Coronavirus updates June 2022

[missy]

Sadly this theme continues. The pandemic is still going strong over 27 months since it began.


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The United States entered Memorial Day weekend with new coronavirus cases at least five times higher than this point last year as the nation confronts the most transmissible versions of the virus yet. Public health authorities are bracing for summer travel and gatherings to fuel new bumps, especially as recent research suggests omicron infections fail to provide lasting immunity. As governments abandon efforts to control the spread, Americans are largely on their own to navigate a third pandemic summer.

Shanghai’s two-month lockdown is coming to an end. Taxis, public buses and ecstatic young people returned to the streets Wednesday morning as China’s financial capital officially lifted its lockdown for most residents. The city of 25 million will reopen gradually and residents say the emotional and financial scars will take time to heal.

OTHER IMPORTANT NEWS

Schools are struggling to meet rising mental health needs as a new federal survey shows seven in 10 public schools are seeing an increase in students seeking services.

Japan is reopening to foreign tourists after more than two years with visitors from select countries including the United States allowed starting June 10.

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[missy]

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Covid was vanishing last Memorial Day. Cases are five times higher now.​

Covid-weary Americans enter summer with little effort to contain a still-raging pandemic​

By Fenit Nirappil
,
Craig Pittman
and
Maureen O'Hagan




For the third year, Americans are greeting the unofficial start of summer shadowed by the specter of the coronavirus amid rising covid-19 casesand hospitalizations across the country.
The United States is recording more than 100,000 infections a day — at least five times higher than this point last year — as it confronts the most transmissible versions of the virus yet. Immunity built up as a result of the record winter outbreak appears to provide little protection against the latest variants, new research shows. And public health authorities are bracing for Memorial Day gatherings to fuel another bump in cases, potentially seeding a summer surge.
It’s a far cry from a year ago, with predictions of a “hot vax summer” uninhibited by covid concerns. Back then, coronavirus seemed to teeter on the brink of defeat as cases plummeted to their lowest levels since spring 2020 and vaccines became widely available for adults. Even the vaccinated and boosted now grudgingly accept the virus as a formidable foe that’s here to stay as governments abandon measures to contain it.
Americans emerged from isolation last Memorial Day: 'Like the end of Prohibition'
As the virus morphs and the scientific understanding of how it operates shifts with each variant, Americans are drawing their own lines for what they feel comfortable doing.



“This time last year, I was so hopeful,” said Margaret Thornton, a 35-year-old Philadelphia researcher preparing to spend her summer socializing mostly outdoors because of her weakened immune system. “Now, I don’t know when it’s going to be over, and I don’t think there is necessarily a light at the end of the tunnel. Or rather, if there is a light, is it an opening to get out? Or is it a train?”
Parents of children too young to be vaccinated are making cross-country travel plans. Octogenarians are venturing to bars. And families are celebrating graduations and weddings with throngs of mostly unmasked revelers — mindful they may get sick. Again.
More than half of the U.S. population is living in areas classified as having medium or high covid-19 levels by the Centers for Disease Control and Prevention. The latest cases have yet to overrun hospitals, but that could change as the virus spreads among more vulnerable people. The dominant strains circulating in the United States are the most contagious thus far.



“This one is really revved up, and it’s probably getting up there with something as transmissible as measles,” said Peter Hotez, dean of the National School of Tropical Medicine at Baylor College, describing the BA.2.12.1 subvariant now accounting for more than half of new cases. “Over the Memorial Day holidays, if you are in settings where you are indoors with large numbers of people without masks … there is a good likelihood you will suffer a breakthrough infection.”

What to expect from the BA.2 'stealth' omicron variant
2:54


Experts had hoped that the explosion of the omicron variant this winter, estimated to have infected a quarter of Americans who hadn’t already been infected, and the subsequent spring wave of omicron’s even more transmissible subvariants, would provide a buffer against future surges.
But an emerging body of research suggests those infections will not confer lasting protection as the virus’s latest iterations show remarkable ability to escape immunity. Experts say the recently infected who also received booster shots can count on at least several months of immunity, while the unvaccinated should expect little protection.
They got covid. Then they got covid again
“You should not think, ‘Oh, I had omicron, I don’t need any shots’ or ’I don’t need any more shots,'” said Melanie Ott, director of the Gladstone Institute of Virology and a co-author of a paper recently published in Nature finding limited natural immunity from the omicron variant. “We are going into a surge of the omicron subvariants that are more and more able to infect people who have preexisting immunity.”
Experts say vaccines are still showing durability in protecting people against severe illness. But the initial burst of antibodies from shots or infections fades after several months, said Celine Gounder, an infectious-diseases specialist and senior fellow at Kaiser Health News. That means the virus can develop into an infection before the body’s immune system kicks in.

People across the street from the TD Garden in Boston. (Vanessa Leroy for The Washington Post)
Burhan Yardimci, his wife and their three young children — who had all contracted coronavirus in February — joined thousands of Turkish Americans on Madison Avenue recently for the return of New York’s annual Turkish Day Parade, canceled the last two years because of the pandemic. The next day, the family stood among another crowd of thousands for the Celebrate Israel Parade.



Yardimci doesn’t take much solace in his recent infection as an extra layer of protection. He thought his booster shot would stop infections, but he knows people who’ve had the virus three times. Because no one in his family became seriously ill, he doesn’t see the need to upend his life when everyone around him appears to be carrying on as normal.
“Hopefully, we’ll never get it again,” said Yardimci, 42.
Covid deaths no longer overwhelmingly among unvaccinated as toll on elderly grows
In the Boston suburbs, Mandy Boyd found herself humbled by coronavirus after getting infected twice in five months: during the massive omicron wave in January, and again in May after attending a 150-person indoor wedding. Neither case was severe.
The experience left the 35-year-old health technology worker reassessing how to protect her 4- and 6-year-old children from infections that would disrupt their schooling or summer camp. She still plans to dine out and go to the gym, but her family will wear masks on their flight to Seattle for an upcoming vacation as well as when they watch a WNBA game while there. She worries about passing on a future variant to her children, even if her short-term immunity protects her from getting sick.
“We’re in a strange spot because it turned into a much more minor virus,” said Boyd of Swampscott, Mass. “From that perspective, I don’t see that the world should stop or schools should close.”

U.S. Naval Academy graduates celebrate in Annapolis. (Michael Reynolds/EPA-EFE/Shutterstock)
Graduations, proms and weddings have also returned after being canceled in earlier stages of the pandemic when cases were lower than they are now.



Adeline Rosales, 26, was among the hundreds of California State University Long Beach students in caps and gowns flooding into Angel Stadium in Anaheim on a recent morning. It was her first encounter with some classmates in the College of Health and Human Services who were only familiar as faces on a computer screen during virtual class. She felt comfortable marching alongside them through a tunnel and onto the field knowing the university required vaccines and booster shots. And it was important for her relatives to celebrate the occasion with her because she is the first in the family to graduate college.
But to avoid graduation crowds, she said the family waited several days for their celebratory dinner because they were “a little scared” as infections rose and Los Angeles County moved from a low to medium covid-19 risk level. Rosales lives with her parents, both of whom have preexisting conditions, and six other relatives.
Virus mutations aren’t slowing down. New omicron subvariant proves it.
“I don’t want to risk it at this point,” Rosales said. “We’re just trying to be as respectful to my parents as possible.”



For most Americans, coronavirus has faded from the foreground.
More than half say they are not too concerned or not at all concerned with coronavirus, according to a May survey by Monmouth University.
Nearly three-quarters say they hope to vacation this summer and less than a third say coronavirus is a major factor in their plans, according to a recent Washington Post-Schar School poll. The Transportation Security Administration on Thursday reported screening more than half a million additional fliers a day compared with the same day last year.
Experts are paying close attention to the Southeast for a potential covid resurgence because the region did not experience as many cases in the spring as the Northeast, and rising temperatures are driving people indoors.

Fans enjoy the atmosphere around the circuit during the F1 Grand Prix of Miami. (Alex Bierens De Haan/Getty Images)
Florida residents are bracing for the return of another summer surge in sharply different ways.



For Jeff Schulte, a 63-year-old retiree, coronavirus has never really gone away, and he sees no reason to change his behavior for an omnipresent threat. He is not planning on masking, social distancing or getting booster shots this summer.
“For the rest of our lives, it’s here,” he said while smoking a cigarette outside the library in downtown Sarasota. “It’s going to catch every one of us.”
To the north near Tampa, Rick Kilby, 57, donned a KN95 mask as he hawked his book about the Victorian-era belief in the healing properties of Florida springs at Floridania Fest in a Gulfport casino ballroom. Mostly unmasked attendees snaked past his table, conveniently situated near an open door that brought in fresh air.
In Florida, a summer of death and resistance in 2021 as virus raged
He’s not worried about getting seriously ill after a second booster shot. But after hearing about five vaccinated friends getting infected in just two days, he does fret about having to cancel his upcoming trip to western Pennsylvania — the only vacation he had planned for the year.



“It’s not like it was two years ago where you are really concerned about going to the hospital and not getting out. Now, it’s more of a concern that this is going to be a real inconvenience to my schedule,” said Kilby, who lives in Orlando. “That’s the wonder of the vaccine. It made it from a life-threatening condition to one that’s really more like having a flu or cold or something.”
Others at the vintage Florida memorabilia festival feared worse consequences.
Patti Kane-Wood, 78, entered the expo wearing a blue surgical mask but felt uncomfortable by how attendees “were squeezed in there like sardines” and didn’t stay long. She has heard about more people getting covid in the last month than in the last two years. While she feels well-protected from getting her second booster dose, she worries about long-term complications after watching friends develop persistent breathing problems following their illnesses. A recent study found vaccines may offer little protection against most long-covid symptoms.
“If I catch covid, even the slightest case of covid, it’s possible I have long covid and have issues for the rest of my life,” Kane-Wood said. “I’m very afraid because people are very relaxed now and understandably so, but it’s not a time to let our guard down.”

