US hospitals seeing different kind of COVID surge this time

https://apnews.com/article/coronavirus-pandemic-business-health-pandemics-49810a71d2ca21c4b56adb1d1092b6dd?fbclid=IwAR1KvwTCWhAHZwDlmzgzMiNL5xhBfOySbZwgzXs3IAXtWlHai_VRfni5eaQ

Registered nurse Rachel Chamberlin, of Cornish, N.H., right, steps out of an isolation room where where Fred Rutherford, of Claremont, N.H., left, recovers from COVID-19 at Dartmouth-Hitchcock Medical Center, in Lebanon, N.H., Monday, Jan. 3, 2022. Hospitals like this medical center, the largest in New Hampshire, are overflowing with severely ill, unvaccinated COVID-19 patients from northern New England. If he returns home, Rutherford said, he promises to get vaccinated and tell others to do so, too. (AP Photo/Steven Senne)

Hospitals across the U.S. are feeling the wrath of the omicron variant and getting thrown into disarray that is different from earlier COVID-19 surges.

This time, they are dealing with serious staff shortages because so many health care workers are getting sick with the fast-spreading variant. People are showing up at emergency rooms in large numbers in hopes of getting tested for COVID-19, putting more strain on the system. And a surprising share of patients — two-thirds in some places — are testing positive while in the hospital for other reasons.

At the same time, hospitals say the patients aren’t as sick as those who came in during the last surge. Intensive care units aren’t as full, and ventilators aren’t needed as much as they were before.

The pressures are nevertheless prompting hospitals to scale back non-emergency surgeries and close wards, while National Guard troops have been sent in in several states to help at medical centers and testing sites.

Nearly two years into the pandemic, frustration and exhaustion are running high among health care workers.

“This is getting very tiring, and I’m being very polite in saying that,” said Dr. Robert Glasgow of University of Utah Health, which has hundreds of workers out sick or in isolation.

About 85,000 Americans are in the hospital with COVID-19, just short of the delta-surge peak of about 94,000 in early September, according to the Centers for Disease Control and Prevention. The all-time high during the pandemic was about 125,000 in January of last year.

But the hospitalization numbers do not tell the whole story. Some cases in the official count involve COVID-19 infections that weren’t what put the patients in the hospital in the first place.

Dr. Fritz François, chief of hospital operations at NYU Langone Health in New York City, said about 65% of patients admitted to that system with COVID-19 recently were primarily hospitalized for something else and were incidentally found to have the virus.

At two large Seattle hospitals over the past two weeks, three-quarters of the 64 patients testing positive for the coronavirus were admitted with a primary diagnosis other than COVID-19.

Joanne Spetz, associate director of research at the Healthforce Center at the University of California, San Francisco, said the rising number of cases like that is both good and bad.

The lack of symptoms shows vaccines, boosters and natural immunity from prior infections are working, she said. The bad news is that the numbers mean the coronavirus is spreading rapidly, and some percentage of those people will wind up needing hospitalization.

This week, 36% of California hospitals reported critical staffing shortages. And 40% are expecting such shortages.

Some hospitals are reporting as much as one quarter of their staff out for virus-related reasons, said Kiyomi Burchill, the California Hospital Association’s vice president for policy and leader on pandemic matters.

In response, hospitals are turning to temporary staffing agencies or transferring patients out.

University of Utah Health plans to keep more than 50 beds open because it doesn’t have enough nurses. It is also rescheduling surgeries that aren’t urgent. In Florida, a hospital temporarily closed its maternity ward because of staff shortages.

In Alabama, where most of the population is unvaccinated, UAB Health in Birmingham put out an urgent request for people to go elsewhere for COVID-19 tests or minor symptoms and stay home for all but true emergencies. Treatment rooms were so crowded that some patients had to be evaluated in hallways and closets.

As of Monday, New York state had just over 10,000 people in the hospital with COVID-19, including 5,500 in New York City. That’s the most in either the city or state since the disastrous spring of 2020.

New York City hospital officials, though, reported that things haven’t become dire. Generally, the patients aren’t as sick as they were back then. Of the patients hospitalized in New York City, around 600 were in ICU beds.

“We’re not even halfway to what we were in April 2020,” said Dr. David Battinelli, the physician-in-chief for Northwell Health, New York state’s largest hospital system.

Similarly, in Washington state, the number of COVID-19-infected people on ventilators increased over the past two weeks, but the share of patients needing such equipment dropped.

In South Carolina, which is seeing unprecedented numbers of new cases and a sharp rise in hospitalizations, Gov. Henry McMaster took note of the seemingly less-serious variant and said: “There’s no need to panic. Be calm. Be happy.”

Amid the omicron-triggered surge in demand for COVID-19 testing across the U.S., New York City’s Fire Department is asking people not to call for ambulance just because they are having trouble finding a test.

In Ohio, Gov. Mike DeWine announced new or expanded testing sites in nine cities to steer test-seekers away from ERs. About 300 National Guard members are being sent to help out at those centers.

In Connecticut, many ER patients are in beds in hallways, and nurses are often working double shifts because of staffing shortages, said Sherri Dayton, a nurse at the Backus Plainfield Emergency Care Center. Many emergency rooms have hours-long waiting times, she said.

“We are drowning. We are exhausted,” Dayton said.

Doctors and nurses are complaining about burnout and a sense their neighbors are no longer treating the pandemic as a crisis, despite day after day of record COVID-19 cases.

“In the past, we didn’t have the vaccine, so it was us all hands together, all the support. But that support has kind of dwindled from the community, and people seem to be moving on without us,” said Rachel Chamberlin, a nurse at New Hampshire’s Dartmouth-Hitchcock Medical Center.

Edward Merrens, chief clinical officer at Dartmouth-Hitchcock Health, said more than 85% of the hospitalized COVID-19 patients were unvaccinated.

Several patients in the hospital’s COVID-19 ICU unit were on ventilators, a breathing tube down their throats. In one room, staff members made preparations for what they feared would be the final family visit for a dying patient.

