Covid-19 Updates & Info

[ti-amie]

I read something yesterday describing what it's like to suffer from Long Covid brain fog. It's horrible.

[ponchi101]

I am sure I have been exposed to C19, and yet have never caught it. So, where do I sign for this plan to check for genetic mutations that provide immunity?
Ah, right. I live here...
---0---
The brain fog thing sounds very frightening/interesting. It sounds as if it is truly something that changes your life, forever, and for worse. How do you test for it properly, to ensure that when treatments are developed (hopefully) you can get them?

[ti-amie]

Ed Yong

I wrote about “brain fog”—one of the most common & disabling symptoms of long COVID (and many other pre-pandemic conditions), and one of the most misunderstood.

Here’s what brain fog actually is, and what it’s like to live with it. 1/
https://www.theatlantic.com/health/arch ... on/671393/

First, what it’s not: Brain fog isn't anxiety, or depression. It’s not psychosomatic. It’s really nothing like a hangover, stress, or tiredness, and comments equating it to those things—“hey we all forget stuff”—trivialize what people are going through. 2/

Despite the name, brain fog isn’t a nebulous umbrella term. It’s a disorder of executive function—the mental skills that inc. focusing attention, holding info in mind, & blocking distractors. Without that foundation, one's cognitive edifice collapses. 3/

That’s why people w/ brain fog struggle with concentration, multitasking, & planning—which underlie almost everything. It raises unconscious activities to the level of effortful consciousness, and makes easy tasks absurdly hard. 4/


Executive function problems also affect memory: The brain can’t effectively focus on what to store or retrieve that info. Many long-haulers feel like they lose parts of themselves. Hannah Davis told me: “It feels like I'm a void & I’m living in a void.” 5/

There’s a spectrum. Most people improve & can function normally—but below their old baseline and with MANY accommodations. Some have been sick since the pandemic’s start (900+ days). Others got brain fog from pre-covid illnesses decades ago. 6/

Brain fog isn’t unique to long COVID. The same specific problems affect many HIV patients, epileptics post-seizures, cancer patients w/ chemo brain & folks w/ chronic illnesses like ME/CFS. Many of these conditions have long been stigmatized & neglected 7/

Some people argue that the colloquial term ‘brain fog’ delegitimizes and trivializes the condition. But disability communities have used it for decades; there are many reasons why it & its associated conditions are neglected, the name least among them. 8/

E.g. Most research/teaching about cognitive impairment centers around degenerative diseases of elderly people; docs largely don’t learn about viruses causing neurological problems in young people, and hubris leads to discounting of patient experiences. 9/

Also people w/ brain fog are also good at hiding it—it’s intermittent and they just don’t see people on the worst days. Stigma also motivates them to present as normal in social situations or doctors’ appts, furthering the false idea that they’re fine. 10/

Many docs also use inappropriate tests—like MoCA, which was only validated for elderly people with dementia—that even people with severe brain fog can ace. Hence: more dismissal. Bad testing is a comorbidity of long COVID. 11/

And yet brain-scan studies, blood flow studies, immunological studies, & more all point to physical & chemical changes in the nervous systems of people who have brain fog. It’s a real neurological problem that brings real cognitive impairments. 12/

Also, the basic science and the patients’ experiences *cohere*. The possible mechanisms for why brain fog occurs—as detailed in this piece—make total sense of why it affects executive function, why thinking feels slugging, why the fog waxes and wanes. 13/

Based on those likely mechanisms, many of the scientists I spoke to were also hopeful that brain fog is reversible. It just needs a lot more research, of the kind that hasn’t happened thus far. That’ll take time, and for now, people need help. 14/

Most of the approaches to treating brain fog are about managing symptoms. And that can do a lot. Several people I spoke to can work and do normal things again—but more slowly, at higher cost, with a ton of lifehacks & recovery periods. 15/

The single most important advice I've heard from clinicians & patients: You. Have. To. Pace. Yourself. Because brain fog often goes hand in hand with postexertional malaise—where people crash severely after even minor physical OR MENTAL exertion. 16/

I cannot stress this enough: For most people with brain fog, exercise—and strenuous mental activity counts, because cognitive work IS physical work—is a completely inappropriate treatment, and could make them substantially worse. 17/

I hope this piece makes those of you who have experienced brain fog feel seen. I hope it shows everyone else what it really means. Thanks to everyone who talked to me for this story. 18/

Finally, a very common thing that people with brain fog tell me is that they find it very hard to read. This is an almost 3000 word piece. I’m trying to get an audio version put together, and am told it will happen. More on that when I know more. 19/

PS. I'm spending as little time on Twitter as possible so won't get to read the replies to this thread. But for the many of you sharing brain fog experiences, I'm sorry. I hope this story helps a little, if only to make it easier to explain to others. And now, logging off again.


https://threadreaderapp.com/thread/1569 ... 08032.html

[ti-amie]

I had the sense to bookmark the above aggregation by @threadreaderapp.