Sunday brunch at Hole in the Wall in Manhattan. (An Rong Xu for The Washington Post)
Parents of young children are entering Memorial Day weekend frustrated that children younger than 5 remain the only group ineligible for vaccines. The prospect of regulators clearing shots by the end of June is becoming increasingly likely after Pfizer-BioNTech reported data showing their three-dose regimen proved 80 percent effective in preventing symptomatic infections in children 6 months to 4 years old.



In the meantime, parents are navigating how to protect their unvaccinated children when cases are rising and others are dropping their guards.
In Portland, Ore., Jessica Poole said she is not taking her 5-year-old daughter, Lucía, and 3-year-old son, Max, to indoor play facilities, where Lucía would catch illnesses even before covid. She asks Lucía to wear a mask while she’s at prekindergarten. And the family isn’t planning any travel, because Max is too young to get vaccinated.
But Poole, 37, is not trying to avoid the virus at all costs.
“Whatever strain is going around now, you can’t be too terrified of it,” Poole said outside a CrossFit gym where she planned to work out without a mask on. “We need to live a normal life now.”
At a southeast Portland pub, George Cummings, 85, took a leap of faith as he joined his friends from a local mountaineering and climbing club for drinks. He knows he’s at a higher risk because of his age and wears a mask at the grocery store. He said he has not received a second booster shot because his doctor had not told him they were available.
He went maskless as he drank lemonade, ate a cheeseburger andmingled with a group of two dozen in the crowded bar.
“I’m not sure I’m 100 percent comfortable with my decision, but the alternative was not to go to the event,” said Cummings, who lives alone and had suspended his social life for the better part of two years.
“It’s almost a question of, do you want to live — and that includes some sort of social life for a human being — or am I going to hide in my basement?”
Pittman reported from Gulfport, Fla., and O’Hagan reported from Portland, Ore. Jack Wright in New York, Yvonne Condes in Anaheim, Calif., and Doug Moser in Boston contributed to this report.

Coronavirus: What you need to read​

Vaccines: Will you need a fourth coronavirus vaccine? Officials have authorized a second booster shot for Americans 50 or older. A vaccine for young kids could also be available soon.
Mask guidance: A federal judge struck down the mask mandate on transportation, but covid-19 cases are on the rise again. We created a guide to help you decide whether to keep wearing face coverings. Most experts say you should keep wearing on planes.


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[missy]

Infectious Disease>COVID-19 Vaccine

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Babies Less Likely to Catch COVID When Born to Vaccinated Moms​

— Vaccination in pregnancy linked with 33-71% lower risk of positive test by 4 months​

by Molly Walker, Deputy Managing Editor, MedPage Today June 1, 2022

Infants born to mothers who were vaccinated against COVID-19 during pregnancy had a lower risk of testing positive for SARS-CoV-2, even when the Omicron variant was dominant, Norwegian researchers found.
During the Omicron period, infants whose mothers received a second or third dose of COVID vaccine during pregnancy had a 33% lower risk of a positive test at age 4 months than infants born to unvaccinated mothers (HR 0.67, 95% CI 0.57-0.79), reported Ellen Øen Carlsen, MD, of the Norwegian Institute of Public Health in Oslo, and colleagues.

The differences between infants with vaccinated versus unvaccinated mothers were even more dramatic during the Delta period, where the risk of a positive test was 71% lower (HR 0.29, 95% CI 0.19-0.46), the authors wrote in JAMA Internal Medicine.
Recent studies showed that vaccination during pregnancy helped protect infants from serious illness and risk of hospitalization from COVID, but did not focus on protection from infection.
Carlsen and co-authors examined data from Norwegian birth registries from September 2021 to February 2022, and used the Norwegian Immunization Register to derive data on COVID vaccines. Women who received a second or third dose of mRNA vaccine, such as Pfizer or Moderna, after 83 gestational days and up to 14 days prior to delivery were considered vaccinated, the team noted.
Overall, 21,643 newborns were included, and 45% of those were born to women who were vaccinated during the last two trimesters of pregnancy. Unvaccinated mothers tended to be younger, with more children and a lower education level, the researchers said.

There were 906 infants who tested positive for COVID via a PCR test within the first 4 months of life, for an incidence rate of 5.8 per 10,000 follow-up days. During the Delta period (defined as before Jan. 1, 2022), incidence rates were 1.2 and 3.0 per 10,000 for infants born to vaccinated and unvaccinated mothers, respectively. Incidence rates for the Omicron period were 7.0 and 10.9 per 10,000 follow-up days. Sensitivity analyses focusing mainly on the Omicron period produced similar results.
There were also 2,839 infants born to mothers who only received one dose of mRNA vaccine during pregnancy. Of those, 36 had a positive COVID test, including fewer than five infants during the Delta period. During the Omicron period, adjusted HR for a positive test among these infants versus those born to unvaccinated mothers was 0.72 (95% CI 0.50-1.03).
Interestingly, the authors noted that among 824 infants whose mothers had a third dose of COVID vaccine during pregnancy, none had a positive test during Delta, and risk of a positive test during Omicron was lower for those with a third dose (aHR 0.22, 95% CI 0.12-0.43) versus those with two doses (aHR 0.70, 95% CI 0.59-0.83).

Limitations to the data include lack of specific information about the variant that each infant tested positive for, and that vaccines during the last 14 days of pregnancy or postpartum were not included. The authors also acknowledged the potential for residual confounders.
"The findings of this study provide early evidence to suggest that infants benefit from passive protection from SARS-CoV-2 infection following maternal COVID-19 vaccination during pregnancy," the researchers concluded.

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[missy]

Seniors' COVID Deaths Up; DOJ Appeals Mask Mandate Ban;​

— A daily roundup of news on COVID-19 and the rest of medicine​

by Joyce Frieden, Washington Editor, MedPage Today June 1, 2022

"
Death rates for those 65 and older rose substantially during this past winter's Omicron wave, as compared to the previous Delta wave. (New York Times)

The Department of Justice asked a federal appeals court to overturn last month's decision barring the nationwide mask mandate for air travel and other public transit. (NPR)

Speaking of mandates, the Centers for Medicare & Medicaid Services has cited 69 hospitals for not complying with healthcare worker vaccine mandates. (Politico)



Why was this patient charged nothing for her first screening colonoscopy, and then $2,185 for the same procedure 6 years later? (Kaiser Health News)

The Supreme Court temporarily stopped the counting of mail-in ballots in Pennsylvania, a move that could affect the Republican primary election for the Senate -- a race that includes celebrity doctor Mehmet Oz, MD. (AP)

U.K. health authorities are urging those with monkeypox symptoms to abstain from sex while they're symptomatic, in order to curb the spread of the disease. (Washington Post)

As of Wednesday at 8:00 a.m. EDT, the unofficial U.S. COVID toll reached 84,201,634 infections and 1,006,229 deaths, increases of 212,110 and 386, respectively, from this time Tuesday. New cases are now averaging over 103,000 per day.

COVID-19 cases in the Big Apple have plateaued, suggesting that the latest COVID surge there might be ending. (ABC News)

Doctors are reconsidering prescribing nirmatrelvir-ritonavir (Paxlovid) for low-risk COVID-19 patients in the wake of reports of rebound infections and the subsequent round of isolation time. (Reuters)



The NIH updated its COVID-19 treatment guidelines, recommending against the use of colchicine for hospitalized patients, and making changes to the sections on critical care for children and antithrombotic therapy, among others.

Abbott announced FDA clearance of its next-generation FreeStyle Libre 3 glucose sensor, which is indicated for people with diabetes ages 4 years and up.

Medical students who reported being mistreated or discriminated against during their first 2 years of medical school were significantly more likely to eventually drop out compared with their peers who did not report any mistreatment, researchers found. (JAMA Pediatrics)

Hospital operating margins in April were down 38.1% from the previous month and 76% from April 2021, reflecting continued challenges in recovering from last winter's COVID-19 Omicron variant surge, according to a report from management consulting firm Kaufman Hall.


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[missy]

Long COVID Neuropsychiatric Deficits Greater Than Expected​

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NEW ORLEANS – Patients experiencing brain fog and other persistent symptoms of long COVID show significant deficits on neuropsychiatric testing that correspond with prior acute COVID-19 infection, adding to mounting evidence of the significant toll the chronic condition can have on mental health.

Dr Sean Lynch
"Many clinicians have observed the symptoms we describe in this study, however this report is among the first which identify the specific deficits using neuropsychological testing to better characterize the syndrome," Sean T. Lynch, MD, first author of a study on the issue presented at the annual meeting of the American Psychiatric Association, said in an interview.


Lynch, of the department of psychiatry, Westchester Medical Center Health System, Valhalla, N.Y., and his colleagues enrolled 60 participants who had experienced acute COVID-19 disease 6-8 months earlier and had undergone neuropsychological, psychiatric, medical, functional, and quality-of-life assessments. Results from the study were published online in the Journal of the Academy of Consultation–Liaison Psychiatry (2022 Jan 25. doi: 10.1016/j.jaclp.2022.01.003).

Among the study participants, 32 were seeking treatment for brain fog in a clinical program for survivors of COVID-19, while the remaining 28 were part of an ongoing longitudinal investigation of neuropsychological, medical, and psychiatric sequelae of COVID-19, but were not seeking care for the persistent symptoms.

Assessments for neurocognitive impairment included a battery of tests used in infectious and other diseases, including the Test of Premorbid Function, the Patient Assessment of Own Function, the Trail Making Test parts A and B, the Stroop Color and Word Test, and others.