One of the unvaccinated was Fred Rutherford, a 55-year-old from Claremont, New Hampshire. His son carried him out of the house when he became sick and took him to the hospital, where he needed a breathing tube for a while and feared he might die.

If he returns home, he said, he promises to get vaccinated and tell others to do so too.

“I probably thought I was immortal, that I was tough,” Rutherford said, speaking from his hospital bed behind a window, his voice weak and shaky.

But he added: “I will do anything I can to be the voice of people that don’t understand you’ve got to get vaccinated. You’ve got to get it done to protect each other.”

The Next Big COVID Variant Could Be a Triple Whammy Nightmare

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Even as daily new COVID cases set all-time records and hospitals fill up, epidemiologists have arrived at a perhaps surprising consensus. Yes, the latest Omicron variant of the novel coronavirus is bad. But it could have been a lot worse.

Even as cases have surged, deaths haven’t—at least not to the same degree. Omicron is highly transmissible but generally not as severe as some older variants—“lineages” is the scientific term.

We got lucky. But that luck might not hold. Many of the same epidemiologists who have breathed a sigh of relief over Omicron’s relatively low death rate are anticipating that the next lineage might be much worse.

The New Version of the Omicron Variant Is a Sneaky Little Bastard

Fretting over a possible future lineage that combines Omicron’s extreme transmissibility with the severity of, say, the previous Delta lineage, experts are beginning to embrace a new public health strategy that’s getting an early test run in Israel: a four-shot regimen of messenger-RNA vaccine.

“I think this will be the strategy going forward,” Edwin Michael, an epidemiologist at the Center for Global Health Infectious Disease Research at the University of South Florida, told The Daily Beast.

Omicron raised alarms in health agencies all over the world in late November after officials in South Africa reported the first cases. Compared to older lineages, Omicron features around 50 key mutations, some 30 of which are on the spike protein that helps the virus to grab onto our cells.

Some of the mutations are associated with a virus’s ability to dodge antibodies and thus partially evade vaccines. Others are associated with higher transmissibility. The lineage’s genetic makeup pointed to a huge spike in infections in the unvaccinated as well as an increase in milder “breakthrough” infections in the vaccinated.

That’s exactly what happened. Health officials registered more than 10 million new COVID cases the first week of January. That’s nearly double the previous worst week for new infections, back in May. Around 3 million of those infections were in the United States, where Omicron coincided with the Thanksgiving, Christmas, and New Year holidays and associated traveling and family gatherings.

But mercifully, deaths haven’t increased as much as cases have. Worldwide, there were 43,000 COVID deaths the first week of January—fewer than 10,000 of them in the U.S. While deaths tend to lag infections by a couple weeks, Omicron has been dominant long enough that it’s increasingly evident there’s been what statisticians call a “decoupling” of cases and fatalities.

“We can say we dodged a bullet in that Omicron does not appear to cause as serious of a disease,” Stephanie James, the head of a COVID testing lab at Regis University in Colorado, told The Daily Beast. She stressed that data is still being gathered, so we can’t be certain yet that the apparent decoupling is real.

Assuming the decoupling is happening, experts attribute it to two factors. First, Omicron tends to infect the throat without necessarily descending to the lungs, where the potential for lasting or fatal damage is much, much higher. Second, by now, countries have administered nearly 9.3 billion doses of vaccine—enough for a majority of the world’s population to have received at least one dose.

Omicron Shows the Unvaccinated Will Never Be Safe

In the United States, 73 percent of people have gotten at least one dose. Sixty-two percent have gotten two doses of the best mRNA vaccines. A third have received a booster dose.

Yes, Omicron has some ability to evade antibodies, meaning the vaccines are somewhat less effective against this lineage than they are against Delta and other older lineages. But even when a vaccine doesn’t prevent an infection, it usually greatly reduces its severity.

For many vaccinated people who’ve caught Omicron, the resulting COVID infection is mild. “A common cold or some sniffles in a fully vaxxed and boosted healthy individual,” is how Eric Bortz, a University of Alaska-Anchorage virologist and public health expert, described it to The Daily Beast.

All that is to say, Omicron could have been a lot worse. Viruses evolve to survive. That can mean greater transmissibility, antibody-evasion or more serious infection. Omicron mutated for the former two. There’s a chance some future Sigma or Upsilon lineage could do all three.

When it comes to viral mutations, “extreme events can occur at a non-negligible rate, or probability, and can lead to large consequences,” Michael said. Imagine a lineage that’s as transmissible as Omicron but also attacks the lungs like Delta tends to do. Now imagine that this hypothetical lineage is even more adept than Omicron at evading the vaccines.

2022’s Hottest New Illness: Flurona

That would be the nightmare lineage. And it’s entirely conceivable it’s in our future. There are enough vaccine holdouts, such as the roughly 50 million Americans who say they’ll never get jabbed, that the SARS-CoV-2 pathogen should have ample opportunities for mutation.

“As long as we have unvaccinated people in this country—and across the globe—there is the potential for new and possibly more concerning viral variants to arise,” Aimee Bernard, a University of Colorado immunologist, told The Daily Beast.

Worse, this ongoing viral evolution is happening against a backdrop of waning immunity. Antibodies, whether vaccine-induced or naturally occurring from past infection, fade over time. It’s not for no reason that health agencies in many countries urge booster doses just three months after initial vaccination. The U.S. Centers for Disease Control and Prevention is an outlier, and recommends people get boosted after five months.

A lineage much worse than Omicron could evolve at the same time that antibodies wane in billions of people all over the world. That’s why many experts believe the COVID vaccines will end up being annual or even semi-annual jabs. You’ll need a fourth jab, a fifth jab, a sixth jab, et cetera, forever.

Israel, a world leader in global health, is already turning that expectation into policy. Citing multiple studies that showed a big boost in antibodies with an additional dose of mRNA and no safety concerns, the country’s health ministry this week began offering a fourth dose to anyone over the age of 60, who tend to be more vulnerable to COVID than younger people.

