first 2 doses of the Novavax vaccine, which some officials hoped would entice unvaccinated individuals to get vaccinated because of its more traditional protein-based platform.

Also on September 12, the EMA recommended authorizing Pfizer-BioNTech’s adapted bivalent vaccine targeting the wild-type spike protein of SARS-CoV-2 and spike proteins of the Omicron BA.4 and BA.5 subvariants. The EC accepted the recommendation the same day, making the booster doses available for immediate shipment to EU Member States. Earlier this month, the EU authorized both Pfizer-BioNTech’s and Moderna’s bivalent vaccine boosters targeting Omicron BA.1.

CHINA As Chinese President Xi Jinping prepares to leave his country for the first time since the COVID-19 pandemic began in early 2020 to meet with Russian President Vladimir Putin, tens of millions of people in China remain under weeks-long lockdowns as part of the nation’s continued “dynamic zero COVID” strategy. President Xi is expected to seek an unprecedented third term as the nation’s leader, and observers say the lockdowns likely will continue at least through the 20th National Chinese Communist Party Congress set to begin October 16. Experts say President Xi likely does not want any uncontrollable rise in COVID-19 cases until after his next term is secured. However, residents in several cities are warning they are running out of food, have limited to no access to medicines and health supplies, and are suffering from psychological and economic impacts. Experts say the government’s insistence on its zero COVID policy exposes the politics behind the measures, with President Xi taking credit for its apparent success in preventing potentially millions of COVID-19 cases. But growing discontent among the nation’s population, as well as economic harms, raise questions about how long the policies can remain in place.

WESTERN PACIFIC REGION New Zealand dropped many of its COVID-19-related requirements on September 12, bringing an end to some of the most restrictive pandemic mandates in the world. People will no longer be required to wear masks in public places, except healthcare and long-term care facilities; all government-imposed vaccine mandates will end on September 26; and only people with COVID-19, and not their household contacts, will be required to isolate for 7 days. Additionally, the government will no longer require vaccinations for incoming travelers and air crew. New Zealand experienced its worst COVID-19 surge this year when Omicron killed more residents than any other pandemic surge. A total of 1,950 people have died of COVID-19 in New Zealand since March 2020. But the average number of new cases and hospitalizations are down significantly since the beginning of August, when influenza cases also surged. Prime Minister Jacinda Ardern said it is time for Kiwis to “take back control” of the future and thanked the population for its cooperation and endurance throughout the pandemic.

In neighboring Australia, federal health officials accepted a recommendation from the Australian Technical Advisory Group on Immunisation (ATAGI) to approve a bivalent vaccine booster from Moderna targeting the original SARS-CoV-2 strain and the Omicron BA.1 subvariant. The booster, which will be available for people aged 18 years and older, is the first bivalent shot cleared for use in Australia. Additionally, state and territorial health ministers moved this week to begin reporting weekly, instead of daily, COVID-19 metrics, including case numbers, new and total deaths, vaccination rates, and breakdowns of hospitalized ICU and ventilated patients.

In Japan, the government signaled its plans to further ease border restrictions aimed at curbing the spread of COVID-19 by waiving tourist visa requirements from some countries and possibly ditching a daily cap on foreign arrivals by next month.

In the Philippines, President Ferdinand Marcos Jr. this week extended the national state of calamity first declared by former President Rodrigo Duterte in March 2020, primarily to allow continued emergency purchases and provide hazard allowances for healthcare workers. While indoor masking requirements will stay in effect, masking rules for outdoor spaces were immediately lifted, except for crowded places where physical distancing is difficult. The nation reopened schools 3 weeks ago, ending one of the world’s longest pandemic-related school system shutdown.

In other Western Pacific nations, public health officials are warning of the possibility of “twindemics,” a rise of another infectious disease during the COVID-19 pandemic. In South Korea, experts are concerned over simultaneous outbreaks of COVID-19 and influenza during the colder fall and winter months, calling for the development of better diagnostic tests, including one that could detect flu and COVID-19 at the same time, and for healthcare services to offer individuals both vaccines during the same visit. In Vietnam, a severe outbreak of dengue fever is overwhelming healthcare facilities that also must treat COVID-19 patients. Experts say that 2 years of pandemic-related lockdowns caused a reduction in routine mosquito vector surveillance and slowed dengue control. The Philippines, Malaysia, and Singapore have also reported year-on-year increase in the number of reported dengue cases.