Coronavirus updates April 2022

[missy]

"

South Africa Likely to See Fifth COVID Wave​

— Recent sharp increases in test positivity, cases driven by BA.4 and BA.5 variants​

by Kristina Fiore, Director of Enterprise & Investigative Reporting, MedPage Today April 27, 2022

U.S. researchers have their eyes on South Africa as the country's COVID-19 test positivity rates rise as sharply as they did at the beginning of the first Omicron wave.
Following the original Omicron wave, there was a period of transmission of BA.2 that never took off in South Africa, though cases never dropped to pre-Omicron lows, said Jacob Lemieux, MD, PhD, an infectious diseases physician at Massachusetts General Hospital in Boston. Now, an uptick there appears to be driven by the BA.4 and BA.5 variants, he said.

"I would say that the data that's coming out of South Africa by the hour really is alarming," Lemieux said during a press briefing, pointing to graphs from South African epidemiologist and statistician Ridhwaan Suliman, PhD, that showed an "exponential rise" in test positivity rates.
BA.4 and BA.5 have risen to make up more than half of cases over the last few weeks, Lemieux noted, and "if you line up the case counts ... you start to see a rise that is reminiscent both in its numbers, its timing, and its test positivity rate of the Omicron wave, possibly taking off even faster."
In a Twitter thread today, Suliman noted that Gauteng province once again appears to be the epicenter of the outbreak, with 3,145 daily cases reported and a rolling 7-day average of more than 2,000. "Case rate up 173% week-on-week or currently doubling every 4.8 days," he tweeted, adding that the case positivity rate in the province jumped to 20.2% from 11.9% just a week prior.

Hospitalizations were up 59% week-over-week, but off a low baseline, with a total of 993 patients currently in Gauteng hospitals, he noted. "This increase is not as steep as that in infections, but needs to be monitored closely."
Deaths remain low, he said, but given the typical lag between infections and deaths, one "cannot read too much into this indicator yet," he tweeted.
While it's still too early to read into the potential severity of the current wave, he noted that early indicators "suggest a similar decoupling effect as with original Omicron wave due to high levels of population immunity. Watching closely." Population immunity in the province is estimated at over 80%, said Suliman.
Lemieux noted that BA.4 and BA.5 are circulating in the U.S., but at very low levels, and it remains to be seen whether they will outcompete other variants currently circulating. BA.2 currently accounts for 68% of sequences in the U.S., followed by BA.2.12.1, which stands at 28.7%, according to CDC's variant proportions tracker.

He said the early data "suggests that we probably will see a fifth wave in South Africa," but the extent of the wave isn't clear. "There's a lot more population level immunity, so perhaps it'll just be a wave in numbers and not in morbidity or mortality, we hope."
Lemieux added, however, that the uptick is yet more evidence against herd immunity for COVID-19: "Lots of people have quantifiable immunity, and the case numbers are not going down. That speaks to the non-sterilizing nature of the immunity. That's likely due to the overall holes, if you will, in the extent and breadth of immunity, and then also the mutations in the virus that confer immune escape."
Whether what is happening in South Africa will play out in the rest of the world is still unknown, Lemieux said.
"From a weather report standpoint, we are watching closely," he said, "but it does have a bit of a flavor of, here we go again."


:

 

[missy]

"
More than half the U.S. population has been infected with the coronavirus at least once since the pandemic began, according to data released by federal health officials. Many of the cases — among roughly 190 million people — are likely to have been asymptomatic or with few symptoms, but the data show infections have been more than double the official count. One-third of Americans had been infected with the virus before the omicron wave, according to the federal health data. By the end of February, that rate had climbed to nearly 60 percent, including three out of four children. Officials cautioned that the data, drawn from tens of thousands of blood samples from across the country, do not mean that people have long-lasting protection against the virus, especially against increasingly transmissible variants that may be able to evade antibodies.

Anthony S. Fauci, President Biden’s chief medical adviser, said Wednesday that the United States has emerged “out of the full-blown explosive pandemic phase” after more than two years and 1 million deaths. “We’re really in a transitional phase, from a deceleration of the numbers into hopefully a more controlled phase and endemicity,” Fauci told The Washington Post, expanding on comments he made earlier on PBS. Fauci cautioned that the pandemic is not over and the United States could still see rising infections, but the virus is no longer causing the levels of hospitalization and death recorded in previous waves, he said. “Right now we’re at a low enough level that I believe that we’re transitioning into endemicity," Fauci said.