That should be the standard everywhere, Ali Mokdad, a professor of health metrics sciences at the University of Washington Institute for Health, told The Daily Beast. “Scientifically, they’re right,” he said of the Israeli health officials.

If there’s a downside, it’s that there are still a few poorer countries—in Africa, mostly—where many people still struggle to get access to any vaccine, let alone boosters and fourth doses. If and when other richer countries follow Israel’s lead and begin offering additional jabs, there’s some risk of even greater inequity in global vaccine distribution.

“The downside is for the rest of the world,” Mokdad said. “I’m waiting to get my first dose and you guys are getting a fourth?”

The solution isn’t to deprive people of the doses they need to maintain their protection against future—and potentially more dangerous—lineages. The solution, for vaccine-producing countries, is to further boost production and double down on efforts to push vaccines out to the least privileged communities.

A sense of urgency is key. For all its rapid spread, Omicron has actually gone fairly easy on us. Sigma or Upsilon might not.

The 1918 flu is even more relevant in 2022 thanks to omicron

Over the past two years, historians and analysts have compared the coronavirus to the 1918 flu pandemic. Many of the mitigation practices used to combat the spread of the coronavirus, especially before the development of the vaccines, have been the same as those used in 1918 and 1919 — masks and hygiene, social distancing, ventilation, limits on gatherings (particularly indoors), quarantines, mandates, closure policies and more.

Yet, it may be that only now, in the winter of 2022, when Americans are exhausted with these mitigation methods, that a comparison to the 1918 pandemic is most apt.

The highly contagious omicron variant has rendered vaccines much less effective at preventing infections, thus producing skyrocketing caseloads. And that creates a direct parallel with the fall of 1918, which provides lessons for making January as painless as possible.

In February and March 1918, an infectious flu emerged. It spread from Kansas, through World War I troop and material transports, filling military post hospitals and traveling across the Atlantic and around the world within six months. Cramped quarters and wartime transport and industry generated optimal conditions for the flu to spread, and so, too, did the worldwide nature of commerce and connection. But there was a silver lining: Mortality rates were very low.

In part because of press censorship of anything that might undermine the war effort, many dismissed the flu as a “three-day fever,” perhaps merely a heavy cold, or simply another case of the grippe (an old-fashioned word for the flu).

Downplaying the flu led to high infection rates, which increased the odds of mutations. And in the summer of 1918, a more infectious variant emerged. In August and September, U.S. and British intelligence officers observed outbreaks in Switzerland and northern Europe, writing home with warnings that went largely unheeded.

Unsurprisingly then, this seemingly more infectious, much more deadly variant of H1N1 traveled west across the Atlantic, producing the worst period of the pandemic in October 1918. Nearly 200,000 Americans died that month. After a superspreading Liberty Loan parade at the end of September, Philadelphia became an epicenter of the outbreak. At its peak, nearly 700 Philadelphians died per day.

Once spread had begun, mitigation methods such as closures, distancing, mask-wearing and isolating those infected couldn’t stop it, but they did save many lives and limited suffering by slowing infections and spread. The places that fared best implemented proactive restrictions early; they kept them in place until infections and hospitalizations were way down, then opened up gradually, with preparations to reimpose measures if spread returned or rates elevated, often ignoring the pleas of special interests lobbying hard for a complete reopening.

In places in the United States where officials gave in to public fatigue and lobbying to remove mitigation methods, winter surges struck. Although down from October’s highs, these surges were still usually far worse than those in the cities and regions that held steady.

In Denver, in late November 1918, an “amusement” lobby — businesses and leaders invested in keeping theaters, movie houses, pool halls and other public venues open — successfully pressured the mayor and public health officials to rescind and then revise a closure order. This, in turn, generated what the Rocky Mountain News called “almost indescribable confusion,” followed by widespread public defiance of mask and other public health prescriptions.

In San Francisco, where resistance was generally less successful than in Denver, there was significant buy-in for a second round of masking and public health mandates in early 1919 during a new surge. But opposition created an issue. An Anti-Mask League formed, and public defiance became more pronounced. Eventually anti-maskers and an improving epidemic situation combined to end the “masked” city’s second round of mask and public health mandates.

The takeaway: Fatigue and removing mitigation methods made things worse. Public officials needed to safeguard the public good, even if that meant unpopular moves.

The flu burned through vulnerable populations, but by late winter and early spring 1919, deaths and infections dropped rapidly, shifting toward an endemic moment — the flu would remain present, but less deadly and dangerous.

Overall, nearly 675,000 Americans died during the 1918-19 flu pandemic, the majority during the second wave in the autumn of 1918. That was 1 in roughly 152 Americans (with a case fatality rate of about 2.5 percent). Worldwide estimates differ, but on the order of 50 million probably died in the flu pandemic.

In 2022, we have far greater biomedical and technological capacity enabling us to sequence mutations, understand the physics of aerosolization and develop vaccines at a rapid pace. We also have a far greater public health infrastructure than existed in 1918 and 1919. Even so, it remains incredibly hard to stop infectious diseases, particularly those transmitted by air. This is complicated further because many of those infected with the coronavirus are asymptomatic. And our world is even more interconnected than in 1918.

That is why, given the contagiousness of omicron, the lessons of the past are even more important today than they were a year ago. The new surge threatens to overwhelm our public health infrastructure, which is struggling after almost two years of fighting the pandemic. Hospitals are experiencing staff shortages (like in fall 1918). Testing remains problematic.

And ominously, as in the fall of 1918, Americans fatigued by restrictions and a seemingly endless pandemic are increasingly balking at following the guidance of public health professionals or questioning why their edicts have changed from earlier in the pandemic. They are taking actions that, at the very least, put more vulnerable people and the system as a whole at risk — often egged on by politicians and media figures downplaying the severity of the moment.

