The Road goes ever on and on ... Day 125 (625)

It's a good thing Omicron has put coronavirus news on some small sort of hold meaning that there weren't a lot of notes to take. Today's plan for the afternoon included taking some more notes, writing this post, and getting back to the binding on the latest quilt. The quilt has been shifted to tomorrow after having been, for the most part, shifted from yesterday to today. The machine part of the binding causes much angst from my fear of screwing the mitering on the corners up more than I know I'll do already. I just need to remember the words I put up on the refrigerator the other day: Whatever you're doing today, do it with the confidence of a 4-year-old wearing a Batman t-shirt. Wise words, I say.

Greece has made vaccines mandatory for people over the age of 60. Those who have not gotten their first shot by January 16 will be fined 100 Euros ($113.38 at today's rate) per month. This sounds like something that was in the works before Omicron reared its ugly head. If people won't respond to a bribe, try a threat. Germany's constitutional court has ruled that restrictions such as curfews, school closures, and contact restrictions in the interest of fighting the coronavirus are, in fact, legal.

Around 20 countries have so far reported finding the Omicron variant. France found it on Reunion, an island in the middle of nowhere in the middle of the Indian Ocean, but still French territory. The person testing positive there went through Mozambique on the way to Reunion. News briefs from other countries include the the fist case in Japan was a Namibian diplomat. There were Omicron cases in the Netherlands before South Africa first reported Omicron. It is not clear if the people with Omicron had visited South Africa. Masks are now required on public transport and in shops in England. People in Scotland, Wales, and Northern Ireland must also wear masks in pubs and restaurants. Norway is requiring masks on transit and in crowded places. 

Altogether, Europe is currently reporting more cases each day than at any previous point in the pandemic. It's not clear what Omicron might do to that rate if it hasn't already done something. The president of the European Commission advises hoping for the best while preparing for the worst. That's probably good advice for anywhere or for anyone. Various reports have pointed out the initial anxiety over the lambda and mu variants about which we no longer hear. Omicron could also turn out to be a nothing burger, though I can't say I believe that. One of the pluses of being a pessimist is that there's no place to go but up. 

The Road goes ever on and on ... Day 124 (624)

Omicron again rules the news, though much of it is repetition. It will be two to three weeks before we know anything "real" about its ability to get past the immune system or how severe cases might be in both unvaccinated and vaccinated people. The list of countries in which Omicron has been found grows steadily. The last I saw, there were 16 on the list (there are more, believe you me, that have not yet been identified): Britain, Germany, France, Denmark, Israel, Canada, Hong Kong, Australia, South Africa, Portugal, Italy, Botswana, Netherlands, Belgium, Spain, and Sweden. I expect that any day or perhaps any hour the US will find itself on that list. 

One troubling thing about that list is that in two places, Germany and Scotland, Omicron cases have been identified that have no connection to travel internationally or even nationally. Community transmission means anyone could be exposed at any time. Indeed, scientists in the UK are said to be expecting to find hundreds of Omicron cases in the UK, some from before Omicron's official announcement. 

The G7 health ministers held an emergency meeting today to discuss Omicron. The European Commission chief says that it will take two to three weeks "to get a full picture of the quality of the mutations" and "we know we are now in a race against time." Dr. Fauci would agree with both those statements. WHO regards Omicron as posing a very high global risk: "Omicron has an unprecedented number of spike mutations, some of which are concerning for their potential impact on the trajectory of the pandemic. The overall global risk related to the new variant ... is assessed as very high." WHO also spoke of the "severe consequences" possible due to Omicron. 

Meanwhile, POTUS says that Omicron is "a cause for concern, not a cause for panic." Indeed, panic would cause more problems than we already have. Still, even if Omicron is a "variant of concern," I'm not sure concern alone will get people motivated to put masks back on or seek out a vaccination or booster. I'm not sure what a better word might be. A cause for worry? A cause with consequences? A cause just because? 

Merriam-Webster has announced its word of the year. That word would be "vaccine." Vaccines do seem to be at the root of how people react to the pandemic. But will "vaccine" end up so tied to the coronavirus that it leaves measles, mumps, rubella, tetanus, chicken pox, whooping cough, and polio in the dust? When someone asks if a person is "vaccinated," they are not talking about any of the vaccines in that list; they are talking about one of the coronavirus vaccines. 

I saw two phrases today that have me thinking philosophically: " As we prepare to enter the third year of the pandemic ..." and "... in the years since the virus first emerged ..." I know I'm not the only person to have trouble remembering what day of the week it is, but is anyone else having trouble remembering what season it is? The time between late spring 2020 and late summer 2021 is blurred. I have to brush the dust off my glasses or the frost off my windshield to identify anything specific from that period. Even after I started to venture out for essentials after hitting (the first) full vaccination mark, the time seems fuzzy. Is this how people with amnesia feel? I'm not saying that this bothers me, but it does intrigue me. Or maybe it's just all the psychology classes I took in what seems like a past life.

The Road goes eve on and on ... Day 123 (623)

It may be Sunday, but the news streams have continued to develop from what I read early this morning. I could probably take as many notes now as I did this morning if I were willing to use the time I'll spend writing this on that note-taking. Particularly frightening were comments from Dr. Fauci and NIH director Collins on the morning news shows. You can find the whole article here. Particularly scary were Dr. Fauci's comments on the potential of the US going into a fifth wave, based on the current rising case numbers and stagnating vaccination rates. My fear is best illustrated in his comment, "How bad it gets is dependent upon us and how we mitigate." Returning to a comment made more than several times in the early days of this blog, we're fucked. 

The experts say that it will take two to three weeks to know for sure just how transmissible Omicron is and just how well it works against vaccine-induced immunity. Given how quickly the percentage of South African cases caused by Omicron has passed those cause by Delta, the transmissibility question seems answered to me. I've got a bad feeling about the immunity one, too.

The doctor who discovered Omicron says that the world is "panicking unnecessarily" and the symptoms are "extremely mild." They did later concede that the cases they had found were in younger adults in their 20s or 30s, some of whom presented with just fatigue and a mild headache. Moderna's chief medical officer says the answers will come based on how Omicron affects the elderly or people with underlying conditions. The UK health minister says that people should continue "as normal" with their plans for Christmas, though at the same time says that vaccines may be less effective against Omicron. "There is reason to think that maybe, and I stress the word may, that this variant may turn out to make our vaccines less effective, it may not. We just don't know enough. We will learn to live with this." Live with this?!?! Is the alternative to die with it?

There is more coronavirus news, but all of it is Omicron. The list of countries in which Omicron has been found will be longer tomorrow morning as will the list of specific travel or entry bans or requirements. Just know that more countries have identified it as present this afternoon than did this morning and that there are countries blocking anyone from coming in or their own citizens from leaving to visit Africa. At least they're taking the risk seriously.

WHO announced officially why nu and xi were skipped when naming Omicron. "Nu" was seen as being mistaken for "new." "Xi" is a surname for many Chinese including the current leader. WHO policy requires "avoiding causing offense to any cultural, social, national, regional, professional, or ethnic groups" when assigning names. 

And now for something totally different. Canada has responded to a maple syrup shortage by releasing 22,000 tonnes from its maple syrup reserve. The Federation of Quebec Maple Syrup Producers is the OPEC of syrup; they cite a short and warm growing season in 2021 and a 36 percent increase in demand as responsible for the shortage addressed by the release. Syrup harvesting is highly dependent on weather, requiring daytime temperatures over freezing and nighttime temperatures under freezing. Some seven million extra trees will need to be tapped in 2022 to make up for the shortage.

Word of the day: armamentarium. According to dictionary.com, its definition is

the aggregate of equipment, methods, and techniques available to one for carrying out one's duties:The stethoscope is still an essential part of the physician's armamentarium.

a fruitful source of devices or materials available or used for an undertaking:The new arts center is an armamentarium for creative activity.

The Road goes ever on and on ... Day 122 (622)

A bit of general coronavirus news before I start on Omicron. Merck's final analysis of clinical trial data suggests its antiviral drug reduced the risk of hospitalization and death by only 30 percent rather than the previously announced 50 percent. No worries. Thirty percent is better than no percent. 

Various sources have said that the US needs to look to Europe to see what is coming on the coronavirus front. We tend to lag behind what happens there. Some people or organizations are more bothered by this than others. The director of the Pan American Health Organization is on the more side of that range, saying, "Time and again, we've seen how the infection dynamics in Europe are mirrored here several weeks later. The future is unfolding before us, and it must be a wake-up call for our region because we are even more vulnerable." The White House coronavirus response coordinator is on the less side, saying, "We are not headed in that direction. We have the tools to accelerate the path out of this pandemic: widely available vaccinations, booster shots, kids' shots, therapeutics." I'd like to know what this guy has been smoking because three of those tools depend on the vaccines that about 40 percent of Americans are not getting initially, booster-wise, or for their kids. Chances are, too, that the therapeutics these people would most trust are not those that do anything to prevent, treat, or cure covid. 

