Tag: omicron

Summer ’24 COVID wave

(COVID Photo by Martin Sanchez on Unsplash)

It’s become more difficult to keep track of COVID-19 cases here in the United States, as less data is being collected and shared with the public.

We do know that this summer’s wave has been substantial, mostly due to the Omicron subvariants known as FLiRT. While death rates have been lower than in previous waves, they have still been ranging in the 400s-700s per week this summer, which is upsetting. These figures may also be lower than the actual count because reporting is less robust than it was under the public health emergency protocols.

Last week, the US Food and Drug Administration approved the Pfizer and Moderna vaccines based on the KP.2 variant, one of the FLiRT family. Doses are already available from some pharmacies and are recommended for everyone ages 6 months and older. While some people will choose to wait until later in the fall to have the strongest protection possible going into the expected winter wave, I will be getting mine in mid-September so that my immunity will be strong when I go to North Adams for the annual Boiler House Poets Collective residency at MASS MoCA (Massachusetts Museum of Contemporary Arts). It looks as though the vaccine will be a good match for the strains that will likely be dominant in the coming months.

The FDA is also expected to approve the Novavax vaccine in the coming weeks. It is a more traditional protein-based vaccine rather than an mRNA one. Some people prefer it because it can cause fewer side effects.

Many people are choosing to ignore any news about COVID and vaccines but it is still a serious problem, here in the US and around the world. This is a reminder that some people are still getting very sick and dying from the SARS-CoV-2 virus. Updated vaccines are known to reduce the risk of hospitalization and death, so please get one if they are available to you. (Contact your health care provider for any special recommendations that may apply.)

Other measures can also help reduce your chances of getting COVID. Wearing a high quality mask, especially in crowded, indoor areas, dramatically decreases the rate of infection. Increasing indoor ventilation and air filtration and holding events outdoors are helpful in preventing the spread of COVID and other viruses. If you are sick, stay home and take precautions against spreading your illness to others in your household. Get adequate rest and nutrition to keep your immune system strong.

COVID-19 has not settled into a pattern like we see with flu and is still much more serious in terms of hospitalizations and deaths. It also impacts more systems in the body and can cause symptoms over a longer period of time, such as we see in cases of long COVID. Some people are willing to risk their own health but please remember that you are also putting your family and vulnerable community members at risk if you spread the illness to them.

Wishing everyone good health in the coming months.

Current COVID stats

Update to my COVID post from earlier in the week: Those Nerdy Girls newest post tells us that, using wastewater surveillance, current estimates are that 5% of people in the United States are currently infected with COVID, the largest proportion since the initial Omicron wave two years ago. In the United Kingdom, JN.1 caused a similar wave just before Christmas, with London having an even higher infected rate of almost 6%.

Those Nerdy Girls remind us that about 1,500 people in the United States are dying from COVID every week, making COVID much deadlier than the flu. They also remind us that the COVID vaccine that became available in September ’23 is effective against JN.1 and urge people to receive it if they haven’t already. They also remind people that masking, ventilation, testing, and staying home when you are sick help in avoiding spread not only of COVID but also flu and other viruses.

Please do what you can to keep yourself and others safe and healthy!
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JN.1

It’s been four years since the first cases of COVID-19 were confirmed in the US but it’s still a major health issue. While vaccines, treatments, and preventative measures have made the current situation less severe than the initial onslaught of SARS-CoV-2, people are still getting sick, with some needing to be hospitalized and some, unfortunately, succumbing to the disease, including the person I referenced in this post. In the week of Dec. 31, 2023-January 6, 2024, COVID caused 4% of all deaths in the United States.

The virus continues to mutate. The current strain that is dominant in the United States and globally is JN.1, which is related to the BA.2.86 variant of Omicron. The good news is that the most recent vaccine, which is based on the related XBB lineage, is a good match for JN.1, so the vaccine significantly reduces the risk of severe symptoms, hospitalization, and death while offering some protection against infection. The bad news is that, in the United States, only about 8% of children and 19% of adults are estimated to have received the newest vaccine, contributing to a surge of cases, amplified by holiday travel and gatherings.

More good vaccine news. This large study from Sweden concludes that vaccination reduces the risk of developing long COVID and that additional vaccine doses reduce risk even more. As someone who has particular concerns about long COVID, I appreciate that these studies are continuing to increase our understanding.