Overall, the battery of assessments showed that 37 (62%) of participants had neuropsychological test impairment, with results below the 16th percentile in two tests, while 16 (27%) showed scores indicative of severe impairment (below the second percentile in at least one test and below the 16th percentile in one test).

Those reporting brain fog had scores that were even lower than expected on tests of attention, processing speed, memory, and executive function. And among those reporting brain fog, significantly more had scores reflecting severe impairment compared with the controls (38% vs. 14%; P < .04).

"Based on what we've observed in our patients and what others have previously reported, we did expect to find some impairment in this study sample," Lynch noted.
"However, we were surprised to find that 27% of the study sample had extremely low neuropsychological test scores, meaning that they scored at least two standard deviations below the expected score on at least one neuropsychological test based on their age and level of education."
The brain fog group also reported significantly higher levels of depression, fatigue, PTSD, and functional difficulties, and lower quality of life.

Severe impairment on the neuropsychological tests correlated with the extent of acute COVID-19 symptoms, as well as depression scores, number of medical comorbidities, and subjective cognitive complaints.

An analysis of serum levels of the inflammatory markers among 50 of the 60 participants showed that 45% of the patients had an elevated IL-6, 20% had elevated TNF-alpha, and 41% had elevated CRP, compared with reference ranges.

IL-6 levels were found to correlate with acute COVID-19 symptoms, the number of medical comorbidities, fatigue, and measures of executive function, while C-reactive protein (CRP) correlated with current COVID-19 symptoms and depression scores.

In terms of clinical factors that might predict low neuropsychological test scores, Lynch noted that the "markers that we found to be significant included severity of acute COVID-19 illness, current post-COVID-19 symptoms, measures of depression and anxiety, level of fatigue, and number of medical comorbidities."

Lynch noted that the ongoing study will include up to 18-month follow-ups that are currently underway. "The [follow-ups] will examine if symptoms improve over time and evaluate if any intervention that took place was successful," he said.

Survey Supports Findings​

The detrimental effects of mental health symptoms in long COVID were further supported in another study at the APA meeting, an online survey of 787 survivors of acute COVID-19.

In the community survey, presented by Michael Van Ameringen, MD, a professor in the department of psychiatry and behavioral neurosciences at McMaster University, in Hamilton, Ont., all respondents (100%) reported having persistent symptoms of the virus, and as many as 68% indicated that they had not returned to normal functioning, despite only 15% of the respondents having been hospitalized with COVID-19.

A large proportion showed significant depression, anxiety, and posttraumatic stress disorder (PTSD), and the most commonly reported persistent symptoms were fatigue in 75.9% of respondents, brain fog in 67.9%, concentration difficulties in 61.1%, and weakness in 51.2%.

As many as 88.2% of patients said they experienced persistent neurocognitive symptoms, with poor memory and concentration; 56% reported problems with word finding; and 54.1% had slowed thinking.

The respondents showed high rates of anxiety (41.7%) as well as depression (61.4%) as determined by scores above 9 on the Generalized Anxiety Disorder–7 (GAD-7) and Patient Health Questionnaires (PHQ-9).

As many as 40.5% of respondents showed probable PTSD, with scores above 30 on the PTSD checklist (PCL-5). Their mean resilience score on the Brief Resilient Coping Scale was 13.5, suggesting low resilience.

Among the respondents, 43.3% said they had received past treatment for mental health, while 33.5% were currently receiving mental health treatment.

Ameringen noted the important limitation of the study being an online survey with no control group, but said the responses nevertheless raise the question of the role of prior psychiatric disorders in long COVID.

"In our sample, 40% of respondents had a past psychiatric history, so you wonder if that also makes you vulnerable to long COVID," he said in an interview.

"About a third were getting psychiatric help, but I think the more impaired you are, the more likely you are to seek help."


Those who were hospitalized with COVID-19 were at a higher risk of PTSD compared with those not hospitalized (P < .001), as were those under the age of 30 (P < .05) or between 31 and 50 vs. over 50 (P < .01).


Ameringen noted that the survey's high rate of subjects who had not returned to normal functioning was especially striking.


"This is not a minor issue – these are people who are no longer functioning in society," he said.

In Pandemics, the Brain Tends to Be "Overlooked"​

Further addressing the neurological effects of COVID-19 at the APA meeting, Avindra Nath, MD, clinical director of the National Institutes of Neurologic Disorders and Stroke in Bethesda, Md., noted that the persisting cognitive and psychiatric symptoms after illness, such as brain fog and depression and anxiety, are not necessarily unique to COVID-19.

"We have seen this before," he said. "There have been at least seven or eight human coronaviruses, and the interesting thing is each one affects the brain and causes neurological complications."


The effects are classified differently and have slightly different receptors, "but the consequences are the same."


Of note, however, research published in The Lancet Psychiatry (2021 May. doi: 10.1016/S2215-0366[21]00084-5) revealed that symptoms such as dementia, mood, and anxiety are significantly higher after COVID-19 compared with other respiratory infections, with the differences increasing at 180 days since the index event.


Nath noted that, over the decades, he has observed that in pandemics "the brain tends to get overlooked." He explained that "what can be most important in the end is what happened in the brain, because those are the things that really cause the long-term consequences."


"These patients are depressed; they have dementia, they have brain fog, and even now that we recognize these issues, we haven't done a very good job of studying them," he said. "There's so much we still don't know, and a lot of patients are left with these symptoms and nowhere to go."


Lynch, Ameringen, and Nath had no disclosures to report.


This article originally appeared on MDedge.com, part of the Medscape Professional Network.

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[missy]

US COVID Cases Up Heading Into Summer​

Carolyn Crist
June 01, 2022
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As June begins and summer vacation plans kick off, COVID-19 cases in the U.S. are about five times higher than they were at this time last year, according to CDC data.

The U.S. is now reporting an average of more than 100,000 new cases each day. Last year, the case count remained under 20,000 for all of June, sometimes dropping below 15,000.

This year's case totals are likely even higher due to the widespread availability of at-home testing, which may not be reported officially, according to ABC News.


This week also marks the eighth consecutive week of increasing COVID cases in the U.S., the CDC data shows, as well as the seventh week straight of increasing cases among children.


About 112,000 pediatric COVID-19 cases were reported last week, according to the latest report from the American Academy of Pediatrics. At this time last year, the U.S. reported about 10,000 pediatric cases per week.

Hospitalizations continue to rise as well, with more than 3,500 coronavirus-positive Americans being admitted to the hospital each day, ABC News reported. Nearly 28,000 patients are now hospitalized with COVID-19 across the country, according to the latest data from the Department of Health and Human Services.

Despite widespread COVID-19 vaccinations and treatments, cases are still trending upward due to fewer coronavirus mitigation measures, public health experts have said.


"The issue is that people are not moving with the data and the times — there's so much COVID fatigue that people aren't using those mitigation strategies anymore," Frita Fisher, MD, a doctor based in Atlanta, told 11 Alive.

During the summer months of 2021, many employers still had mask mandates and required vaccinations, the news outlet reported. Masks were also required on public transportation systems.

By the end of the summer, as cases increased again nationwide, the CDC urged people to wear masks while indoors. Some cities also put indoor mask mandates back in place at the end of July.

Without those precautions this year, the cases will likely continue to increase this summer, Fisher said.


"There is a great chance that we will have another surge after Memorial Day weekend," she told 11 Alive. "I want folks — despite their COVID-19 and pandemic fatigue — to still have a community spirit so that we can move toward an endemic phase and get out of the pandemic phase, which we are very much still in."

Sources​

CDC: "COVID Data Tracker: Trends in Number of COVID-19 Cases and Death in the US Reported to CDC, by State/Territory."


ABC News: "Reported COVID-19 infection levels nearly 6 times higher than last Memorial Day."


American Academy of Pediatrics: "Children and COVID-19: State-Level Data Report, data available as of May 26, 2022."


U.S. Department of Health and Human Services: "Hospital Utilization, last updated June 1, 2022."


11 Alive: "COVID cases up as US heads into summer with fewer mitigation measures."
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[missy]

CDC Says About 20% Get Long COVID. New Models Try to Define It​

Kathleen Doheny
June 01, 2022

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As the number of people reporting persistent, and sometimes debilitating, symptoms from COVID-19 increases, researchers have struggled to pinpoint exactly how common so-called "long COVID" is, as well as how to clearly define exactly who has it or who is likely to get it.
Now, Centers for Disease Control and Prevention (CDC) researchers have concluded that 1 in 5 adults aged 18 and older have at least one health condition that might be related to their previous COVID-19 illness; that number goes up to 1 in 4 among those 65 and older. Their data was published last week in the CDC's Morbidity and Mortality Weekly Report.
The conditions associated with what's been officially termed post-acute sequelae of COVID-19, or PASC, include kidney failure, blood clots, other vascular issues, respiratory issues, heart problems, mental health or neurologic problems, and musculoskeletal conditions. But none of those conditions is unique to long-COVID.
Another new study, published in The Lancet Digital Health, is trying to help better characterize what long COVID is, and what it isn't.

The research team, supported by the National Institutes of Health, used machine learning techniques to analyze electronic health record data to identify new information about long COVID and detect patterns that could help identify those likely to develop it.

CDC Data​

The CDC team came to its conclusions by evaluating the EHRs of more than 353,000 adults who were diagnosed with COVID-19 or got a positive test result, then comparing those records with 1.6 million patients who had a medical visit in the same month without a positive test result or a COVID-19 diagnosis.
They looked at data from March 2020-November 2021, tagging 26 conditions often linked to post-COVID issues.
Overall, more than 38% of the COVID patients and 16% of those without COVID had at least one of these 26 conditions. They assessed the absolute risk difference between the patients and the non-COVID patients who developed one of the conditions, finding a 20.8 percentage point difference for those 18-64, yielding the 1 in 5 figure, and a 26.9 percentage point difference for those 65 and above, translating to about 1 in 4.