Action against Omicron has already trickled (or poured) down to the state level. The governor of New York State has declared a state of emergency. This gives her the power to order hospitals to limit nonessential procedures in order to boost capacity. 

As for Omicron, there appear to be cases in the UK now. A US scientist noted that Omicron's arrival in the US is inevitable, but the environment into which it comes is not. The environment can be altered prior to Omicron's identification here. Masks, distancing, and hand-washing--all those things we were told to do in the very early days of the pandemic--will help slow Omicron's advance or intensity. Doing those now might lower the probability that such restrictions as curfews or crowd size limits will need to be put in place again.

A few facts about Omicron. Scientists say that it may have arisen during a chronic infection of an immunocompromised individual such as an untreated HIV/Aids patient. Scientists do not expect it to be entirely unrecognizable to existing antibodies, but it is possible that current vaccines may offer less protection than they have offered against Delta and earlier variants. While antiviral drugs may still work, it is not at all clear how monoclonal antibodies will react. It will take several weeks to discover whether there is any change in symptoms or severity compared to Delta. Finally, some companies are already working on updating vaccines to react to the new spike protein. It could take six months, though, before any vaccines needed would be widely available. 

The travel restrictions put in place in the US do not apply to American citizens or lawful permanent residents, though those people will need to show negative test results. Dr. Fauci notes that the real purpose of the travel ban or restrictions is to buy time. It's going to take a while to learn the specifics of Omicron, and the more its arrival can be delayed the more time there is for that research. It seems that some South African officials feel as if the travel restrictions are punishment for alerting global health authorities about Omicron. They say that this may keep countries from reporting future variants. While it has been reported that at least 10 countries had announced travel restrictions before South African scientists had finished meeting with WHO official about the variant, that meeting lasted all day. 

It is a waiting game. We wait to see when the first case is identified here and whether that case leads to community transmission. We wait to hear whether Omicron is more transmissible than Delta. We wait to find out whether the existing vaccines are adequate. We wait for notice of additional guidance or even restrictions. We hope it's a nothing burger, but we'll have to wait and see.

The Road goes ever on and on ... Day 121 (621)

Before we get to the disturbing news of the new variant that will not be named Nu but Omicron, Dollar Tree will next year start charging $1.25 for most items. But don't worry. We might be locked down again and not able to go to Dollar 'n a Quarter Tree for a while. 

Virtually all the coronavirus news out there today concerns Omicron, designated a variant of concern by WHO less than 72 hours after its discovery was announced. For comparison, Delta was around for two months before "interest" was changed to "concern." Omicron has been described as "potentially the worst so far identified" having what has been called a "very unusual constellation of mutations," over 30 in the spike protein alone. It shares similarities with the Lambda and Beta variants which are linked to innate evasion of immunity. It may also be more transmissible. On a more positive note, it is easily detected on a PCR test, and it appears easier to compare one genetic strain to another.

Various countries, including the US, have already begun to restrict arrivals from countries known to have cases of Omicron including South Africa, Eswatini, Zimbabwe, Namibia, and Botswana. Israel identified Omicron in an arrival from Malawi. The Israeli prime minister reports that they "are close to an emergency situation." Actually, Israel may be more ready to deal with Omicron tha many other countries, having held a "war games" style drill earlier this month preparing for an "Omega" variant. Hong Kong identified one case as having arrived from Africa and another case as the person across the hall from him in government quarantine. Suspicion is that the new arrival did not wear a mask when opening the door, and the hallway neighbor inhaled virus particles.

I am particularly nervous about the Omicron case identified in Belgium, the first such case in Europe. The person arrived from Egypt on November 11. Eleven days later, on the 22nd, he began to show symptoms and was tested. He had not been vaccinated. My concern is that how long he might have been contagious before showing symptoms is not known. Once we learn more about Omicron, we might know for how many days someone is contagious before they become symptomatic themselves. I would expect that this person was shedding virus on some of those 11 days, meaning that there will be more positive cases coming. 

South Africa is also concerned about more cases on the way. Officials say it is "only a matter of time" before the virus spreads across the country as schools close and families travel. Omicron has mostly been seen in young people in South Africa, the group with the lowest vaccination rate, not helping answer the question of how well the vaccines currently in use would react against it.

About Omicron the head of Germany's Robert Kock Institute says, "We are in fact very worried." And so am I, obviously, though my worrying doesn't carry the public weight of his. I have already decided that if Omicron makes it into the US (which it probably has done already), I'll forfeit the $25 I've paid to go to a quilt show in Hampton, Virginia in February. Actually, I guess the organizers could cancel the in-person event and hold a virtual one as they did last year. I've thought all along that the pandemic is not even close to being over. That does not mean, however, that I am pleased Mother Nature may be agreeing with me. No one is safe until everyone is safe, so let's get at it!

The Road goes ever on and on ... Day 120 (620)

It is Thanksgiving. You can address this prayer (found here) to the deity(ies) of your choice or not. 

Let our hearts be filled with kindness,

Our minds be calm and light

May thanks arise with in us

For all we share tonight.

Happy Thanksgiving. 

 

 

 

 

 

The Road goes ever on and on ... Day 119 (619)

The day before Thanksgiving, otherwise known as the day to prepare everything I can in advance so I don't live in the kitchen tomorrow. The pumpkin pie is done as is the cranberry sauce. I've toasted the torn bread for dressing. We usually run out before the turkey leftovers are gone, so I decided to double the recipe. I'm now wondering if I'll have enough pans for cooking it. Still to do--six cups of chopped onions, chopped celery in some amount, and a few other things I'm repressing. I refuse to open the wine until the dressing is in the oven.

New Zealand will allow fully vaccinated international travelers into the country beginning next year. Regulations will ease gradually. New Zealand citizens and residents can start going in from Australia on January 16; New Zealanders from the rest of the world can start going in on February 13. Other people can start going in on April 30 as long as they enter from a country that is not considered at high risk. There are some conditions, though. Those entering must have isolated at home for seven days, prove they are fully vaccinated, show a negative covid test, and attest they have not been to a high risk country. New Zealand has had over 10,600 cases but just 40 deaths. It helps that 84 percent of New Zealanders are fully vaccinated and 92 percent have gotten at least one dose. 

A critical care doctor at the local university describes the current situation as "a race against time." Cases are rising in a majority of states with hotspots in the mid-west, northeast, and parts of the south. We could hit one million deaths by spring; WHO says deaths in Europe could top two million by March. TSA says that travel is inching up to pre-pandemic levels. Many Massachusetts hospitals are at or over capacity and cutting off elective procedures. Staff shortages have led to the loss of approximately 500 medical, surgical, and ICU beds. Hospitals are over capacity in central California and are trying to transfer patients to hospitals in Los Angeles. Ninety-five percent of ICU beds in Colorado are occupied. A county health officer says, "Between now and next year, we may be in for a very challenging winter, Bone up on your turkey and your gravy but also don't forget to fill up on your mental and spiritual resilience." 

France is announcing new restrictions on Thursday; the Netherlands, on Friday. Senior doctors from Russia's largest hospitals are urging anti-vaccination figures to visit both ICUs and morgues. Only 37 percent of 146 million Russians have been vaccinated. Positive covid tests are on the rise in the UK.In the past week, there have been 303,071 positive tests, an 11.1 percent increase from the previous week. 

WHO tweeted, "While Europe is again the epicenter of the Covid-19 pandemic, no country or region is out of the woods." WHO has also been warning that while vaccines save lives, they do not fully prevent covid transmission. We could probably benefit from their advice: "We cannot say this clearly enough: even if you are vaccinated, continue to take precautions to prevent becoming infected yourself, and [to prevent] infecting someone else who could die."

Tomorrow is a time to be thankful. I am thankful for family and friends who, for the most part, put up with and even encourage my eccentricities. I am thankful for those, organized or as individuals, who care for others and work to make to world a better place. And in that vein I am thankful for science and scientists, some of whom have given us the vaccines and treatments that are getting us through the pandemic.  

The road goes ever on and on ... Day 118 (618)

ICUs in Germany are nearing capacity, and doctors are preparing to apply a triage system. Cases are surging to the point that the health minister predicts, "Probably by the end of winter everyone in Germany will be vaccinated, cured, or dead. That sounds cynical, but that is the reality." He went on to say that the Delta variance makes this prediction very probable. Calling a spade a spade? Hyperbole or reality? Germany has not ruled out a national lockdown like the one its neighbor Austria has instituted. 

