Coronavirus thread

[Karl Henning]

Vermont confirms first case of Omicron variant — 12:27 p.m.
By The Associated Press

Health officials in Vermont have confirmed the state's first case of the Omicron variant of the COVID-19 virus.

The state Department of Health said Saturday that genetic sequencing identified the variant in a specimen collected Dec. 8 from a Lamoille County resident in their 30′s.

[Karl Henning]

Spain's PM Sanchez calls emergency meeting — 7:58 a.m.
By Bloomberg

In a televised address on Sunday, Spanish Primer Minister Pedro Sanchez said the leaders will analyze the evolution of the pandemic in an extraordinary online meeting scheduled for Wednesday.

Spain's 14-day average infection rate climbed to more than 500 cases per 100,000 inhabitants, with hospitalizations tripling to 6,667 patients over the past month, according to Health Ministry data released on Friday.

[Karl Henning]

South Africa minister gets COVID -19 again — 5:30 a.m.
By Bloomberg
South African Minister of Minerals and Energy Gwede Mantashe tested positive for Covid-19 after experiencing mild symptoms, the second time he's contracted the virus.

The minister is in good spirits and in self-isolation, the presidency said in a statement on Sunday. Mantashe, 66, was hospitalized last year with Covid.

[Karl Henning]

Labor Department extends deadline for companies to mandate vaccines — 10:16 p.m.
By New York Times

The Labor Department said on Saturday that it would delay until Feb. 9 the deadline for full enforcement of its rule requiring large companies to have their workers get coronavirus vaccines or be tested weekly, after weeks of legal battles created uncertainty and confusion for employers.

The department's move came a day after a federal appeals panel reinstated the Biden administration's rule requiring that companies with at least 100 employees mandate their workers be vaccinated against the coronavirus or face weekly testing by Jan. 4. The rule had also mandated that those employers require masks for unvaccinated workers by Dec. 5.

On cruise ships, Omicron puts safety protocols to the test — 9:05 p.m.
By New York Times
Since the cruise industry restarted operations in the United States this June, its efforts to keep the coronavirus at bay — or at least contained, unlike the major outbreaks experienced in 2020 — have been largely successful. Most cruise companies mandate full vaccinations for crew and most passengers, and have implemented strict health and safety protocols to swiftly identify coronavirus cases onboard and reduce their spread.

But in recent months, as new and highly contagious variants have emerged and case numbers steadily increase worldwide, these measures are being put to the test. Many lines are adjusting their masking, testing and vaccine rules, while criticism is mounting about the lack of transparency in reporting positive cases to passengers and crew members during sailings.

Omicron accounts for 80 percent of Miami-Dade's coronavirus cases, doctor says — 6:51 p.m.
By Lauren Booker, Globe Staff

A doctor says that more than 80 percent of recent coronavirus patients had the Omicron variant in Miami-Dade County, according to WPLG, a South Florida news station.

Dr. David Andrews, who works as a pathologist at the University of Miami Health, told the station that "this is unprecedented."

"We saw our first case of omicron on a sample obtained on Dec. 2," Andrews told WPLG.

[Que]

Doug Ericksen, state senator who fought vaccine mandates, dies at 52

[Florestan]

SA could soon drop quarantining of Covid-19 contacts as this doesn't serve its purpose, says MAC

The 10-day requirement to quarantine when you have come into contact with a Covid-19 case, and the subsequent contact tracing, could soon become a thing of the past if health minister Joe Phaahla approves a proposal to discontinue these prerequisites.

In an advisory dated December 16 and signed by the co-chairs of the ministerial advisory committee (MAC) on Covid-19, Prof Kholeka Mlisana and Prof Marian Jacobs propose that quarantining be discontinued with immediate effect for contacts of cases of Covid-19 as this "no longer serves a public health role".

"Identifying contacts of Covid-19 cases (that is) contact tracing equally serves very little role. In addition, contact tracing is impractical once the Covid-19 caseload rises due to the large number of contacts that have to be identified for each case, and is extremely burdensome in its use of human and financial resources," they said in a statement addressed to Phaahla and acting director-general for health Nicholas Crisp.

If approved, the discontinuation will apply to both vaccinated and non-vaccinated contacts.

"No testing for Covid-19 is required irrespective of the exposure risk, unless the contact becomes symptomatic. We further propose that contact tracing be stopped. As current testing only identifies a small minority of all Covid-19 cases, quarantining contacts of these cases serves no demonstrable general public health purpose," reads the document.

[Florestan]

Covid hospitalisations up 70% in past week, but actual numbers very low

Omicron is in more than 76 countries across the globe, and in SA Covid-19 hospitalisations have seen a rapid 70% increase in the past week.

