Coronavirus thread

[Karl Henning]

Two Boston researchers propose 'circuit breakers' to stem spread of COVID-19

By Amanda Kaufman Globe Staff, Updated December 27, 2021, 53 minutes ago

Two Boston researchers are calling on the United States to implement a system that would urge local officials to temporarily pause certain activities like indoor dining or large gatherings in order to prevent hospitals from becoming overwhelmed amid a rise in COVID-19 cases fueled by the Omicron variant.

In a memo to Dr. Rochelle Walensky, the director of the Centers for Disease Control and Prevention, two Harvard-affiliated researchers last week proposed the use of "circuit breakers," which are temporary, local restrictions on "high-risk" activities like indoor dining, performances, or non-essential work outside of homes.

"Because many regions are entering this wave with higher hospital censuses (both due to Covid-19 and other conditions) than in previous waves, it is possible that uncontrolled spread of Omicron could quickly overwhelm hospital capacity, despite the existing immunity of the population," Dr. Jeremy Faust, an emergency medicine physician at Brigham and Women's Hospital and instructor at Harvard Medical School, and William Hanage, an epidemiology professor at the Harvard T. H. Chan School of Public Health, wrote in the memo.

The so-called circuit breakers would be triggered once individual regions have met or are approaching certain thresholds, Faust and Hanage said, and might last about five to seven days "but would be unlikely to be necessary for longer than 14 days in order to achieve the stated objective."

"As the risks of Omicron are acute, we fear that any delayed action may be of substantial consequence," Faust and Hanage said.

On Saturday, Faust wrote on Twitter that "several Massachusetts counties are at risk or likely to have already exceeded normal hospital capacity."

Boston was designated as "unsustainable," according to the measure Hanage and Faust are using, "meaning that given current hospital capacity and new daily Covid, there could be a problem soon," Faust said in the tweet.

Faust and Hanage wrote in the letter to Walensky that while they recognize Americans don't want to "disrupt their lives" to mitigate the spread of COVID-19, they believe the population would be willing to and should be asked to, "with the narrow goal of avoiding catastrophic hospital overload and the avoidable deaths and suffering that would otherwise ensue."

In an interview on CNN on Saturday, Faust said that the "circuit breakers" would be temporary restrictions to avoid a situation in which hospitals are overwhelmed, and someone seeking treatment in an emergency situation like a heart attack isn't able to get the life-saving treatment they need.

The measures could include restrictions on large gatherings, dining capacity, or hospital policies, Faust said.

"It's not a lockdown or a shutdown," Faust told CNN. "But it could be a change in our behavior, or go to hospitals to say, 'Look, make some choices about how we use our capacity now, so that we can take a wave that we expect and actually can foresee coming.'"

Dr. Shira Doron, an infectious disease physician and hospital epidemiologist at Tufts Medical Center, said she disagreed with the approach Faust and Hanage have proposed, arguing that economic restrictions put in place to stem the rise in COVID-19 cases can also be harmful.

"Those are things that will cause people to lose their livelihoods, and in some cases permanently," Doron said in an interview last Thursday.

Massachusetts and the country cannot return to the first few months of the pandemic, Doron said, adding that while she is concerned with rising COVID-19 cases, she is simultaneously worried about officials' "knee-jerk response" to the increase in infections and the potential implementation of restrictions that can be detrimental to the population's health and well-being. She cited colleges closing and schools returning to remote learning as examples.

"We can't go back to March of 2020," Doron said of the proposal submitted by Faust and Hanage. "There are certain things that we did then that we can't do again, so we we have to figure out a new way that we deal with rising cases."

Governor Charlie Baker has already implemented a number of measures in Massachusetts hospitals in order to relieve the strain from COVID-19 patients and staff shortages. Last week, Baker directed hospitals to cancel all non-essential surgeries that require patients to stay overnight in order to make beds available for patients with urgent medical needs. He also deployed the National Guard to help hospitals fill gaps in staffing.

COVID-19 cases and hospitalizations are rising in Massachusetts in a winter surge driven by the highly contagious Omicron variant. According to the most recent data from the Massachusetts Department of Public Health released Friday, 91 percent of medical and surgical beds are occupied, while 83 percent of intensive care unit beds are filled.

(Disclosure, Jeremy Faust is a fine musician and a friend)

[Karl Henning]

https://www.youtube.com/v/TZhr8Hz03jY

[Karl Henning]

Flight disruptions pile up at Logan for fourth day in a row amid nationwide cancellations

[Mandryka]

https://twitter.com/chrisceohopson/status/1475540064121806856?s=21

The above thread shows how difficult the situation is to read in the UK. There are lots more people in hospital with covid than pre-omicron, but many are there incidentally, asymptomatic even, they've been admitted for other reasons, tested as part of the admissions procedure and found to be positive.