It's not hard to see the rationale for the Austrian lockdown. The incidence rate in Austria hit 1,107 per 100,000 and there are over 3,000 patients in a hospital. For comparison, the incidence rate in Germany is 409.2 per 100,000; in the UK it is 422.7 per 100,000. Under the lockdown, Austrians can leave home to go to work, shop for essentials, or exercise. Schools are open, but parents have been urged to keep children at home whenever possible. Also recommended is working from home. Sixty-eight percent of Germans and 66 percent of Austrians are fully vaccinated, but virologists and epidemiologists say those numbers are not high enough to keep the pandemic under control. If those percents aren't enough, let's not talk about our 59 percent in the US.

US cases have risen 30 percent this month, but the coming of colder weather is not one of the causes. If it were, the pattern of surging cases would look very different. Canada and the northern states in the US would have surged before more southern states, and that has not happened. A University of Minnesota epidemiologist notes that there is more that scientists do not know about how coronavirus spreads than they do know. Minnesota and Washington are two states that keep very detailed data on cases, hospitalizations, and deaths. In Minnesota, the death rate for fully vaccinated people under the age of 50 during the Delta surge was 0.0 per 100,000. Some people did die, but not enough to round the 0.0 up to one. The most recent report out of Washington did not even include a death rate for fully vaccinated residents under the age of 65. In Minnesota the average weekly hospitalization rate for vaccinated residents ages 18 through 49 during the Delta surge was one per 100,000. All that said, for people in their 80s or 90s, covid appears to be more dangerous than typical flu.

Covid cases in children are up 32 percent from two weeks ago. In the week ending November 4, there were 107,000 such cases; for the November 11 - 18 week, there were 140,000. The number of cases for people under the age of 18 is about one-fourth of the national total. People under the age of 18 make up about 22 percent of the population. Despite data that show vaccines are far safer than covid, three in 10 parents still say that they will definitely not get the vaccine for their children ages five through 11. Another three in 10, though, say they'll get their children vaccinated "right away."

South Korea shut down a religious facility after 210 of the 427 residents tested positive. At least 191 of the 210 were unvaccinated. Cases have surged in South Korea in the past two weeks, but are still relatively low, with five daily cases per 100,000 people. That compares with 29 daily cases in the US and 36 in Singapore. ICUs in and around Seoul are at about 77 percent capacity.

I've been thinking about the vaccinated, cured, or dead comment in the opening paragraph, what the world would look like if at some precise time all the unvaccinated people (except for children too young to be vaccinated) just vanished. The coronavirus rapture, perhaps, where all the unvaccinated are swept up into wherever unvaccinated people would go? Where would we go from there in a science fiction story? As I type that, I also consider what things might be like if it were the vaccinated and recovered who are swept up, leaving the unvaccinated behind. What sort of society would continue or evolve in either case? 

The Road goes ever on and on ... Day 117 (617)

Random question that occurred to me yesterday and to which there is probably no easy answer: What if hospitals refused to treat unvaccinated people (children under age 5 excepted) who contract Covid-19? Would that motivate people to get at least one dose of vaccine? Oops, that was a second question. 

Non-coronavirus related, but important to think about nonetheless. The Institute for Democracy and Electoral Assistance has released its annual list of countries separated into 98 democracies, 20 hybrid, and 47 authoritarian nations. Yes, the US is one of the 98 democracies, but--and this is a huge but--for the first time the US is categorized as a "backsliding" democracy. A couple of relevant quotes from the organization's secretary general: "The visible deterioration of democracy in the United States, as seen in the increasing tendency to contest electoral results, the efforts to suppress participation (in elections), and the runaway polarisation ... is one of the most concerning developments." AND "The violent contestation of the 2020 election without any evidence of fraud has been replicated, in different ways, in places as diverse as Myanmar, Peru, and Israel." Looking at the three types of government above, consider that 70 percent of the global population lives in authoritarian or hybrid countries or in backsliding democracies. Is this really a group we want to be a member of?

Back to coronavirus issues. Dr. Fauci is warning that time is running short to prevent a "dangerous" covid surge in the US. Cases are approaching 1,000 daily with the average up 29 percent in the last two weeks. The coming holidays and winter could only be fuel on the fire. Dr. Fauci says that the surge could possibly be avoided if the public acts now to get boosters and vaccinate children. Some 60 million eligible people have yet to be vaccinated. Dr. Fauci explains, "We have a lot of virus circulating about. You can't walk away from the data, and the data show that the cases are starting to go up, which is not unexpected when you get into a winter season. People start to go indoors more and we know that immunity does wane over time." Dr. Fauci hopes that boosters push immunity out far enough that annual boosters will not be required. 

This one deserves its own paragraph. According to the Wall Street Journal, the 2021 covid death toll just passed that of 2020.

In terms of vaccinations, there are several Asia Pacific nations with immunization rates better than those of the US and many European countries. Cambodia, for example, began vaccinating people on February 10, about two months after the US and UK. By early May, only 11 percent of the 16 million people were fully vaccinated, half the US rate and one-third of the UK rate in the same time period. Now, 78 percent of Cambodians are fully vaccinated compared with 58 percent of Americans. Around a dozen other Asia Pacific countries have fully vaccinated over 70 percent of their populations or are about to do so. Why are they doing so much better? First, all Asia Pacific countries have experience with infectious diseases such as SARS and strong vaccine procurement programs. Many countries knew to order from multiple manufacturers to spread the risk of not getting enough vaccine. 

Complacency can be dangerous and even deadly. European surges are happening even as the vaccines work and work well there. According to a German professor of epidemiology and public health surveillance at Hamburg University, "Vaccinations help. They're one stone in the process of stopping the virus. But it's not strong enough alone." A professor of preventive medicine and public health at the University of Valencia agrees, saying, "Vaccines alone cannot fully contain a virus."

And now for something completely different. I did not know that pillow fighting is now a contact sport. The Pillow Fight Championship will be available live on pay-per-view on January 29. Competitive pillow fighting has been described as "hardcore swinging with specialized pillows." I guess throwing the pillows at each other is not allowed. Bouts are three rounds, and I have no idea how they might be scored. Direct hits on specific areas of the body? I definitely did not see this one coming. Maybe I should have encouraged my kids to have more pillow fights in case their chosen careers (data science and software engineering) don't work out.

The Road goes ever on and on ... Day 116 (616)

I visited my mom this morning, and the entry questions at her assisted living facility once again include a series on vaccination. The first question asks if you are fully vaccinated. The second question asks whether you have received all but the booster shot. The times, they are a'changing.

Protests continue in Europe even as it continues to be the pandemic's epicenter. The national lockdown in Austria starts tomorrow. Rather than hit the grocery store to stock up on munchies, some 40,000 people (a police estimate) protested in Vienna. There were also protests in Italy against the health pass. Attendance there was nowhere near what it was in Austria. With the health pass required for entry to clubs and bars, 84 percent of Italians ages 19 through 29 are vaccinated. There may be new or tightened restrictions in Germany where case numbers have soared, largely among children, teens, and unvaccinated adults. Portugal has one of Europe's highest vaccination rates but is still adding some restrictions. Finally, the president of Slovakia has raised the prospect of a nationwide vaccine mandate.

The state legislature in Florida passed and the governor signed a bill blocking covid vaccine mandates. The governor said that he wants to protect workers who could lose their jobs for not getting vaccinated. The law prohibits employers from enforcing strict vaccine mandates; Disney, for example, has put its staff vaccination mandate on hold. Weekly covid testing can be required but must be at the expense of the employer not the employee. Fines could cost  $10,000 per day per employee for businesses with fewer than 99 employees or $50,000 for larger businesses. The mandate ban also applies to government entities and school districts. 

A fully vaccinated but also immuno-compromised Canadian senator died from covid just days after getting home from the hospital. In a statement released after her death, she urged people to get vaccinated noting how different her fight would have been had she not been vaccinated. 

As holidays and winter loom, Americans are desperate for normalcy even as covid cases climb. Boosters have been approved for all adults, though are only urged for people over 50 or with underlying medical conditions. Pfizer has asked the FDA to authorize its antiviral Paxlovid. Paxlovid is geared toward older people and those with underlying conditions. It is meant to be dispensed by pharmacies and taken at home. 

How long will masks be with us? When might we be able to stop wearing them?  The CDC recommends masks for everyone where community transmission is "substantial or high." Right now, 85 percent of US counties meet this criterion of 50 new cases weekly per 100,000 residents. That suggests masks aren't going anywhere anytime soon. From an infectious disease modeler at the University of Cambridge: "I think mask-wearing is, in many ways, one of the interventions you probably want to relax last. Mask-wearing is very, very low cost in comparison to most other interventions." Many experts say that it will be easier to ease mask requirements in 2022. They also note that some people may wear masks indefinitely (raising my hand here and saying, "Me! Me!"), especially in cold and flu seasons. 