Vice President Harris tested positive for the coronavirus on Tuesday, becoming the most senior Biden administration official to be infected with the virus. Harris, 57, is fully vaccinated and boosted, showed no symptoms, had not been in close contact with Biden recently, and was isolating in her residence, the White House said. A spokeswoman for Harris said Tuesday evening that Harris was prescribed and had taken Paxlovid, the Pfizer antiviral pill.

The Biden administration announced plans to double the number of locations that carry Paxlovid as many consumers report difficulty finding a doctor to prescribe the medication, or a pharmacy that carries it. The administration's plan includes standing up more “test-to-treat” programs in pharmacies and clinics, where people would be able to get a five-day regimen of pills after testing positive for the coronavirus. Studies have shown Paxlovid can reduce the risk of hospitalization or death by about 90 percent when taken within three to five days of the start of symptoms.

Biden and more than 2,000 journalists, celebrities and politicians are set to gather at the White House Correspondents’ Association dinner this weekend. Organizers say they are committed to significantly reducing the risk of coronavirus infections, pointing to vaccine and testing requirements that were strengthened after Washington's Gridiron Club dinner this month was linked to at least 80 infections that sickened Cabinet members and other guests. Some White House officials and experts worry that this weekend’s events may become another high-profile superspreader event, three administration officials said.

Other important news​

Many of America’s more than 3 million Muslims are spending the month of Ramadan in community again after two years of pandemic isolation.

A months-long lockdown of Shanghai due to China’s strict zero-covid policy is hampering economic growth, and workers across the country are feeling the effects.
"

 

[missy]

"
How COVID Disinformation Kills

A family from Long Island told NPR that COVID-19 conspiracy theories are what really killed their mother.

NPR traced the story of 75-year-old Stephanie, who had refused to get vaccinated against COVID-19 because she believed the shots contained microchips. Stephanie died of COVID-19 in December 2021 after also refusing remdesivir and monoclonal antibodies when she was hospitalized.



Stephanie's daughter Laurie told NPR that the trouble started before the pandemic hit, when Stephanie could no longer play tennis because of knee problems. Upset that she could no longer pursue her hobby, she seemed to have turned to watching conspiracy theory videos online, the family said.

Diane Benscoter, who runs a nonprofit that helps families whose loved ones have been sucked into cults, said conspiracy narratives can provide reassurance and emotional stability by reducing complex problems into simple questions of right versus wrong.

When the pandemic hit, Stephanie echoed what her online videos told her: that COVID was a hoax. She refused to get vaccinated, and her husband complied to keep the peace between them.

She developed COVID-19 in November 2021, and tried to buy ivermectin and hydroxychloroquine online, according to NPR. When her daughters discovered that her blood oxygen levels had fallen to 77%, they rushed her to the hospital.



There, she refused all treatments and ultimately declined to be put on a ventilator, dying on December 28. Her husband, Arnold, was also hospitalized with COVID, but accepted all medical treatments and was discharged before her.

"I know we're not alone," daughter Laurie told NPR. "I know this is happening all over the place."

"Whoever is creating all this content, is on some level waging a war -- here in America -- inside of every family," she added. "I think people need to wake up to that."


"

 

[missy]

Fauci Clarifies Pandemic Phase; Moderna Seeks Youngest Kids Vax; Ground Beef Recall​

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

by Mike Bassett, Staff Writer, MedPage Today April 28, 2022
"
A day after saying the U.S. was "out of the pandemic phase," NIAID Director Anthony Fauci, MD, clarified his remarks, telling several news outlets it has instead moved into a new phase because daily counts of new cases, hospitalizations, and deaths have been declining. (New York Times)

Moderna asked the FDA to authorize its COVID-19 vaccine for kids 6 months to under 6 years old.



The European Commission estimates that between 60% and 80% of the European Union population has been infected with COVID-19. (Reuters)

Meanwhile, Denmark has become the first country to halt its COVID-19 vaccination program. However, the Danish Health and Medicines Authority said there will probably be a need to restart vaccinations in the fall. (CNBC)

As of Thursday at 8:00 a.m. EDT, the unofficial COVID toll in the U.S. reached 81,213,629 infections and 993,920 deaths, increases of 95,456 and 727, respectively, from this time yesterday.

A seafood processing plant in Washington state has been fined $56,000 in connection with a COVID-19 outbreak in 2021 that left one employee dead. (AP)

Vice President Kamala Harris is taking Pfizer's antiviral COVID pill nirmatrelvir-ritonavir (Paxlovid) after testing positive for the virus, a treatment decision that coincides with the Biden Administration's efforts to expand access to the medication. (Bloomberg).

At the same time the Biden Administration is warning that Congress needs to provide the necessary funding for the country's COVID-19 response to ensure there are enough vaccines, treatments, and tests to handle potential surges and new variants.