The other side of this is that the impact of omicron on older people is still unclear. Christmas has probably ensured a fair number of them have caught it, so we should know in a couple of weeks max. Note that it now looks as though the delay from infection to hospitalisation is 10 days -- much shorter than before.

Anyway, it looks as though the Government is fairly cool about the situation in England at least-- no more restrictions planned to slow down the infection rate. In my opinion, that's very good news indeed.

[Holden]

An interesting take on the mask debate

https://www.traveller.com.au/masks-on-planes-are-useless-especially-when-you-take-them-off-to-eat-h20syd

This has been common knowledge since the pandemic began.

[André]

An interesting take on the mask debate

https://www.traveller.com.au/masks-on-planes-are-useless-especially-when-you-take-them-off-to-eat-h20syd

This has been common knowledge since the pandemic began.

The article's writer quickly takes her own mask off: « muzzle mandates », « daft protocols », « time for a few fast facts », « all the hysteria »...

Sorry but that kind of posturing does not help. Quite the contrary. 

[Holden]

The article's writer quickly takes her own mask off: « muzzle mandates », « daft protocols », « time for a few fast facts », « all the hysteria »...

Sorry but that kind of posturing does not help. Quite the contrary.

Not interested about the writer's posturing, more about the transmission facts she quoted.

One thing I've certainly not seen is a list of what situations create the most to least transmission of Covid19. My understanding is that it's the home environment that's responsible for the largest number of transmissions which raises questions about who, in a household, should isolate. The least is the outdoors obviously.

One thing both Australia and NZ do is list 'places of interest' where someone who is infected has visited. The QR tracing App (which we're all supposed to use) can then contact people who were there and they go and get tested. Surely, this would provide some of the data I've alluded to but we never see it.

[drogulus]

     

[Karl Henning]

The article's writer quickly takes her own mask off: « muzzle mandates », « daft protocols », « time for a few fast facts », « all the hysteria »...

Sorry but that kind of posturing does not help. Quite the contrary. 

Consider the source, erm, the messenger. "An interesting take." He's a sucker for performative bullshit.

[vers la flamme]

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....

I was just in Florida this past weekend visiting my dad. They do NOT wear masks in Florida. I didn't see a single damn one. People looked at me like I had two heads for wearing one.

[Pohjolas Daughter]

I was just in Florida this past weekend visiting my dad. They do NOT wear masks in Florida. I didn't see a single damn one. People looked at me like I had two heads for wearing one.

Eek!   

PD

[Karl Henning]

I was just in Florida this past weekend visiting my dad. They do NOT wear masks in Florida. I didn't see a single damn one. People looked at me like I had two heads for wearing one.

Anti-mask propaganda central

[MusicTurner]

There's an anonymized app here in DK you can choose to participate in, which will tell you, if you've been close to an identified virus case for more than 15 minutes. If you get infected, you report it to the app. It's been downloaded by around 40% of the population. But the system is experiencing big problems; I went to another PCR test after Christmas, after such a notification, maybe because of a train ride - and now it gives the same notification once again, but it can only be because of the visit to that test centre (where good distance is kept). People are telling of illogical or delayed notifications. Every single Dane has now been tested 20 times on average, we're past 100 mio of them, and I've had 16 tests this year, partly because my jobs are less social, all were negative.

Scenarios have been very varying regarding the Christmas holiday, between 9,000 and 45,000 daily cases - it was a record-breaking 16,500 yesterday, but 13,000 today. Not expected to go down soon, however - maybe some time in January. Being unvaccinated implies a 5x risk of being hospitalized, statistics show, but if you're vaccinated, you'll have about the same risk of being infected, albeit on a lower sickness level. Re-infected are now 100s daily. We'll know more about Omicron in a week or so.

[fbjim]

The climate in the US certainly seems to suggest a lack of appetite for further restrictions beyond the same emphasis on masks and now testing. I do wonder if they're softly transitioning to see if Omicron is possibly the "end" of the thing.

[Mirror Image]

I was just in Florida this past weekend visiting my dad. They do NOT wear masks in Florida. I didn't see a single damn one. People looked at me like I had two heads for wearing one.

Not surprised, but the state we live in isn't much better I'm afraid. Ignorant, dumbass people are rampant in this state.

[Karl Henning]

Not surprised, but the state we live in isn't much better I'm afraid. Ignorant, dumbass people are rampant in this state.