Vaccine mandates. Boosters. Masks. All are just details. I have to agree with a UCLA epidemiologist: "Cases are starting to rise again, and we have not yet conquered this virus. We may be tired of Covid and Covid restrictions and public health measures, but this virus is certainly not done with us yet."

The Road goes ever on and on ... Day 115 (615)

I've been cleaning which mostly means straightening the piles into which items seem to have fallen. In the process, I have found numerous things of interest including the starts of several things I thought I might write about. I also found the original list of 50 things I thought I'd try to do the year I turned 49, aka, my 50th year. Son #2 suggested the list when I commented that a business would celebrate their 50th year all year long so what should I do during my own 50th year? There are six left that I will try to complete while in my 66th year. There's one I'll have to twiddle; it's read a book in Spanish that I no longer have. I'll have to substitute something there. In the meantime, there is more cleaning. Company is coming for Thanksgiving dinner. Company gives me an unavoidable excuse for cleaning and straightening. 

Starting in Europe, where a number of demonstrations have taken place protesting whatever mitigation measures the country's governing bodies are instituting. The mayor of Rotterdam called Friday night's demonstration there an "orgy of violence." The protesters started fires and threw rocks and fireworks at the police who then fired warning shots. The unrest stopped some time after the police used a water cannon to cool things off. The Dutch government wants to introduce a law that will allow businesses to restrict the covid pass system to include fully vaccinated or recently recovered people but exclude people presenting negative test results. If you've been reading this blog for a while, you probably know how I feel about negative test results. Testing negative yesterday could mean testing positive today. The Dutch government has banned New Year's Eve fireworks for the second year in a row. Having spent a New Year's Eve in the Netherlands, I can attest that they do like their Eve fireworks.

Europe continues to be the epicenter of the pandemic. On October 1, there were 110 new daily cases per one million people. Thursday, six weeks later, there were 446. Protests continue in Austria even as there were 15,809 new cases within 24 hours on Saturday, another record. Far-right groups were urging their members to go to Vienna and join the protests, raising the fear of violence. Other protests were planned or held in Germany, Italy, and Switzerland.

There have been protests in Melbourne and other cities in Victoria state over a proposed pandemic bill designed to govern the state's future pandemic responses and powers. The law would give the state government a legal basis for lockdowns, mask and vaccine mandates, and curfews. Some amendments have been offered, but the main points of the original legislation would

• shift the power to declare a pandemic from the chief health officer to the premier;
• allow pandemic status to be declared for up to three months at a time with no outer limit;
• give a health minister broad powers to make public health orders;
• and create an independent pandemic management advisory committee composed of public health, human rights, and community representatives. 

The health minister says that the proposed law reflects what they have learned during the current pandemic. The amendments proposed so far concern stronger human rights protection, a stronger threshold for declaring a pandemic, and faster publication of public health advice. 

Remember the 150 Cathay Pacific cargo pilots and employees who got sent to government quarantine centers in Hong Kong for three weeks after staying at a Frankfort hotel at which three Cathay Pacific pilots contracted covid? Those three pilots have been fired for leaving their rooms while on layover. Strict enforcement is carried out strictly. 

The US is struggling with a shortage of nurses getting worse as they get burnt out with anxiety, depression, and exhaustion. Many are leaving the field rather than just stepping away for a while. With cases rising--they are up 20 percent over the past two weeks--we may be needing all the nurses we can get. The CDC is now recommending boosters for all adults, though it's not clear how fast vaccinated adults will step up to get them. It also does nothing about the adults who remain unvaccinated. 

Finally, a sobering research finding. Pregnant women who had covid when they delivered a baby were twice as likely to have a stillbirth. The study looked at 1.2 million deliveries in the US between March 2020 and September 2021. The arrival of the Delta variant really upped the risk. 

The Road goes ever on and on ... Day 114 (614)

Abraham Lincoln delivered the Gettysburg Address 158 years ago today. In high school, possibly ninth grade, the Gettysburg Address was one of the things we had to memorize, another being the Preamble to the US Constitution. I only remember the first part of the Gettysburg Address now, but re-reading the speech just now jogged a few memory cells. I've visited Gettysburg twice, and it was meaningful both times. It offered me the means of seeing how a battle happened, who attacked whom from where and when. I would not hesitate to visit again should the chance arise.

So, coronavirus news. It appears to be quite possible that patient zero was a vendor at the Wuhan market who became symptomatic on December 11, 2019. An analysis of the cases recorded before an alert was sounded showed half of them linked to the market, a place roughly the size of a soccer field. Most of the symptomatic cases were linked to the western section of the market where, and I have no idea how important this factoid was or is, raccoon dogs were caged. 

If you've wondered why there do not appear to be covid surges in Africa, you are not alone. Scientists are somewhat mystified by how Africa can be doing better than the US or Europe but without vaccines or other resources. Fewer than six percent of the people are vaccinated. Still, for months now WHO has been describing Africa as "one of the least affected regions in the world" in weekly reporting. Some ideas as to what's going on there include that the population is younger, with an average ago of 20 compared to Europe's average age of 43. There is a much lower rate of urbanization there, and people spend much more time outdoors. 

Another possibly relevant point is that covid patients with high rates of exposure to malaria are less likely to suffer severe disease or death than patients with little exposure. With Ebola, more malarial exposure means more serious Ebola. One theory is that malaria's effect could be to "blunt" the immune system's going into overdrive when the coronavirus infection strikes. In general, community health workers in Africa are experienced in dealing with outbreaks in general. The chair of global public health at the University of Edinburgh offers, "I think there's a different cultural approach in Africa, where these countries have approached COVID with a sense of humility because they've experienced things like Ebola, polio, and malaria." A doctor in Zimbabwe gives a warning we should take note of here: "Complacency is what is going to destroy us because we may be caught unaware."

Austria will begin a nationwide lockdown on Monday. The lockdown will last until December 12, though the situation will be reassessed 10 days in. Austria has also issued Europe's first national vaccine mandate with a start date in February 2022. Over the past seven days, there have been 990 cases per 100,000 people.

Almost 40 percent of business travelers who before the pandemic used to travel at least three times each year say they'd never do it again. If such a decrease were to happen, it would have a huge effect on the economy. It already has had some effect. In 2020, US company spending on travel dropped 71 percent. Leisure travelers should start wondering and worrying about their costs going up to help offset the loss on the business side.

Finally, over one million people in the US are still missing their sense of smell after having had covid. The last time I asked her, my mom was one of those. And the governors of Connecticut and New Mexico say that they don't consider a person to be fully vaccinated against covid without a booster. According to the CDC, only 17 percent of adults have gotten one. When boosters started, the entry questions required to visit the facility in which my mom lives no longer included one to the effect of "are you fully vaccinated?" I guess they wanted to avoid confusion. I'll let you know if that question comes back.

The Road goes ever on and on ... Day 113 (613)

Busy day, so this will be a short post. I lunched with my oldest friend here, oldest in terms of her age and our friendship; we were supposed to lunch last week, but my now-departed cold reared its ugly head. Then I had the hair appointment that was also postponed by that darn cold. I managed a few notes this morning in between walking and heading out, so I'll just go with those.

Think this pandemic has been bad? Experts say that the next flu pandemic could be worse than the covid pandemic has been if the world is not prepared. The National Academy of Medicine is advising that work needs to start now on next-generation vaccines. 

I think I wondered here recently when "fully vaccinated" would include a booster shot. The UK says it will not be long before it changes "fully" to include the booster. Other European countries are talking about doing the same thing. 

Looking at cases per 100 people in the last two weeks, four US states saw increases of over 20 percent: Minnesota, Michigan, Vermont, and New Hampshire. Some other states saw increases of 10 to 20 percent: Massachusetts, Rhode Island, Wisconsin, Ohio, Pennsylvania, Illinois, Indiana, Arizona, New Mexico, and Kansas. Only one state had a decrease of over 20 percent, Alaska. Idaho and Montana saw decreases between 10 and 20 percent. In other words, more states are trending up than are trending down, not what we want to see as winter and winter holidays set in. Two-thirds of Americans plan Thanksgiving gatherings similar to pre-pandemic ones. This too is worrisome. 

What else is working against us here in the US? We're holding steady at 59 percent of Americans being fully vaccinated. Only 37 percent of adults over 65 have gotten a booster dose, and only 10 percent of children ages five through 11 have gotten an initial dose. Rapid tests are hard to find if you're looking to be safer in terms of gatherings or you want to follow up on symptoms that might be a common cold or might not be. Finally, while daily deaths are down 13 percent, there are still over 1,000 each day.

Words of wisdom from the director of the Center for Infectious Disease Research and Policy: "This virus is doing what this virus does. We don't understand why surges start, we don't understand why they end."