Another recent study shows that the Omicron variants don’t cause peak viral loads until day 3-4, much later than the earlier strains of the virus. The practical implication of this is that at-home COVID tests may not pick up a positive reading until several days into the illness, during which time the person could be infecting others. It also has implications for prescribing anti-virals, which need to begin within the first five days of symptoms to be effective. For me, this is a reminder to mask around other people whenever I have symptoms, as an early negative test might not be accurate.

A study published just a few days ago seems to put some science behind what we have all experienced, that SARS-CoV-2 doesn’t have a “season” in the way that some other viruses, like influenza, do. Changes in temperature and humidity don’t appear to have significant influence in transmission. This seems to go along with what we have experienced in the United States, with major waves happening in different seasons of the year. We’ve had waves in the heat of summer as well as the cold of winter. This suggests that our current winter wave is due more to low vaccination rates and holiday travel and gatherings than to the fact that it is winter. It also highlights the importance of increasing ventilation and using masks in crowded indoor spaces, as both summer heat and winter cold tend to drive people to gather indoors.

Four years in, I’ve written a lot of COVID-19 posts. From my days as part of the Pfizer/BioNTech vaccine trials through the present, I’ve always tried to give the most updated information and public health guidance available. It’s frustrating that there is less information from the Centers for Disease Control and Prevention than when the state of emergency was still in effect but some useful recent data can be found here. A lot of the information in this post came to my attention through this post from Dr. Katelyn Jetelina, writing as “Your Local Epidemiologist” and this post from Those Nerdy Girls.

Through all these challenges, especially when spouse B had the first case of COVID in our house in November, I’ve managed to avoid infection, unless I had a totally asymptomatic case at some point. I use my research to make decisions about vaccination, masking, crowd avoidance, etc. that are right for me and my family. I don’t think that advocating for health measures ought to be seen as controversial or political. There are, though, forces in the US that have warped disease prevention into a political test. It’s very sad that Republicans are more likely to die from COVID than non-Republicans. Please, don’t put your health and the health of your family and neighbors at risk over politics. COVID-19 is still out there. Take care of your health and your loved ones.
*****
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a belated Thanksgiving

Because spouse B had contracted COVID and needed to isolate at home and daughter T and I were masking around each other in case one of us was infected, we didn’t celebrate Thanksgiving last Thursday – or, I should say, we celebrated with a nice, but not fancy, dinner of roast pork with roasted vegetables with T and I eating in the dining room and B at the kitchen table where we could talk to each other at a safe distance. Instead of the traditional pie, we had (the also-traditional) Aunt Gert’s Indian pudding for dessert.

That Thursday was Day 12 of B’s COVID experience and the first day he had tested negative. On average, Omicron infections last for eight days, so B was on the long side of the spectrum but someone has to be to balance out those who have a short infectious phase. Because he needed to have two negative tests 48 hours apart for us to be unmasked around each other, he decided that our fancier Thanksgiving dinner should be on Sunday.

While, for many years, I did the bulk of the cooking at our house, I don’t especially enjoy it. B, on the other hand, likes cooking and baking, so he chose the menu and made the meal. We enjoyed a delicious dinner of individual beef Wellington with roasted Brussels sprouts with bacon and a Braeburn and Cortland apple pie for dessert.

One of the things for which we are most thankful is that B’s bout with COVID was relatively mild, even if his infectious period did hang on longer than expected. We are also thankful that T and I remained uninfected. The pool of people I know who have never had COVID has dwindled to just a few, so I know it’s likely we will contract it someday, but, for now, we are all happy to be able to spend time together at home unmasked in the same room, whether or not there is a fancy late-Thanksgiving meal on the table.

Photo by Pro Church Media on Unsplash

One-Liner Wednesday: booster

Today, I’m getting my sixth dose of Pfizer/BioNTech COVID-19 vaccine, this one targeting Omicron variant XBB.1.5 and shown to be effective against other currently circulating Omicron sub-variants. Please consider joining me if your health professional or public health agency recommends it for you.
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This public health message is brought to you as part of Linda’s One-Liner Wednesdays. Join us! Find out more here: https://lindaghill.com/2023/09/20/one-liner-wednesday-the-ultimate-404-error/

COVID update – late summer 2023

There are many people here in the United States who are no longer taking COVID-19 seriously and a disturbing number who never did.

