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.”

Did you know that as of January 1st, Omicron represents 95.4% of US cases?

May be an image of text that says '100% As of January 1, Omicron represents 95.4% of US cases Other 75% lota Gamma 50% Omicron Omicron Alpha 25% Delta 0% Mar 13 May 22 Jun 26 Jul31 Jul Sep 11 Oct 23 Source: Centers for Disease Control Apr17 17 Estimated proportions of COVID-19 infection in the US (March 13, 2021 to Jan 1, 2022) USAFACTS Nov 27 revention'

In the second year of the COVID-19 pandemic, a lot changed in how the US responded to the virus and adapted to new variants.

Did you know that as of January 1st, Omicron represents 95.4% of US cases?

Find out more: https://usafacts.org/vis…/coronavirus-covid-19-spread-map/

Quote of the Day: On Understanding

“I can give you an argument, but I can’t give you an understanding.”

Samuel Johnson

The Next Big COVID Variant Could Be a Triple Whammy Nightmare

https://www.yahoo.com/news/next-big-covid-variant-could-100250868.html

Getty

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.

America Is Not Ready for Omicron

America was not prepared for COVID-19 when it arrived. It was not prepared for last winter’s surge. It was not prepared for Delta’s arrival in the summer or its current winter assault. More than 1,000 Americans are still dying of COVID every day, and more have died this year than last. Hospitalizations are rising in 42 states. The University of Nebraska Medical Center in Omaha, which entered the pandemic as arguably the best-prepared hospital in the country, recently went from 70 COVID patients to 110 in four days, leaving its staff “grasping for resolve,” the virologist John Lowe told me. And now comes Omicron.

Will the new and rapidly spreading variant overwhelm the U.S. health-care system? The question is moot because the system is already overwhelmed, in a way that is affecting all patients, COVID or otherwise. “The level of care that we’ve come to expect in our hospitals no longer exists,” Lowe said.

The real unknown is what an Omicron cross will do when it follows a Delta hook. Given what scientists have learned in the three weeks since Omicron’s discovery, “some of the absolute worst-case scenarios that were possible when we saw its genome are off the table, but so are some of the most hopeful scenarios,” Dylan Morris, an evolutionary biologist at UCLA, told me. In any case, America is not prepared for Omicron. The variant’s threat is far greater at the societal level than at the personal one, and policy makers have already cut themselves off from the tools needed to protect the populations they serve. Like the variants that preceded it, Omicron requires individuals to think and act for the collective good—which is to say, it poses a heightened version of the same challenge that the U.S. has failed for two straight years, in bipartisan fashion.

The coronavirus is a microscopic ball studded with specially shaped spikes that it uses to recognize and infect our cells. Antibodies can thwart such infections by glomming onto the spikes, like gum messing up a key. But Omicron has a crucial advantage: 30-plus mutations that change the shape of its spike and disable many antibodies that would have stuck to other variants. One early study suggests that antibodies in vaccinated people are about 40 times worse at neutralizing Omicron than the original virus, and the experts I talked with expect that, as more data arrive, that number will stay in the same range. The implications of that decline are still uncertain, but three simple principles should likely hold.

First, the bad news: In terms of catching the virus, everyone should assume that they are less protected than they were two months ago. As a crude shorthand, assume that Omicron negates one previous immunizing event—either an infection or a vaccine dose. Someone who considered themselves fully vaccinated in September would be just partially vaccinated now (and the official definition may change imminently). But someone who’s been boosted has the same ballpark level of protection against Omicron infection as a vaccinated-but-unboosted person did against Delta. The extra dose not only raises a recipient’s level of antibodies but also broadens their range, giving them better odds of recognizing the shape of even Omicron’s altered spike. In a small British study, a booster effectively doubled the level of protection that two Pfizer doses provided against Omicron infection.

Second, some worse news: Boosting isn’t a foolproof shield against Omicron. In South Africa, the variant managed to infect a cluster of seven people who were all boosted. And according to a CDC report, boosted Americans made up a third of the first known Omicron cases in the U.S. “People who thought that they wouldn’t have to worry about infection this winter if they had their booster do still have to worry about infection with Omicron,” Trevor Bedford, a virologist at Fred Hutchinson Cancer Research Center, told me. “I’ve been going to restaurants and movies, and now with Omicron, that will change.”