My sister in Tennessee, God save her, refuses to wear a mask (she's on the disinformation drip) so that she has canceled medical appointments because the doctors' offices are requiring masks on patients.

[Karl Henning]

Five things about omicron that I want my friends and family to know

By Dan Diamond
Health reporter
December 21, 2021 at 7:36 a.m. EST

As a health reporter who's been writing about coronavirus since early January 2020, I often get questions about the pandemic. But after the omicron variant emerged last month, those questions became more urgent — with some readers complaining of mixed messages about the new variant and existing vaccines — and deeply personal, as friends and family tried to plan their winter holidays.

Over the weekend, I wrote a Facebook post trying to distill what I've heard from experts and officials as they race to fight the new variant. A lightly edited version of that post appears here.

1. Omicron might not be 'mild' for the unvaccinated

The omicron variant is real, and the reports of it being "milder" appear mostly based on the generally mild breakthrough cases in vaccinated and previously infected people.

If you've been vaccinated and boosted, there's reason to expect your omicron infection will lead to minimal symptoms.

If you haven't previously been infected, and you haven't been vaccinated, there's no reason yet to expect a "mild" case.

Experts have warned, again and again: The bulk of the pain will be felt by Americans who remain unvaccinated, have had immunity wane from prior vaccines and are yet to get boosted, or are immunocompromised.

But anyone who swears that omicron will surely lead to a mild case in a vaccinated person is overpromising. Again, there's good reason to expect it, but we don't have the data to know for sure. This variant was only detected a month ago. Researchers are racing to keep up and study it in real-time.

And the picture from overseas isn't always clear, especially because the demographics in southern Africa, where omicron first exploded, don't line up perfectly with the older U.S. population.

2. Brace yourself for a positive test result. Omicron's mutations make it very transmissible.

Many, many people who are vaccinated or previously infected are going to test positive in the next few weeks, given the omicron variant's sheer transmissibility and ability to evade antibodies.

Every expert I've interviewed, including some of the nation's top health officials, has adjusted his or her mind-set and now is mentally bracing to test positive after spending two years dodging the virus. "Breakthrough" cases are going to be normalized in a hurry, if they aren't already.

To put it very simply, while earlier forms of the virus got stopped at your body's front door if you were "fully vaccinated" or previously infected, omicron can get inside. Still, vaccines and boosters hold the power to defang the worst consequences of omicron and fight off infections. It's possible that some folks reading this have omicron right now and don't know it because their immune system is doing such a good job containing the infection and the symptoms are small or nonexistent.

3. This is exactly what boosters are for

Boosters can specifically help by bringing your antibodies back to a level where there are enough of them, like bouncers at a club, to often keep omicron from getting inside.

Underlining that point: Boosters are one of the best tools to fend off omicron, per every study so far.

We also have far better testing than in early 2020 — though the United States dropped the ball on ensuring access to rapid tests, as anyone hunting for a test now has experienced. There is one monoclonal antibody treatment that appears to still work against omicron, but it's in short supply.

4. Expect hospitals to be pushed to their limits

Federal officials are bracing for U.S. infections to skyrocket into January 2022, with numbers that could top 500,000 new cases per day. (The previous peak was 250,000 cases per day in January 2021.) Some experts predict daily case rates that could be much higher, because so many vaccinated Americans are going to test positive, although we may not capture all the data from people taking at-home tests.

Even if only a small percentage of those people need hospital care, it will tax a health system that is already straining under pandemic fatigue and treating cases linked to the older delta variant. It's also going to be a psychological blow after the past two years of fighting the pandemic, and businesses, families and others will surely be racing to adjust plans.

5. Upgrade your mask and think twice about taking risks. This month will be crucial.

Officials hope that the peak of the omicron wave will be over by early February.

A rise in covid cases is followed days later by a rise in hospitalizations, which is followed days later by a rise in deaths. This has been the consistent pattern for two years.

As a result, the next month in America could rival the worst days of the pandemic, as a sheer wave of cases crashes into our country. Every expert I spoke to is cutting back on scheduled plans, and several urged: Don't take risks that could land you in a doctor's office or hospital emergency room at a moment when demand on our health-care system is going to surge.

If you are passing through an airport or train station, you are undoubtedly being exposed to someone with omicron at this point.

As someone who's been boosted and wears an N95 mask indoors, I feel like I'm taking the best precautions I can. I'm also exhausted with the pandemic and had started to get back to hobbies like swimming, going to movies, having dinner with friends.