"These findings suggest the need for increased awareness for post-COVID conditions so that improved post-COVID care and management of patients who survived COVID-19 can be developed and implemented," said study author Lara Bull-Otterson, PHD, MPH, co-lead of data analytics at the Healthcare Data Advisory Unit of the CDC.

Pinpointing Long COVID Characteristics​

Long COVID is difficult to identify, because many of its symptoms are similar to those of other conditions, so researchers are looking for better ways to characterize it to help improve both diagnosis and treatment.


Researchers on the Lancet study evaluated data from the National COVID Cohort Collaborative, N3C, a national NIH database that includes information from more than 8 million people. The team looked at the health records of 98,000 adult COVID patients and used that information, along with data from about nearly 600 long-COVID patients treated at three long-COVID clinics, to create three machine learning models for identifying long-COVID patients.


The models aimed to identify long-COVID patients in three groups: all patients, those hospitalized with COVID, and those with COVID but not hospitalized. The models were judged by the researchers to be accurate because those identified at risk for long COVID from the database were similar to those actually treated for long COVID at the clinics.


"Our algorithm is not intended to diagnose long COVID," said lead author Emily Pfaff, PhD, research assistant professor of medicine at the University of North Carolina Chapel Hill. "Rather, it is intended to identify patients in EHR data who 'look like' patients seen by physicians for long COVID.'''


Next, the researchers say, they will incorporate the new patterns they found with a diagnosis code for COVID and include it in the models to further test their accuracy. The models could also be used to help recruit patients for clinical trials, the researchers say.

Perspective and Caveats​

The figures of 1 in 5 and 1 in 4 found by the CDC researchers don't surprise David Putrino, PT, PhD, director of rehabilitation innovation for Mount Sinai Health System in New York City and director of its Abilities Research Center, which cares for long COVID patients.


"Those numbers are high and it's alarming," he said. "But we've been sounding the alarm for quite some time, and we've been assuming that about 1 in 5 end up with long COVID."


He does see a limitation to the CDC research — that some symptoms could have emerged later, and some in the control group could have had an undiagnosed COVID infection and gone on to develop long COVID.


As for machine learning, "this is something we need to approach with caution," Putrino said. "There are a lot of variables we don't understand about long COVID,'' and that could result in spurious conclusions.


"Although I am supportive of this work going on, I am saying, 'Scrutinize the tools with a grain of salt.' Electronic records, Putrino points out, include information that the doctors enter, not what the patient says.


Pfaff responds: "It is entirely appropriate to approach both machine learning and EHR data with relevant caveats in mind. There are many clinical factors that are not recorded in the EHR and the EHR is not representative of all persons with long COVID." That data can only reflect those who seek care for a condition, a natural limitation.


When it comes to algorithms, they are limited by data they have access to, such as the electronic health records in this research. However, the immense size and diversity in the data used "does allow us to make some assertations with much more confidence than if we were using data from a single or small number of healthcare systems," she said.


MMWR Morb Mortal Wkly Rep. Published online May 24, 2022. Full text

"

 

[missy]

First Omicron Wave Infected 37% of
Canadian Adults​

Fran Lowry
June 01, 2022

"
Nearly 40% of Canadian adults became infected with the Omicron variant of the coronavirus during winter 2022.

According to new data from the Action to Beat Coronavirus (Ab-C) study, 9 million Canadians were infected during the initial Omicron BA.1/1.1 variant wave.

Dr Patrick Brown
"The Omicron variant spread very quickly worldwide, even among the vaccinated," lead author Patrick E. Brown, PhD, professor of statistical sciences at the University of Toronto, Canada, and collaborator in the Ab-C study, told Medscape Medical News.


Vaccination protected against severe illness. Adults with three vaccine doses and a previous COVID-19 infection had the highest protection.

The findings were published online May 18 in a letter to the New England Journal of Medicine.

Increased Incidence with Omicron​

"The incidence of Omicron variants is poorly understood. Studies like this help us quantify the spread of COVID and give information about Canadians' immunity to the virus," Brown said.



The Ab-C study series began in May 2020. Each of the four serial assessments have involved 5000 to 9000 adults and used the Angus Reid Forum, an online polling platform.

A representative sample of Canadians received test kits by mail and voluntarily provided dried-blood-spot samples. The researchers tested the samples with highly sensitive and specific chemiluminescence-based enzyme-linked immunosorbent assays targeting the spike protein, receptor-binding domain, and nucleocapsid (N) protein.

"Vaccines that have been used in Canada only contain spike protein, and thus should not elicit N protein positivity. Because the N protein is not affected by vaccination, only by infection, we can tell that if people have been protein-responding, then they must have been infected, despite having been vaccinated," explained Brown.

The cumulative incidence of N protein positivity before the omicron BA.1/1.1 variant wave was 11%. Of 5155 participants tested, 571 had a positive result.


But during the Omicron surge, incidence rose to 37%. Of 5031 participants tested, 1869 had a positive result.

In all, some 9 million adults were newly infected during the Omicron BA.1/1.1 wave, including almost 1 million infections among 2.3 million unvaccinated adults.


The data also show that Omicron infections spread more widely in younger adults (younger than age 60) than in older adults.


The other significant finding from the study was how important the third vaccination is in affording protection from COVID-19, Brown noted.


"People who have had two doses have nowhere near the protection that people with three doses have. Also, if you weren't vaccinated, being infected with COVID doesn't provide very much protection. Getting that third dose is very important, but in Canada, only about half of us are getting that third dose," Brown said.


"One of the things I hope will happen as a result of our study is that policy will change and make it easier for all to get their third dose," he said.

Updated Vaccines Needed​

"I'm not surprised at all by these findings because we know that Omicron was so highly infectious," Anna Banerji, MD, of the Dalla Lana School of Public Health, University of Toronto, told Medscape.


"The original vaccine was designed to match the first strain, the Alpha strain, and now we're into the Omicron, so I think at this phase of the outbreak, it's time to make the booster eligibility more inclusive because we find that over a period of time, immunity wanes. And now that we have these multiple strains, it's time for an updated vaccine. That shouldn't be hard for any of these pharmaceutical companies," said Banerji, who wasn't involved with the Ab-C study.

Dr Stephen Hoption Cann
"This new analysis supports what one would expect intuitively: that more vaccine doses are associated with higher spike protein titers, and the combination of previous infection and multiple doses are associated with the highest spike protein levels," Stephen Hoption Cann, PhD, clinical professor, University of British Columbia School of Population and Public Health, Vancouver, told Medscape.


"Their finding of a 26% increase in N protein positivity (a surrogate for COVID-19 infection) during the latter part of the Omicron wave, January 24 to March 15, is remarkable, but reflects the much higher transmissibility of this variant. However, this increase may also be partly due to pandemic fatigue, where people weary of restrictions become less cautious, as well as the easing of public health guidelines that occurred during this time," said Cann, who was not associated with the Ab-C research.


"Overall, despite the rapid increase in those positive for infection, this is still far from herd immunity, and reflects the need to continue vaccination programs, targeting those who are unvaccinated or undervaccinated," he said.


The rise in Omicron infection in Canada was stark, agreed immunologist Craig Jenne, PhD, of University of Calgary Cumming School of Medicine, Calgary, Canada, who did not participate in the study. He told Medscape that he would like to see more data on hospitalization rates and on how different regions in Canada were affected.


"We know the virus did not spread evenly across the country, so are we seeing overrepresentation of some people and underrepresentation of others, especially given that this is a volunteer poll?" he asked.


The Ab-C study is supported by the COVID-19 Immunity Task Force, the Canadian Institutes of Health Research, Pfizer Global Medical Grants, and St. Michael's Hospital Foundation. Brown, Banerji, Cann, and Jenne reported no relevant financial relationships.


N Engl J Med. Published online May 18, 2022. Correspondence

"

 

[missy]

"

COVID Cases Rise in the Americas, Nations Must Also Monitor Other Viruses: PAHO​

By Steven Grattan
June 02, 2022

SAO PAULO (Reuters) - COVID-19 cases in the Americas increased 10.4% last week from the previous one, but countries must also pay attention to a rise in other respiratory viruses in the region, the Pan American Health Organization (PAHO) said on Wednesday.
The Americas saw 1,087,390 new COVID cases and 4,155 deaths last week.
Cases in South America rose 43.1%, the biggest jump in the region, while the highest increase in COVID-related deaths was in Central America at 21.3%, PAHO said in a news conference, adding that cases in the region have been growing for the past six weeks.
Other viral diseases, such as influenza, Monkeypox and viral hepatitis, are also surging, and nations need to pay close attention to these diseases too, PAHO Director Dr. Carissa Etienne said.

"The flu virus is circulating again and not just during traditional flu season," she said. "Countries should expand surveillance to monitor other respiratory viruses, not just COVID."

Mexico and Peru have seen higher numbers of influenza cases than expected, and Argentina, Chile and Uruguay have reported more hospitalizations than usual due to the virus.
PAHO warned that many places could face the double threat of an influenza surge alongside a rise in COVID-19 cases, "which will put healthcare workers, the elderly and pregnant women at additional risk."
The rise of extreme weather events, like hurricanes, heavy rains and floods in many parts of the Americas is another pressure for health services in the region, Etienne said.