I am not one of them.

I’ve written dozens of posts over the past three and a half years about it, including about my family’s participation in the Pfizer/BioNTech Phase III clinical trial. I’ve tried to encourage people to take precautions to reduce their chances of infection and serious illness. In that vein, I offer this update.

There was a summer wave in the US with the most prevalent strain being Omicron XBB.1.5. On September 12, the Centers for Disease Control and Prevention Advisory Committee on Immunization Practices will meet to develop a recommendation for a newly formulated booster based on the XBB.1.5 variant. It’s anticipated that the recommendation will be that most people get this new booster, which is expected to be available by the end of September. I will get the booster as soon as I am able. To my knowledge, I’ve still not contracted COVID and would love to keep it that way. Even if the vaccine does not keep me from getting infected, it, along with taking an anti-viral such as Paxlovid, will likely keep me from being hospitalized.

Of course, SARS-CoV-2 continues to mutate. Even now, the variant mix has shifted in the US. EG.5 has become the highest in prevalence with FL.1.5.1 next in an array of variants currently circulating. (You can find current data in the US at the CDC site here.) It is expected that the new booster, though based on XBB.1.5, will still be effective against these other Omicron strains.

The unfortunate wild card at this point is another Omicron variant BA.2.86. The link is to a 8/22 post from epidemiologist Dr. Katelyn Jetelina, explaining why this variant may be more problematic than others, perhaps even warranting the World Health Organization to name it a variant of concern with the name “Pi.” BA.2.86 has over 30 mutations of the spike protein, which is part of the virus that our bodies learn to recognize via vaccines, infection, or both. The fear is that we could see another world-wide wave develop because BA.2.86 might be able to evade our defenses. Researchers are studying it to see if our current tests, vaccines, and treatments will work against it and how it might affect individuals and populations exposed to it. The current number of cases world-wide are thought to be small, but that has been the beginning status of any variant that has become dominant.

Part of the problem is that we don’t have as much data to work with. Most COVID cases aren’t reported to public health authorities anymore. Surveillance and genomic sequencing are lower. This results in less public awareness and information. Theoretically, we should be able to ramp up our system more quickly if a new wave occurs but I wish we had kept up our system in the first place in a proactive stance.

I’m concerned about the attitude that equates COVID infection with other viruses. A study in the journal Nature Medicine shows increased risks for an array of medical conditions, including diabetes, pulmonary and cardiovascular problems, two years after COVID infection, even if the initial case was mild.

“A lot of people think, ‘I got covid, I got over it and I’m fine,’ and it’s a nothingburger for them. But that’s not everything,” said the study’s senior author, Ziyad Al-Aly, a clinical epidemiologist at Washington University School of Medicine in St. Louis. After a couple of years, “maybe you’ve forgotten about the SARS-CoV-2 infection … but covid did not forget about you. It’s still wreaking havoc in your body,” said Al-Aly, chief of research at the Veterans Affairs St. Louis Health Care System.

source: https://www.washingtonpost.com/health/2023/08/21/long-covid-lingering-effects-two-years-later/

The risk of long COVID is real. The article cited above, which is free to access, explains more about the attempts to do research and get care for people with long COVID. People need to realize that they might be someone who gets COVID and has a mild case without long-term repercussions or they might become seriously ill or they might have symptoms for months and years to come. They could also infect someone else who would face the same uncertainties.

I’m once again imploring people to take COVID seriously. Vaccinate, if it is recommended for you. (Being in the US, I’m most familiar with recommendations here but people should look to their own local health authorities and medical practitioners for guidance in their area.) Test and treat an infection. Stay home if you are sick and avoid infecting others. Avoid crowds indoors; wear a high-quality mask if you can’t. If infection rates are significant in your area, mask indoors when you are away from home. Increase ventilation and air filtration. Wash your hands. Get adequate rest and nutrition. Remember that everyone deserves respect, so never question someone else’s decision to mask; they could be immunocompromised, caring for a vulnerable person, etc. and need that protection.