Public health officials also may be repeating the mistakes of the past. Conjuring echoes of Denver in late 1918, under pressure to prioritize keeping society open rather than focusing on limiting spread, the Centers for Disease Control and Prevention changed its isolation recommendations in late December. The new guidelines halved isolation time and do not require a negative test to reenter work or social gatherings.

Thankfully, we have an enormous advantage over 1918 that offers hope. Whereas efforts to develop a flu vaccine a century ago failed, the coronavirus vaccines developed in 2020 largely prevent severe illness or death from omicron, and the companies and researchers that produced them expect a booster shot tailored to omicron sometime in the winter or spring. So, too, we have antivirals and new treatments that are just becoming available, though in insufficient quantities for now.

Those lifesaving advantages, however, can only help as much as Americans embrace them. Only by getting vaccinated, including with booster shots, can Americans prevent the health-care system from being overwhelmed. But the vaccination rate in the country remains a relatively paltry 62 percent, and only a scant 1 in 5 have received a booster shot. And as in 1918, some of the choice rests with public officials. Though restrictions may not be popular, officials can reimpose them — offering public support where necessary to those for whom compliance would create hardship — and incentivize and mandate vaccines, taking advantage of our greater medical technology.

As the flu waned in 1919, one Portland, Ore., health official reflected that “the biggest thing we have had to fight in the influenza epidemic has been apathy, or perhaps the careless selfishness of the public.”

The same remains true today.

Vaccines, new treatments and century-old mitigation strategies such as masks, distancing and limits on gatherings give us a pathway to prevent the first six weeks of 2022 from being like the fall of 1918. And encouraging news about the severity of omicron provides real optimism that an endemic future — in which the coronavirus remains but poses far less of a threat — is near. The question is whether we get there with a maximum of pain or a minimum. The choice is ours.

Experts say COVID-19 cases don’t tell whole story

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Coronavirus Pandemic (COVID-19) - Statistics and Research - Our World in  Data


For nearly two years, Americans have looked carefully at coronavirus case numbers in the country and in their local states and towns to judge the risk of the disease.

Surging case numbers signaled growing dangers, while falling case numbers were a relief and a signal to let one’s guard down in terms of gathering with friends and families and taking part in all kinds of events.

But with much of the nation’s population vaccinated and boosted and the country dealing with a new COVID-19 surge from omicron — a highly contagious variant that some studies suggest may not be as severe as previous variants — public health officials are debating whether the nation needs to shift its thinking.

Many people are going to get omicron — but those that are vaccinated and boosted are unlikely to suffer dire symptoms.

As a result, hospitalizations and deaths are the markers that government officials need to monitor carefully to ensure the safety of communities as the nation learns to live with COVID-19.

“This is the new normal,” said Leana Wen, a public health professor at George Washington University and former Baltimore health commissioner. “This is what we will have to accept as we transition from the emergency of COVID-19 to living with it as part of the new normal.”

David Dowdy, an epidemiologist at Johns Hopkins Bloomberg School of Public Health, said that Americans all need to shift to focus on hospitalizations over cases as we enter into another year of the pandemic.

“I think that we need to start training ourselves to look, first of all, at hospitalizations. I think hospitalizations are a real-time indicator of how serious things are,” he said.

Rising case numbers still say something about the disease, and the spikes from omicron are leading to real concerns.

Anthony Fauci, the government’s top infectious disease expert, noted on Sunday that even if omicron leads to less severe cases of COVID-19, if it infects tens of millions it will have the potential of straining resources in hospitals.

“If you have many, many, many more people with a less level of severity, that might kind of neutralize the positive effect of having less severity when you have so many more people,” he said during an appearance on ABC’s “This Week.”

At the same time, the nation must get used to dealing with the coronavirus as it would deal with an annual flu season. It’s a challenge for most parts of American life, from schools and businesses that have to consider worker and student safety, to professional sports leagues that must decide how long someone sits out after a positive test — even if the person is vaccinated and not symptomatic.

“Omicron in a way is the first test of what it means to live with COVID-19,” said Wen. “And by that I mean we are going to see many people getting infected but as long as our hospital systems are not overwhelmed and as long as vaccinated people are generally protected against severe outcomes, that is how we end the pandemic phase and switch into the endemic phase.”

The omicron strain is so infectious that once the current surge has faded in the United States, it’s likely a large majority of the population will either have been vaccinated against COVID-19 or have been infected, experts say. At that point, the focus should shift away from preventing infection to preventing serious illness, multiple experts said, a message already being echoed in some corners of the White House.

Many states have been seeing staggering numbers of positive tests and lines for COVID-19 testing that stretch for several blocks. Washington, D.C., and New York state have set records in recent days for the number of new cases reported as omicron barrels through the population.

But even with case totals surpassing last year’s numbers, President Biden and White House officials have been quick to point out that hospitalizations haven’t been as high as the numbers seen in the winter of 2020.

“Because we have so many vaccinated and boosted, we’re not seeing hospitalizations drive as sharply as we did in March of 2020 or even this past fall. America has made progress; things are better,” Biden said on Monday on a White House COVID-19 response team call with the National Governors Association to discuss the administration’s response to the omicron variant.

“But we do know that with rising cases, we still have tens of millions of unvaccinated people and we’re seeing hospitalizations rise,” he added, saying that some hospitals are going to get overrun both in terms of equipment and staff.

The White House pointed to Biden’s remarks last week when asked about whether the president wants Americans and health experts to take the emphasis off of case numbers and put it on hospitalizations.

“Because omicron spreads so easily, we’ll see some fully vaccinated people get COVID, potentially in large numbers. There will be positive cases in every office, even here in the White House, among the vaccinated … from omicron. But these cases are highly unlikely to lead to serious illness,” Biden said on Dec. 21.

Chief of staff Ron Klain on Monday retweeted a CNN report about how hospitalizations are about 70 percent less than what they were around the last peak in September, but that COVID-19 cases in unvaccinated Americans could end up overwhelming health systems.