The U.S. National Oceanic and Atmospheric Administration and the Central America Integration System expect to see more storms than average this year, PAHO said, especially in the Atlantic, the Gulf of Mexico and the Caribbean.
"This is concerning as it only takes one massive storm to destroy people’s livelihoods, cripple our health systems and lead to countless lives lost," Etienne said.
"We must prepare early so we aren't caught off guard."
"


"

Pathogens Jumping to Humans From Animals Becoming More Frequent, Warns WHO​

By Natalie Grover
June 02, 2022

LONDON (Reuters) - Outbreaks of endemic diseases such as monkeypox and lassa fever are becoming more persistent and frequent, the World Health Organization's (WHO) emergencies director, Mike Ryan, warned on Wednesday.
As climate change contributes to rapidly changing weather conditions like drought, animals and human are changing their behaviour, including food-seeking habits. As a result of this "ecologic fragility", pathogens that typically circulate in animals are increasingly jumping into humans, he said.
"Unfortunately, that ability to amplify that disease and move it on within our communities is increasing - so both disease emergence and disease amplification factors have increased."
For instance, there is an upward trend in cases of Lassa fever, an acute viral illness spread by rodents endemic to Africa, he said.

"We used to have three to five years between Ebola outbreaks at least, now it's lucky if we have three to five months," he added.

"So there's definitely ecological pressure in the system."
Ryan's commentary comes as cases of monkeypox continue to rise outside Africa, where the pathogen is endemic.
On Wednesday, the WHO said it had so far received reports of more than 550 confirmed cases of the viral disease from 30 countries outside of Africa since the first report in early May.

Meanwhile, although COVID-19 cases are declining globally, there are regions such as the Americas with concerning trends, WHO director-General Tedros Adhanom Ghebreyesus highlighted in a briefing on Wednesday.
In North Korea, officials suspect there are over 3.7 million cases of fevered people, that could be COVID, as the country battles against its first ever COVID outbreak. It declared a state of emergency and imposed a nationwide lockdown last month.
Ryan said although the WHO had offered the country support in terms of vaccines, treatments and other medical supplies, it had encountered problems in securing access to raw data that would reflect the situation on the ground.
The experience of COVID has triggered the WHO to kickstart a process to draft and negotiate an international treaty to strengthen pandemic prevention, preparedness and response.

Pandemics, like climate change, affect every citizen on the planet, said Ryan.

"We've seen the difficulties we faced in this pandemic - we may face a more severe pandemic in the future and we need to be a hell of a lot better prepared than we are now," said Ryan.

"We need to establish the playbook for how we're going to prepare and how we're going to respond together. That is not about sovereignty. That's about responsibility."
"

 

[Begonia]

Thanks for all this @missy.
I'm vaxed, boosted, and masked when not at home. Good reminder to stay vigilant.

 

[dk168]

No more masks in shops and public transport; life appears to be getting back to normal.

I was asked to travel to China for work in July 2022, no can do as I cannot afford the time to be in quarantine for 14 days before stepping outside to do some work!

No sign of the second booster programme except for the very vulnerable and over 75yo.

I sporadically performed LFTs since I had Covid in March 2022, all negative so far.

DK

 

[Daisys and Diamonds]

Im worried about the UK
i don't think i saw one mask over the 4 day jubilee celebrations

Excuse my lack of links - i just woke up
its flu season here so a double worry
i havn't had so much as a sniffle in almost 4 years - i think a cold will floor me
Dunedin hospital is closed to all visitors due to covid being rampant
Old age care homes have failed their residents
Nurses are resigning daily
Its like we learnt nothing in the 2
years we were shut from the rest of the world

At work our bakehouse has been hit hard
if you cant make it you can't sell it
we need healthy bakers but as one gets better one gets sick
One came back too soon and infected others ....
They can produce the produce they made daily (pies and donoughts and bread) but we need fruit loaves, big cakes, bags of biscuits (no more scones - we need cookies) fruit pies and our slices - the things our older customer base buy up the hill at my branch
so of course takings are down even if at the end of the day we have sold every single doughnut (often by 1pm)

Meanwhile we wear masks but its hit and miss if customers bother evwn though the govt say you have to wear a mask in a shop
we have our two in two out policy but that's hit and miss too
Some people/ most even have no consideration for others
i see myself wearing a mask for the foreseeable future
The rest of my life if necessary

 

[missy]

"

The latest​

Moderna is seeking authorization from the Food and Drug Administration for an omicron-specific shot that is the company’s leading candidate for a fall booster. Although preliminary data showed the new booster produced more neutralizing antibodies in response to the omicron variant that spread rapidly last winter, it is not yet known how effective the vaccine is against newer mutations of the virus, including the dominant BA.2.12.1 and the more recent BA.4 and BA.5 subvariants that now make up 13 percent of cases in the United States. Still, the company is optimistic that the booster will provide protection against the different versions of the omicron variant. “We’re pretty confident this vaccine is going to provide a benefit even against the family of omicron subvariants,” Moderna president Stephen Hoge said.

Advisors to the FDA recommended that the agency authorize the Novavax coronavirus vaccine, which is a traditional protein-based vaccinedeveloped using similar technology as the influenza and shingles vaccines. The FDA is still evaluating data on manufacturing from Novavax, so it remains unclear when the agency will greenlight the vaccine. The two-shot regimen would provide another vaccine option, including for people who are allergic to ingredients in the mRNA vaccines currently available.

Other important news​

With no additional funding from Congress, the Biden administration shifted $10 billion from coronavirus testing and other programs to buy new vaccines and coronavirus treatments.

Target is cutting prices to clear excess pandemic-era inventory as consumers change their spending habits and choose to spend more on experiences and less on goods. "

"

Your questions, answered​

I've had two Moderna shots plus both boosters. But the news says their protection wanes after a few months. My last booster was in April. I'm 77 and very vulnerable to the virus. Should I continue protecting myself until the next shot becomes available? – Nancy R., N.Y.

This is a common dilemma at this stage in the pandemic. We have a tool to protect us against severe disease: vaccines. But the vaccines do not create a perfect shield against infection, particularly as new variants such as omicron have developed.

So that leaves people with a complicated risk calculation. A “mild” case could still result in a rough illness and potentially long covid, with lingering symptoms such as fatigue and brain fog. Risk tolerance varies. Many people sleep through the night more easily knowing they had zero risk of exposure.

But social isolation carries its own risks.

“I certainly would suggest that she continue to use a mask when she is indoors among crowds, but she can consider going to the supermarket or religious services (sit in the back, wave to friends),” William Schaffner, a professor of medicine at Vanderbilt University Medical Center who has followed the pandemic closely from the beginning, wrote in an email.

“She should by all means go out for walks and stay in contact with friends and family members by phone, FaceTime and careful visits," he said. "Perhaps a game of bridge with equally careful friends. These are important to ward off feelings of isolation or depression.”

William Hanage, an epidemiologist at the Harvard T.H. Chan School of Public Health, reminded us that Queen Elizabeth II, 96, just overcame a bout of covid and celebrated her 70th anniversary on the throne.

“Once you’ve got four shots, you are in a pretty good place,” he said. “We need to be more full-throated about the fact that the vaccines, while they don’t prevent infection, they are very, very good at preventing severe illness.”

Andrew Noymer, an epidemiologist the University of California at Irvine, tells us by email: “Protecting oneself remains important…Age is well-established as a risk factor for disease severity, in covid as in many other diseases. Social isolation brings its own problems, however, and covid is with us to stay; I don't think permanent isolation is a good solution except for an extremely small number of natural introverts. My recommendation is to resume, bit by bit, a more normal (pre-pandemic) routine, but with masking. I recommend N-95 masks, which are no longer hard to find. The mask should be well fitting, with no gaps. Remember that outdoor air is much safer than indoor air, so meeting a friend for a walk in the park or around the block can be an option. Getting groceries for oneself, with a mask on, rather than having them delivered, is something I would also recommend. There is no such thing as zero risk, but being housebound and less social than normal, also carries its health risks.”

"

 

[Daisys and Diamonds]

Yes we need to get out more especially Gary who only has the cats to talk to when im at work
but i stand by my reasoning that you can only trust the people you actually live with
the only other people on the planet i would trust are Missy & Greg and my English friend Eillen on my Springsteen forum because over the course of the pandemic they have never let their guard down

 

[missy]

Yes we need to get out more especially Gary who only has the cats to talk to when im at work
but i stand by my reasoning that you can only trust the people you actually live with
the only other people on the planet i would trust are Missy & Greg and my English friend Eillen on my Springsteen forum because over the course of the pandemic they have never let their guard down

Aww thanks Daisy. I am not sure you can trust being around us anymore because tomorrow though Greg is having some cardiac testing (nuclear stress test etc) that will take 5 hours plus and I don't think he can wear his mask. I am concerned but told him to make sure everyone around him is wearing their mask properly. I was almost going to cancel this appointment but decided not to. Hope we don't regret that decision.

Stay safe and be well. XO

 

[Daisys and Diamonds]

Aww thanks Daisy. I am not sure you can trust being around us anymore because tomorrow though Greg is having some cardiac testing (nuclear stress test etc) that will take 5 hours plus and I don't think he can wear his mask. I am concerned but told him to make sure everyone around him is wearing their mask properly. I was almost going to cancel this appointment but decided not to. Hope we don't regret that decision.

Stay safe and be well. XO

Well the heart is kind of an important organ ....
I hope all goes well
im sure heart specialists will be extra villigent with covid prevention
Best not to put it off
its amazing what they can do to fix and manage heart trouble these days

On Tuesday Gary has his eye opp in Porirua
We got some accommodation locally that we know in Tawa, they said we are welcome to drop our bags off in the room early before they clean it if need be -
we will be early
We are early to everything

but we will be extra careful
Thank you for reminding me
we wont be going out for dinner or breakfast but i will have to go to a supermarket to buy extra milk ...maybe some chocky bickies ....