However, absolute numbers remain relatively low, and while the number of infections is rising quickly in every province, in Gauteng they are coming down.

This is according to health minister Joe Phaahla, who hosted a briefing on Friday morning.

He said a week ago, Gauteng accounted for around 80% of all new infections but it is now at 25%.

Numbers have already exceeded the peaks of all other waves, and the positivity rate (percentage of tests confirming infections) is at a high of 31%.

On the upside, however, the ratio of hospitalisations to infections in the second week of the fourth wave has been 1.7%. In the same week of the third wave it was 19%.

The recovery rate is 91%, and there are around 7,600 patients in hospital with Covid-19.

Phaahla cautioned: "Mildness with Omicron may not be less virulent but seems so due to high vaccine coverage. In the over-60s almost two-thirds of the population are vaccinated and in the over-50s it's at around 60%."

He said natural immunity from past infections was also likely to be playing a role in reducing severity of disease.

[Florestan]

Omicron variant: The West finds yet another reason to keep Africans out

Late last month, scientists in South Africa announced that they had identified a new variant of Covid-19 — Omicron — and that it was spreading fast.

Less than 48 hours later, the United Kingdom had banned travel from South Africa and its neighbours, and cancelled flights. The European Union followed suit, as did North America and some Middle Eastern nations. Almost overnight, Southern Africa became a pariah, almost totally isolated from the outside world. Even some African countries have restricted travel from the region.

Early in the pandemic, there were warnings that Western nations would swallow up vaccines and then point to Covid in Africa as a reason to lock down borders. Africa would become "the Covid Continent", warned John Nkengasong, the boss of Africa Centres for Disease Control and Prevention.

These new restrictions were initially justified as a necessary response to the new variant. If the variant can't get in, it can't spread.

Except the variant was already there.

More than 40 countries have now detected cases of Omicron. Some of these appeared to have no connection to Southern Africa. In at least one instance — in the Netherlands — the positive sample was collected before South Africa made its announcement, suggesting that it was circulating in Europe before it got to Southern Africa.

Yet the travel restrictions against Southern Africa remain in place. No travel restrictions have been implemented against Western countries where Omicron has been detected.

African leaders are getting increasingly irate: there appears to be one rule for Africa, and another for everywhere else.

Speaking at the Dakar International Forum on Peace and Security this week, South Africa's President Cyril Ramaphosa was decidedly undiplomatic. He said he had received "patronising" and "paternalistic" phone calls from European leaders — none of whom was able to adequately justify the draconian restrictions. "You ask yourself, where is science? They always said to us, base your decisions on science, but when the moment comes for them to be more scientific they are not," he said.

Malawi's president said the bans were "Afrophobia" in action. Botswana's president called them "unnecessary" and "irresponsible". Nigeria's high commissioner to the UK described them as "travel apartheid", and the African Union highlighted the hypocrisy by saying: "Despite the widespread distribution of Omicron cases globally, the majority of border closures solely target flights to and from South Africa and neighbouring countries in southern Africa, some of which have no evidence of the omicron variant and relatively low daily Covid-19 case numbers." Leaders are rarely so blunt.
'It makes no sense at all'

It's not just African leaders who are nonplussed. The response by some of the most prominent public health experts in Africa was unequivocal.

"The current bans do not make sense at all from a public health perspective," said Catherine Kyobutungi, an epidemiologist and executive director of the African Population and Health Research Centre. "Travel bans can only make sense if they are total, that is, that a country shuts itself off completely from the rest of the world."

This is the approach that China has taken, with a few exceptions.

Kyobutungi added: "The problem is that the countries instituting travel bans also have lousy in-country Covid-19 prevention measures and rather than deal with their failures they are using travel bans to give the impression of doing something."

Daily cases in South Africa are in the single digit thousands, but those in Germany and the UK are in the tens of thousands. Mismanagement of the pandemic in the latter has meant the deaths of some 150 000 people.

Thierno Balde, the incident manager for the World Health Organisation's Covid-19 Emergency Response in Africa, echoed this sentiment. "Travel bans directed at Southern African nations are unfair and we strongly encourage countries to reconsider these bans."

He warned that they may ultimately prove counterproductive — because, in effect, Southern Africa is being punished for the excellence and the openness of its scientists. "If any country, not just African countries, fears crippling consequences that can negatively impact the personal and professional lives of their citizens, we may not see such openness in future. This would most certainly threaten global disease control."

These consequences are already being felt. Because of the dramatic drop in flights to the region, South African scientists are running out of the chemicals necessary to do more Covid-19 sequencing.

