The Road goes ever on and on ... Day 276 (776)

I just hit "publish" for yesterday's post. Our router is having intermittent problems keeping a connection, and I was apparently not connected when I hit "publish" and shut my laptop last night. It was a long day.

Assuming that the FDA and CDC authorize vaccine(s) for children ages four or five and under, how many parents will take their children to get vaccinated? Under 30 percent of children ages five through 11 are fully vaccinated ("fully vaccinated" means two doses; boosters have yet to be authorized for children), along with under 60 percent of children ages 12 through 17. Fewer than 30 percent of the youngest kids? Let's go with 25 percent at most. 

One of the things I find most interesting about the early-childhood vaccines is that both Pfizer and Moderna say their vaccines work fine in kids from six months to two years and not as well in the rest of the under-fives. Why the vaccines don't work as well in that "in-the-middle" age group intrigues me. Does some sort of biological developing go on then or slow down then that contributes to the effect? Your guess is as good as mine; I hope the new data to be submitted to the FDA in the next little while explains this better.

Cases and hospitalizations are rising in 47 states. It's the first widespread increase since January's Omicron surge. Just a month ago, cases were relatively flat nationwide. That has definitely changed; the good side is that those cases so far are mostly mild. Over 30 states and territories have seen hospitalization rates rise over the past two weeks. In much of the Northeast, the rate has risen by 40 percent or more. That said, hospitalizations are still at one of the lowest points of the pandemic. 

The US is seeing fewer than 400 deaths per day, the lowest daily average since before Omicron, and down 20 percent in the last two weeks. Interestingly, over 42 percent of the deaths in January and February were in vaccinated people, most of whom had not yet gotten a booster. The elderly remain the most at-risk group, accounting for a third of deaths from Delta and two-thirds of the deaths from Omicron. My Mom is still the only resident of her assisted living facility whom I see wearing a mask. She is also one of the only 10 residents and staff members who expressed interest in getting a second booster shot that has yet to be given. I somewhat see the residents without masks and not interested in boosters as being more ready to pass than My Mom. I can't believe it's a devil-may-care, let-the-chips-fall-where-they-will sort of attitude. I think that if it were, I would see more or any, actually, residents smiling. 

The Sons are running a 100K race today, crewed by The Professor. My Brother arrives tomorrow for a visit that will include Mother's Day. I think I'll go do the last bit of straightening up for his visit and then stop to savor the silent solitude. 

The Road goes ever on and on ... Day 275 (775)

Just a few quick notes from a day I did not expect to have. I can't say it was a bad day, just one that felt--still feels--very, very long.

The FDA has said that they should make their decision on early-childhood vaccines sometime in June. It sounds as though they will rule or announce a decision on Pfizer and Moderna together. Some pundits say that is good; others disagree. I just hope the protection lasts longer than in the first studies done. It's one thing to tell an adult to get a shot twice a year (or more often); they will or they won't. But making, well, taking a young child for a shot that often just won't work. 

The Bay Area Rapid Transit in the San Francisco area has reinstated its mask mandate until at least July 18. Bay Area residents in general have been open to wearing masks. People tend to take (and wear) one when offered one.   

The Road goes ever on and on ... Day 274 (774)

A reader commented that my recent mention of Safelite's having replaced my windshield left them with the Safelite jingle as a earworm. Apologies. I've had my own earworm today, Itsy Bitsy Teenie Weenie Yellow Polka Dot Bikini. My apologies if I just shared that one with you.

Dr. Fauci is walking back his comments about the US's being out of the "full-blown explosive pandemic phase," offering, "I want to clarify one thing. I probably should have said the acute component of the pandemic phase. And I understand how that can lead to some misinterpretation." We may be in a different phase, he said, but "By no means does that mean the pandemic is over." He also said that the future may see the need for intermittent vaccinations, possibly every year. I recently had a conversation with someone who said she would gladly get one shot a year just as she does with influenza. More often than that, she said, she probably would skip.

A story popped up last night about South Africa's possibly facing a fifth wave, this one from BA.4 and BA.5. The full extent of such a surge is not yet clear, but cases in one province are doubling every 4.8 days. An infectious disease physician from Mass General Hospital warns, "I would say that the data that's coming out of South Africa by the hour really is alarming ... From a weather report standpoint, we are watching closely, but it does have a bit of a flavor of, here we go again." It's not clear if herd immunity is even possible any longer.