Ok ok its true we have both been salivating thinking about orange beef from our old Chinese take aways
No one in Wanganui has ever heard of it apart from one young man who poped his head around the corner and asked if we were from Wellington? when we enquired at one place this one time - evidently no one in Wanganui knows it

Ok we are also ordering enough to have it for breakfast too

 

[missy]

Predicting the Fall and Boosters

We’ve been using the same vaccine formula throughout the pandemic—one created in early 2020 to fight against the original Wuhan variant. But the virus continues to mutate quickly. This means our antibodies are waning fast and (re)infections are coming more often. Marry this with the fact that...

yourlocalepidemiologist.substack.com

"

Predicting the Fall and Boosters​

Katelyn Jetelina Jun 10

We’ve been using the same vaccine formula throughout the pandemic—one created in early 2020 to fight against the original Wuhan variant. But the virus continues to mutate quickly. This means our antibodies are waning fast and (re)infections are coming more often. Marry this with the fact that coronaviruses thrive in the winter, and we likely need an updated strategy going into the fall.
So what’s our next move?

A hard problem to solve​

One way to get ahead of the virus is to anticipate the dominant variant this winter, just like we do with the flu each year.
For flu, scientists meet annually to evaluate new circulating strains and determine if an updated vaccine formula is needed. Each year, the WHO makes recommendations in February for the upcoming Northern Hemisphere influenza season. Then it takes about 5-6 months for the vaccine to be available. This isn’t a perfect process, but on average we have 60% vaccine effectiveness each year.
It’s suggested that we adapt this process for COVID-19. And I agree. But I can’t highlight enough how incredibly challenging this is right now. For several reasons:

1. SARS-CoV-2 is changing 4 times faster than the flu due to high transmission. New variants can emerge and dominate after the vaccine process has begun. This happened famously before the 2009 and 2014 flu season. It could certainly happen with COVID19. This time last year Alpha was dominant. By winter, we went through two new variants of concern.
2. We have no idea how this virus will mutate. We haven’t had enough time to see ladder-like patterns , like we see with flu. We think Omicron will continue to mutate—there’s a 70% chance we will not have another Omicron-like event—but this is just an educated guess.
3. For flu, there is just one main vaccine platform (egg-based). With COVID-19 we have a few. Timelines, processes, manufacturers’ experience, and facility capacity vary for each.
4. Because of the predictive power and manufacturing experience with flu vaccine, no new clinical data is required by the FDA each year. With COVID19, though, the FDA requires vaccine-specific safety profiles and effectiveness data.

The FDA met in April to discuss this very subject. More challenges were discussed than solutions. But reading between the lines, it was clear that if we get another fall vaccine, it would need to achieve three things:

1. Improve durability. We need something that lasts at least 6 months to get us through a winter wave.
2. Retain protection against previous variants of concern. With infection-induced immunity, Omicron does NOT protect well against previous variants of concern. We need to make sure our vaccines do in case a previous variant, like Delta or Beta, take hold again.
3. Protect against future, unknown variants of concern.

Moderna’s answer​

Yesterday, Moderna’s results were released for a booster called mRNA1273.214. This vaccine is 50 micrograms, which is the same dosage as the original booster and half the dosage of the original Moderna series. They tested a bivalent vaccine, which means its formula covers two variants: the original Wuhan virus and Omicron (BA.1). For this clinical trial, 437 people were randomized to get the new vaccine or old vaccine as a second booster. We have a few details (science by press release) on how this trial went:

• Side effects were similar to the original booster. The new booster may actually have slightly reduced side effects.
• There was an 8-fold increase in neutralizing antibodies (our first line of defense) one month after vaccination.
  • This was higher than the original booster.
  • There was a stronger effect among those with previous infection.
• The new booster had better protection against all other variants of concern, compared to the original.
• We don’t know about durability; we are at the mercy of time. But Moderna said their bivalent Beta-vaccine lasted against Omicron for 6-months+. This probably means the Omicron bivalent vaccine will last just as long.

​

(Source: Moderna Slides Here )

Unanswered, lingering questions​

In all, the new vaccine seems to work great, but we need to see more data than a press release. Pfizer should have a bivalent vaccine coming soon, too. On June 28 , the FDA will discuss the new results and overall U.S. strategy for fall. There are some lingering and unanswered questions that I hope are addressed during this meeting:

• Booster or series? Moderna’s intent is to treat this as a one-shot seasonal vaccine. However, at the last FDA meeting, it was said that if the vaccine formula changed, it would have to be a whole new series. We need clarification.
• Omicron has mutated. This vaccine is made with the first Omicron variant (BA.1). Now we have a BA.4/5 wave in the horizon, which is significantly and meaningfully different from BA.1. How well does the new vaccine work against BA.4/5?
• More data. We need to make sure these vaccines also improve secondary defenses like B-cells and T-cells. We’ve seen evidence from monkeys that an Omicron-specific vaccine does not expand the memory of B-cells.
• Beta vaccine? Moderna previously released data for a Beta-bivalent vaccine. A side-to-side comparison would be helpful. According to Dr. John Beigal at the NIH, there are really only two antigenic spaces or areas of vulnerability that would allow for another “Omicron-like event”: a virus that is closer to Beta, or a virus that is closer to Delta. Both are very far from Omicron, which perhaps makes an Omicron-specific booster not a slam dunk decision.
• Kids . Unless FDA changes the way they evaluate vaccines, kids will never have access to up-to-date boosters. We can’t continue with a process that leaves kids constantly two years behind.

Bigger questions (beyond the FDA) include:

• Payment . Congress has not passed COVID19 funding, so we don’t have money to pay for everyone’s new boosters in the U.S. Not everyone would get in line given vaccine hesitancy, but the discrepancy and the implications are important.
• Vaccination rate. All of this science is great. But only 48% of people in the U.S. have their original booster. Only 23% of eligible people have their second booster. Why aren’t we leveraging social science as much as bench science to increase effectiveness of vaccine rollouts?

Bottom line​

Predicting what happens this fall is challenging. We are trying our darndest to mount a proactive (instead of reactive) response. Given Moderna’s preliminary data, I would expect a bivalent vaccine in fall. Will we have a booster every fall? No idea. It completely depends on how this pandemic progresses.

"

 

[GemmaBella]

I am still extremely careful. I will go out for medical appointments, the vet, to an outdoor garden center for flowers and that is it. I mask outdoors at parks with my son. We have playdates with one other family, masked and outdoors. I see my father who has lupus outdoors only and masked. All supplies to exist I have delivered. I am one of those natural introverts so it hasn't been much of an issue forgoing pre-pandemic behaviours. I am just not willing to take a chance with Long Covid. I haven't eaten out since March 2020, and sure, I miss that once in awhile but it is not worth it to me to risk getting my son or my mom sick. I homeschool my son (because of not only Covid but also gun violence concerns) and my son is doing very well. At age 6 he is reading theories about the Big Bang. I am not concerned about his intellect. He has adapted and is quite smart. I hope for a better future for our children's sake. Hopefully more robust vaccines. Until then it is just one day at a time through this.

 

[GemmaBella]

@missy I appreciate and read all of the articles you link. Thank you for providing these resources. It has been so helpful. You provide links to information that I don't have popping up in my regular news feed and it gives me a much more well rounded idea of what is going on with the virus. I hope things go well for your husband. You guys are in my thoughts!

@Daisys and Diamonds I can relate to how you feel and am thinking of you and wishing you guys well. I know I would love a break from the kitchen once in awhile myself! I make my son our own "Chinese" food (not that I am an expert chef) and he enjoys the flavors. I love using sesame oil and coconut aminos in our dishes with rice, chicken and broccoli.

 

[missy]

@GemmaBella thank you. I am glad it is of some help. And same. We haven't eaten out since early 2020. It isnt worth it to us either. I am glad home schooling is going well with your son. He sounds very bright and he is lucky to have you as his caring mom. Thank you for keeping us in your thoughts. Much appreciated and sending you well wishes too.

 

[missy]

"

​ The latest​ The Centers for Disease Control and Prevention on Friday lifted the negative test requirement for international travelers boarding flights to the United States. A Biden administration official said science and data showed that the requirement was no longer necessary, following a meeting between the White House and travel groups that had pushed for the testing rule to end. The requirement will expire at 12:01 a.m. Sunday. Federal regulators and their advisers will scrutinize the safety and efficacy of vaccines for children younger than 5 next week and, if all goes as expected, clear the way for the shots to be available by the end of the month. My colleagues Lena H. Sun and Laurie McGinley answer key questions parents may have about vaccinating young children. The theory that the coronavirus may have escaped from a lab needs “further investigations,” according to a panel of scientists convened by the World Health Organization. The “lab leak” theory is one of the competing explanations about where the virus originated. The scientists also said available data supported the theory that the virus originated in an animal host and then jumped to humans, though they could not identify which animal infected humans or where human infection first occurred.​ Other important news​ American tourists can now visit many parts of Asia – including Thailand, Vietnam, Japan, South Korea and several other countries – as nations lift pandemic restrictions. Chinese high school students spent weeks in quarantines or other lockdowns ahead of grueling college entrance exams.​ ​ ​

​

​ Guide to the pandemic​ Track confirmed cases, hospitalizations and deaths in the U.S. and the spread around the world. U.S. vaccine distribution and delivery, tracked by state. Guides: Booster shots | Vaccines | Variants | Masks​

"

Questions answered

"
Now that we are hitting the summer months, I am wondering where to store my supply of rapid tests. I don't have air conditioning, and it can regularly get into the upper 80s in the apartment in July and August, which I've heard destroys the chemicals. Can I store the tests in the fridge and then warm them up when I need to use one, or does cold also destroy the test chemicals? – Jaye, New York

Very hot and very cold temperatures can inhibit the performance of at-home coronavirus tests, according to guidance from the Food and Drug Administration and test manufacturers. But you don’t have to worry about short stints in the heat – the tests are designed to withstand brief exposure to extreme temperatures that may occur in shipping.