Health experts have suggested the White House’s shift in messaging away from a focus on the number of cases is a sign of what’s to come as the pandemic eventually becomes endemic.

“For two years, infections always preceded hospitalizations which preceded deaths, so you could look at infections and know what was coming,” Ashish Jha, dean of the Brown University School of Public Health, said Sunday on ABC. “Omicron changes that. This is the shift we’ve been waiting for in many ways.”

Dowdy said positive tests are also up because people are getting tested before visiting relatives.

“If a lot of people are testing positive because they are asymptomatic and wanting to make sure that they can travel etc., having a lot of those kinds of cases is not a big problem,” he said.

“In fact, that’s a good thing. It means that we’re doing the right thing as a country to define those cases,” Dowdy added.

Lawrence Gostin, a professor of global health at Georgetown University, said the shift away from tracking case numbers as a way to measure the pandemic means devoting more resources toward treatment options like the Pfizer antiviral pill.

Gostin also said testing should increasingly be used to self-diagnose so individuals can get proper treatment, rather than testing for the purpose of stopping the spread of the virus.

“The White House has got a very difficult balancing act. Certainly for now it’s going to have to emphasize the idea of masking and distancing for the purpose of protecting the health system,” Gostin said.

“We can’t live our lives in a bubble to prevent us from getting a pathogen that’s so contagious that you can’t avoid it if you’re going to be circulating and living a life in this world,” he continued. “What it means to transition to a normal life or more normal life is you have to focus not so much on preventing cases, but on preventing hospitalizations and deaths.”

We’ll Never Be Rid of COVID, Fauci Says

A photo of Anthony Fauci, MD

On the spectrum from active outbreak to eradication, control is the most likely path forward for COVID-19 in the U.S., NIAID Director Anthony Fauci, MD, said during a National Press Club briefing today.

Fauci’s words served as a reality check for those holding out hope that COVID-19 one day might be as rare as measles or polio in America.

“We’re never going to eradicate this,” he said. “We’ve only eradicated one virus, and that’s smallpox. Elimination may be too aspirational, because we’ve only done that with infections for which we’ve had a massive vaccination campaign like polio and measles. Even though we haven’t eradicated [those viruses] from the planet, we have no cases, with few exceptions, in the U.S.”

Fauci said the country should focus on control — a level of infection “that isn’t zero, but that with the combination of the vast majority of the population vaccinated and boosted, together with those who recovered from infection and also are hopefully boosted, that we will get a level of control that will be non-interfering with our lives, our economy, and the kinds of things we would do, namely to get back to some degree of normality.”

“It’s not going to be eradication, and it’s likely not going to be elimination,” he said again later in the briefing. “It’s going to be a low, low, low level of infection that really doesn’t interfere with our way of life, our economy, our ability to move around in society, our ability to do things in closed indoor spaces.”

Fauci said the only way to achieve this will be with vaccinations, boosters, and mitigation strategies such as wearing masks in congregate settings.

“Over time, we feel confident we will get this under control,” he said. While he said he “hopes” this comes in the “next several months,” he cautioned that he “never predict[s], because you never get it right. Sure enough, someone will come back and say, ‘You said this in December and you were wrong.'”

In terms of boosters, Fauci said it’s possible that a third shot — “and maybe an additional one” — will be enough to provide durable immunity, but that “we’ll just have to wait and see. We don’t know yet.”

Kids under age 5 who have yet to be vaccinated will have to wait a few more months to get their shots, he added. While the lower, 3 μg dose of the Pfizer vaccine looked sufficient for children ages 6 months up to 2 years, that dose was not sufficient for those ages 2 to 5, he said.

“The company decided that they believe this is really a three-dose vaccine, and there’s no doubt if you give three doses you’re going to get an effective and safe vaccine,” he said. “But they haven’t proven it yet, so that’s the delay.”

“I can guarantee you it’s going to be effective,” Fauci added.

Data aren’t expected until the end of the first quarter of 2022, he said, meaning vaccines for this pediatric population likely won’t be available until “a few months into 2022.”

Health officials say omicron variant likely to cause record-high coronavirus cases, hospitalizations in U.S.

Top government health officials on Sunday warned that the United States will probably see record numbers of coronavirus cases and hospitalizations as the omicron variant spreads rapidly and forces Americans to again grapple with the dangers of a pandemic that has upended life around the globe.

“Unfortunately, I think that that is going to happen. We are going to see a significant stress in some regions of the country on the hospital system, particularly in those areas where you have a low level of vaccination,” Anthony S. Fauci, the nation’s leading infectious-disease specialist, said on CNN’s “State of the Union” when asked whether the United States could see record numbers of cases, hospitalizations and deaths.

Fauci described the variant as “extraordinary” in its transmissibility, with a doubling time of two to three days. It accounts for 50 percent of coronavirus cases in parts of the country, which meant it would almost certainly take over as the dominant variant in the United States, he added.

“It is going to be a tough few weeks, months, as we get deeper into the winter,” Fauci said.

On CBS News’s “Face the Nation,” Francis Collins, director of the National Institutes of Health, said that cases will rise steeply over the next couple of weeks and that the country could soon see 1 million new cases a day tied to the omicron variant, dramatically exceeding the record of about 250,000 new cases per day set in January.

“The big question is, are those million cases going to be sick enough to need health care and especially hospitalization?” Collins said. “We’re just holding our breath to see how severe this will be.”

Fauci and Collins painted a stark but realistic picture of the winter ahead, on the heels of a week of coronavirus-related setbacks. Coronavirus cases, hospitalizations and deaths rose across much of the country last week, with officials warning of a surge just as millions of Americans — already weary after nearly two years of the pandemic — are expected to travel for Christmas and New Year’s. On Friday, Pfizer and BioNTech announced that coronavirus vaccines for children younger than 5 would be pushed back further into 2022, as the companies modified their trials to include a third dose. On Sunday, New York, one of the country’s early epicenters in the pandemic, reported 22,478 cases.