Beijing is closing all city schools indefinitely. No announcement was made regarding virtual learning or studying for exams. Students currently make up over 30 percent of total covid cases. Clusters have been linked to six schools and two kindergartens. The government is trying to avoid the large-scale measures being used in Shanghai and only locking down the districts in which cases are identified. The goal is to test every resident three times this week. Two down, and one to go. Staying internationally, Denmark has stopped its covid vaccination program, the first country in the world to do so. Authorities say that they expect to need to restart it in the fall.

Moderna has asked the FDA to authorize its vaccine for children under the age of six. Data submission should be complete by May 9. At this point, Moderna is only approved for adults; however, the company has also requested that their vaccine be authorized for the six to 11 and 12 to 17 groups. The FDA may consider all three age groups at the same time. 

POTUS still plans to attend the White House Correspondents' dinner. He will not eat and he may wear a mask when not speaking. Everyone attending must show proof of vaccination as well as a negative test within the preceding 24 hours. It is not clear, though, if the same requirements will hold for the servers. Superspreader? You tell me.

The Road goes ever on and on ... Day 273 (773)

Are we there yet, Mom? Dr. Fauci said that the US is "out of the full-blown explosive pandemic phase" and moving into a transitional phase. The coronavirus and covid will always be here in some form on some scale. The White House covid coordinator notes that stopping infections is "not even a policy goal. The goal of our policy should be: obviously, minimize infections whenever possible, but to make sure people don't get seriously ill." I include that quote because it is so convoluted. He should have just said that we will never be able to stop infections and need instead to work to minimize them. The EU says that it is moving out of an emergency phase but still focusing on vaccination, pandemic surveillance, and testing in anticipation of a fall surge. As for the world as a whole, there's still a pandemic going on.

The CDC says that 60 percent of Americans including 75 percent of children had been infected with the coronavirus by February. If this sounds good, keep in mind that natural antibodies do not guarantee protection. The director of the Center for Health Security at Johns Hopkins University advises, "Betting that you are in the 60 percent is a big gamble. For anyone who's not been vaccinated and boosted, I would take this new data as a direct message to get that done or expect that the virus is likely to catch up to you if it hasn't already."

Pfizer has requested FDA authorization for a (first) booster to be given to children ages five through 11. It appears that the FDA might be willing to consider both Moderna and Pfizer vaccines for children ages six months through four years. I wonder what the vaccine hesitancy rate is going to be for that age group. Probably higher than for the five through 11 one, I'd say. 

The Vice President has tested positive pretty much just as her husband is leaving isolation. The Veep will stay away from the White House until she tests negative and was, fortunately, not in close contact with POTUS in the days before she tested positive. This has raised the question of whether POTUS and FLOTUS should attend the White House Correspondents' Dinner. They're expecting some 2,600 people to be there, a total that does not include Dr. Fauci. He declined the invitation "because of my individual assessment of my personal risk." (Does anyone in Washington speak clearly any more?)

Remember the early days of the pandemic, the days of murder hornets and other plaques? The answer to those is mousepox. Researchers are using computer power to study which animal viruses might jump to humans. They program a computer to take in all the information about viruses and how they mutate, spread. etc. They then add information about thousands of animal viruses and wait for the computer to highlight the riskiest viruses. Mousepox tops every list so far. Mousepox was discovered in 1930 and kills mice with "ruthless efficiency." About 250 human diseases have arisen when animal viruses jumped to humans. The best known examples are probably HIV (from chimpanzees) and covid (from bats).

The Road goes ever on and on ... Day 272 (772)

Right before the pandemic started, the first item on my list of big things to take care of was to check with Safelite about getting the windshield on my car repaired or replaced. It had some dings, three of which were spidering. Bam! Pandemic! I finally got around to going to Safelite today. The replacement was supposed to take an hour, but my dinged windshield put up a fight and fought leaving what it thought was its proper place. The time I set aside to write was spent reading at Safelite instead. I hate wimping out so soon after another such day, but that's life for you, or, at least for me. I can say, though, that looking through a clean, dingless windshield while driving home was pretty sweet.