Eventually, we may get to a place where COVID is endemic, like the flu, but we aren’t there yet. Be careful and be kind as we continue to face this still-formidable challenge.

XBB.1.5

A new COVID subvariant has emerged here in the United States. It is designated XBB.1.5 and is considered the most transmissible Omicron variant to date by the World Health Organization. It is also considered to be highly immune evasive, which means it is more likely to cause infection among those who have COVID antibodies, whether from vaccines or prior infection. However, the vaccines should still be effective in reducing hospitalization and death rates from infection.

XBB.1.5 is especially prevalent in the northeastern region of the US. It is powering the rise in regional cases accounting for 72.7% of cases in the past week. It is also likely the driver behind Broome County, New York, where I live, again moving into the CDC’s high community risk level classification. (That will mean mandatory masking at our concerts this weekend.)

The XBB.1.5 subvariant orignated in the US, but has spread to some other countries. Meanwhile, China is suffering through a huge infection wave, although there is no reliable official data on its extent.

In many places, especially in the Northern Hemisphere winter, there are also high rates of flu and RSV.

As always, I’ll repeat my advice. Vaccinate, if you are eligible and vaccines are available to you. In particular, if you are eligible for the bivalent COVID booster, get it as soon as possible because it is much more protective against all Omicron strains than the original formulation. If you are sick, get tested. If you contract COVID or flu, immediately contact a medical provider to see if you can take antiviral medication to cut down on symptom severity. When there is risk in your area, use a high-quality mask in indoor public spaces and avoid crowds. Increase ventilation and/or air filtration indoors. Wash hands frequently and avoid touching your face (more for flu/RSV prevention than for COVID). Try to eat and sleep well. Look out for one another.

We need to work together for this pandemic to end. We are all tired of COVID but we need to fight effectively and continuously. Ignoring the risk and letting the virus spread just gives it even more opportunity to mutate and develop more virulent strains. We are now in our fourth year of the COVID pandemic. Let’s work together to make it the last.
*****
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two years into COVID vaccines

After yet another period of high community risk level for COVID here in Broome County, New York, we have just today returned to medium level. After a post-Thanksgiving spike in infections, we experienced a hospitalization spike which had increased our community risk level. With the US health system also dealing with an early, hard-hitting flu season and RSV, the dreaded triple-demic, in some areas hospitals are reaching capacity and sending patients to other locations. Additionally, infection rates are predicted to rise as family and friends gather for Hanukkah, Christmas, and New Year celebrations in the coming weeks.

This comes at a time when only 14.1% of people five and over in the US have received the new bivalent COVID booster, which was designed to better combat the Omicron BA.4/5 variants and is proving effective against the current dominant strains, BQ1 and BQ1.1, which are part of the BA.5 lineage.

Furthermore, a recent study indicates that the US vaccination program likely saved 3.2 million lives and prevented 18.5 million COVID-related hospitalizations. The vaccines are estimated to have averted nearly 120 million infections. Another recent study shows that in the two years of COVID vaccine availability in the US, the excess death rate among Republicans is significantly higher than among Democrats, mirroring the difference in vaccination rates, a sad reflection of the politicization and misinformation around vaccines by many prominent Republicans.

It’s horrifying.

The mistrust sown over the COVID vaccine among Republicans seems to be spreading to other vaccines as well. A newly published survey finds that over 40% of Republican or Republican-leaning respondents oppose requirements for the MMR (measles, mumps, rubella) for school children.

This does not bode well for public health measures. It’s frightening how many people will believe politicians or media figures rather than doctors and public health experts on these important issues. People have been infected because they weren’t up to date on vaccinations. People have been hospitalized, developed long COVID, experienced complications, or died at higher rates because they refused vaccines or boosters. The data show this.

Please, get a bivalent COVID booster if you are eligible. Begin or continue the primary vaccination series if you haven’t completed it. If you get symptoms, test immediately and contact a health professional if you test positive to see if antiviral medication is right for you. Don’t go out and expose others if you sick with COVID, flu, or anything else. Mask indoors when infection levels for COVID, flu, RSV, etc. are high in your area. Avoid crowds. Increase ventilation. Wash hands and avoid touching your face – more for flu/cold prevention than COVID. Try to eat and sleep as well as possible.