[MJ2004]

US criticised for rolling out Covid boosters without human trials
Some health experts say vaccination campaign risks undermining public trust

Health experts have warned that the US decision to roll out new coronavirus boosters without clinical testing on humans risks denting public trust and increasing hesitancy about vaccines.

The Joe Biden administration is using the bivalent boosters, which contain the original Covid-19 strain and the genetic code of the Omicron sub-variants BA.4 and BA.5, to vaccinate more Americans against the virus.

It has bought 171mn doses of the BioNTech/Pfizer and Moderna boosters for $5bn and fast-tracked their authorisation before human trials are complete, hoping that they provide better protection against the dominant variants than existing Covid vaccines.

As doses began arriving at pharmacists for distribution this week, US officials said the rollout marked an “important milestone”. In future people would probably only require annual boosters just as they take a yearly influenza jab, they said.

But several health experts said that the boosters have yielded only limited data from a small number of tests on mice. They said there is no evidence that they provide better protection against infection or severe disease than existing jabs.

“Without the data and getting a human response in at least a limited number of people, you just set it up for the anti-vaxxers, anti-science [people],” said Eric Topol, founder and director of the Scripps Research Translational Institute.

“There are already groups calling it the mouse vaccine . . . We already have a trust problem in this country and we don’t need to make it worse,” he said.

Last month, the UK became the first country to approve a bivalent booster. But it waited for clinical data to greenlight a shot targeting the original Covid strain and the BA.1 sub-variant, which has since been superseded by BA.4/BA.5.

On Monday, Pfizer and BioNTech said the European Medicines Agency had recommended the BA.4/BA.5 bivalent booster for conditional marketing authorisation based on data from the companies’ bivalent jab targeting BA.1 and pre-clinical data.

Both companies said the European Commission would review the EMA recommendation and make a final decision soon.

Experts say vaccine hesitancy is just one of several challenges facing the US booster campaign and have urged caution in prematurely declaring victory over the virus.

Two and a half years into the pandemic there is growing public complacency towards Covid, as most people have already contracted the virus and been vaccinated. The Biden administration has also failed to secure $22.4bn additional funding from Congress, which could restrict its ability to replenish vaccine supplies.

“People have booster fatigue. They feel by this stage they are mostly protected and the pandemic is largely behind them: so I think there will be less interest in these boosters,” said Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia.

Offit was one of two members of a US Food and Drug Administration advisory panel to vote against asking Pfizer and Moderna to develop the bivalent vaccine without clinical data showing it performed better than the existing Covid jab.

“What bothers me in this is that we’re willing to move forward with a vaccine with no human data? I just think that’s a lot to ask people,” he told the Financial Times.

Vaccination and booster rates in the US already lag other developed countries with two-thirds of Americans receiving two Covid jabs and only a third of the population boosted. The comparable figures in France are 83 per cent and 65 per cent.

Health experts say the modest vaccination rate in the US is one of the main reasons it has recorded more deaths from Covid than any other country — 1.04mn. The virus continues to kill about 350 people per day, according to the Centers for Disease Control and Prevention, and yet the number of Americans seeking boosters has fallen sharply this year.

Authorities say the threat posed by waning immunity from vaccination and the potential for a fresh wave of infections in autumn justify its decision to roll out bivalent boosters without clinical data.

They argue that by tailoring the jab to target BA.4/BA.5, sub-variants that account for more than 90 per cent of infections, as well as the original Covid strain, it should boost immunity and do a better job in blocking infections. The vaccine is so similar to the existing Covid jab and a separate bivalent jab targeting the BA.1 variant, which has undergone trials, there is no need to wait for results in ongoing human trials, they say.

Some scientists agree, noting that new clinical data are not always required when the influenza jab is tweaked annually to target the latest strains.

Nancy Jecker, professor at University of Washington School of Medicine, said the risk of approving the boosters was minimal given they are not significantly different to the original Covid jabs.

“Emergency authorising Moderna and Pfizer boosters based on animal studies gives people the chance to minimise their risk of Covid as more people congregate indoors during fall and winter months,” said Jecker.

But Topol and Offit argued the US should have waited for evidence the boosters are better than the existing jabs.

“I don’t think they have proven that this influenza vaccine strategy — where we pick influenza strains every March for a vaccine that comes out in September — makes sense for Covid,” said Offit.

He said there is no evidence showing the BA.4/BA.5 booster provided better protection than existing jabs. Initial clinical data for the BA.1 bivalent booster showed it produced virus-fighting antibody levels that were 1.5 to 1.75 times higher than the existing jab, which was not a clinically significant difference, Offit said.

The CDC cites polling which suggests 72 per cent of respondents would definitely or probably receive bivalent boosters. If uptake of the jabs reach similar levels to the annual flu vaccine — half of US adults — by early autumn CDC modelling predicts it would prevent 100,000 hospitalisations, save 9,000 lives and billions of dollars in healthcare costs.

To boost uptake the CDC has simplified its guidance on eligibility, recommending a single bivalent booster for everyone over 12 years of age who has already received a Covid vaccine.