Finally, Germany continues to set records for the number of new cases, seeing a 61 percent increase over two weeks, and two Austrian states are imposing general lockdowns next week that cover both unvaccinated and vaccinated people. 

The question came up over lunch of just why we're again welcoming European tourists just as their case numbers are surging. It was only partially rhetorical.

The Road goes ever on and on ... Day 112 (612)

Starting with something totally different, the US center of population (the average of where 331.4 million residents live) in 2020 was near Hartville, a town of about 600 in central southern Missouri. I found that a little surprising. I would have thought it would be a more easterly location.

The Olympics are going to be interesting. A Polish luge athlete who broke a leg while training near Beijing was flown out on a cargo plane after covid restrictions prevented him from flying commercial. It seems that the cargo plane was equipped much like a commercial liner, so it wasn't as if he lay on a stretcher in a cargo hold. How is this going to work if someone is injured during the Games? Speaking of cargo pilots, this week 130 Cathay Pacific cargo pilots based in Hong Kong were ordered to spend three weeks in quarantine after staying at a hotel near Frankfurt where three crew members who tested positive had also stayed. This sort of thing may be why Hong Kong has only recorded 213 deaths in a city of 7.5 million.

The Netherlands is running out of covid tests. Administering them is said to be something of an "all hands on deck" approach. Positive tests have gone up 44 percent in one week. Ireland's bars and nightclubs will be required to close at midnight starting on Friday in response to the surge there. People have been asked to work from home, and vaccine passes will be required for things such as going to the theater. Models show that without mitigation measures, Ireland could see 200 to 450 ICU patients by Christmas. The country only has 300 permanent ICU beds. Sweden meanwhile will introduce vaccine passes for indoor events with over 100 people in attendance. 

Germany is also dealing with a fourth wave of covid. There were 52,826 cases on Wednesday, up by half from a week ago. The 294 deaths Wednesday bring the total death toll to 98,274. Responses being discussed include forcing people to show proof of vaccination, recovery, or a negative tests in order to take public transport or to work. Tighter restrictions on leisure activities are also possible. The prime minister of Belgium describes the situation there, "The alarm signals are all red. We had all hoped to have a winter without coronavirus, but Belgium is not an island." Belgium has one of the highest per capita rates in the EU, one per 100 people.  Hungarian doctors warn of a "very sad Christmas." And the Czwch Republic will ban unvaccinated people from access to public events and services. The prime minister warns, "People have to finally believe that Covid kills."

To summarize the European situation, WHO said that deaths in Europe rose by five percent in the last week making it the only region where covid mortality has increased. I may have cited that before, but it probably bears repeating. What happens in Europe often happens here next.

The White House plans to invest billions of dollars to expand US vaccine manufacturing with the goal of producing at least one billion doses per year starting in the second half of 2022. The intent is addressing the immediate needs overseas and preparing for future pandemics. The goal in regard to future pandemics is to have vaccine capability within six to nine months after a pathogen is identified. 

Dr. Fauci (Remember him? I haven't mentioned him in a while.) says that if we can get the vaccination rate up and increase the number of boosters being given, it's feasible that covid could be reduced from pandemic to endemic by spring 2022. He said that covid cannot be eliminated but will always be present in the population to some degree just as chickenpox and the flu are. He elaborated, "To me, if you want to get to endemic, you have to get the level of infection so low that it does not have an impact on society, on your life, on your economy. People will still get infected. People might still get hospitalized, but the level would be so low that we don't think about it all the time and it doesn't influence what we do."

Can the US go endemic while the rest of the world stays pandemic? I do wonder.

The Road goes ever on and on ... Day 111 (611)

The UK's Joint Committee on Vaccination and Immunisation has approved coronavirus boosters for people ages 40 through 49 and a second injection for youth ages 16 and 17. There is already a program for additional doses for people with compromised immune systems. Whether to extend boosters to people under the age of 40 is still under consideration. WHO continues to oppose boosters in high-income countries when so few people in low-income countries have been vaccinated; they have referred to the coronavirus as "a pandemic of poor nations." It's not clear how many vaccinations boosters are directing away from the poorer nations. Fewer Americans than expected are taking advantage of booster doses; the CDC reports that only 36 percent of Americans ages 65 and older have gotten a booster shot. 

Various cities including New York City are facing questions about the future of outdoor dining. For example, before the pandemic, the Bronx had just 30 sidewalk cafes or the equivalent. Now, it has over 650. People complain that such establishments are noisy, attract rodents, and lead to more trash left on the sidewalks. They can also block sidewalks, bike lanes, parking spots, and places where emergency vehicles might idle. In New York City, the Department of Transportation is expected to oversee and enforce a permanent outdoor dining program, and is currently negotiating legislation that might be needed. A permanent outdoor dining program would require approval by the City Council and could not start until 2023. As might be expected, the New York Hospitality Alliance supports outdoor dining. The city's mayor-elect, who takes office on January 1, 2022, says that he also supports keeping outdoor dining but a re-evaluation of the safety and spacing of structures is needed. 

Last year, New York City allowed only front-line workers and their families in Time Square for the New Year's Eve dropping of the crystal ball. All people are welcome this year as long as they are fully vaccinated or present evidence of a negative test in the 72 hours before the event.  Children under the age of five must be with a fully vaccinated adult. The plan is getting mixed reviews. A Columbia University epidemiologist offers, "I would say, 'I'll wait for another year and choose to watch it from home.'" Some major cities around the world have canceled New Year's Eve celebrations outright including London, Munich, and Amsterdam. 

Pfizer will allow its covid treatment to be made and sold inexpensively in 95 poorer nations home to over half of the world's population. Those nations must first approve the use of the treatment. Early data suggest that the treatment may prevent severe covid. Pfizer has halted clinical trials in the US because the results were so good. The company is now asking the FDA for Emergency Use Authorization. 

Yesterday's armadillos may wreak horticultural havoc, but they sound so much safer than the swarm of deadly scorpions in the Nile Delta that has killed three people and put 500 in the hospital. 

The Road goes ever on and on ... Day 110 (610)

Thanksgiving is next week, so articles are starting to appear on how to celebrate safely. One author recommends a "vax-giving," a gathering of fully or partially (as in children ages five through 11) vaccinated people. Children ages four and under would be relatively safe if all other people at the gathering were vaccinated. For added security, those attending might all take rapid covid tests the morning of the gathering. This on-the-spot risk assessment is similar to what is practiced for winter driving. You check the relevant info, take the proper precautions, and prepare as much as possible for the conditions you expect to encounter. With covid, stay aware of local conditions such as hospitalizations and vaccination rates, avoid crowds and gatherings for which you have no knowledge of the vaccination status of other attendees, wear masks, use rapid tests as needed, and ensure that anyone sneezing or coughing stays home. A safe Thanksgiving is all about risk management. 

Over 60 percent of Brazilians are now fully vaccinated, slightly above the 59 percent here in the US. In Rio de Janeiro, 70 percent of people are fully vaccinated, higher than in New York City. It has helped that Brazil has a decades-old immunization program with tens of thousands of permanent vaccination posts around the country. Many states in the Amazon have rates under 50 percent, though, something probably not surprising when many cities there can be reached only by boats. 

Japan tops Brazil, with almost 75 percent of residents fully vaccinated. The number of daily covid cases has plummeted, from over 25,000 three months ago to 202 on Saturday. Tokyo recorded 24 new cases Saturday compared with 15,773 on August 15, just after the Summer Olympics ended. This improvement is astounding given that Japan was one of the world's least vaccine-confident countries.

Austria's new lockdown confines unvaccinated people ages 12 and older to their homes for at least 10 days. A person may leave only for essential reasons including grocery shopping and medical appointments. Violators will face fines between $570 and $1,890.  

The Florida state legislature is holding a week-long special session with the aim of thwarting vaccine mandates. Four bills will be considered to impose penalties on businesses and local governments that require vaccination. Keep in mind that even with 58 percent of Floridians fully vaccinated, the state has the third highest death rate in the country, behind only California and Texas. As for vaccine mandates, there are ways around them if you don't mind possibly getting caught. Several dozen New York City sanitation workers have been suspended without pay for using fake covid vaccination cards. 

A Houston hospital has suspended a doctor for spreading "dangerous misinformation" the hospital said is "harmful to the community." The doctor posted several tweets in which she said she was against vaccine mandates; in other tweets, she promoted the use of ivermectin. Her lawyer has said that she is not against vaccines, just vaccine mandates. The doctor said she was resigning and moving her patients to other hospitals. 

Last year, more Americans than usual got flu shots. Likely because of that and anti-covid measures including masks and frequent hand-washing, flu season was considered "tame." So far this year, though, flu shots are down eight percent from the same time last year, and health officials are worried. Since last year was a low flu year, many people may have less lingering immunity from past years. The good news is that there is still time to get a flu shot. Flu season has yet to begin in earnest. 