COVID lockdowns across China -- including its largest cities of Beijing and Shanghai -- are affecting up to 165 million people. (CNN)

A New Jersey manufacturer is recalling more than 120,000 pounds of ground beef due to concerns it could contain E. coli.

The World Health Organization and UNICEF, noting the substantial increase of measles cases in January and February, warned of the potential of larger outbreaks of vaccine-preventable diseases in 2022.

Health care providers in the operating room setting need to be aware of the risk of airway obstruction when using certain electromyogram endotracheal tubes, according to an FDA recommendation.

The FDA also alerted customers of Drug Depot, LLC about a voluntary recall of a number of its compounded drugs "due to a lack of sterility assurance."

An acute-care surgeon from Long Island is suing the federal government over the No Surprises Act, arguing it violates his constitutional right to bill patients directly for any "balance of the fair value" of his services. (STAT)



Oklahoma is banning the use of nonbinary gender markers on birth certificates. (ABC News)

An Arizona couple, still paying off more than $7,000 in medical bills despite paying more than $1,000 a month for health insurance, headed to Mexicowhen their son needed treatment for a dislocated shoulder. (NPR)

A 4-year old boy in Central China has become the first human infected with the H3N8 strain of bird flu. (Reuters)
"

 

[missy]

"

The U.S. has a Covid data problem​

Earlier this year, a few states made a little-noticed change in how they counted Covid-19. In their daily tallies of hospitalizations, New York and Massachusetts began to differentiate between people who were admitted because of the virus, and those who’d come in for something else but tested positive. What they found during the omicron wave was that about half of their patients were admitted “with” Covid but not “for” Covid. It was a sharp departure from earlier in the pandemic, when almost every Covid patient in the hospital was there because of the disease. It’s become a crucial difference. U.S. government officials, health experts and regular people all use hospitalization figures to help calculate the risk of the virus and how to react to it. But outside that handful of states and some university research groups, almost nowhere else is making the distinction. The Centers for Disease Control and Prevention, for example, still uses the more blunt definition when calculating its Covid “Community Levels”that are used to set recommendations on things like masking around the country. And programs like Medicare do, too, by paying hospitals more for any Covid admission. (Both “with” and “for” hospitalizations add to the burden on hospitals because of isolation requirements, but not to the same level — a patient with severe Covid will consume more staff and equipment resources than somebody with a mild case.) The Covid hospital data problem is just one way the country’s pandemic metrics haven’t evolved sufficiently over the past two years. After almost a million Americans have died, billions of dollars in spending, and more than half the country having been infected, we’re in a different moment. People need new ways of measuring the cost of the virus and what they’re willing to do to avoid those consequences. Our latest story in Businessweek looks at how U.S. Covid data haven’t kept pace, and how that’s made it harder to have the discussions as a society we’ll need to have if (or when) Covid comes back in force. You can read it here, and learn more about what would give us a better set of facts to make those choices.—Drew Armstrong and Cynthia Koons

​ ​ ​ ​ "

 

[missy]

“​

Fauci: COVID-19 Is Here to Stay, but We Can Control It​

— Next steps may include variant-specific vaccines​

by Jennifer Henderson, Enterprise & Investigative Writer, MedPage Today April 29, 2022

Though it would be next to impossible to eradicate SARS-CoV-2, it is fully feasible to control it, said Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases (NIAID), during a virtual event held Friday morning by the National Press Club.
A variety of factors make COVID-19 different from polio and measles, viruses that were previously eliminated in the U.S., including the number of genotypically and phenotypically diverse variants of SARS-CoV-2, and that SARS-CoV-2 has animal reservoirs for the virus, Fauci noted.

There has also been a lack of widespread acceptance when it comes to COVID vaccines, and immunity through vaccination or infection wanes over several months.
"We're hoping for control," Fauci said, which would involve a combination of common-sense hygiene and mitigation measures, intermittent vaccination, and treatment with effective antivirals and monoclonal antibodies.
As for the next generation of COVID shots, and how regularly they would be needed, Fauci was both optimistic and realistic.
"I would hope that we get to the point where immunity lasts long enough where we only intermittently need to be boosted," he said, adding that he doesn't think a schedule of receiving shots as often as once every 4 months is feasible.
However, waning immunity is not surprising, he noted.
"The protection that follows infection is not particularly durable, and you would expect, that being the case, that the protection following [vaccination is] not going to be durable," Fauci said. "We are trying very hard to develop vaccines that give a greater degree of durability of immunity."