But workers on the frontline of the inoculation drive are sceptical the public will rush to get another jab.

“I think demand will continue to be sporadic because those people who want to be vaccinated have already got the vaccine and been boosted,” said Rene Rodriguez, owner of Tens Pharmacy in Roseland, a small town in New Jersey.

“There are really two types of people: those who believe in the vaccine, who are generally up to date with their jabs, and those that don’t.”

[MJ2004]

I forgot to cite the article - it was from the FT. Here is the link with a few extra graphics, although I know the direct link doesn't always work:
https://www.ft.com/content/92d52780-14c ... 722363254f

We're trying to decide when we should get this new booster shot. We had the first booster November last year, so we're not sure if we should get it quickly since it's been ten months, or it's better to wait until Nov again to be freshly boosted before the holiday season/winter travels.

There's very little guidance on the question of when people should be getting boosted.

[Deuce]

I forgot to cite the article - it was from the FT. Here is the link with a few extra graphics, although I know the direct link doesn't always work:
https://www.ft.com/content/92d52780-14c ... 722363254f

We're trying to decide when we should get this new booster shot. We had the first booster November last year, so we're not sure if we should get it quickly since it's been ten months, or it's better to wait until Nov again to be freshly boosted before the holiday season/winter travels.

There's very little guidance on the question of when people should be getting boosted.

I've begun timing my boosters to correspond with the time of year and the greater prevalence of COVID in the general community. I got my first booster in January of this year, and my second at the beginning of June so that I could get my next one in November, which is when people are indoors more because of the colder weather, and so more people will be contracting COVID. Here, the suggestion is to get the boosters spaced 5 or 6 months apart.

For the article above, the link requires a subscription. Of course, the entire article is posted above - but for those who want a link to possibly pass onto others, here is one...

https://theperfectenemy.com/us-criticis ... .news&utm_

.

[ponchi101]

US criticised for rolling out Covid boosters without human trials
Some health experts say vaccination campaign risks undermining public trust

Health experts have warned that the US decision to roll out new coronavirus boosters without clinical testing on humans risks denting public trust and increasing hesitancy about vaccines.

...

If the slightest thing goes wrong with this booster (a runny nose, 3 hours of hiccups, anything) not only it will be used by anti-vaxxers for their agenda. It will blow a huge hole in any trust in medical science, which is already questioned constantly by all the "alternative" medicine quacks and followers.
It is very risky. You know they cling to any little bit of anecdotal data to sink the entire effort: "I heard that a friend of a cousin of the front man in the apartment next door to the one where my former girlfriend's aunt lives turn into a lizard after he got his booster. I AM NOT GETTING IT".

I agree that it should not have been rolled out so easily.

[dryrunguy]

Speaking of brain fog... My former anti-vax boss who is now basically my corporate equal has screwed up three proposal submissions in the past 2 weeks since she "recovered" from COVID. And when I look at the errors she made along the way, trust me when I say that all three errors could conceivably be attributed to brain fog. As in, "I never got that email with the business proposal"/"No one ever sent me the file for submission"... But she actually did receive it, and the files actually were sent to her.

Maybe it could be attributed to too many emails (she has a lot of work on her plate)--and important stuff just got buried in Outlook. That's possible. But still... You have to wonder.

She has since been stripped of all proposal submission responsibilities.

[Deuce]

.

A little more information on the booster shot...

Why You Need The Original Vaccine(s) Before Being Eligible For The Omicron-Targeted Booster

.

[dryrunguy]

Here's the latest Situation Report.

::

EPI UPDATE The WHO COVID-19 Dashboard reports 607 million cumulative cases and 6.50 million deaths worldwide as of September 14. Global weekly incidence continues to decline, for the fifth consecutive week—down 25% from the previous week. Global weekly mortality decreased as well, for the fourth consecutive week—down 19% from the previous week.

Weekly incidence continues to decline in all WHO regions, ranging from -5% in Europe to -36% in the Western Pacific region. Notably, the pace of the decreasing trend in Europe appears to be slowing, and the region may be approaching a local minimum or plateau.

UNITED STATES
The US CDC is reporting 95.2 million cumulative cases of COVID-19 and 1,046,195 deaths. Daily incidence continues to decline, down to 60,558 new cases per day. This is the lowest average since May 1 and a 54% decrease from the most recent peak on July 16. Daily mortality continues to decline as well, down to 350 deaths per day. This is the lowest average since July 9 and a decrease of 30% from the most recent high on August 12. The CDC reported a slight increase in both daily incidence and mortality on September 12, but this is likely due to delayed reporting over the US Labor Day holiday weekend.*
*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 exhibit downward trends, with decreases of 6.5% and 5.4%, respectively, over the past week. Both trends peaked around the last week of July, similar to trends in daily incidence, and both are approximately 80% lower than the record peak in mid-January 2022.