The Road goes ever on and on ... Day 271 (771)

It seems that locking down Shanghai, where there were over 19,000 new covid cases and 51 deaths yesterday, is one thing. Areas of Beijing are being locked down after the discovery of only 70 cases there. Having seen the food shortages in Shanghai, many residents of Beijing are stockpiling non-perishable food. Beijing is testing some residents and workers three times this week. Two other Chinese cities are being locked down, one on the border of North Korea.

The pandemic has changed our lifestyles to the point that builders are redesigning homes to meet those changes. Rooms are becoming smaller to function as offices, playrooms, gyms, and the like. Bathrooms are getting bigger to account for the increased use they're seeing. Houses in general are becoming more like office space. A countertop island in a kitchen or between a kitchen and another room can function as a conference table. Family members meet there then go to their own spaces for other purposes.

Welcome to World Immunization Week! That's all immunizations, not just the ones against the coronavirus. Southeast Asia and the Mediterranean regions are the hardest hit in terms of children missing out on basic vaccinations. Vaccine hesitancy is a spectrum, from rockhard resistance to questioning. This spectrum has, though, become more polarizing and political during the pandemic. A fact about this polarization that I found just fascinating is that in the US, right-leaning voters are less likely to be vaccinated, while in the UK, Tory voters are more likely to be vaccinated. While personal beliefs don't dictate attitude toward vaccinations, those beliefs can serve to harden hesitancy into refusal. 

Health experts put forward steps that can improve vaccine uptake. First are presumptive recommendations. These would include a doctor's saying it's time for a child's vaccination as opposed to asking whether the parent wants to schedule an appointment for a shot. Don't ask, but tell, factually and politely. In motivational interviewing, doctors open a dialog, inviting parents to voice concerns or ask questions. WHO offers the 3Cs of vaccine hesitancy: convenience, complacency, and confidence. All have a definite impact on why a person believes what they do. And sometimes it just comes down to asking people why they are not getting vaccinated or getting their children vaccinated. Orthodox Jewish communities in London initially had low covid vaccination rates not because people opposed or were afraid of the vaccines. They simply did not want to haul children on public transit to vaccination sites across town. When vaccination sites were set up in or near those communities, vaccination rates were no longer an issue.

I read an article today saying that one complication of people returning to the office was the increase in transit crime. The number of incidents may not have gone up, but the rate has risen because fewer people have been using public transit. I openly admit that I spent most of the last two years driving myself only to medical appointments or to visit My Mom. I had to ask The Professor whether it was my imagination that there were more bad drivers out there now. There is one stop light on our way to or from town through which I used to see a car or two cross on red because they were accelerating and almost in to the intersection when the light turned red. I recently saw four cars run the red light full on. That would be four cars (two per lane) crossing on a full read light after the cars that were accelerating to get through as the light was changing. I have had more cases of people cutting in front of me than I can remember having in the years before the pandemic. Are people in more of a hurry now? Do they think if they drive fast enough they can drive out of the pandemic? I hate to tell them, but that's not gonna happen no matter how much they want it to. And The Professor said he could not disagree with my statement about there being more bad drivers now than two years ago.

The Road goes ever on and on ... Day 270 (770)

The different responses of the two Chinas to covid have been interesting. The restrictions in Shanghai have tightened. Some districts that had met the conditions set for the loosening of restrictions have now been told that won't happen. When they say "zero-covid," they mean it. The goal in the People's Republic of China is to eradicate the coronavirus. Busloads of people have been taken to quarantine centers including some outside of the city, centers said to be akin to prisons. Families are being split and sent to different centers. Still, they say there have only been 36 deaths in the past week.

Taiwan, meanwhile, will not go into lockdown as 99 percent of the cases there are asymptomatic or mildly symptomatic. Their vaccination rate is higher than that in the PR of China, with 80 percent of the population double-vaccinated and 60 percent having gotten a first booster. They say they are gradually moving into a "new Taiwan  model" and learning to live with the virus. The premier explains, "We will gradually deal with it and won't be like Shanghai and go into lockdown, but we won't immediately stop wearing face masks and not take anti-pandemic measures." 

Vaccination rates are stalling in most low-income countries. Some public health experts think the momentum may never be re-acquired. WHO's goal was to fully vaccinate 70 percent of the population in every country by June 2022, a goal that will fall well short. Only a few of the 82 poorest countries have hit the 70 percent goal including Bangladesh, Bhutan, Cambodia, and Nepal. Many countries have less than 20 percent of the population fully vaccinated. Only two-thirds of the richest countries have hit the 70 percent goal, not including the US. We remain stuck at 66 percent. The vaccination situation does not look good when one considers possible future variants. 