Dr Mounia Amrani, the Southern Africa medical coordinator for Médecins Sans Frontières, said the public health community has known for months that travel bans "are completely ineffective. So what is surprising is to see them used again, particularly when we had so little information about the omicron variant."

More surprising is that "they blocked only the outside borders, while the virus is already circulating in the EU".

[Karl Henning]

Like Trump, B.J. reserves the right to host super-spreader events, I guess:

Britain's omicron cases soar as new lockdown party allegations at Boris Johnson's residence come to light

By William Booth
Today at 9:00 a.m. EST

LONDON — Scientists are pushing Prime Minister Boris Johnson to take tougher measures to slow the exploding number of new infections driven by the omicron variant — as more photos emerge of more alleged parties held at his 10 Downing Street office during lockdown last year.

It is an almost surreal split screen Monday on the BBC.

Coronavirus cases are surging, especially in London, where Mayor Sadiq Khan declared an emergency amid fears that so many essential workers will become infected and need to isolate that health and security services may be threatened.

Meanwhile, Johnson finds himself at the center of another mini-scandal. The Guardian newspaper on Sunday published a photograph depicting a "wine-and-cheese party" in the garden of Downing Street. Bottles and glasses can clearly be seen — and so can Johnson and his wife Carrie, alongside 17 other attendees.

The Guardian reported that the outdoor affair took on May 15, 2020, when gatherings of more than two people were banned in outdoor public places.

A spokesman for Downing Street said no lockdown rules were broken, that the garden was a private not a public place, and that this was not a party, but a "work meeting," which was deemed "essential."

Deputy Prime Minister Dominic Raab told BBC, "I know how hard that Number 10 team were working, as the hub, the fulcrum of the crisis response. I think there's a lot of exhausted people, and they, as people do in work, were having a drink after the formal business had been done."[not an "essential" "work meeting," in other words.—kh]

The leader of the opposition Labour Party, Keir Starmer called Raab's claim "a stretch" and reminded the country that in May 2020 many people who followed the rules were unable to attend funerals of loved ones.

The latest photograph follows a string of other recent setbacks and embarrassments, including mock news conference that saw a chief spokeswoman making light of alleged violations of lockdown measures by Downing Street staff during Christmas 2020.

Johnson has denied that any rules were broken, but under pressure from his own Conservative Party, he ordered an internal inquiry by Britain's top civil servant, Simon Case.

Soon after, Case was forced to recuse himself from the probe following reports that a gathering was held in his own office around the same time.

In London, shopping streets saw smaller crowds over the weekend, while pub and restaurant owners complained of a flood of party cancellations.

The Natural History Museum announced it was temporarily shutting down due to staff shortages caused by infections and isolation rules.

Patricia Marquis, England director for the Royal College of Nursing union, told the BBC Monday that hospitals were under "immense stress and pressure" because health-care workers were themselves becoming infected and had to stay home

"So, staff are looking forward now thinking, 'Oh my goodness, what is coming?'" Marquis said.

Johnson and his cabinet are scheduled to meet Monday to discuss tougher measure to confront omicron. Among the options, described by British news media, are an advisory to ask families to host smaller holiday parties; a legal mandate on household mixing; an evening curfew on pubs and restaurants; or a return to full lockdown.

Scientific advisers to the government warned that without stricter measures, 3,000 people could enter hospitals in Britain each day, up from the 900 daily admissions now.

In the midst of the holiday season, the government advisers said large indoor gatherings posed high risk of seeding "multiple spreading events."

[Karl Henning]

Nearly 50 people on Royal Caribbean cruise that docked in Miami test positive for coronavirus

[Karl Henning]

COVID-19 hospitalizations are rising, but some cases are milder than before

By Kay Lazar and Andrew Brinker Globe Staff  and Globe Correspondent, Updated December 19, 2021, 5:09 p.m.

Amid surging COVID-19 infections, overflowing hospitals, and exhausted healthcare workers, Massachusetts hospital leaders are hanging [onto] a glimmer of hope: some treatments, vaccines, and hard-won knowledge from the earlier outbreaks have meant fewer severely ill COVID patients.

And those who do need intensive care generally are recovering more quickly, doctors say.

"The proportion of [COVID] patients in the ICU has gone down slightly and the average length of stay for the ICU has gone down slightly," said Dr. Paul Biddinger, director of emergency preparedness at Mass General Brigham, the state's largest hospital system.

But doctors are not letting their guard down.

"This is encouraging to be sure, but no one should be blasé about this," said Dr. Richard Schwartzstein, chief of pulmonary, critical care, and sleep medicine at Beth Israel Deaconess Medical Center.