Third, some better news: Even if Omicron has an easier time infecting vaccinated individuals, it should still have more trouble causing severe disease. The vaccines were always intended to disconnect infection from dangerous illness, turning a life-threatening event into something closer to a cold. Whether they’ll fulfill that promise for Omicron is a major uncertainty, but we can reasonably expect that they will. The variant might sneak past the initial antibody blockade, but slower-acting branches of the immune system (such as T cells) should eventually mobilize to clear it before it wreaks too much havoc.

To see how these principles play out in practice, Dylan Morris suggests watching highly boosted places, such as Israel, and countries where severe epidemics and successful vaccination campaigns have given people layers of immunity, such as Brazil and Chile. In the meantime, it’s reasonable to treat Omicron as a setback but not a catastrophe for most vaccinated people. It will evade some of our hard-won immune defenses, without obliterating them entirely. “It was better than I expected, given the mutational profile,” Alex Sigal of the Africa Health Research Institute, who led the South African antibody study, told me. “It’s not going to be a common cold, but neither do I think it will be a tremendous monster.”

That’s for individuals, though. At a societal level, the outlook is bleaker.

Omicron’s main threat is its shocking speed, as my colleague Sarah Zhang has reported. In South Africa, every infected person has been passing the virus on to 3–3.5 other people—at least twice the pace at which Delta spread in the summer. Similarly, British data suggest that Omicron is twice as good at spreading within households as Delta. That might be because the new variant is inherently more transmissible than its predecessors, or because it is specifically better at moving through vaccinated populations. Either way, it has already overtaken Delta as the dominant variant in South Africa. Soon, it will likely do the same in Scotland and Denmark. Even the U.S., which has much poorer genomic surveillance than those other countries, has detected Omicron in 35 states. “I think that a large Omicron wave is baked in,” Bedford told me. “That’s going to happen.”

More positively, Omicron cases have thus far been relatively mild. This pattern has fueled the widespread claim that the variant might be less severe, or even that its rapid spread could be a welcome development. “People are saying ‘Let it rip’ and ‘It’ll help us build more immunity,’ that this is the exit wave and everything’s going to be fine and rosy after,” Richard Lessells, an infectious-disease physician at the University of KwaZulu-Natal, in South Africa, told me. “I have no confidence in that.”

To begin with, as he and others told me, that argument overlooks a key dynamic: Omicron might not actually be intrinsically milder. In South Africa and the United Kingdom, it has mostly infected younger people, whose bouts of COVID-19 tend to be less severe. And in places with lots of prior immunity, it might have caused few hospitalizations or deaths simply because it has mostly infected hosts with some protection, as Natalie Dean, a biostatistician at Emory University, explained in a Twitter thread. That pattern could change once it reaches more vulnerable communities. (The widespread notion that viruses naturally evolve to become less virulent is mistaken, as the virologist Andrew Pekosz of Johns Hopkins University clarified in The New York Times.) Also, deaths and hospitalizations are not the only fates that matter. Supposedly “mild” bouts of COVID-19 have led to cases of long COVID, in which people struggle with debilitating symptoms for months (or even years), while struggling to get care or disability benefits.

And even if Omicron is milder, greater transmissibility will likely trump that reduced virulence. Omicron is spreading so quickly that a small proportion of severe cases could still flood hospitals. To avert that scenario, the variant would need to be substantially milder than Delta—especially because hospitals are already at a breaking point. Two years of trauma have pushed droves of health-care workers, including many of the most experienced and committed, to quit their job. The remaining staff is ever more exhausted and demoralized, and “exceptionally high numbers” can’t work because they got breakthrough Delta infections and had to be separated from vulnerable patients, John Lowe told me. This pattern will only worsen as Omicron spreads, if the large clusters among South African health-care workers are any indication. “In the West, we’ve painted ourselves into a corner because most countries have huge Delta waves and most of them are stretched to the limit of their health-care systems,” Emma Hodcroft, an epidemiologist at the University of Bern, in Switzerland, told me. “What happens if those waves get even bigger with Omicron?”