As readers might have guessed, I'm somewhat paranoid about masking and trying to limit my possible exposure to covid. Today I read a new reason to remain so. An article in the Lancet reports that one year after hospitalization with covid for a cohort of over 2,300 patients, only one in four had fully recovered. I don't like those odds and would hate to add some new members to my family of underlying conditions.

Moving on to the social side of the coronavirus, a survey conducted by the National Literacy Trust showed that early learning suffered as parents talked and read less to children in 2021. A full one-fourth said that they did not chat with their child every day compared with only 10 percent in 2019. Only 53 percent said they read to their child daily compared with 66 percent in 2019. Finally, 72 percent of parents played with their child daily in 2021 compared to 76 percent in 2019. I have to admit that playing with a child might be seen as easier than chatting with or reading to a child, but that's no reason not to do those other two things. Interaction with children dropped even as time spent with children rose. The experts say that children experience frustration at not being able to communicate, which is where the chatting, reading, and playing really matter. Some speech-language therapists currently have waiting lists nine months long. 

The coronavirus gets you coming and going. If it can't hurt you medically, then how about socially. 

The Road goes ever on and on ... Day 269 (769)

I have some coronavirus notes, not many, but some. But having spent the past more than several hours dealing with photos from the quilt show that need to be put on the website, I'm calling time-out of screen time. The photographer did not name the files meaning I've been going back and forth from one thing to another to figure out which quilt is which and who won what ribbon. There are still four quilts to go, one of which I may have found. I'll decide on that later. If I need to email quilters and ask for a photo or description of their quilt, four is much easier to handle than forty.

I hope everyone is having the beautiful weather I'm seeing out my window. I think I'll go enjoy it in person for a while.

The Road goes ever on and on ... Day 268 (768)

Happy Earth Day! If you can't plant a tree, at least say hello to one and thank it for its role in keeping us all oxygenated. Try to avoid single-use plastic anything; those recycling triangles don't mean that an item will definitely get recycled even if it's placed in a recycle bin.

It's been a hard morning on the news-finding front, quite possibly the hardest I've yet encountered. If you think it might be because the pandemic is weakening, you might want to think again. Omicron variants BA.4 and BA.5 have been discovered in South Africa, and they appear to be just as transmissible as other varaints on their Omicron family tree. As proof that an Omicron variant has the potential to evade immunity from a natural infection, a fully vaccinated, 31-year-old healthcare worker in Spain tested positive for covid twice within a three-week period. She tested positive right before Christmas 2021 and again in January 2022. It was not the case that she was just testing positive for much longer than most people do; whole genome sequencing showed that she had been infected by two different variants. In December, she was infected with Delta; in January, Omicron. 

One problem with the airplane mask mandate was that it was being haphazardly enforced. Masks came off for meals and/or drinks and often did not make it back on when the eating or drinking was done. Or the mask made it up far enough to cover the mouth while the nose was free-range. A University of Minnesota epidemiologist said that a mask mandate with as many exceptions as the airline one is like a submarine closing three of its five doors. 

In terms of mask mandates and other public health measures, the following quote jumped out at me: "A central lesson of public health is that people have a limited capacity to change their routine." It's probably human nature, in the if-it-ain't-broke-don't-fix-it vein. If something suddenly does not work, it could be a one-off event. I didn't get the usual kibble after pressing the bar this time, but if I press the bar again ... and again ...

And in China, Shanghai says that it will ease controls on truck drivers. Locking down drivers has hurt delivery of food supplies in particular and trade in general. Hong Kong is ending a two-year ban on non-residents flying in. They must be vaccinated and test negative first. The relaxed measures begin on May 1. They have not said "no" to zero-covid, though, so things could get even more interesting. 

The Road goes ever on and on ... Day 267 (767)

A long day, but I've done all but one of the things I've been putting off not to mention physical therapy (the knee pain is apparently a nerve issue from one hip being higher than the other) and lunch with our financial advisor. I'm starting this later than I usually do, but lunch was more than I usually eat, so dinner may not be needed.