If you are someone who has been getting health information from pundits, please turn to your personal health care provider, public health department, or national health organizations, such as the CDC. Look for data and advice from public health experts, not anecdotes.

For readers outside the US, turn to your public health experts to see what measures are available and appropriate for you.

Reminder to all: COVID 19 is still a global pandemic. Act accordingly for your health, your household’s and community’s health, and global health.

COVID bivalent boosters

As you may recall, spouse B, daughter T, and I were all participants in the Phase III clinical trial for the COVID-19 vaccine from Pfizer/BioNTech. We then all participated in a follow-on third dose trial. B and I left the trial this spring because we were eligible to receive a fourth dose and wanted the extra protection before travelling. T stayed in the trial until its end earlier this summer.

Here in the United States, a new booster was recently approved which combines the original formulation with a new one designed to better combat the Omicron BA.4 and BA.5 variants. BA.5 is the dominant variant currently in the US, accounting for about 88% of cases. About 11% are caused by BA.4. The new booster is expected to strengthen protection against serious illness/death and, one hopes, cut down on symptomatic infection somewhat, as well.

Given that I am still trying to remain COVID-free and that I have several trips coming this fall, I decided to receive one of the new boosters at my local pharmacy. I chose to receive the Pfizer formulation because all my others have been theirs, although there is a Moderna version which is also a fine choice. This was my first time receiving the vaccine in a pharmacy setting. My prior doses had all been in a medical office or a state vaccination site. I made an appointment online and everything was very fast and efficient.

Dr. Ashish Jha, who is the White House COVID-19 response coordinator, and Dr. Anthony Fauci, the long-time director of the National Institute of Allergy and Infectious Diseases, have said that it is possible that we may have reached a point where an annual booster will be enough to protect the vast majority of Americans from serious illness/death from COVID, similar to annual flu shots. Some people who are especially vulnerable due to age or medical condition might need more frequent boosters. The wild card, though, would be the emergence of a new strain that could evade our antibodies and current vaccines.

So, my message is to receive one of these new boosters as soon as they become available wherever you are. The US has been first to authorize them, but it seems they will become more widely available globally soon. Remember, though, that these are booster doses given to people who have already completed an initial vaccine series. If you haven’t completed an initial vaccine series, start NOW!

Meanwhile, here in Broome County, our community risk level is still medium. While I wait for the new booster to take full effect, I will still mask for indoor gatherings and shopping. I’ll be evaluating what to do after that, although these boosters are so new that data may be hard to come by.

I hope to stay well and hope that you do, too.

finally, but…

Broome County, New York, where I live, finally managed to get into the low community risk category on the CDC’s COVID map late last week, after many months in the high category with a few weeks of medium thrown in.

This is long hoped for news, but it is likely only a very temporary lull.

We had been high for so long due to our lower level of up-to-date vaccination and the fact that an Omicron subvariant that became dominant originated in central New York.

Unfortunately, another Omicron subvariant BA.5, is making its way into our area. BA.5 is already the most dominant strain in the US and carries the dubious distinction of being more contagious than other forms of Omicron. It may also have a tendency to more often affect the lower part of the respiratory tract, although this is still being researched; Omicron in general has been more likely to remain in the upper respiratory tract. It also appear to more easily infect people who are up-to-date on vaccination and those who have already had Omicron, even if the prior infection was only a few weeks ago. It’s difficult, though, to tease out which effects in the population are from the variant itself and which are from decreasing immunity that occurs over time.

It is also unfortunate that repeat infections increase the post-infection risk of stroke, heart attack, and other serious illnesses and bring the risk of long COVID.

Even with BA.5, though, being vaccinated and boosted is helpful. It lowers rates of severe disease, hospitalization, and death. Pfizer and Moderna are each developing vaccines/boosters that are more effective against Omicron that will be available in the fall. Of course, masking, avoiding crowds, and other public health measures are also helpful if transmission is high in your area.

Remember: the pandemic is still with us. Another new variant is spreading in India and several other countries and could cause another global wave of infections if it can out-compete BA.5. Stay alert and do what you can to take care of yourself, your family, and your community.

I’ll be doing that here. Even though our current infection rate is low, it has begun to creep up. I’ll be watchful.