The BA.5 sublineage continues as the dominant strain in the US, accounting for 87.5% of sequenced specimens; however, growing evidence indicates that BA.4.6 might be capable of outcompeting it. The prevalence of BA.4.6 has steadily increased since at least mid-summer 2022, but the BA.5 prevalence increased more rapidly over much of that period. This is the first week that the CDC’s Nowcast projection shows a noticeable decrease in BA.5 prevalence**, while BA.4.6 continues to account for a larger share of US cases. Since last week, the BA.4.6 prevalence increased from 8.3% to 9.2%, while the prevalence of BA.5 fell slightly from 87.9% to 87.5%. The prevalence of all other reported lineages continues to decline, and together, the Omicron sublineages account for essentially all new US cases.
**From the week of August 27 to the week of September 3, the BA.5 prevalence decreased from 88.0% to 87.9%, but we interpret this as essentially remaining constant over that period.

PANDEMIC RESPONSE EVALUATIONS As daily COVID-19 incidence and mortality continue to decline globally, attention is shifting to pandemic recovery efforts, including lessons for future pandemic preparedness and response. In a long-awaited report published September 14, The Lancet COVID-19 Commission described the tremendous pandemic death toll as “both a profound tragedy and a massive global failure at multiple levels,” underlined by an absence of international cooperation, dismissal of risks by national leaders, influence of misinformation, paucity of governmental and organizational transparency, and disregard for basic public health precautions. As a result, COVID-19 impacted countries in “highly unequal” ways, with particularly severe outcomes for the most vulnerable populations, including children, immigrants and refugees, and those in low- and middle-income countries (LMICs). Additionally, a substantial portion of COVID-19 survivors continue to experience prolonged health effects stemming from SARS-CoV-2 infection, and many people are dealing with the impact of COVID-19-related deaths among family and friends. The report cites the rapid development of vaccines as a positive example of international cooperation, but it also acknowledges substantial disparities in vaccination coverage at the national level, particularly between LMICs and higher-income countries. The report also calls attention to downstream and longer-term effects of the pandemic, including setbacks in progress toward achieving Sustainable Development Goals (SDGs) in many countries.

The report—produced by a panel of 28 experts who consulted more than 170 contributors through 12 task forces—makes several recommendations falling under 5 pillars: prevention, containment, health services, equity, and global innovation. The recommendations include improving multilateral cooperation; implementing a “vaccination-plus” strategy that combines vaccination with other medical countermeasures (MCMs) and nonpharmaceutical interventions (NPIs); improving surveillance and prevention for natural and accidental spillover events; expanding international research and development and manufacturing capacity for vaccines and other products; establishing sustainable financial support for LMICs; and strengthening the WHO and national health systems. The report also calls for intensifying efforts to identify the origins of SARS-CoV-2, noting that the task force examining the pandemic’s origins was ended because “the divisive public discussion about the source of SARS-CoV-2 damaged the trust needed for the task force to complete its work.”

The report has already met pushback from some experts and organizations, including the WHO. The WHO issued a statement in response to criticisms that it acted too cautiously and sluggishly, both to declare a public health emergency of international concern (PHEIC) and warn of the potential for airborne/aerosol transmission. The WHO emphasized that it welcomes the report’s overarching recommendations but argued that there are “several key omissions and misinterpretations,” particularly related to the speed with which the WHO responded to the initial outbreak. Additionally, several experts criticized the report for reviving debate about the virus’ origins and for omitting recent relevant evidence that the novel coronavirus likely emerged through a zoonotic event in a market in Wuhan, China. Notably, the commission’s Chair, Dr. Jeffrey Sachs, has publicly supported the “lab leak” theory as the origin of the virus, and some contest that his personal beliefs unduly influenced the commission’s findings.

Earlier on September 14, WHO Director-General Dr. Tedros Adhanom Ghebreyesus told journalists during his weekly briefing that the world has “never been in a better position to end the pandemic” but is “not there yet.” He called on the international community to “seize this opportunity” and announced the release of 6 WHO policy briefs that outline essential actions for national and subnational policymakers to help reach the goal of ending the pandemic. The briefs include guidance for testing, vaccination, clinical disease management, healthcare facility infection control, combating misinformation, and community engagement. Following those comments, Africa CDC Acting Director Dr. Ahmed Ogwell Ouma emphasized that low vaccination coverage and ongoing transmission across the continent illustrate that COVID-19 remains a major threat.

In related news, an investigation published today by POLITICO and the German newspaper WELT examines the influence of several entities in the COVID-19 pandemic response, including the Bill & Melinda Gates Foundation; the Wellcome Trust; Gavi, the Vaccine Alliance; and the Coalition for Epidemic Preparedness Innovations (CEPI). The investigation concludes that the organizations were better prepared than governments for an infectious disease outbreak; the groups’ leaders were able to routinely meet with high-level government and multilateral organization leaders; they pledged billions of dollars to help close equity gaps for vaccines and treatments but hoarding by high-income nations got in the way; and their initial lack of support for intellectual property waivers might have impeded access to vaccines and therapeutics in LMICs. Several experts have criticized the report for being shortsighted and naïve, including by undervaluing public-private partnerships in pandemic responses and misrepresenting CEPI and Gavi—both financial intermediary funds (FIFs) under the World Bank—as nongovernmental organizations.