The Omicron wave won’t completely topple America’s wall of immunity but will seep into its many cracks and weaknesses. It will find the 39 percent of Americans who are still not fully vaccinated (including 28 percent of adults and 13 percent of over-65s). It will find other biologically vulnerable people, including elderly and immunocompromised individuals whose immune systems weren’t sufficiently girded by the vaccines. It will find the socially vulnerable people who face repeated exposures, either because their “essential” jobs leave them with no choice or because they live in epidemic-prone settings, such as prisons and nursing homes. Omicron is poised to speedily recap all the inequities that the U.S. has experienced in the pandemic thus far.

Here, then, is the problem: People who are unlikely to be hospitalized by Omicron might still feel reasonably protected, but they can spread the virus to those who are more vulnerable, quickly enough to seriously batter an already collapsing health-care system that will then struggle to care for anyone—vaccinated, boosted, or otherwise. The collective threat is substantially greater than the individual one. And the U.S. is ill-poised to meet it.

America’s policy choices have left it with few tangible options for averting an Omicron wave. Boosters can still offer decent protection against infection, but just 17 percent of Americans have had those shots. Many are now struggling to make appointments, and people from rural, low-income, and minority communities will likely experience the greatest delays, “mirroring the inequities we saw with the first two shots,” Arrianna Marie Planey, a medical geographer at the University of North Carolina at Chapel Hill, told me. With a little time, the mRNA vaccines from Pfizer and Moderna could be updated, but “my suspicion is that once we have an Omicron-specific booster, the wave will be past,” Trevor Bedford, the virologist, said.

Two antiviral drugs now exist that could effectively keep people out of the hospital, but neither has been authorized and both are expensive. Both must also be administered within five days of the first symptoms, which means that people need to realize they’re sick and swiftly confirm as much with a test. But instead of distributing rapid tests en masse, the Biden administration opted to merely make them reimbursable through health insurance. “That doesn’t address the need where it is greatest,” Planey told me. Low-wage workers, who face high risk of infection, “are the least able to afford tests up front and the least likely to have insurance,” she said. And testing, rapid or otherwise, is about to get harder, as Omicron’s global spread strains both the supply of reagents and the capacity of laboratories.

Omicron may also be especially difficult to catch before it spreads to others, because its incubation period—the window between infection and symptoms—seems to be very short. At an Oslo Christmas party, almost three-quarters of attendees were infected even though all reported a negative test result one to three days before. That will make Omicron “harder to contain,” Lowe told me. “It’s really going to put a lot of pressure on the prevention measures that are still in place—or rather, the complete lack of prevention that’s still in place.”

The various measures that controlled the spread of other variants—masks, better ventilation, contact tracing, quarantine, and restrictions on gatherings—should all theoretically work for Omicron too. But the U.S. has either failed to invest in these tools or has actively made it harder to use them. Republican legislators in at least 26 states have passed laws that curtail the very possibility of quarantines and mask mandates. In September, Alexandra Phelan of Georgetown University told me that when the next variant comes, such measures could create “the worst of all worlds” by “removing emergency actions, without the preventive care that would allow people to protect their own health.” Omicron will test her prediction in the coming weeks.

The longer-term future is uncertain. After Delta’s emergence, it became clear that the coronavirus was too transmissible to fully eradicate. Omicron could potentially shunt us more quickly toward a different endgameendemicitythe point when humanity has gained enough immunity to hold the virus in a tenuous stalemate—albeit at significant cost. But more complicated futures are also plausible. For example, if Omicron and Delta are so different that each can escape the immunity that the other induces, the two variants could co-circulate. (That’s what happened with the viruses behind polio and influenza B.)