But for me, the omicron variant means I'm going to pause some of those activities, and I'm going to make sure I've always got a high-quality mask with me to navigate crowds and indoor spaces. Even if infections are inevitable, I don't want to help omicron along, especially until we get more data in the coming weeks. And I don't want to unwittingly get sick and carry an infection to family members this holiday season.

[Karl Henning]

Rhode Island's Lieutenant Governor tests positive for COVID-19 — 12:40 p.m.
By Brian Amaral, Globe Staff

Rhode Island Lieutenant Governor Sabina Matos has tested positive for COVID-19, she said Tuesday.

Elorza tightens COVID vaccine requirement for Providence city employees, removing option to get tested — 12:07 p.m.
By Brian Amaral, Globe Staff

Providence Mayor Jorge Elorza on Tuesday announced that city employees will have to get vaccinated against COVID-19, and will no longer be able to provide proof of a negative virus test.

NYC plans to double COVID testing in schools when students return — 10:39 a.m.
By The New York Times

New York City will double Covid testing in schools when students return in January, Mayor Bill de Blasio said.

De Blasio, Mayor-elect Eric Adams and Governor Kathy Hochul all spoke on Tuesday at a virus briefing of the importance of bringing students back to school in January, for kids and for parents. Schools are the "safest places to be in New York City," de Blasio said.

"Your children are safer in school," Adams said during the briefing. He and de Blasio said they have been working closely planning for Jan. 3, when schools will reopen.

The new approach for schools in January is called "stay safe and stay open," the mayor said. Under his plan, the city plans to distribute at-home testing kits to classrooms when a student tests positive. All students who are asymptomatic and test negative will be able to return to schools. Students will take two at-home tests over the course of seven days, he said.

Hochul said she sent 600,000 rapid tests to the city last week. The state and the city are working to make sure there's no shortage of supply, Hochul said.

Spain sets pandemic record for new cases — 5:27 a.m.
Associated Press

Spain is dealing with the highest ever number of coronavirus infections, with some regions considering further curbs on social life ahead of the end of the year.

Updating pandemic figures for the first time in four days, health authorities reported 214,619 new cases late on Monday, bringing the 14-day national caseload to a pandemic record level of 1,206 new infections per 100,000 residents. At the height of the January surge, which until now was the one that infected most people in Spain, the rate had surged to 900.

The explosive spike is largely blamed on the omicron variant, which scientists say spreads faster than previous strains although the number of infected patients who need hospital care is proportionally less than in previous surges. Official data shows that 7.5% of Spanish hospital beds and 18% of intensive care units are treating COVID-19 patients.

Authorities reported 120 new deaths since Dec. 23.

In response to the soaring caseload, some Spanish regions are now considering restrictions they resisted only a week ago, when authorities only imposed mandatory mask wearing outdoors.

The northern regions of Navarra, Aragón and Cantabria, among others, are now limiting nightlife, imposing curfews or considering caps on members of different households allowed to gather together.

Omicron may reduce Delta infections, South African study shows — 5:00 a.m.
Bloomberg

Infection with the omicron coronavirus variant can also strengthen immunity against the earlier delta strain, reducing the risk of severe disease, according to a paper released by South African scientists.

While omicron has been shown to be highly transmissible and can evade some antibodies, after two weeks of getting symptoms immunity to subsequent infections from the strain rose 14-fold, according to the authors led by Alex Sigal and Khadija Khan of the Durban, South Africa-based Africa Health Research Institute. A smaller improvement was found against delta, they said.

"If we are lucky, omicron is less pathogenic, and this immunity will help push delta out," said Sigal, who has previously found a two-dose course of Pfizer Inc. and BioNTech SE's Covid-19 shot as well as a previous infection may give stronger protection against omicron.

The latest findings suggest the likelihood of someone infected with omicron being reinfected by delta is limited, reducing the presence of the latter strain. Omicron is the dominant variant in South Africa's fourth wave of infections, delivering record case numbers, and is fast becoming the dominant strain globally.

Delta ripped through the country in July and August, leading to record hospitalization figures. Omicron hasn't yet had such an impact on health services.

The study is based on 15 participants, of which two were excluded as they didn't detectably neutralize omicron, and the data are being submitted to MedRxiv, a preprint medical publication. It has not been peer reviewed.

Expect more shipping chaos as Omicron forces transport workers to quit — 6:47 p.m.
Bloomberg

[Florestan]

Reading this topic I often get the impression that some people simply revel în reporting bad news and are upset  if the worst  scenario doesn't happen to be the case...

[Holden]

Reading this topic I often get the impression that some people simply revel în reporting bad news and are upset  if the worst  scenario doesn't happen to be the case...

+1