Abbott’s BinaxNow tests, for example, can be stored between 35.6 degrees and 86 degrees Fahrenheit, but it probably won't ruin the tests if they're temporarily kept a little bit hotter.

“If the test is stored outside the temperature range for a relatively short period of time – for a couple of hours up to a day or two – it will be fine to use,” Abbott spokesman John Koval said in an email.

The box that your at-home test came in should list the range of temperatures the manufacturer says are safe for long-term storage. Most at-home test kits can be stored between about 36 degrees and 86 degrees, though there is some variation among brands of tests. As long as your refrigerator’s temperature falls in the range printed on your test kit, you can safely store the test there.

Remember to warm up your test materials to room temperature for at least two hours before using them. The tests need to be used at a temperature between 59 and 86 degrees, according to the FDA’s guidance.

Finally, if you’re worried that a test kit may have gone bad because it got too hot or too cold, carefully compare your test result to the example results in the manufacturer’s instructions.

“As long as the test line(s) appear as described in the instructions, you can be confident that the test is performing as it should,” according to the FDA’s guidance.
:

 

[missy]

"

Good News for Heart Failure Patients Getting COVID Booster Shots​

— Group saw lower risks for hospitalization, ICU admission, death versus the unvaccinated​

by Molly Walker, Deputy Managing Editor, MedPage Today June 10, 2022

Vaccination against COVID-19 was associated with significant reductions in serious outcomes among patients with heart failure (HF), according to a retrospective cohort study.
Compared with unvaccinated patients with HF, those who were fully vaccinated (HR 0.36, 95% CI 0.30-0.43) and those who were fully vaccinated and boosted (HR 0.33, 95% CI 0.23-0.48; P<0.001 for both) were less likely to die, reported Anuradha Lala, MD, of the Icahn School of Medicine at Mount Sinai in New York City, and colleagues.

Moreover, vaccinated patients were less likely to be hospitalized (incidence rate ratio [IRR] 0.68, 95% CI 0.65-0.71) and admitted to the ICU (IRR 0.63, 95% CI 0.58-0.68, P<0.001 for both) compared with unvaccinated or partially vaccinated patients, the authors wrote in the Journal of Cardiac Failure.
"The findings further emphasize that heart failure patients need to take vaccines seriously, since they have worse outcomes if infected with COVID-19, and stresses the importance of receiving the full COVID-19 vaccination dosage, especially since our previous work shows those with heart failure are 2.5 times more likely to die from the virus," Lala said in a statement.
She noted that she has used these results to "educate reluctant patients" about COVID vaccines, and hopes that cardiologists will do the same with their patients, adding that she had heard reports of heart failure patients who were afraid to be vaccinated due to vaccine-associated myocarditis.

"Until now, it has been difficult to explain to these patients how the cardiovascular benefits of vaccination substantially outweigh the risks of complications to them, because we didn't have concrete evidence to show the substantial risks of being unvaccinated, as few studies have focused on this specific high-risk population and COVID-19 vaccinations," she said.
For this study, Lala and colleagues examined data from patients with heart failure in a large New York City health system from Jan. 1, 2021 to Jan. 24, 2022. Patients were eligible if they had an ICD-10 code for a heart failure diagnosis in the past 2 years. Vaccination status was determined via either electronic health record entry or clinician or staff documentation of vaccination "based on patient report and demonstration of vaccine card," they noted.
Overall, 7,094 patients met the criteria: 45.1% were unvaccinated, 31% were vaccinated, 15% were vaccinated and boosted, and 9% were partially vaccinated. Mean age was 73, 52% were men, and 63% had Medicare insurance. Not surprisingly, 78% had "other cardiovascular diseases," 58% had hypertension, and 32% had type 2 diabetes.

The vaccinated and vaccinated/boosted cohorts were slightly older, more likely to be white, and had significantly higher rates of other cardiovascular disease, hypertension, pulmonary disease, and diabetes compared with the unvaccinated and partially vaccinated cohorts.
Over a mean follow-up of about 277 days, 904 patients died. Of these, 73% were either unvaccinated or partially vaccinated.
Limitations to the study included the fact that it was conducted at one center, and patients were not distinguished based on the type or stage of heart failure. In addition, potential unmeasured confounders could have affected the results.



"

 

[missy]

Opinion piece:

Is the Novavax COVID Vaccine Worth the Hype?​

— The technology is quite innovative and has potential to enhance protection against SARS-CoV-2​

by Amesh Adalja, MD June 9, 2022

"
The favorable analysis of Novavax's COVID-19 vaccine by an FDA advisory committee means the U.S. is likely to soon have a fourth COVID-19 vaccine available for adults, pending any manufacturing review delays.

But with COVID-19 vaccines already widely available, and most adults who will get vaccinated already having done so, why should we care?

Unpacking Traditional

One of the many buzzwords that surround Novavax's vaccine, which has been available in the E.U. for some time, is "traditional." However, it is important to understand this concept and how truly innovative this vaccine is.



From a practical standpoint, the vaccine is easier to handle and doesn't require the strenuous cold chains of the current mRNA vaccines. This will make the vaccine logistics easier and more efficient.

What about its constituents? The Novavax vaccine is protein-based. It delivers the SARS-CoV-2 spike protein (the antigen) in the injection while the mRNA and viral vector vaccines deliver the genetic sequence of the spike protein to the body's cells, which then manufacture the spike protein. This type of antigen delivery is very familiar and characterizes the nature of several other vaccines, notably the injectable influenza vaccine.

But the Novavax vaccine is innovative in its own right even though its end result is a standard protein vaccine. What is most innovative is that the protein is produced using a platform technology that employs insect cell lines and insect viruses. In a process like that used in the FluBlok influenza vaccine, the spike protein is inserted into a baculovirus (a virus that infects insects), which is then used to infect insect cells that pump out the spike protein used in the vaccine. This cell line, known as a baculovirus expression system (BEVS), is very versatile and an important aspect of vaccine technology.



The Novavax vaccine is coupled to an adjuvant. Adjuvants are substances used to boost immune responses. For example, the standard Tdap vaccine includes aluminum as an adjuvant. Novavax's adjuvant is called Matrix-M and is derived from a family of molecules known as saponins, which originate in the soap box tree. A similar adjuvant is included in the Shingrix shingles vaccine.

Now, on to Novavax's real life application: the question at hand is whether the vaccine will help protect more adults against COVID-19.

The Vaccine Hesitant

Currently, approximately one-fourth of U.S. adults are not fully vaccinated against COVID-19, and a portion of these adults are considered vaccine hesitant. Some people believe a vaccine such as Novavax's may be more palatable to this segment of the population because of how the mRNA and viral vector vaccines have been unjustly maligned.

However, at this point in the pandemic, I do not expect to see much uptake of this vaccine by those who have refrained from getting vaccinated. Recall the widely held notion that a proportion of this segment was supposedly awaiting full FDA approval to get vaccinated -- yet, no major jump in vaccination rates were seen when Pfizer and Moderna both were granted full approval. While we can be hopeful for uptake of the vaccine, we should also be realistic. Just look at the experience in Europe where the vaccine has been available for several months and there has been no surge in uptake. In my mind, the vaccine hesitant adults that remain are unlikely to change their minds (though some may continue to try, and other tools such as antivirals and monoclonal antibodies can be lifesaving for them). It is the scientific method that they must come to accept before they will accept any specific vaccine. After all, it is the same scientific method that generated the prior COVID-19 vaccines as generated this one and will generate all future COVID-19 vaccines and other vaccines.



A potential important caveat is that perhaps if pediatric indications for the vaccine are pursed, this vaccine might be a more acceptable vaccine to parents who have refrained from vaccinating their children with the Pfizer vaccine. However, it would have to first be proven safe and effective in this population, and closely examined for increased incidence of myocarditis, as we've seen in adults.

Mixing and Matching Boosters

An additional benefit of Novavax is having a vaccine using a disparate technology to potentially enhance future mixing-matching booster strategies for the vaccinated. It is becoming clear that different presentations of the spike protein to the immune system may produce extra benefit compared to repeatedly boosting with the same product. As we optimize booster strategies, having as many components as possible to mix-and-match to find the best durability and breadth of response against variants will be key. Within the scientific community, we are keenly awaiting results of studies using the Novavax vaccine as a booster for those who have received their primary series using other technologies.



The most remarkable aspect of the Novavax vaccine's impending availability is more overarching. The fact that we will have four vaccines -- not to mention many more outside the U.S. -- against a pathogen that, until December 2019, was not even known to science is a testament to the power of a concerted effort of powerful scientific minds to wield incredible tools to successfully solve a complex life-or-death problem.

Amesh Adalja, MD, is a senior scholar at the Johns Hopkins Center for Health Security and a practicing infectious disease, critical care, and emergency physician in Pittsburgh. He has no relevant disclosures.


"

 

[missy]

Covid Roundup from the past week plus

N.Y.C. Drops Toddler Mask Mandate; Big Win for RSV Vaccine; COVID Origins Still Murky​

— A daily roundup of news on COVID-19 and the rest of medicine​

by Kristen Monaco, Staff Writer, MedPage Today June 10, 2022


"
Come Monday, toddlers ages 2 to 4 will no longer be required to wear masks at day care or preschool in New York City. (Newsday)

Nine infant deaths possibly related to Abbott's powdered baby formula have been reported to the FDA. (eFoodAlert)

GlaxoSmithKline announced positive interim findings from a study evaluating its respiratory syncytial virus (RSV) vaccine candidate for adults 60 and older -- the first phase III trial to show a significant benefit in this population, the company says.