Omicron also reminds us that more variants can still arise—and stranger ones than we might expect. Most scientists I talked with figured the next one to emerge would be a descendant of Delta, featuring a few more mutational bells and whistles. Omicron, however, is “dramatically different,” Shane Crotty, from the La Jolla Institute for Immunology, told me. “It showed a lot more evolutionary potential than I or others had hoped for.” It evolved not from Delta but from older lineages of SARS-CoV-2, and seems to have acquired its smorgasbord of mutations in some hidden setting: perhaps a part of the world that does very little sequencing, or an animal species that was infected by humans and then transmitted the virus back to us, or the body of an immunocompromised patient who was chronically infected with the virus. All of these options are possible, but the people I spoke with felt that the third—the chronically ill patient—was most likely. And if that’s the case, with millions of immunocompromised people in the U.S. alone, many of whom feel overlooked in the vaccine era, will more weird variants keep arising? Omicron “doesn’t look like the end of it,” Crotty told me. One cause for concern: For all the mutations in Omicron’s spike, it actually has fewer mutations in the rest of its proteins than Delta did. The virus might still have many new forms to take.

Vaccinating the world can curtail those possibilities, and is now an even greater matter of moral urgency, given Omicron’s speed. And yet, people in rich countries are getting their booster six times faster than those in low-income countries are getting their first shot. Unless the former seriously commits to vaccinating the world—not just donating doses, but allowing other countries to manufacture and disseminate their own supplies—“it’s going to be a very expensive wild-goose chase until the next variant,” Planey said.

Vaccines can’t be the only strategy, either. The rest of the pandemic playbook remains unchanged and necessary: paid sick leave and other policies that protect essential workers, better masks, improved ventilation, rapid tests, places where sick people can easily isolate, social distancing, a stronger public-health system, and ways of retaining the frayed health-care workforce. The U.S. has consistently dropped the ball on many of these, betting that vaccines alone could get us out of the pandemic. Rather than trying to beat the coronavirus one booster at a time, the country needs to do what it has always needed to do—build systems and enact policies that protect the health of entire communities, especially the most vulnerable ones

Individualism couldn’t beat Delta, it won’t beat Omicron, and it won’t beat the rest of the Greek alphabet to come.

Self-interest is self-defeating, and as long as its hosts ignore that lesson, the virus will keep teaching it.

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.”

How to Talk about Vaccines at Thanksgiving

May be an image of 6 people and text that says 'How to talk about vaccines at Thanksgiving The big thing to know when talking to family and friends about vaccine falsehoods during the holidays: It's better to respond with facts than to offer corrections.'

“Please pass the green beans.” “What kind of pie is that?”“What about spike proteins!?”These are some of the phrases that may be uttered during your Thanksgiving and holiday dinners this season. But! We have prepared a glossary for you. Swipe through a quick guide to some of the most misused terms around vaccines that PolitiFact has noticed in our fact-checking. And because we know that shouts of “that’s wrong!” don’t go over smooth like gravy, we’re including an expert’s advice on how to talk about vaccine falsehoods with family and friends.The big thing to know: It’s better to respond with facts than to offer corrections.”If they said something like ‘the vaccine is dangerous,’ include a statistic about how 75% of the people in their state have gotten vaccinated and none have died, or how severe and dangerous COVID-19 is,” said Rupali Limaye, an associate scientist at Johns Hopkins School of Public Health. “And, ultimately, make sure you’re saying it all with empathy.”