"There are patients getting as sick as they were before and still dying, despite these advanced therapies," Schwartzstein said. "But the vast majority are the ones who are not vaccinated," he said.

A snapshot of COVID-positive patients in Beth Israel's intensive care units over two days last week underscored that point: fewer than half were vaccinated.

At Tufts Medical Center, the discrepancy is even starker. Six of seven COVID-19 patients in critical care on Thursday were unvaccinated. And those without shots represented almost 60 percent of the total hospitalized patients with COVID there.

"The key is that those who are vaccinated leave earlier, leave faster, and aren't as sick," said Terry Hudson-Jinks, chief nursing officer at Tufts. "That is the theme every single time."

Of those developing serious illness and dying from COVID, most are "the oldest patients, 80s and 90s," said Todd Ellerin, director of infectious diseases at South Shore Hospital in Weymouth. And, he said, they are also the patients who have weakened immune systems or multiple underlying health problems.

Across Massachusetts, all hospitalized patients are tested for COVID, so such a diagnosis could be incidental to what landed a person in the hospital. State data does not distinguish between those hospitalized for COVID-19 care and those diagnosed with the virus but admitted for other reasons, nor does the data from most hospitals.

The latest state data show that just 2 percent of the roughly 5 million fully vaccinated people have so-called breakthrough COVID infections. And a more detailed breakdown of such cases requested by the Globe shows that a much smaller number of people, roughly 0.5 percent of all the breakthrough cases, are hospitalized and die. Roughly half of that group were 80 years or older, the data show.

Now, as more vaccinated people get booster shots, the percentage of vaccinated patients admitted to hospitals for COVID treatment is declining, said Dr. Eric Dickson, chief executive of UMass Memorial Health.

"The booster is starting to have a positive impact in reducing the number of breakthrough cases," he said. "It's still largely three-quarters a surge of the unvaccinated."

Compared to the early days of the pandemic, fewer COVID patients are dying, hospital administrators said, in part due to lessons learned that improved care. Hospitalized patients now are often given high-dose oxygen as soon as possible in hopes of avoiding placing them on ventilators, machines that pump air into their lungs, but can produce long-term complications.

Another advancement is the use of dexamethasone, a powerful steroid that helps reduce inflammation and has been shown to be helpful in people with severe COVID who are hospitalized and on ventilators or who require supplemental oxygen. Many people had not heard of the drug before October 2020 when President Trump received it during his treatment for COVID-19.

Newer in the armament is Tocilizumab, a monoclonal antibody that reduces inflammation and had been used in the treatment of other diseases such as cancer. It was authorized in June by federal regulators to treat COVID in ventilated patients and those receiving oxygen. Doctors still use the antibodies from Regeneron and Eli Lilly that were approved earlier in the pandemic, but as the Omicron variant storms across the country, some monoclonal antibodies have been found to have significantly diminished potency against the new strain.

Monoclonal antibodies, the laboratory-made proteins that mimic the body's immune system and stop the virus, can keep people with COVID from getting seriously ill if taken within 10 days after symptoms appear. Doctors say these drugs have been remarkably effective in keeping people from needing hospitalization.

"Some of the patients with monoclonal antibodies end up being hospitalized, but they are not as sick," said Dickson, of UMass Memorial Health, which has been administering about 200 such treatments per week in its outpatient center and a small number in the hospital.

One monoclonal antibody that is holding promise of standing up to Omicron is a new drug, called Evusheld, recently authorized by the Food and Drug Administration, that can be given to patients with weak immune systems before they're exposed to COVID, in hopes of limiting severe illness.

"We don't have it available yet, but I think it will be here before the end of the year," said Biddinger of Mass General Brigham.

As the number of people hospitalized for COVID in Massachusetts continues to rise sharply — it has more than doubled over the past month, to 1,499 — Biddinger and other hospital leaders say the deluge is overwhelming their already strained operations and bone-weary staff.

"The demand for care is as high as it's ever been," Biddinger said.

Hospitals, anxious about being swamped early in the pandemic, postponed many procedures, such as colonoscopies and joint replacements, to make room for COVID patients. Now patients with advanced cancers, heart disease, and other chronic illnesses who delayed care are swamping hospitals, sicker than ever.

Many of the facilities are also facing staffing shortages. And now, Biddinger said, patients frustrated at having to wait hours and even days for a hospital bed are taking their anger out on staff.

"Things are much more crowded and you spend 18 hours on a hallway stretcher, you get cranky," he said.

"Not all [visiting] family members wear their masks the way they should," Biddinger added. "Many times a day, nurses have to remind a family member to follow our infection-control procedures. It's just exhausting."