The mRNA vaccines have a "phenomenally" high degree of efficacy and safety, but the durability of protection isn't life-long or even years long. "We've got to do better," he added, pointing out that improvements in durability may involve adjuvants.
In response to a question from MedPage Today about the potential significance of variant-specific vaccines, Fauci noted that NIAID is currently testing them. The ongoing COVID-19 Variant Immunologic Landscape (COVAIL) trial is administering a fourth ancestral strain-specific dose, a variant strain-specific dose, or both to people who have received a third dose of mRNA vaccine; initial findings could be available this summer.
Fauci stressed that it will be essential to continue to monitor for variants. There are currently subvariants of Omicron that are 25% to 30% more transmissible, though they are not necessarily more severe.

​

"But we always have to be on the lookout and vigilant," he said. Of particular concern is a variant that may be so different from prior strains that it evades immune protection.

Also important, Fauci noted, is ensuring that the American public and healthcare providers know about the oral antiviral Paxlovid.
Ultimately, to attain control, case counts need to be low enough that they are not disrupting society, overwhelming hospitals, or creating fear, Fauci said, putting SARS-CoV-2 in a similar place as other respiratory viruses like RSV and influenza.
But he made it clear that the U.S. is still dealing with a pandemic, and that individual risk assessments and choices about health remain necessary. It's important not to question others' personal decisions because they may be made due to personal factors that are not outwardly obvious, he said.
“

 

[missy]

Urgent data sought on Pfizer’s Covid pill​

Pfizer’s Paxlovid has become the go-to drug for people who get Covid and are at higher risk of developing a severe case. Now U.S. government researchers are planning studies of how often and why coronavirus levels rebound in some patients who have completed a course of the pill treatment. “It is a priority,” Clifford Lane, deputy director for clinical research at the National Institute of Allergy and Infectious Diseases, told Bloomberg in an interview this week. He called the issue “a pretty urgent thing for us to get a handle on.” The agency is discussing a variety of possible epidemiological and clinical studies to examine the rebound phenomenon, he said. While only one case has been reported so far in medical literature, a number of similar cases have been described on Twitter and medical blogs, and several doctors contacted by Bloomberg reported hearing of such cases in recent weeks. It wasn’t hard at all for Bloomberg to find a new case: One of the first researchers we called was David Ho, a veteran virologist who leads the Aaron Diamond AIDS Research Center at Columbia University. He personally experienced post-Paxlovid viral rebound after coming down with Covid in early April. The virus — and its symptoms — went away quickly with Paxlovid, then came back for a second round after the drug was stopped. “It surprised the heck out of me,” he told us. “Up until that point, I had not heard of such cases elsewhere.” Pfizer says it’s unlikely the rebound is related to Paxlovid. Photographer: Kobi Wolf/Bloomberg Little is yet known about the rebound cases, such as whether the highly transmissible omicron variant plays a role. While there’s no proof it’s caused by the drug, doctors say they need more information about what action to take when the virus surges in someone who’s just been treated. Meanwhile, the Food and Drug Administration says its also looking into the reports. For its part, Pfizer says it’s unlikely the rebound is related to the pill treatment, given that people on placebo in its final-stage trial experienced rebounds at a similar rate as those who got Paxlovid. Still, the demand for answers is rising. Among questions the NIH hopes to get a better handle on is how often viral rebounds occur after five days of Paxlovid treatment, who’s at risk for relapse and whether it could be avoided with a longer regimen. If viral rebound is shown to occur at a significant rate, then some people may need longer dosing of Pfizer’s drug than the standard five days, said Lane, the NIAID deputy director. “There’s two things that suppress the virus: the drug and the host immune response,” he told us. “If you stop the drug before the host immune response has had a chance to kick in, you may see the virus come back.”—Robert Langreth and Madison Muller

 

[TooPatient]

My "little" cousin (19 years old) just tested positive. He, his mother, and his sister live with my grandmother. He seldom leaves the motorhome out back. We think he got it from my aunt's other half or her. Both are in the church choir and had been in nearly daily rehearsals when the organist tested positive. He has been symptomatic but tested negative (on one at home test assuming he actually took one) So sick of them all! So careless all the time.

Now the rest of us are scrambling to figure out what to do. My mom's husband was supposed to be coming home tomorrow but she is likely exposed. He is high risk with heart issues and a pacemaker. I am supposed to be there to care for my grandmother three days next week so mom can return to work. Not sure who all in the house is positive. All of them exposed. Cousin who has it is unvaccinated. Cousin, mom, and aunt had first two but refuse booster. I have been at home not going out (except to be with my grandfather this last month) so have not had my booster yet since the vaccines and appointments were in short supply in this area and those who work in person (most everyone here) needed it more than me.