And now for something totally different and, possibly, unexpected. Armadillos have now spread to places such as western North Carolina, western Virginia, Missouri, Kentucky, Iowa, and even southern Nebraska. In many of those places they are wreaking "horticultural havoc." Not even rivers can stand in the way of migrating armadillos. They can hold their breath for up to six minutes and just walk across on the riverbed. They can also inflate their intestines and float to the other side. 

Who's with me in wanting to see an armadillo float?

The Road goes ever on and on ... Day 109 (609)

Two-thirds of all new covid infections in the world are happening in Europe. It is the only region in the world where covid cases and deaths are steadily rising. According to WHO, European cases rose seven percent and deaths rose 10 percent over the past week. Dutch towns canceled the arrival of Sinterklaas that would otherwise have been celebrated this weekend. Germany may still cancel its famed Christmas markets. The most likely factors contributing to Europe's status include a low vaccination rate, waning immunity from early vaccinations, growing complacency over masks and distancing, and relaxation of mitigation restrictions. WHO's regional director for Europe notes, "The message has always been: do it all. Vaccines are doing what was promised: preventing severe forms of the disease, and especially mortality. But they are our most powerful asset only if used alongside preventive measures." How bad are things, really? "We've returned to the dark days of the pandemic," according to an Italian doctor. I don't know if the country of Russia is considered solely in Europe or split between Europe and Asia, but it is now the world leader in covid deaths for the first time since the start of the pandemic. 

Three snow leopards at the Children's Zoo in Lincoln, Nebraska have died of covid. They tested positive a month ago. Some Sumatran tigers also tested positive, but they have presumably recovered. The range of animals that get and die from the coronavirus is a bit unnerving. 

Ivermectin and bleach have company in the coronavirus's collection of strange medicines. You can supposedly removed the effects of vaccination via a bath containing baking soda, epsom salts, and borax. It won't remove the vaccine's effects but it won't kill you either, though borax is considered "potentially caustic and harmful." Then there is the practice of "cupping." This has been done for reasons other than counteracting coronavirus vaccines. Some athletes say it can relieve post-workout soreness by increasing blood flow to the "cupped" areas. You hold a jar upside-down over a candle or heat source then place it on your skin (or you have someone else do this to you because I sure as heck can't imagine doing it to myself) so that the air in the jar can cool in to your flesh. It leaves a red circle the size of the cup or jar's mouth and resembling the imprint from a tentacle of an octopus. (I say this having seen the hickey a giant Pacific octopus left on Son #2's arm during a behind-the-scenes visit at the Vancouver Aquarium.)

New York State is opening 10 of its covid mass vaccination sites to children ages five through 11. They hope to expand to include the other three sites eventually. I wonder, though, if kids will be freaked out by the sheer size and "busyness" of a mass site. Most kids are probably used to getting shots in a smaller, less overwhelming location such as a doctor's office, clinic, or drugstore. If it gets the shots into kids' arms,  though, that's what really matters. New York City is setting up clinics in over 200 of its public schools, and would like to take half-day vaccine clinics to each of over 1,000 schools. 

Speaking of schools, school nurses are being put on the front lines facing vaccine-hesitant or pandemic-doubting parents. They have gotten threatened when ordering quarantines for groups of students such as sports teams when one member tests positive. They're just doing their job, enforcing health regulations they didn't set and can't change. 

Finally, New Mexico has joined California and Colorado in expanding booster availability to all adults ages 18 and older. Boosters can be obtained two months after receiving a dose of the Johnson & Johnson vaccine or six months after receiving the second dose of the Pfizer or Moderna vaccine. I imagine that boosters will eventually be available for all adults nationwide, something that will not at all please the WHO.

The Road goes ever on and on ... Day 108 (608)

Six times more booster shots are being given around the world daily than first doses in low-income countries, a situation WHO calls "a scandal that must stop now." It seems that 92 countries, none of which classify as low-income, have approved boosters. I should note that there are boosters and there are additional doses, and the two are not the same. A booster is designed to bolster a recipient's immunity. An additional dose is one given to someone who needs more vaccine than the first shots provided, for example, someone who is immunocompromised. The standard one or two doses don't given them enough immunity; they need more, and that is where the additional dose comes in. I could not help but think, as I read about the disparity between higher- and lower-income countries, if the thought going through some minds is that once we take care of things here or in the other higher-income countries, we can turn our attention to controlling the virus in the low-income countries. I'm too cynical to think that we would do that. If we get the virus under control here, we may no longer care about it in other countries, forgetting that none of us is safe until all of us are safe.

AstraZeneca has been selling its vaccine at not-for-profit prices, something that is about to end. The company will begin pricing their vaccine to make a "modest" profit. Their plan is to progressively transition to a "for-profit" approach while ensuring "the vaccine is affordable for low and middle-income countries." They gave no details as to how they plan or hope to accomplish this. 

A week ago, Austria announced new restrictions on unvaccinated people, barring them from cafes, restaurants, pubs, theaters, gyms, and hairdressers. Guess what. More people are getting vaccinated. The day after the official announcement, almost 40,000 people got vaccinated, twice as many as a week before. Austria has one of the lowest vaccination rates in western Europe with 65 percent of residents fully vaccinated. That may be about to change. 

Los Angeles is putting in one of the strictest vaccine rules in the US, one that sounds a bit like what Austria is doing. Full vaccination will be required for restaurants, theaters, gyms, and other public spaces. The hope is that they can avoid last winter's situation, where one person was dying of covid every 20 minutes. Unfortunately, I don't think it's going to work as well here as it seems to be across the pond. 

Finally, the Oklahoma National Guard has a new commander thanks to the state's governor. The now former commander was a vocal backer of covid vaccination; he was fired and replaced with a vocal opponent of vaccine mandates. The new commander's first act was to order "that no Guardsmen be required to take the Covid-19 vaccine, not withstanding any other federal requirement ... no negative administrative or legal action will be taken against Guardsmen who refuse the Covid-19 vaccine." 

The Road goes ever on and on ... Day 107 (607)

Joyous news on the SARS-CoV-2 front this morning. Not! Scientists have evidence that the virus spreads rapidly in white-tailed deer and that it's widespread in the US deer population. A recent survey of road-kill deer and deer killed by hunters found that 40 percent of the white-tailed deer in the Northeast and Midwest had covid antibodies. One concern is that white-tailed deer could become a covid reservoir, that is, that they could carry the virus indefinitely and spread it back to humans periodically. At one point, the prevalence of covid in deer in Iowa was 50 to 100 times the prevalence in humans there. Genetically, the variants in deer match the variants humans have. Remember the minks from last spring? Minks caught covid from  humans, the virus mutated while in minks, with the variant passed back to humans. It's becoming clear that the viral level of wildlife needs to be monitored. 

The city of Utrecht in the Netherlands has canceled its annual Sinterklaas party; yes, they are canceling Santa Claus. The Netherlands is also about to become the first western European country since the summer to impose a partial lockdown. Bars, restaurants, and non-essential shops must close after 7:00 pm in a lockdown projected to last three weeks. At the same time, Austria is about to place unvaccinated people in lockdown. Germany is offering free covid tests again, and doctors will be given greater financial incentive to vaccinate people. [Off-the-wall observation from the peanut gallery: In the US, we offer financial incentives to the people being vaccinated; Germany offers the incentive to the people doing the vaccinating.] Germany will consider visitors from Austria "high risk" and subject to quarantine on arrival unless they have been vaccinated or recently recovered from covid. Denmark again considers the coronavirus a "socially critical disease." A senior clinical lecturer at Exeter University College of Medicine and Health describes the situation in Europe, saying, "To really control it, it has to be multi-layered ... avoid crowds, avoid poorly ventilated placed, be immunized, wear your mask." A lot of those aren't happening or aren't happening enough. 

Eric Topol, director of the Scripps Research Translational Institute, warns that for the US to avoid a fifth wave of covid we must learn from the current situation in Europe. Europe has a large proportion of unvaccinated people in each country, but this is far from the big picture. Belgium is 74 percent fully vaccinated but has the tenth highest case load in the world. To achieve any sort of herd immunity from the Delta variant may require 90 to 95 percent of the population to be fully vaccinated. Topol offers the following factors contributing to the current European surge. First, European countries were slow to start vaccinating teens. Children and teens have been the driving spread in the US and the UK. Second, vaccines are waning in their immunity against the Delta variant. The AstraZeneca vaccine declined below the anti-spike antibody threshold (it stopped working well) after about 96 days. The same happened after 257 days with the Pfizer vaccine. Finally, Europe relaxed or abandoned mitigation measures too quickly. 