Health officials have continued to urge the unvaccinated to get their shots and those who have received only two doses of either the Pfizer or Moderna mRNA vaccines to get booster doses. Vaccines cannot be the only layer of protection against the omicron variant, Fauci said, but defeating the pandemic would not be possible without them.

There are still safe ways for vaccinated people to get together for the holidays, including wearing a mask while traveling, testing beforehand and knowing the vaccination status of everyone present at indoor celebrations, Fauci said on “Face the Nation.”

“If you do these things, I do believe that you can feel quite comfortable with a family setting,” he said. “Nothing is 100 percent risk-free, but I think if you do the things that I just mentioned, you’d actually mitigate that risk enough to feel comfortable about being able to enjoy the holiday.”

Collins stopped short of urging people to cancel holiday plans but said travel will be risky even for vaccinated people.

“This virus is going to be all around us,” he said. “I’m not going to say you shouldn’t travel, but you should do so very carefully. … People are going, ‘I’m so sick of hearing this,’ and I am, too. But the virus is not sick of us, and it is still out there looking for us, and we’ve got to double down on these things if we’re going to get through the next few months.”

Doctors, nurses and others are warning that the nation’s health system continues to be strained by an unending stream of coronavirus cases. Confirmed U.S. coronavirus infections have surpassed more than 128,000 per day and confirmed virus deaths are near 1,300 per day, according to The Washington Post’s rolling seven-day average.

“For people trained to save lives, this moment is frustrating, exhausting and heartbreaking,” the American Hospital Association, the American Medical Association and the American Nurses Association said in a joint statement on Friday, urging more Americans to get booster shots.

Public health experts are bracing for a winter surge of cases driven by the omicron variant, which can evade some protection conferred by vaccinations and prior infections, as well as cases linked to the delta variant. Officials caution that they are still relying on preliminary data about the omicron variant’s severity compared with earlier forms of the virus.

President Biden plans to address the nation Tuesday on the status of the country’s fight against the virus, the White House said Saturday.

“We are prepared for the rising case levels,” White House press secretary Jen Psaki wrote on Twitter, adding that Biden “will detail how we will respond to this challenge. He will remind Americans that they can protect themselves from severe illness from COVID-19 by getting vaccinated and getting their booster shot when they are eligible.”

The speech, coming just before Christmas and New Year’s Day, underlines Biden’s struggle to contain the pandemic nearly a year into office. On top of the emergence of new variants and attendant challenges, the administration has at times faced criticism for what some have described as mixed signals.

Biden won high marks from the public during the first half of the year as cases declined, the country opened up from shutdowns and vaccines became widely available. But the past few months have been more difficult. After he gave a speech on July 4 saying the country was “closer than ever to declaring our independence from a deadly virus,” the situation started changing. Case rates increased as the delta variant gained a foothold and many Americans refused to get vaccinated.

And despite Biden’s promise that at-home rapid tests would become a widely available tool to fight the coronavirus, the tests remain hard to find in many parts of the country and are more expensive than in some other places across the globe.

Fauci conceded Sunday that the administration needed to do better on increasing the availability of at-home coronavirus rapid tests, though he emphasized that the country was in a much better place than it was a year ago, with 200 million to 500 million tests available per month, many of them free.

“We’re going in the right direction,” he said on CNN. “We really need to flood the system with testing. We need to have tests available for anyone who wants them, particularly when we’re in a situation right now where people are going to be gathering.”

The omicron variant also has challenged the nation’s coronavirus medicine cabinet, with evidence that mutations will wipe out or weaken the effectiveness of treatments that can reduce the virus’s severity and keep people out of hospitals. As a result, the Biden administration around Thanksgiving paused distribution of sotrovimab, the one monoclonal antibody that remains effective against the omicron variant, with senior officials such as David Kessler calculating that the drug should be maximally deployed when the variant becomes more prevalent.

By Thursday, administration officials decided to resume shipments of the drug, amid indicators that the omicron variant was spreading faster in states such as New York and Washington than data published by the Centers for Disease Control and Preventionearlier in the week indicated, said two officials with knowledge of the deliberations.

“Shipment of product will begin soon, and jurisdictions will see product arrive as early as Tuesday, December 21, 2021,” the federal health agency said in a statement on Friday, announcing that about 55,000 doses of sotrovimab would soon go out.

Doctors said they were desperate for treatments like sotrovimab as emergency rooms begin to crowd and case numbers soar.

“Too slow! We are already seeing widespread omicron,” texted one infectious-disease doctor at a large New York City hospital, who estimated that at least 50 percent of patients had contracted the variant and requested confidentiality to discuss patient care. “It’s a lot of hospitalizations that could have potentially [been] averted because of slow response.”

Fauci said Sunday that he expected it to be months before antiviral drugs can be mass-produced and available to anyone who needs them. While he did not foresee the kind of shutdowns that were put in place in the early days of the pandemic, Fauci also noted that it would be difficult to keep the virus under control when there remained “about 50 million people in the country who are eligible to be vaccinated who are not vaccinated.”

Similarly, several governors on Sunday shied away from the possibility of implementing more shutdowns to fight the spread of the new variant. Maryland Gov. Larry Hogan (R) said on “Fox News Sunday” that his state, which has seen a 150 percent increase in hospitalizations over the past two weeks, was not considering shutdowns and instead was putting more resources into testing and encouraging vaccinations and boosters. New Jersey Gov. Phil Murphy (D) said on the same show that shutdowns remained “on the table” but that he didn’t think such a move was likely because a high percentage of the state’s population was vaccinated.

Colorado Gov. Jared Polis (D) emphasized that people in his state should keep themselves safe with “individual freedom and local control.” He also said Colorado officials were looking to change the definition of “fully vaccinated” to include three shots, as health officials in the country and around the world have signaled in recent days they are also considering.