US GLOBAL RESPONSE & RECOVERY The Biden administration today released an updated version of its US COVID-19 Global Response & Recovery Framework, meant to help guide the US commitment to a globally equitable end to the emergency phase of the pandemic by working with international partners to use available tools and expertise, integrating COVID-19 response elements into existing health structures, and improving global pandemic preparedness. The plan outlines 3 primary objectives to achieve those goals: vaccinating those who are at highest risk and the hardest-to-reach by ensuring access to vaccines and integrating vaccinations into existing health structures; integrating and scaling testing and treatment efforts into existing health structures without disrupting other health services; and preparing for future variants and pandemic threats by strengthening health security infrastructure to detect and rapidly respond to emerging threats. The updated global framework comes at a time when the US is facing domestic pandemic fatigue, dwindling amounts of federal funding, and hundreds of daily deaths due to COVID-19.

US ECONOMIC IMPACTS Recent data from the US Census Bureau is helping to illuminate impacts of the COVID-19 pandemic and response. The bureau released 1-year estimates from its American Community Survey today, showing various social and economic changes. For example, fewer people moved to a new home, more people gained internet access through expanded coverage and computer ownership, more unmarried couples moved in together, more people spent over 30% of their income on rent, preschool enrollment dropped, and public transportation use dropped by half. Another report, the 2022 Current Population Survey Annual Social and Economic Supplement (CPS ASEC), included some rare good news. Childhood poverty is at a historic low, falling from 9.7% to 5.2% between 2020-2021. Experts attribute much of this improvement to the boosted child tax credit included in the American Rescue Plan that provided families additional money to pay for food, clothes, education, and extracurricular activities. Notably, the overall poverty rate also fell to 7.8% in 2021 from 9.2% in 2020. Additionally, the report shows that insurance coverage expanded in 2021, most likely due to pandemic-related measures that mandated a continuous enrollment provision Medicaid. Many of these measures have already ended or are set to expire, and it is now up to the US Congress to decide whether these measures should be renewed or stay in place.

LONG COVID IN EUROPE An estimated 17 million people across the WHO’s Europe region experienced post-acute sequelae or long-term symptoms of COVID-19, also known as long COVID, during the pandemic’s first 2 years, according to a modeling study conducted by the Institute for Health Metrics and Evaluation (IHME) for WHO/Europe. The region comprises 53 Member States across Europe and Central Asia that are home to nearly 900 million people. The report highlights the ongoing public health challenges posed by the condition, which is characterized by cognitive and mental health problems, fatigue, shortness of breath, and other symptoms experienced 12 weeks or more following a COVID-19 diagnosis.

The report, published September 13, found the number of new long COVID cases identified between 2020 and 2021 rose threefold, driven by the rapid increase in confirmed COVID-19 cases from late 2020 through 2021; women are twice as likely than men to suffer from the condition; and the risk of long COVID increases dramatically among people with severe infections who need hospitalization. WHO officials and the report authors said that although most people fully recover from COVID-19, the findings underline the need for additional analysis and investment to determine the long-term effects of the disease, including implications for the workforce and the need for rehabilitative and support services.

SARS-COV-2 VACCINE BOOSTER DURABILITY Recently published data on SARS-CoV-2 vaccine booster durability indicate that protection wanes by approximately 10-20% each month. Researchers at Ohio State University conducted a longitudinal study of healthcare workers to assess the durability of antibody titers stimulated by booster doses and published their preliminary analysis as a commentary in the New England Journal of Medicine. The study included 46 fully vaccinated participants who received their first booster—24 with the Moderna vaccine and 22 with the Pfizer-BioNTech vaccine*—and serum specimens were collected every 3 months after the booster dose to assess neutralizing antibody titers against the multiple variants, including the Omicron variant of concern (VOC).
*Neither the commentary nor supplementary appendix explicitly indicates whether the booster doses were the monovalent or bivalent formulation, but based on the study timing and duration, we understand them to be monovalent.

Among the participants, 14 had breakthrough infections during the study period, including 9 during the US Omicron variant surges. Notably, the duration of antibody titers was more robust in individuals with prior SARS-CoV-2 infection. Overall, neutralizing antibody titers decayed at a mean rate of 17.53% per month against lineages containing the D614G mutation (ie, Omicon sublineages). More specifically, titers decayed by 19.50% against the B.1 sublineage, 18.44% against BA.2.12.1, and 19.55% against BA.4/5 each month. Among participants with previous SARS-CoV-2 infection, antibody titers decayed 17.07% against lineages containing the D614G mutation, 14.22% against BA.1, 9.97% against BA.2.12.1, and 12.12% against BA.4/5. Additionally, the decay in antibody titers following the first booster dose was slower than after receiving the second dose of the primary series of the vaccines.