May be an image of text that says '"Spike protein" The human body and other organisms are made up of a variety of proteins, and SARS-COV-2, the virus that causes COVID-19, has its own. The virus' spike protein, which allows the virus to penetrate cells and cause infection, has sharp bumps that protrude from the surface of the virus' outer envelopes. COVID-19 vaccines introduce a piece of the protein- but not the harmful part of the virus which the immune system quickly identifies, attacks and destroys as a foreign invader.'
May be an image of text that says '"mRNA" The Pfizer and Moderna COVID-19 vaccines use messenger RNA to deliver an instruction manual to cells for making the coronavirus' spike protein. They're different from conventiona vaccines that use part of a bacterium or virus to induce protein production. The mRNA is fragile and quickly broken down in the body once the cells learn the blueprint, which is usually within three days of receiving the vaccine. The molecule does not we repeat, does not enter the nucleus of cells and alter a person's DNA.'
May be an image of text that says '"VAERS" VAERS stands for the Vaccine Adverse Effects Reporting System, a critical reporting tool for the federal government to collect and analyze data on after-effects from all vaccines, not just COVID-19. Unlike other government data sources, VAERS is designed so that anyone- parents, patients and health care professionals can report health effects that occur after a vaccination, whether or not those effects were caused by the vaccine. The reports aren't verified before they're entered, and anyone with a computer can access the data.'
May be an image of text that says '"Syncytin-1" Syncytin-1, a protein found in humans and some animals, is most known for helping develop the placenta, the temporary organ that helps nourish a fetus during pregnancy. Syncytin-1 and the coronavirus spike protein have almost nothing in common, making the vaccine highly unlikely to trigger a reaction. "If someone says they heard the vaccine causes infertility, would just respond with something direct- like that there are no studies that show a link between the vaccines and infertility Zero," an expert said.'
May be an image of text that says '"Ivermectin" vermectir is an anti-parasitic medication that has been widely touted as a COVID-19 treatment despite health authorities warning against COVID-19 patients self-medicating with the drug. When people started to believe it could treat COVID- 19, some of them ingested forms of the drug made for animals, causing a dramatic uptick in calls to poison control. Officials warn that more research is still needed on ivermectin's effectiveness as a COVID-19 treatment.'
May be an image of text that says 'A final word about words The best way to talk through different views on vaccines with loved ones is by making your point in a personal context that takes the focus off them. "Think of family member they want to protect, so it's not all about them," said Rupali Limaye, an associate scientist at Johns Hopkins School of Public Health." "Like 'Hey, I'm really concerned about grandma and just want to make sure we are doing all we can to protect her. It leaves the pressure off them but they still have some skin in the game."'

30% of hospital healthcare workers remained unvaccinated as of September

Dive Brief:

  • Some 30% of U.S. healthcare workers employed at hospitals remained unvaccinated as of Sept. 15, according to an analysis of Centers for Disease Control and Prevention data published Thursday by the Association for Professionals in Infection Control and Epidemiology.
  • The findings include data from 3.3 million healthcare workers at more than 2,000 hospitals, collected between Jan. 20 and Sept. 15.
  • Healthcare personnel working in children’s hospitals had the highest vaccination rates, along with those working in metropolitan counties.

Dive Insight:

The vaccination rate for healthcare workers is roughly in line with that of the general population, though the risk of exposure and transmission can be higher in settings where infected COVID-19 patients are treated, Hannah Reses, CDC epidemiologist and lead author of the analysis, said.

When the shots were initially rolled out, vaccination rates climbed among healthcare workers, rising from 36% to 60% between January and April of 2021, the analysis found. But a major slowdown occurred shortly after.

From April to August, vaccination rates rose just 5%. They then rose 5% again in just one month — from August to September — likely due to the delta variant and more systems implementing their own mandates, the report said.

Researchers also found discrepancies in vaccination rates based on the type of hospitals and their geographic locations.

By September, workers at children’s hospitals had the highest vaccination rates (77%), followed by those at short-term acute care hospitals (70%), long-term care facilities (68.8%), and critical access hospitals (64%).

Among healthcare workers at facilities in metropolitan areas, about 71% were vaccinated by September, compared to 65% of workers at rural facilities.

The findings come as health systems work to comply with new vaccination mandates from the Biden administration.

Healthcare facilities must follow the CMS rule, which stipulates employees must be fully vaccinated by Jan. 4 or risk losing Medicare and Medicaid funding. Unlike the Occupational Safety and Health Administration’s rule that applies to businesses with 100 employees or more but excludes healthcare providers, the CMS rule does not allow for a testing exception.

Both agencies’ rules were met with pushback. The attorneys general of 10 mostly rural states — Missouri, Nebraska, Arkansas, Kansas, Iowa, Wyoming, Alaska, South Dakota, North Dakota and New Hampshire — filed a lawsuit on Oct. 10 against CMS for its rule and said the mandates would exacerbate existing staffing shortages.

“Requiring healthcare workers to get a vaccination or face termination is unconstitutional and unlawful, and could exacerbate healthcare staffing shortages to the point of collapse, especially in Missouri’s rural areas,” the state’s attorney general, Eric Schmitt, said in a statement.