The US thinks that it is immune to what is happening in Europe, but the following factors suggest it is not. Only 58 percent of Americans are fully vaccinated, and a low proportion of those eligible are actually getting booster shots. We were also slow in starting to vaccinating children and teenagers. Mitigation measures have been weakened or ended, and there are very, very few cheap, rapid home tests available. To avoid a fifth wave similar to what is happening across the Atlantic, we must strongly promote primary vaccination and boosters, counter misinformation and disinformation, accelerate and expand vaccine mandates, distribute medical quality masks and home testing kits, and approve and use the antivirals developed by Moderna and Pfizer. Think we can do all that and in time? Neither do I.

Over two million at-home covid tests have been recalled in the US due to a higher-than-acceptable number of false positive test results. At least false positives are better than false negatives. In other words, it could be worse. The chair of the medicine department at the University of California, San Francisco says he has decided to go back to his normal life while accepting the risks of covid. He says the virus will never go away, but it can be a manageable virus similar to seasonal influenza. He says he will again play poker, unmasked, with a group of fully vaccinated friends. He does admit that he might wear a mask in supermarkets or on planes for the rest of his life; such is one way of managing the risk. 

What are your ways to manage the risk? I'm still thinking about mine.

The Road goes ever on and on ... Day 106 (606)

An unlikely side effect of the pandemic is that there is apparently but one color of the year. Paint and other companies each year tout their chosen color for the coming year. It seems that the one for 2022 is a shade of muted green-grey. Here's what different companies call that shade:

            Sherwin-Williams -- Evergreen Fog

            Behr -- Breezeway

            PPG -- Olive Sprig

            Benjamin Moore -- October

            Glidden -- Guacamole Mist      

            Valspar -- Blanched Thyme

How did the different companies come up with very similar colors? One theory is that we all pretty much followed the same routine in the past 18 months, a routine that brought mental health to the forefront. Green-grey is seen as a soothing color, which may be just what we all need right now. One interior designer says that it reflects a renewed appreciation for the outdoors and a sense of harmony and relief. "We're in this moment of cherishing nature and wanting to transfer that inside. Wild, but not risky." To pick the color of the year, companies study lifestyle trends, search engine data, and trade shows. The color chosen must represent the political climate, economic health, social behavior, and the general collective mood. Evidently the companies think that green-grey does this. Behr calls the color "spiritual reemergence." PPG says that it symbolizes "new beginnings in a post-pandemic world."

For reference, here's what the PPG website shows as "olive sprig."

Around the world, Europe had over half the world's covid deaths in the first week of November according to WHO. New cases were highest in Russia, Britain, and Turkey. Berlin is set to ban unvaccinated people from restaurants, bars, gyms, and hairdressers. After five months of silence, Singapore's restaurants and bars can again play recorded music, just not too loudly. Starting on Wednesday, "soft recorded music" will be allowed, though live music will remain banned. It is not clear if "soft" is in reference to the volume of genre of the music. In July, South Korea said that music played at gyms could be no faster than 120 beats per minute. Africa has seen a higher covid fatality rate in people with diabetes, HIV, and hypertension. The prevalence of diabetes has been growing rapidly in Africa, and 70 percent of the people with it don't know they have it. 

The White House has made a deal with Johnson & Johnson and COVAX to distribute the Johnson & Johnson vaccine in conflict zones and other hard-to-reach areas. The Johnson & Johnson vaccine only requires one dose and is easier to store and transport than the mRNA vaccines are. 

A federal judge ruled that Texas's ban on mask mandates violates the Americans with Disabilities Act. At the same time, a court in Pennsylvania struck down their mask requirement in schools. The governor appealed, and the mask mandate remains in place for now. Is it a good idea or a bad one that states determine these things on their own, absent any national oversight? That's mostly a rhetorical question given that I've read the Constitution. 

Some people are evidently saying that the pandemic is over. New flash, folks: It isn't. Looking at the percent change in covid cases per 100,000 people in the last two weeks, seven states saw a rise of over 10 percent: Vermont, New Hampshire, Michigan, Minnesota, Colorado, Arizona, and New Mexico. The per capita rate went down over 20 percent in Alaska and Idaho, and down between 10 and 20 percent in Montana and Wyoming. All the other states stayed pretty much the same. 

I found a covid vaccine tracker that reports on the vaccines that have reached trials in humans. There are 49 vaccines in Phase 1, which means testing safety and dosage. Forty-seven vaccines are in Phase 2, expanded safety trials. There are 41 in Phase 3 which is large-scale efficacy tests. Eight vaccines have reached Phase 4, seeking approval for use. Science working for the public good. Unfortunately, there have been around 100 laws passed that take power away from the hands of public health officials. In other words, the people who know something about science, medicine, and health won't be the ones making decisions in those areas. Be afraid; be very afraid.

The Road goes ever on and on ... Day 105 (605)

More than 360,000 children ages five through 11 have already gotten their first shot of vaccine. They can't be fully vaccinated (two shots plus two weeks after the second) in time for Thanksgiving, but Christmas is likely to be looking up for a number of families. In an October survey by the Kaiser Family Foundation, 27 percent of parents said that they would get their children vaccinated "right away," down from 34 percent in September. Unfortunately, the percentage of parents  saying that they would "definitely not" vaccinate their children went up, from 24 percent in September to 30 percent in October. Black parents were more hesitant than white parents, and families with public insurance and lower incomes were more hesitant than other families. Scheduling is a problem for parents working multiple jobs; some areas are doing vaccinations at schools to work around this. 

Europe continues to be the epicenter of the pandemic even as Europeans pour into the US now that restrictions have been loosened. Germany continues to record record highs, and the disease control center has warned that lockdowns could be needed if vaccinations don't pick up. Hungary just recorded it highest daily total since April, with new cases doubling from one week to the next. Slovakia and the Czech Republic have also reported record highs. WHO's covid envoy warns that we should minimize international travel as much as possible.

Vaccine equity continues to be a problem. WHO warns that it will prolong the pandemic and "could easily drag on deep into 2022." In the UK, 74 percent of the population have gotten at least one dose, 67 percent have gotten two doses, and 15 percent have gotten two shots plus a booster. In Africa, only nine percent of the population have received at least one dose. The per capita vaccination rates--doses per 100 people--for various regions are 

                    133    North America

                    117    Europe

                    113    Latin American & Caribbean

                    110    Oceania

                    107    Asia

                      15    Africa

Not too pretty a picture. To transition from pandemic to epidemic, populations need to build up immunity. Vaccine hesitancy and refusing to wear masks only add to the time scale.

China is doubling down on its zero-tolerance covid policy. In the city of Shenyang, travelers from overseas must spend 28 days in hotel quarantine followed by another 28 days at a residence. The Winter Olympics are getting more interesting every day. Will athletes be required to come some number of days before their event and quarantine with no practice time? Your guess is as good as mine.

On a down note, nearly 80 percent of Americans have been exposed to false claims about covid. The most common is that the government is exaggerating death counts. Three in 10 people weren't sure about the side effects of the vaccines after getting misinformation on that subject. Who is most to blame here? The schools that didn't include enough science education? The students who weren't paying attention? People not willing to step outside some small comfort zone and at least consider something different? There are no easy answers, which is why I fear the "deep into 2022" comment may well come to pass.

The Road goes ever on and on ...Day 104 (604)

Life in the time of covid isn't like life in the time before covid. Sunday night I began to feel as if I were coming down with a cold. Yesterday morning, that feeling became reality, a cold that is kicking my butt much quicker than colds usually do. [Let me say as an aside here that my temperature has been its usual 97F, and I can still smell and taste just fine. Should anything develop that might suggest I have covid rather than a cold, I shall get myself to a testing center ASAP.] Today, I was supposed to have coffee and blueberry muffins with my oldest friend here after which I was supposed to go to a hair appointment. I texted my friend yesterday and told her I did not want to expose her even to a common cold and was bailing on our get-together. This morning, I texted my hairdresser and ended up with today's appointment moved to the end of next week. In pre-covid time, while I would probably still have postponed coffee with someone who is 85 years old, I probably would have kept the hair appointment. Covid brings with it a new set of factors to take into account in terms of things we used to do without thinking.

Americans living in rural areas are now twice as likely to die from covid compared with Americans living in urban areas. Besides the fact that rural areas lag about 10 percent behind urban areas in vaccination, rural populations tend to be older, sicker, and poorer than their urban counterparts. The report I read about this did not detail the rural-urban distinction. I live four miles from the edge of a small city. Is that rural or urban?

A recent survey found that most Americans including two-thirds of Republicans gave their local schools high marks on their handling of covid. Fewer than one in 10 parents said that schools had done a "very poor job." Unfortunately, most Americans feel that the danger from the Delta variant is over, and that sort of thing could come back to bite us. 