Experts note that waning protection is not unexpected for vaccines, emphasizing that this should not dissuade anyone from recommended booster doses. Some experts, however, have called attention to the contrast between this analysis and federal officials’ recent comments about plans for annual boosters, much like seasonal influenza. They argue that if antibody titers wane over a period of several months, annual boosters may not be often enough to provide sufficient protection. Available evidence demonstrates that booster doses do maintain protection against severe disease; however, rapid waning of that protection may necessitate regular booster doses—potentially as frequently as 4 months—especially for those at elevated risk of severe disease and death. Others posed questions regarding barriers to accessing booster doses, particularly in the context of the generally low coverage for annual seasonal influenza vaccinations.

Another issue is the absence of clearly defined and regular seasonal trends for COVID-19. While seasonal influenza tends to peak annually in the winter months, the COVID-19 pandemic has not exhibited traditional seasonality, peaking multiple times each year, across all seasons. Additionally, the emergence of new variants of concern or associated sublineages has occurred more frequently than once per year so far in the pandemic, which White House officials acknowledged could necessitate additional booster doses. Many questions remain regarding future COVID-19 trends and how those will factor into vaccination planning and guidance.

https://covid19.who.int/

[ti-amie]

US ECONOMIC IMPACTS Recent data from the US Census Bureau is helping to illuminate impacts of the COVID-19 pandemic and response. The bureau released 1-year estimates from its American Community Survey today, showing various social and economic changes. For example, fewer people moved to a new home, more people gained internet access through expanded coverage and computer ownership, more unmarried couples moved in together, more people spent over 30% of their income on rent, preschool enrollment dropped, and public transportation use dropped by half. Another report, the 2022 Current Population Survey Annual Social and Economic Supplement (CPS ASEC), included some rare good news. Childhood poverty is at a historic low, falling from 9.7% to 5.2% between 2020-2021. Experts attribute much of this improvement to the boosted child tax credit included in the American Rescue Plan that provided families additional money to pay for food, clothes, education, and extracurricular activities. Notably, the overall poverty rate also fell to 7.8% in 2021 from 9.2% in 2020. Additionally, the report shows that insurance coverage expanded in 2021, most likely due to pandemic-related measures that mandated a continuous enrollment provision Medicaid. Many of these measures have already ended or are set to expire, and it is now up to the US Congress to decide whether these measures should be renewed or stay in place.

Another reason the upcoming election is so important.

[ponchi101]

If the US electorate were in any way sophisticated (and there are very few that are, worldwide), the configuration of congress would be easily moved. The GOP has proven again and again that they care not one bit for the people of the USA; they care about the corporations.
But we know that the people of the USA cannot make the connection. So, who knows how that ends in November.

[dryrunguy]

Biden thoroughly deserves to get dragged for his "the pandemic is over" comment. Just because that's what people want to hear doesn't make it true.

Also, be sure to take note of this little gem buried in the latest Situation Report--1200 reported COVID death globally per day (that's probably woefully low), and 400 of those deaths occur in the United States even though the United States only comprises 4% of the global population. Think on that.

Sure, the pandemic is over.

::

“PANDEMIC IS OVER” In an interview with “60 Minutes” at the North American International Auto Show in Detroit, Michigan, US President Joe Biden said he believes that the COVID-19 “pandemic is over” while simultaneously acknowledging that the disease continues to be a “problem.” Notably, a White House team that reviewed the transcript of the interview, which aired September 18 but was taped last week, did not alert its COVID-19 response team about the declaration, leaving senior federal health officials surprised and without a coordinated response for the immediate reactions. President Biden had not originally planned to make headlines on COVID-19, nor had he discussed an end to the pandemic with his health advisors. The day after the interview aired, US HHS Secretary Xavier Becerra supported the president’s comments, saying that effective vaccines, tests, and treatments put the nation on a better path than earlier in the pandemic and noted the administration is reviewing whether it will renew the national declaration of a public health emergency.

But President Biden’s comments drew swift and sharp reactions from public health experts and appeared to further divide opinions over when and how the nation will move out of a pandemic state and into one of endemicity. Some experts supported the president’s comments, noting that while COVID-19 should continue to qualify as a top national priority, much of the nation is settling into a new way of life. Other experts fear that President Biden’s declaration further muddles the messaging surrounding the pandemic and comes at an inopportune time, when the US government is rolling out new bivalent vaccine boosters and asking the US Congress for additional emergency spending. Additionally, virologists are seeing signs of viral resurgence, underlining the enormous amount of uncertainty surrounding the future.

While there are no clear markers to the end of a pandemic, some experts point to 2 ways to determine when an outbreak emergency is over: by looking at what the disease is doing physically and psychologically to a population. To be sure, President Biden’s comments reflect a general national sentiment that people want to move on from the pandemic and that the situation differs significantly from 2 years ago. Schools are open; air travel has returned to pre-pandemic levels; workers are returning to offices at the highest rates since the start of the pandemic, although 1 in 3 say they fear infection by working in offices; and COVID-19 testing labs and at-home test manufacturers are downsizing, but primarily due to a lack of funding.