A New Jersey man pleaded guilty to a slew of charges after allegedly amassing millions in a scam selling pesticides he said were "approved" as disinfectants to fight COVID, the Justice Department announced.

Maine funneled $230 million into its statewide suicide prevention program and mental health services after it discovered that 85% of gun deaths in 2020 were from suicides. (AP)

Confirmed U.S. cases of monkeypox/orthopoxvirus reached 45 as of Thursday, according to the CDC's new state-by-state counter.

Just how prepared is the nation to treat these rising monkeypox cases? (STAT)

Meanwhile, as of Friday at 8:00 a.m. EDT, the unofficial U.S. COVID toll reached 85,333,917 infections and 1,009,856 deaths, increases of 126,304 and 275, respectively, from this time yesterday.

Curious to know exactly where COVID came from? Well, the jury is still out, mainly due to a lack of pertinent data from China, according to a new World Health Organization report. (Reuters)



Ukraine is making quick moves to legalize medical cannabis, hastened by the mental health toll of the war. (NPR)

A new, yet-to-be-named novel form of macular dystrophy potentially caused by TIMP3 signal peptide defects was discovered by researchers at the National Eye Institute. (JAMA Ophthalmology)

Geico was ordered to pay a Missouri woman $5.2 million as part of a settlement after she apparently contracted HPV from her partner in his vehicle, which happened to be insured by the company. (CNN)

HHS announced a national competition offering $1 million in cash prizes to bolster innovation through technical assistance to health centers.

And the National Association of County and City Health Officials doled out $300,000 to aid local health departments in their fight against vaccine hesitancy.

A new lawsuit is alleging that sexual abuse ran rampant at a Los Angeles County-run shelter for kids, with charges including a physician who worked there. (AP)

NFL player Laurent Duvernay-Tardif, MD, is putting his football career on holdto enroll in a residency program at a hospital next week. (ESPN)
"

 

[dk168]

@Daisys and Diamonds , it is pretty much back to normal in UK, and very few places require a mask to be worn - my hair and beauty salon still does due to their line of work being close contact etc ...

DK

 

[missy]

Speaking of the UK...

"

Travel to the UK during Covid-19: What you need to know before you go​

CNN Staff • Updated 10th June 2022

​

​

Editor's Note — Coronavirus cases are in flux across the globe. Health officials caution that staying home is the best way to stem transmission until you're fully vaccinated. Below is information on what to know if you still plan to travel, last updated on June 10.

(CNN) — If you're planning to travel to the UK, here's what you'll need to know and expect if you want to visit during the Covid-19 pandemic.

The basics​

The United Kingdom has seen one of the highest number of deaths from Covid-19 in the world, resulting in multiple lockdowns. Earlier in 2022, the Omicron coronavirus variant spread rapidly across the UK.

Covid restrictions have since been mostly removed across England, Scotland, Wales and Northern Ireland. See more detail below.
There are currently no Covid-related restrictions on international travel to the UK.
London, the UK has one of the world's greatest cities. But beyond the architectural marvels and nightlife of the capital, there is much to explore -- the rugged peaks of the Scottish Highlands, distant Welsh lakes and the wide sweep of Cornish beaches, for starters, plus historic towns and cities such as Bath, Oxford and Harrogate.

Who can go​

Anyone can enter the UK without any additional testing or quarantine requirements, regardless of vaccination status.

What are the restrictions?​

There are currently no Covid-related restrictions on international travel to the UK.
Arrivals no longer need to fill out a Passenger Locator Form before arriving in the UK.
Red list countries
The UK divides destinations into "red" and "green" destinations. At present, there are no countries on the "red" list.
Previously, certain arrivals from red list countries were required to quarantine in designated hotels, but the infrastructure for hotel quarantine was "fully stood down" at the end of March 2022.
The UK government said it will "maintain a range of contingency measures in reserve" which could be activated if concerning coronavirus variants emerge.
The UK government had previously said if red list restrictions needed to be reintroduced, home isolation would likely be the preferred option.
Green list countries
Any destination not on the red list is considered green -- so currently all destinations are green, but some green destinations don't currently permit nonessential travel from the UK.
Anyone -- regardless of vaccination status -- from green list countries can enter the UK without any additional testing or quarantine requirements.
For full UK government guidance on traveling to the UK, see here.
Other developments:
International and domestic cruising is operational in the UK -- see government guidance here and check the specific cruise line for regulations.
If you test positive for Covid-19 while in the UK, you are not legally required to self-isolate but England, Scotland, Wales and Northern Ireland all recommend self-isolation.
Some airlines flying into England no longer require passengers or crew to wear masks, but it depends on the specific route so you should check before boarding.

What's the Covid situation?​

The UK has suffered considerably during Covid-19 and cases peaked earlier in this year following the emergence of Omicron. Cases have since fallen.
There have been over 22.5 million Covid cases and more than 179,800 deaths in the UK as of June 10. Over 73.6% of the population has been fully vaccinated.

Daily reported Covid-19 cases​

What can visitors expect?​

• England

There are no legal Covid restrictions in England.
Face coverings are no longer mandatory anywhere. They aren't required on any public transport, however Transport for London recommends travelers wear face masks.
London's Heathrow Airport has removed its face covering mandate. In a press release, the airport said "Heathrow strongly encourages those at the airport to continue wearing a face covering -- particularly when coming into close contact with others -- although this will no longer be a firm requirement."
Venues operating with large numbers -- like theaters, concert venues and nightclubs -- no longer require proof of vaccination or proof of a negative test.
For England-based Covid guidance, see here.

• Wales

In Wales, Covid restrictions have been lifted.
Face masks are no longer a legal requirement in Wales, although the Welsh government continues to recommend they are worn in health care settings and "indoor crowded or enclosed places." See full Welsh face mask guidance here.
Venues like theaters, concert venues and nightclubs no longer require proof of vaccination or proof of a negative PCR test or negative rapid lateral flow test.
For Welsh Covid guidance, see this link.

• Scotland

There are no remaining Covid restrictions in Scotland.
The legal requirement to wear face masks in Scotland was removed in April, but masks continue to be "strongly recommended."
Scottish venues like theaters, concert venues and nightclubs no longer require proof of vaccination or proof of a negative PCR test or negative rapid lateral flow test.
People in Scotland must show they've had a booster jab to be considered fully vaccinated if their last vaccine dose was more than four months ago.
For Scotland's current Covid guidance, see here.

• Northern Ireland

There are no legal Covid restrictions in Northern Ireland.
Wearing a face covering is no longer a legal requirement in Northern Ireland, but face masks continue to be "strongly recommended in indoor areas where you come into contact with people you do not usually meet" -- such as public transport.
Venues like theaters, concert venues and nightclubs no longer require proof of vaccination or proof of a negative PCR test or negative rapid lateral flow test.
For Northern Ireland's current Covid guidance, see here.
Related content
Traveling to France during Covid-19: What you need to know

Useful links​

England Covid guidance
Wales Covid guidance
Scotland Covid guidance
Northern Ireland Covid guidance

Our recent coverage​

The Derry-Coleraine railway in Northern Ireland and the West Highland Railway in Scotland made our list of Europe's most beautiful train journeys.
The West Highland Railway was also spotlighted in our round-up of the world's most incredible railway routes.
Speaking of trains, London's long-awaited Elizabeth line is now open, and you can also read our report on London's abandoned Down Street station here.
The town of Clovelly in southwest England made our round-up of the most beautiful towns in Europe.
You can also check out our list of the top places to visit in the UK, or if it's England specifically you're interested in, here are some of the loveliest spots in the country. You'll find our list of Scotland's top spots here, and you can read a travel love story that began in Scotland here.


"

 

[mellowyellowgirl]

@Daisys and Diamonds Australia is letting it rip here! Masks are mandatory on public transport but I think half the people aren't obeying the rules.

Many people in my social circle are catching the flu and wishing they had Covid instead because this flu is particularly nasty and seems to last a looooot longer than Covid. No one seems to be asymptomatic against it either.

It was really interesting because in March-ish Covid made its round in all the schools. We were getting emails thick fast, it went through the kids one by one and now.... nothing (except the flu). It will be interesting to see if reinfections occur, whether it will make a full round again and when!

I'll post when/if it does.

 

[Daisys and Diamonds]

@Daisys and Diamonds Australia is letting it rip here! Masks are mandatory on public transport but I think half the people aren't obeying the rules.

Many people in my social circle are catching the flu and wishing they had Covid instead because this flu is particularly nasty and seems to last a looooot longer than Covid. No one seems to be asymptomatic against it either.

It was really interesting because in March-ish Covid made its round in all the schools. We were getting emails thick fast, it went through the kids one by one and now.... nothing (except the flu). It will be interesting to see if reinfections occur, whether it will make a full round again and when!

I'll post when/if it does.

I hope your family avoid the flu
i read the flu is less transmissible than covid, so im hoping mask wearing and hand washing etc counts in our favour

I read this eaelier this week

Stuff

i.stuff.co.nz

 

[Daisys and Diamonds]

no way would i get on an aeroplane with no mask !
Or a bus or a train

 

[mellowyellowgirl]

no way would i get on an aeroplane with no mask !
Or a bus or a train

Neither would I! I eat out heaps and go shopping with no mask but a crowded train with no mask is a bridge too far for me.

I caught a train earlier in the year that was packed with people coughing. I was convinced I would catch Covid from it (seriously you could practically see the germs) but I didn't.

I do wonder what infection though. I was carrying and kissing my Covid ridden child and I never caught it.