The CDC has asked the Justice Department to appeal the ruling striking down the mask mandate for public transportation. The appeals court has a conservative bent as does the Supreme Court. One concern is that should the case go all the way to the Supreme Court, a ruling against the mandate there could weaken the CDC's authority in future public health matters. A poll conducted by the Associated Press and the NORC Center for Public Affairs Research over five days just before the ruling showed 56 percent of Americans as favoring masks on public transportation. It should not be surprising that there was a partisan divide in those results. Eighty percent of Democratic respondents favored requiring masks on public transit while only 33 percent of Republicans did.

Regional officials at WHO have encouraged everyone to continue to wear masks in public, saying, "Our general advice is that the general public should wear a non-medical mask indoors, or in outdoor settings where physical distancing of at least one meter cannot be maintained."

Growing out of the pandemic, routine childhood vaccinations are way down. This may be due to skipped checkups or unease over the covid vaccine raising unease over vaccines in general. On the school front, chronic absences have skyrocketed now that full, non-virtual instruction is back in force. In one Connecticut district, over 40 percent of students are chronically absent this year. While absentee rates for high-income students are leveling off, rates for low-income students are worsening. Some schools are offering attendance incentives such as gift cards for groceries or gas and adding night classes for students who are working during the day. At one school, the staff member in charge of attendance eats an insect monthly, but only students with perfect attendance can see her do it. One month, the insect was chocolate-covered; in another, it was salted. Neither sounds particularly appetizing to me. 

The Road goes ever on and on ... Day 266 (766)

The gremlins decided to release their control of my Chromebook when The Professor attempted to get it working last night. He did nothing that I had not already tried but since it got me my Chromebook back, I'm not going to complain.

Remember the "if we stop testing, we'll have fewer cases" days? China must; they're doing something similar with the number of deaths. Shanghai has had over 400,000 cases (the population is 25 or 26 million after all) and, wait for it, 17 deaths. Yes, 17, or about four per 100,000 cases. They count cases very narrowly in China. If someone who has a chronic medical condition becomes infected with covid and then dies, the person did not die of covid. They died of the underlying chronic condition. In other words, if there's another remotely possible cause of death, that is the cause of death.

The federal government says that it will appeal the court ruling ending the public transportation mask mandate if the CDC advises that masks are a public health necessity. Because any mandate has now become the responsibility of a business or civic entity, a patchwork of rules is emerging (I cannot take credit for the "patchwork" reference; it was how a traveler quoted in one article described it). For example, a person will not be required to wear a mask on an Amtrak train going into Chicago or New York City, but will need one to board the public commuter rail service in Chicago or the subway in New York City. I wonder how many of the people who dropped their masks into garbage bags held by flight attendants deplaned only to discover they needed that mask for the next leg of their journey. I always carry a couple extras in my purse, but then I would not have removed my mask on the airplane in the first place.

The White House is still recommending masking on transit, but based on what has happened in other countries, going from "compulsory" to "recommended" is heard by most people as "don't bother."

People who have yet to get their children between the ages of five and 11 vaccinated might be interested to know that unvaccinated children in that age range were hospitalized at twice the rate of vaccinated children during the winter Omicron surge. Three fourths of the children hospitalized were admitted primarily for covid. Omicron was on the mild side, though, so children were far less likely to become seriously ill than was the case with earlier variants.   

I learned last night that one of the regular readers of this blog passed away recently. She was a fellow quilter in the group I call my internet quilt guild. I never met her, but she still sent me Martha, the ceramic goose that sits outside my front door with clothes for every month of the year. I forget what remark I made about such geese in a conversation not at all about quilting, but soon thereafter, Martha flew in courtesy of the US Postal Service. Glenda never commented on the blog but told me in email how much she looked forward to it. I'm gonna miss you, Glenda!

The Road goes ever on and on ... Day 265 (765)

It's not my day computer-wise. First, my ChromeBook died. Twiggy, the laptop I bought in 2018 will not keep a connection to the router, so I moved back to Hal, my 2013 laptop. I made the mistake of agreeing to the Windows updates it wanted to install. Some 15 minutes later, it was still restarting from those. I then dug out Hiram, the cheap burner laptop I got to take to Peru in 2017. It's working so far, but the keyboard is teeny (it was a good size for travel but tedious for daily work) meaning I am backspacing to correct almost as much as I'm typing characters forward. 