The anxiety among hospital leaders is palpable as they talk about the weeks ahead, when the current surge of COVID cases from the Delta variant is expected to swell to a tsunami with Omicron, too.

"There was so much hope that perhaps [vaccination] would prevent another surge," said Hudson-Jinks, the chief nursing officer at Tufts. "It's very disappointing that we are here again, seeing the numbers of COVID patients increase in the community and in here. It's exhausting."

[Karl Henning]

What happens when students remove masks? These Mass. schools are finding out

By Naomi Martin Globe Staff, Updated December 19, 2021, 5:48 p.m.

HOPKINTON — By lunchtime Thursday, word had spread through Hopkinton High School about a slew of basketball players testing positive for COVID-19. Already far more students had begun wearing face-coverings in the school, which in November became the first in Massachusetts to allow vaccinated students to go mask-less.

Over lunch, five senior boys expressed anxiety. They hoped the school board that night would temporarily reinstate the school's mask mandate. But other students wanted the relaxed mask policies, which they didn't believe caused the outbreak, to continue. Two sophomore girls in the library studied without masks, happy to see each other's smiles. They felt the mask-choice policy gave them something elusive in the past two years: a typical high school experience.

"Last year, it felt like you couldn't talk to anyone who wasn't your friend," said Sophie Weeden, 15. "This year, it's gotten back to a little more normal — it's so much better."

The division over how to proceed at Hopkinton High, one of a handful of schools that has followed the state's protocol for making masks optional, reveals the complexity of changing COVID policies in one of the country's most vaccinated states, as officials aim to better serve students' learning and social needs while trying to keep families and teachers safe amid an ever-changing pandemic.

At least five schools in Massachusetts — including Westborough's high school and middle school, Norwell High School, and King Philip Regional High School in Wrentham — have allowed vaccinated students to unmask. Most of the school districts have not seen significant increases in COVID cases among students or staff, state data show. Until this past week, neither had Hopkinton High. But as of Friday, the school had recorded 15 new cases.

"It's been exciting to get back to some sense of normalcy, but as we're seeing an uptick in cases, we're once again getting reality shoved at us," said Hopkinton math teacher Jenna Galster, whose statistics class was about half-masked Thursday.

To become exempt from the state's school mask mandate, the schools had to first attest to the state that 80 percent of students and staff were fully vaccinated.

While many schools in Massachusetts meet that threshold, only 28 schools have sought and received state permission to lift their mask mandates, officials said. Most have not moved forward with the change, amid rising COVID cases and the uncertainty about the new Omicron variant. In some places, like Franklin and Ashland, school officials paused plans to go mask-optional this month.

But with the state's school mask mandate set to expire Jan. 15, education policymakers are looking toward the towns that have already allowed students to remove masks as they consider the thorny decisions about what to do in local communities. At local and state public meetings, some parents have testified through tears about their kids experiencing mental distress and learning difficulties due to masks, while other families have urged officials to protect high-risk students and staff with universal masking.

[Mirror Image]

I got the booster on Friday, it was the Moderna. I was expecting to be completely wiped out for days like after I got the first shot (the J&J) about 6 months ago, but it was surprisingly mild. Just a headache and some fatigue. Glad to have these antibodies in my system... God knows what the future will look like covid-wise.

Anyone else get their booster recently? What have your experiences been like?

I haven't received my booster yet, but I had my 2nd dose of Pfizer in September, so I'll have to wait until March to get it.

[MusicTurner]

There's a tendency in many places to shorten the time for availability of the 3rd jab.

[fbjim]

I got mine early during a check-up for another medication I take- they just offered it to me, as kind of a "wink wink" thing even though I was technically a few weeks early.



If the mildness of the new wave seems to hold, I imagine the next big policy fight will be whether or not this is good cause to start relaxing pandemic restrictions.

[Karl Henning]

An old friend of mine, who can be both an annoying knowitall, and rather an ass, lectured me last night on how masks supposedly make no difference. /he's down in The Sunshine State, and the lecture sprang from my asking if folks down by him wear masks. Note to self: You may think it's an innocent question, but....

[fbjim]

nothing is innocent in the culture war.

[MusicTurner]

After more than 3 weeks, still a lot of uncertainty about Omicron here in DK, except from it being much more infectuous. So far, hospitalizations and ICUs seem to have been relatively few, but the infection rate continues to be steep, and January is expected to be tough in the health sector.

[Karl Henning]

nothing is innocent in the culture war.

Truly.

[André]

There's a tendency in many places to shorten the time for availability of the 3rd jab.

As of today the 3rd dose is allowed after a 3 month delay. Before that it was 6 months. I'm getting mine tomorrow.