However, many, including White House Chief Medical Advisor Dr. Anthony Fauci, are worried the nation is not where it needs to be in order to “live with the virus.” The US continues to record more than 400 daily deaths, and the world counts more than 1,600 deaths each day. Notably, this means the US accounts for nearly 25% of the worldwide daily COVID-19 mortality, despite representing only 4% of the global population. A significant portion of the US population remains unvaccinated or under-vaccinated, and therefore at elevated risk of severe disease and death. Nationally, 68% of the population has received a primary vaccine series but only 35% of those over age 5 have gotten a first vaccine booster dose. The president’s remarks could further hinder efforts to increase vaccination and booster rates ahead of what many expect will be a surge in cases over the winter. Additionally, the pandemic has had crippling health, social, and economic impacts on essential workers and vulnerable populations, such as those who are immunocompromised, and on the estimated 18-23 million US residents who are suffering the long-term physical and mental health effects of long COVID.

President Biden’s remarks also likely will undercut his administration’s efforts to procure additional emergency spending for COVID-19. The White House has requested US$22.4 billion from the US Congress, but leading Republicans, who were already skeptical about authorizing additional funding, said the president’s comments essentially shut the door on negotiations as well as raise questions about other pandemic-related measures. Without additional funds for vaccine, treatment, and diagnostic supplies, or for research into next generation vaccines that could prevent SARS-CoV-2 transmission, the burden to pay for pandemic-related tools and stop chains of transmission will shift to the US public, and it remains to be seen whether federal and state policymakers will learn lessons from this pandemic in order to strengthen public health infrastructure to prepare for the next.

US VACCINATION CAMPAIGN The US Department of Health and Human Services last week released a video advertisement to encourage people to get updated SARS-CoV-2 vaccine booster shots. The ad specifically highlights those who are aged 50 and older, and shares the importance of getting the updated, bivalent vaccines, which are expected to provide additional protection against currently circulating SARS-CoV-2 Omicron subvariants. More than 200 million people are eligible for the new vaccines, however demand has dropped considerably with each new round of shots. More than half of people eligible for previous boosters never got them. Nevertheless, several pharmacies and hospitals in California, Hawaii, and Washington, DC, have reported running out of doses of the updated Moderna booster but expect additional supplies soon.

Additionally, several reports have raised concerns over the potential for vaccine administration errors, particularly among children. While there is no evidence vaccine mix-ups have caused more severe adverse events, the complexity involved in keeping straight up to 11 different vaccine brands and formulations has led the US CDC to produce visual guides for vaccine administrators. The potential for errors further undercuts parents’ already low interest in vaccinating their young children. Only about 410,000 children aged 5 and younger have been fully vaccinated since the vaccines became available for this age group in June, according to CDC data. The number of COVID-19 deaths among children is low, but scientists remain concerned about possible long-term complications of COVID-19 among children. Many physicians, and parents, have cited failures among government and local public health agencies to adequately promote the vaccine, communicate about its availability, and debunk circulating myths. Some health officials are concerned that hesitancy to vaccinate children against COVID-19, as well as other diseases, could lead to future outbreaks of other childhood infections.

Public health experts had hoped that another vaccine option—the adjuvanted protein-based SARS-CoV-2 vaccine from Novavax that uses a more traditional platform—would help win over those who were hesitant to receive the newer mRNA-based vaccines. But since it was authorized in July, uptake remains low, with only 6,278 people fully vaccinated using the Novavax vaccine. Outside of the US, the Novavax vaccine has been approved in 38 other countries, including in Japan and Australia, which each recently approved the vaccine for use as a booster.

EU EMERGENCY SUPPLY CHAIN POWERS The European Commission has shared a proposed rule that would make EU Member States prioritize the production of key goods and services to preserve supply chains in a crisis. The Single Market Emergency Instrument would create a crisis governance framework to prevent market fragmentation, drawing on lessons from the COVID-19 pandemic. Among the interventions available to the European Commission, breaking contracts to facilitate the production and stockpiling of critical products would be an option, as well as repurposing production lines and facilitating expansion to prevent bottlenecks like those experienced during the COVID-19 pandemic and the Russian invasion of Ukraine. The emergency powers of the proposal aim to reorganize supply chains as quickly as possible and support the increase and availability of crisis-relevant goods. The proposal includes fines up to 300,000 euros for companies that share incorrect or misleading information. The effort, which echoes similar efforts in the United States and Japan, will likely face pushback from businesses concerned with the expanded power the ruling is overreaching and intrusive.