But some regional systems that implemented their own mandates have seen positive results.

After UNC Health and Novant Health in North Carolina required the shots, staff vaccination rates rose to 97% and 99%, respectively, according to a White House report.

Among Novant Health’s 35,000 employees, about 375 were suspended for not complying, and about 200 of those suspended employees did end up getting vaccinated so they could return to work, according to the report.

And some major hospital chains across the country are joining suit with the looming deadline, including HCA with its 183 hospitals and more than 275,000 employees.

The chain is requiring employees be fully vaccinated by the CMS deadline on Jan. 4, a spokesperson said in an email statement.

At the same time, this year’s flu season is difficult to predict, though, “the number of influenza virus detection reported by public health labs has increased in recent weeks,” Reses said.

“The CDC is preparing for flu and COVID to circulate along with other respiratory viruses, and so flu vaccination therefore will be really important to reduce the risk of flu and potentially serious complications, particularly in combination with COVID-19 circulating,” Reses said.

The magic of 70% and masks.

May be an image of text that says 'Stark correlation between California counties' vaccination and case rates Region: Bay Area GaS San Joaquin Valley Northern California Southern California STATE 50 ga 25 45% population with least one dose California's new COVID cases are settling down after this summer's surge, and a divide has clearly emerged.'

This chart shows that once 70% of the population gets at least one shot and mask compliance is very good: you can beat this virus.

Pfizer says its COVID-19 vaccine is safe, effective in kids ages 5 to 11

https://thehill.com/policy/healthcare/572967-pfizer-says-its-covid-19-vaccine-is-safe-effective-in-kids-ages-5-to-11

COVID vaccine for kids 5-11: Pfizer says low dose safe, effective

Pfizer on Monday announced that testing showed that its COVID-19 vaccine was “safe” and “well tolerated” by children ages 5 to 11 and “robust neutralizing antibody responses” were observed.

The pharmaceutical company said that a “favorable safety profile” had been observed in its trial of the vaccine among children under the age of 12. For its trial, the company used doses a third of what is administered to people ages 12 and up.

“Over the past nine months, hundreds of millions of people ages 12 and older from around the world have received our COVID-19 vaccine. We are eager to extend the protection afforded by the vaccine to this younger population, subject to regulatory authorization, especially as we track the spread of the Delta variant and the substantial threat it poses to children,” Pfizer CEO Albert Bourla said.

“Since July, pediatric cases of COVID-19 have risen by about 240 percent in the U.S. – underscoring the public health need for vaccination. These trial results provide a strong foundation for seeking authorization of our vaccine for children 5 to 11 years old, and we plan to submit them to the [Food and Drug Administration (FDA)] and other regulators with urgency,” he added.

Pfizer’s trial included 2,268 participants between the ages of 5 and 11. According to the company, the doses resulted in side effects comparable to what was observed among the trial for patients ages 16 to 25. It also said that it expects to include its results in an upcoming submission to the FDA for emergency use authorization.

In the U.S., no COVID-19 vaccines have been approved for children under the age of 12, leaving many children and the adults who are in close proximity to them particularly vulnerable during the most recent surge brought on by the delta variant.

National Institute of Health Director Francis Collins on Sunday said he believed parents and teachers should be placed in the same category as health care workers in terms of COVID-19 risk, due to their close contact with children who are ineligible to be vaccinated.

In August, the number of pediatric hospitalizations in the U.S. due to COVID-19 reached a record high of nearly 2,000. While children are generally believed to be less likely to develop severe cases of the coronavirus, new variants continue to pose the potential threat of causing more severe symptoms.

This announcement comes shortly after an advisory panel for the FDA voted last week in favor of recommending a third dose of the Pfizer-BioNTech vaccine for people over 65 and in certain high-risk groups. The panel voted against administering a third dose to all vaccine-eligible people.

According to the Centers for Disease Control and Prevention, nearly 75 percent of the eligible population — ages 12 and up — has received at least one dose of a COVID-19 vaccine. Around 64 percent of those over the age of 12 are fully vaccinated.