“That’s certainly where it’s headed,” Polis said on NBC News’s “Meet the Press.” “I wish they’d stop talking about [the third shot] as a booster. It really is a three-dose vaccine.”

CDC: Omicron accounted for 73% of recent COVID-19 cases

COVID testing in NYC

The Omicron variant accounted for more than 73% of recent COVID-19 cases in the U.S., according to Centers for Disease Control and Prevention’s updated data released on Monday.

The big picture: The data showed nearly a six-fold increase in Omicron’s share of COVID-19 infections in just one week.

What they’re saying: “These numbers are stark, but they’re not surprising,” said Rochelle Walensky, the CDC’s director, adding that the growing infections reflect what has been seen in other countries.

  • While the Delta variant still drives up a lot of new infections, Walensky told AP she anticipates “that over time that Delta will be crowded out by Omicron.”

What’s next: President Biden on Tuesday will deliver a speech outlining new steps the administration will take to address the rapid spread of the new variant.

Michigan this week counted more people hospitalized with COVID-19 than at any other time during the pandemic

https://www.cnn.com/2021/12/09/us/hospital-covid-19-deaths-michigan/index.html

Coronavirus: Michigan's highest-in-the-U.S. case count exceeds California,  Texas combined | CTV News

Nurse Katie Sefton never thought Covid-19 could get this bad — and certainly not this late in the pandemic. “I was really hoping that we’d (all) get vaccinated and things would be back to normal,” said Sefton, an assistant manager at Sparrow Hospital in Lansing, Michigan. But this week Michigan had more patients hospitalized for Covid-19 than ever before. Covid-19 hospitalizations jumped 88% in the past month, according to the Michigan Health & Hospital Association.

“We have more patients than we’ve ever had at any point, and we’re seeing more people die at a rate we’ve never seen die before,” said Jim Dover, president and CEO of Sparrow Health System.

“Since January, we’ve had about 289 deaths; 75% are unvaccinated people,” Dover said. “And the very few (vaccinated people) who passed away all were more than 6 months out from their shot. So we’ve not had a single person who has had a booster shot die from Covid.”

Among the new Covid-19 victims, Sefton said she’s noticed a disturbing trend.

We’re seeing a lot of younger people. And I think that is a bit challenging,” said Sefton, a 20-year nursing veteran.She recalls helping the family of a young adult say goodbye to their loved one. “It was an awful night,” she said. “That was one of the days I went home and just cried.”

‘We haven’t peaked yet’

It’s not just Michigan that’s facing an arduous winter with Covid-19. Nationwide, Covid-19 hospitalizations have increased 40% compared to a month ago, according to data from the US Department of Health and Human Services. This is the first holiday season with the relentless spread of the Delta variant — a strain far more contagious than those Americans faced last winter.

“We keep talking about how we haven’t peaked yet,” Sefton said.Health experts say the best protection against Delta is to get vaccinated and boosted. But as of Thursday, only about 64.3% of eligible Americans had been fully vaccinated, and less than a third of those eligible for boosters have gotten one.

Sparrow Hospital nurse Danielle Williams said the vast majority of her Covid-19 patients are not vaccinated — and had no idea they could get pummeled so hard by Covid-19.“Before they walked in the door, they had a normal life. They were healthy people. They were out celebrating Thanksgiving,” Williams said. “And now they’re here, with a mask on their face, teary eyed, staring at me, asking me if they’re going to live or not.”

‘The next few weeks look hard’

Dover said he’s saddened but not surprised that his state is getting walloped with Covid-19.“Michigan is not one of the highest vaccination states in the nation. So it continues to have variant after variant grow and expand across the state,” he said.

“The next few weeks look hard. We’re over 100% capacity right now,” Dover said.”Most hospitals and health systems in the state of Michigan have gone to code-red triage, which means they won’t accept transfers. And as we go into the holidays, if the current growth rate that we’re at today, we would expect to see 200 in-patient Covid patients by the end of the month — on a daily basis.”And that would mean “absolutely stretching us to the breaking point,” Dover said.”We’ve already discontinued in-patient elective surgeries,” he said. “In order to create capacity, we took our post-anesthesia recovery care unit and converted it into another critical care unit.”

‘There’s a lot of frustration’

Nurse Leah Rasch is exhausted. She’s worked with Covid-19 patients since the beginning of the pandemic and was stunned to see so many people still unvaccinated enter the Covid unit.

“I did not think we’d be here. I truly thought that people would be vaccinated,” the Sparrow Hospital nurse said.”I don’t remember the last time we did not have a full Covid floor.”The relentless onslaught of Covid-19 patients has impacted Rasch’s own health. “There’s a lot of frustration,” she said. “The other day, I had my first panic attack … I drove to work and I couldn’t get out of the car.”

‘We need everybody to get vaccinated’

Dover said many people have asked how they can support health care workers.”If you really want to support your staff, and you really want to support health care heroes, get vaccinated,” he said. “It’s not political. We need everybody to get vaccinated.”

He’s also urging those who previously had Covid-19 to get vaccinated, as some people can get reinfected.”My daughter’s a good example. She had Covid twice before she was eligible for a vaccine,” Dover said. “She still got a vaccine because we know that if you don’t get the vaccine, just merely having contracted Covid is not enough to protect you from getting it again. And I know that from personal experience. “And those who are unvaccinated shouldn’t underestimate the pandemic right now, Dover said.

“The problem is, it’s not over yet. I don’t know if people realize just how critical it still is,” he said.”But they do realize it when they come into the ER, and they have to wait three days for a bed. And at that point, they realize it.”

A tale of two New Yorks: COVID-19 hospitalization rate surging upstate

https://www.yahoo.com/gma/tale-two-yorks-covid-19-100301204.html

COVID-19-related hospitalizations have been on an upward trend in New York state since last month, but there appears to be a drastic divide between the Big Apple and some of the state’s more rural areas, health data shows.

In New York City, the seven-day average of new COVID-19 hospitalizations per 100,000 people rose from 0.5 on Nov. 10 to 1.1 on Dec. 7, the New York State Department of Health said.