VACCINE PRODUCTION IN AFRICA Amid slowing global demand for SARS-CoV-2 vaccines, the world’s largest producers of vaccines for COVID-19—Pfizer-BioNTech and Moderna—continue to face pressure to allow low- and middle-income countries (LMICs) to produce their vaccines after much of the supply was purchased by high-income countries. Under a fill and finish agreement with Pfizer-BioNTech, the South Africa-based Biovac Institute, which is partly owned by the South African government, recently produced its first batch of the companies’ vaccine. The doses, the first of Pfizer-BioNTech’s shots to be produced in Africa, will undergo regulatory review and additional batches are expected to be commercially available next year. Aspen Pharmacare, which is authorized to fill and finish vials of the J&J-Janssen SARS-CoV-2 vaccine under its Aspenovax brand for distribution in Africa, earlier this year cautioned it might have to halt its vaccine production lines because it had not received a single order. At the end of August, Aspen announced it signed a deal with the Serum Institute of India to manufacture and sell 4 Aspen-branded vaccines for Africa, effectively keeping the production lines open. Moderna reportedly is seeking a partner on the continent to produce its SARS-CoV-2 vaccine.

In related news, Moderna has allowed the use of its vaccine in clinical trials to test a shot developed by Afrigen Biologics & Vaccines, another South African biotechnology company working with the WHO as part of its mRNA Vaccine Technology Transfer Hub. Afrigen is working to develop mRNA-based SARS-CoV-2 vaccines to increase production and access for LMICs. Instead of supplying the vaccine directly, Moderna approved the Medicines Patent Pool to provide its vaccine to Afrigen for use in early-stage clinical trials; Pfizer-BioNTech refused a similar request because the companies did not see the need as urgent. Afrigen expects to begin human trials of its mRNA vaccine candidate by May 2023. Additionally, Moderna last week said it is open to supplying the Chinese government with its vaccine, although no final decision has yet to be reached. China has not authorized the use of any foreign-made SARS-CoV-2 vaccines, relying on several domestically produced shots.

TREATMENT ACCESS & UPDATES Amid heightened demand from low- and middle-income countries (LMICs) for expanded access to COVID-19 therapeutics, little progress has been made at the World Trade Organization (WTO) toward reaching an agreement to include COVID-19 therapeutics and diagnostics in a limited deal reached earlier this year to temporarily waive patents on SARS-CoV-2 vaccines. High-income countries, including the UK, Switzerland, EU Member States, and the US, as well as pharmaceutical companies, appear opposed to extending the deal to treatments and tests by the end-year deadline.

Separately, a program aimed at bringing oral COVID-19 antivirals to 10 LMICs in sub-Saharan Africa and Asia—Ghana, Kenya, Laos, Malawi, Nigeria, Rwanda, South Africa, Uganda, Zambia, and Zimbabwe—recently launched. With support from nonprofit organizations and other partners, the COVID Treatment Quick Start Consortium will provide Pfizer’s Paxlovid (nirmatrelvir-ritonavir) through pilot programs to evaluate the best ways to implement test-to-treat programs in areas with limited healthcare resources and infrastructure.

In other treatment news, the European Medicines Agency (EMA) last week extended its authorization of AstraZeneca’s preventive COVID-19 therapy Evusheld (tixagevimab co-packaged with cilgavimab) as a treatment for the disease among adults and adolescents with COVID-19 who do not need supplemental oxygen but who are at increased risk of disease progression. Last month, Japan became the first country to approve the monoclonal antibody for COVID-19 treatment. Several nations already have authorized Evusheld as a preventive therapy among people with compromised immune systems who do not respond to vaccination in several nations, including the US.

Additionally, the WHO last week strongly advised against the use of 2 different antibody therapies—sotrovimab as well as casirivimab-imdevimab—to treat patients with COVID-19 because they have limited clinical activity against currently circulating viral variants. The US FDA previously pulled or limited the use of the drugs, and some experts criticized the WHO for waiting to make the updated recommendation. The WHO expanded its conditional recommendation for the antiviral remdesivir to cover patients with severe COVID-19 and those with non-severe infections but who are at high risk of hospitalization.

Only a handful of COVID-19 therapeutics remain useful against currently circulating SARS-CoV-2 strains. While researchers quickly developed 4 effective treatments for hospitalized COVID-19 patients in the year between January 2020 and February 2021, no new therapies for hospitalized patients have been authorized since February 2021, raising concerns about whether treatment advancements have stalled.

[ponchi101]

1,200 deaths/day reported worldwide simply means that the rest of the world is not reporting, and the USA is. I really doubt that Colombia even cares anymore; people here have more problems, so nobody is getting tested. One has to wonder how the C19 deaths are reported (but of course, we have very few anti-vaxxers).
Biden's "pandemic is over" comment: eventually, you need to get to RealPolitiks. The mid terms are coming and the last thing you need is the GOP securing both the House and the Senate, and then you can see what is going to happen to any possible legislation or any possible advancement. If the GOP gets the senate, you can bet they will pass a law banning abortion (Biden will veto) and that can lead to more deaths than C19.
So, if in order to get the dumb electorate to vote democrat in November he needs to declare the pandemic is over, do it. Anyway, the people more at risk are those that still refute the science. I feel no pity for them, so be it.