Global cases now number over 250 million; together, the US, India, and Brazil account for 40 percent of the reported cases. Globally, four billion people have received at least one dose of vaccine, and 3.1 billion people are fully vaccinated. Starting in early December, Singapore will no longer pay for covid testing for people who are unvaccinated by choice. The government will only cover the costs of tests for children and people who cannot be vaccinated. I guess that's one strategy to try to persuade people to get vaccinated. While the US's vaccine mandate for all businesses with over 100 employees has been put on hold, other countries are pressing ahead. All National Health Service workers in the UK must be vaccinated by spring. Italy and France are also requiring healthcare workers to be vaccinated. New Zealand has added teachers to health and disability workers in terms of mandatory vaccination. Finally, in Canada all workers in federal public service and federally regulated transport sectors must be vaccinated. 

Vermont is recording record numbers of covid cases as colder weather makes people move inside. New cases are up 51 percent over two weeks ago; hospitalizations are also up. One caveat is that Vermont tests for covid more often than most states. St. Michael's College, a Vermont liberal-arts school with about 1,700 students, is seeing its own surge. After recording only 11 cases between August 17 and October 22, the school saw 77 students test positive this week and last week. Halloween parties are suspected of being the source of the outbreak. 

Finally, a couple of sports notes. National Basketball Association champions Milwaukee Bucks visited the White House yesterday. No NBA champion team visited during XPot's term. The team gave POTUS a team jersey bearing the number 46. The New York Times ran an online (and possibly print) story with the headline "Scientists Fight a New Source of Vaccine Misinformation: Aaron Rodgers." Rodgers lost an endorsement deal with a health firm but so far is keeping his endorsement contract with State Farm Insurance. They're somewhat downplaying it, though. On Sunday, only 1.5 percent of their televised ads included Rodgers compared with 25 percent the two preceding Sundays. 

The Road goes ever on and on ... Day 103 (603)

Not all covid death tolls are created equal. The toll reported by Belgium includes all probable covid deaths, while the toll reported by Hungary only counts hospital deaths with a positive covid test. The death count in the UK based on people testing positive for covid is 140,000, while 164,500 death certificates mention covid. Turkmenistan and North Korea have reported no covid deaths, though I would not want to move to one of those two places to try to escape the coronavirus. 

One method frequently used to estimate covid death tolls looks at the number of deaths that occurred over a time period with the number of deaths that occurred in normal times. Even this method has different schools of thought. In the UK, the Office of National Statistics uses the average between 2015 and 2019 as the baseline. In recent weeks, they show many hundreds of deaths. The Institute and Faculty of Actuarials adjust for population changes to get a different baseline. This one yields fewer than 100 extra deaths in the latest week. The Economist built a model to estimate excess global deaths. Under this, the 230,000 covid deaths Russia reports could be four times as large. India's death toll could be 10 times higher than the 460,000 they've reported. 

US vaccination rates are some of the lowest in industrialized countries with readily available vaccines. If the currently blocked national vaccine mandate were put in place, 11 percent of unvaccinated people said they would most likely get the vaccine, while 46 percent said that they would agree to be tested weekly. Over a third, however, said they would just quit. The federal mandate would allow businesses in states with a ban on mandates to have their employees vaccinated. Says a former OSHA head and now a professor of public health, "This actually allows employers to do what they want to do and blame the federal government."

WHO says that Europe in at the center of the pandemic and at a "critical point." Cases are at near-record levels, and 500,000 more deaths are forecast by February. WHO's Europe director is urging governments to reimpose or continue with social and public health measures. He says that even in countries with high vaccination rates, immunization alone can only do so much. Vaccinations are valuable but only if used in conjunction with public health and social measures.

Record high numbers of new cases have recently been recorded in Germany, Bulgaria, and Romania. Latvia, Lithuania, and Estonia are also reporting their highest numbers. The Dutch have reimposed requirements for masks in public spaces and covid passes for museums and other public spaces. Case numbers in Europe and central Asia rose six percent in one week while deaths rose by 12 percent. New cases are surging by 55 percent over one month. Europe and central Asia combined now account for 59 percent of confirmed cases globally and almost half of all deaths. 

WHO estimates that 95 percent universal mask use in Europe and central Asia could save 188,000 of the 500,000 lives forecast to be lost by February. WHO's Europe director notes that "Preventive measures do not deprive people of their freedom, they ensure it." He also said that passes showing proof of vaccination should be seen a "a collective tool towards individual liberty."

At the end of 2020, the per capita death toll was roughly equal for Republican American and Democratic America. The rate in counties in which XPot won 60 percent of the vote was only a few percentage points higher than the rate in counties in which POTUS got 60 percent of the vote. The death toll was higher than either in counties in which neither candidate got 60 percent of the vote. To paraphrase a song lyric that comes to mind from childhood, "and along came vaccines." The slight partisan gap quickly led to a larger gap in death tolls, a gap that has widened now for five consecutive months. The October death rate in Republican counties was 25 per 100,000 people. In Democratic counties it was 7.8 per 100,000 people. 

Travel restrictions into the US ease up today. It will be interesting to see how that all works out.

The Road goes ever on and on ... Day 102 (602)

A federal court has temporarily blocked POTUS's vaccine mandate for businesses with more than 100 employees. This might raise a Constitutional issue. Who has the authority in this case? A Labor Department official claims that OSHA's authority trumps that of the states, but is that correct? Reading about the court action immediately brought the tenth amendment to the US Constitution to mind:

The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people.

So, is the right to issue such a mandate one that would be delegated by the Constitution, because unless it is, it sounds as if each state can do as they please. There is the phrase "nor prohibited by it to the States" in there. If the Constitution does not grant this particular power to the federal government, does it say that the states can't do it? 

Today seems to be a Number Day, or perhaps there just wasn't any new news. On Saturday, there were 411,296 cases and 6,306 deaths worldwide. The most deaths were recorded in Russia (1,179), India (506), and Ukraine (449). Over the course of the pandemic, cases and deaths break down as follows:

                                                        Cases                           Deaths

United States                               46,461,779                    754,279

Brazil                                           21,874,324                    609,388

India                                             34,355,536                    460,791

Mexico                                          3,825,404                     289,674

Russia                                            8,795,095                     246,814

Peru leads the world in deaths per capita with 608 deaths per 100,000 people. Following Peru are Bulgaria with 359, Bosnia Herzegovina with 357, the Republic of North Macedonia with 346, Montenegro with 342, and Hungary with 323. After Peru, it's all eastern European countries that are lagging behind other European countries in terms of vaccinations.

How are deaths and cases spread over continents or regions of the world? The developed areas really are being hit harder than the developing countries.

Latin American & Caribbean

    Deaths:        1,525,388

    Cases:        46,084,819

Europe

    Deaths:        1,424,434

    Cases:        76,202,176

Asia

    Deaths:        876,875

    Cases:        56,130,911

US & Canada

    Deaths:        783,411

    Cases:        48,189,463

Africa

    Deaths:        219,336

    Cases:        8,531,449

Mideast

    Deaths:        209,980

    Cases:        14,024,411

Oceania

    Deaths:        2,906

    Cases:        267,951

Australia

    Deaths:        1,597

    Cases:        just over 180,000

Things are looking up in Australia. Sydney is loosening more restrictions. Fully vaccinated people have no limits on house guests or outdoor gatherings. Cases are down in Victoria. The Northern Territory is about to end a snap lockdown it issued to deal with a small outbreak. Some 80 percent of the country is fully vaccinated. Western Australia will re-open with it reaches 90 percent fully vaccinated. 

Now, in the spirit of the approval of vaccinations for children between the ages of five and 11, a tweet from Big Bird:

I got the COVID-19 vaccine today! My wing is feeling a little sore, but it'll give my body an extra protective boost that keeps me and others healthy.

Ms. @EricaRHill even said I've been getting vaccines since I was a little bird. I had no idea!

In the spirit of the times, though, the tweet has already drawn criticism claiming that Sesame Street should not be political. I try not to get discouraged about such comments, but it's easier some days than others. 

Finally, a reader remembered my comments some months ago on picking out new curtains to go with the same furniture we've always had. Just as I tell people that I do not make heirloom quilts, I do not stage my house. Ease and functionality rule here. The grommeted curtains are so easy to open and close, and the blackout backing on the curtains means we do not also need shades for insulation. Here are the dining and living rooms.

There was also a question about the room filled floor to ceiling with furniture. I'll try to remember to take a shot of it tomorrow. The furniture has been replaced by boxes that don't go quite as high as the furniture did. Most of the contents of those boxes belong to The Sons who say they will go through them someday. I I need to warn them that someday I may want the space in that room and will deal with the boxes myself. Someday will come one way or another.