Starting internationally, the British reopening may come with a price. There could be one to two million cases in the coming weeks, although vaccinations mean that there will be fewer hospitalizations and deaths from these cases. While virtually all legal restrictions will end, people will be urged to wear masks in crowded enclosed spaces. Decisions about working from home will be left up to individual companies, though a public health official said that it would be best if workers stayed home for four to six more weeks. The health secretary has warned that the situation is "going to get a lot worse before it gets better."
Malta, with 77.7 percent of residents fully vaccinated, will ban visitors over the age of 12 from entering if they have not been fully vaccinated, becoming the first European country to impose such restrictions. Vaccination is to be proven by a vaccination certificate issued 14 days after the final dose of vaccine; right now, documents issued by Malta, the EU, or the UK will work. Children between the ages or 5 and 12 must have a record of a negative PCR test. Children under 5 are exempt.
Thailand is giving health care workers inoculated with Sinovac another dose of either the AstraZeneca or Pfizer vaccines. This will offer greater protection against variants and reassure people who feel their immunity from Sinovac is waning. Greece will require health care workers and nursing home staff to be vaccinated. Nursing home staff must get vaccinated immediately, while health care workers have until September 1. Israel is going to offer a booster to immunocompromised people and is trying to decide whether everyone should get a third dose.
The Dutch prime minister has reinstated curbs on bars, restaurants, and night clubs just two weeks after lifting them. He also apologized for removing the restrictions too soon, saying, "What we thought would be possible turned out not to be possible in practice. We had poor judgement ... for which we apologize. Valencia's regional government is imposing new restrictions to fight a surge in cases among unvaccinated young people. The threshold for "extreme risk" is said to be 250 cases per 100,000 people. The rate among people ages 20 to 29 has risen to 1,047 cases per 100,000. The Delta outbreak in Sydney is not slowing down at all. They just recorded the highest one-day total of cases since the outbreak began in mid-June. The lockdown that was supposed to end this Friday may well be extended.
Finally, the covid technical lead at WHO expressed concern over the Euro 2020 final in London at which unmasked crowds were singing and shouting. "Am I supposed to be enjoying watching transmission happening in front of my eyes? ... Devastating."
Cases are again rising here in the US. The last seven days saw an average of 19,455 new cases, a 47 percent increase over the previous seven days. A third of the cases came from Florida, Louisiana, Arkansas, Missouri, and Nevada. Over half of unvaccinated Americans live in households that make less than $50,000 per year. Two thirds of those unvaccinated people still say that they will definitely or probably get vaccinated. We need to make it easier for them to do so in terms of work and child care issues. Of note, though, is that some Republican lawmakers want to give the unvaccinated the same civil rights protection given on the basis of race, gender, or religion.
If you thought the early-in-the-pandemic ventilator shortages were wicked, the ECMO shortages are still going on. ECMO is ExtraCorporeal Membrane Oxygenation, a technique that adds oxygen and removes carbon dioxide from a patient's blood before pumping it back into the body. It requires expensive equipment similar to a heart-lung machine, specially trained staff, and one-on-one nursing. Many hospitals have not been able to accommodate all the patients who need it. Doctors try to select the patients most likely to benefit from it, but in the absence of sharing systems, have to apply differing criteria. Things such as insurance coverage, geography, and even personal appeals may come into play. Adding to the stress, patients undergoing cardiac surgery may also need ECMO, meaning covid and cardiac issues have to be weighed against each other.
The FDA today said it will attach a warning of Guillain-Barre syndrome, a rare nerve disease, to the Johnson & Johnson covid vaccine. The proportion of Guillain-Barre in people vaccinated with Johnson & Johnson is three to five times higher than in the general population. In Guillain-Barre, the body's immune system mistakenly attacks part of its peripheral nervous system; most people do recover. Some officials are worried that the warning could deter vaccine-hesitant people from getting any kind of vaccine. It could also be the kiss of death for the Johnson & Johnson vaccine.
A reader commented that hospital visitation policies are one way to judge that the pandemic is waning or, eventually, over. I checked the policies at the two local hospitals. The local university's medical center still has restrictions in place. End-of-life and childbirth are considered special circumstances and have the most open policies. The local hospital not connected to the university appears to be back to normal visitation except for patients suffering from covid who cannot have any visitors. I think but am by no means sure that most covid patients went to or ended up at the university's medical center, which may explain part of the why the policies differ. I'll have to keep checking that; it may very well be the way to tell when we're supposedly back to normal.
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