The story is different in several counties hundreds of miles north, where new COVID-19 hospitalizations are rising at a higher rate. In the Finger Lakes region, officials in several counties declared a state of emergency after the seven-day average of new COVID-19 hospitalizations per 100,000 people went from 2.9 on Nov. 10 to 4.9 on Dec. 7.

David Larsen, an associate professor of public health at Syracuse University, told ABC News that there are several factors behind this divide, but the most important one is the lower vaccination rates in certain counties upstate.

“At the end of the day, you’re more likely to get severe COVID-19 symptoms and go to the hospital if you’re not vaccinated,” Larsen said.

Health experts and state officials predict the situation upstate is only going to get worse during the holidays and colder months, but the tide can be turned if more people get their shots and heed health warnings.

As of Dec. 8, 74.9% of all New York state residents have at least one COVID-19 vaccine dose, but those numbers vary by region, according to state health data.

New York City and Long Island had over 78% of their populations with at least one shot, the state data showed. Further north, the rates for at least one dose in the Mohawk Valley, the Finger Lakes and North Country sections were 60.6%, 68.5%, and 63% respectively.

There is even more division within the regions when it comes to vaccination, the data shows; for example, counties that are along the Interstate 87 corridor, such as Hamilton, Schenectady and Saratoga, all have rate of at least one dose above 75% of their populations.

Counties directly west of those locations, Schoharie, Fulton and Montgomery, have one-dose vaccination rates under 65%, the state data showed.

New York Gov. Kathy Hochul has repeatedly highlighted that the unvaccinated are the ones suffering and being hospitalized.

“It is a conscious decision not to be vaccinated. And the direct result is a higher rate of individuals in those regions upstate as well as it has a direct correlation to the number of hospitalizations,” she said during a Dec. 2 news conference.

Dr. Isaac Weisfuse, an adjunct professor of public health at Cornell University, told ABC News that there are fewer options for upstate residents to turn to for medical help and fewer hospitals in the area are handling patients from more locations.

Weisfuse, a former deputy health commissioner for New York City’s Health Department, noted that New York City residents have much closer access to amenities like free testing sites and medical clinics than their upstate counterparts.

“If you live in a rural county in New York state and it takes a while to get to a doctor, you may put it off. So when you do eventually go get care, you may be sicker versus someone who lives closer and gets a quicker diagnosis,” he said.

Larsen added that there has been pandemic fatigue across the country, and many Americans have scaled back on mitigation measures, especially mask-wearing indoors.

While New York City requires proof of vaccination for indoor activities, such as movie theaters and restaurants, there are no such rules in many upstate counties. As a result, some upstate residents have less of an incentive to get their shots, and are less cautious in indoor group settings, according to Larsen.

PHOTO: A sign asks for proof of COVID-19 vaccination in Manhattan at the entrance to a museum on Nov. 29, 2021, in New York City. (Spencer Platt/Getty Images)

“We’re doing less mask wearing. What that does is it increases transmission, which is fine for the vaccinated people but it does go to the unvaccinated people and they are higher risk,” he said.

Weisfuse said the hospitalizations are likely to grow upstate and have ripple effects for those regions. The governor has ordered elective surgeries to be postponed at 32 hospitals upstate that have seen their available beds decrease.

PHOTO: Tse Cowan, 8, winces as he is administered the Pfizer COVID-19 vaccine at a pop-up vaccine site at P.S. 19 on Nov. 08, 2021 in the Lower East Side of New York City. (Michael M. Santiago/Getty Images)

State officials said they are beefing up their marketing efforts to encourage eligible New Yorkers to get their shots.

Weisfuse said this outreach needs to be done meticulously if upstate officials want to avoid more overcrowded emergency rooms this winter.

“The state needs to take a good look at the pockets of non-vaccination,” he said. “They need to make some targeted intervention in those neighborhoods.”

Anyone who needs help scheduling a free vaccine appointment can log onto vaccines.gov.

Omicron variant ‘almost certainly’ not more severe than Delta, Fauci tells AFP

https://www.france24.com/en/live-news/20211207-omicron-variant-almost-certainly-not-more-severe-than-delta-fauci-tells-afp

 Top US scientist Anthony Fauci said Tuesday that while it would take weeks to judge the severity of the new Covid-19 variant Omicron, early indications suggested it was not worse than prior strains, and possibly milder.

Speaking to AFP, President Joe Biden’s chief medical advisor broke down the knowns and unknowns about Omicron into three major areas: transmissibility, how well it evades immunity from prior infection and vaccines, and severity of illness.

The new variant is “clearly highly transmissible,” very likely more so than Delta, the current dominant global strain, Fauci said.

Accumulating epidemiological data from around the world also indicates re-infections are higher with Omicron.

Fauci, the long-time director of the National Institute of Allergies and Infectious Diseases (NIAID), said lab experiments that tested the potency of antibodies from current vaccines against Omicron should come in the “next few days to a week.”

On the question of severity, “it almost certainly is not more severe than Delta,” said Fauci.

“There is some suggestion that it might even be less severe, because when you look at some of the cohorts that are being followed in South Africa, the ratio between the number of infections and the number of hospitalizations seems to be less than with Delta.”

But he added it was important to not over-interpret this data because the populations being followed skewed young, and were less likely to become hospitalized.

“I think that’s going to take another couple of weeks at least in South Africa,” where the variant was first reported in November, he said.

“As we get more infections throughout the rest of the world, it might take longer to see what’s the level of severity.”

Fauci said a more transmissible virus that doesn’t cause more severe illness and doesn’t lead to a surge of hospitalizations and deaths was the “best case scenario.”

“The worst case scenario is that it is not only highly transmissible, but it also causes severe disease and then you have another wave of infections that are not necessarily blunted by the vaccine or by people’s prior infections,” he added.

“I don’t think that worst case scenario is going to come about, but you never know.”