The court ruling striking down the transportation mask mandate does not mean that a company has to lift any mandate they have put in place. Alas, it appears no US airline wants to keep their mandates. In fact, some announced mid-flight that passengers could remove their masks. Some airlines did say later that masks may still be required on flights to destinations that have mask mandates in place. As of this morning, the airlines that have ended their mask mandates are Delta, American, United, Southwest, Alaska, Jet Blue, Spirit, and Frontier. I'm trying to think of a US airline not on that list and drawing a blank.

Health experts, meanwhile, were not pleased. A pediatrician at Harvard Medical School noted, "I think it's extreme shortsighted and, if I were impolite, would say kind of stupid." Booster rates for seniors and other vulnerable groups remain low, and many members of those groups rely on public transit, meaning the ruling hurts rather than helps them. One physician noted that the ruling limits the government's power to issue mandates during any public health crises, saying, "If this becomes a precedent, that a judge can overrule government and CDC experts, that puts us in a problematic place for the next surge, the next pandemic, bioterrorism, or who knows." He continued, "Should you wear a mask when you're in an aluminum tube shoulder to shoulder with people for six hours? I think you should and I will."

Official covid case counts are up 43 percent nationwide, but hospitalizations are not. Experts are citing three possible causes. First, vaccines and boosters are effective and keep breakthrough infections mild. Second, it is getting easier to get treatments such as Pfizer's Paxlovid. Finally, people may have had covid but not known and afterwards have some extra immunity from the prior infection. The prevalence of home testing also complicates things. As a result, several sources have said that they will concentrate their reporting on hospitalization rather than case counts.

Moderna announced preliminary results for the vaccine they are developing to handle various variants. They hope to have a vaccine candidate with even better results by late May or early June. I wonder if that will be around when the next new, totally unexpected variant appears. A vaccine that can handle Omicron and its subvariants is made and then there's a brand new variant. It could happen.

It seems that in the first year of the pandemic, four Americans were infected with a version of the coronavirus that is found mostly in minks. Two of those people worked at a mink farm; the other two were a taxidermist and his wife. This would be the first known instance of possible animal-to-human transmission, though that cannot be conclusively proved. Mink-to-human transmission has also been reported in Denmark and the Netherlands.

And now the not-so-fun job of proofreading and hoping at least one slightly larger laptop is working for me tomorrow.

The Road goes ever on and on ... Day 264 (764)

A federal judge in--where else--Florida has struck down the public transportation mask mandate including the part that applies to airplanes. I can live with that (still not comfortable flying) as long as they don't say that you can't wear a mask. I would not, after all, be wearing it to hide my identity. I'm just glad they didn't do this weeks or months ago.

China reported 23,460 new covid cases on Monday, of which 22,251 were in Shanghai. Still, China may start to lift the citywide lockdown in Shanghai and implement a "closed-loop management" system under which people live at their workplaces and test frequently. Many people are already doing this. Living in one's office sounds rough, but imagine the Shanghai convention center's being home to 50,000 beds in its new role as a quarantine facility. The lights stay on 24 hours daily, and there are no hot showers. (I'm not sure there are cold ones either.) Testing positive for covid while showing no or only mild symptoms will win you a week in a quarantine facility such as this. 

It seems that fully vaccinated people are more likely to have a breakthrough infection if they also suffer from any psychiatric disorder, though it's only three percent higher overall. Certain disorders carry higher risk. For people over the age of 65, the greatest risks were seen in people suffering from substance use disorder, psychotic disorder, or bipolar disorder. For younger people, risk was highest for those with anxiety disorder, adjustment disorder, or substance use disorder. The study was done retrospectively using data from the Veterans Administration. There were some limitations. For one, the researchers relied on administrative data and electronic health records that could contain errors. The researchers also did not look at the severity of the breakthrough infections. 

The coronavirus may have another victim ... the business suit. With people working from home plus, in the early days of the pandemic, unable to go for personal fittings, suits just aren't as popular as they used to be. In fact, the UK's Office of National Statistics has removed suits from the list of goods it uses to calculate the annual inflation rate. They've replaced "suit" with "formal jacket or blazer." The popularity growth of Casual Fridays had already cut into the popularity of suits; the coronavirus may have sounded its death knell. 

In terms of suits--business suits for men or pantsuits for women--I was quite happy to spend the last quarter century of what passed for my career working from home. I did at various points have suits with skirts, the most recent one obtained over a decade ago to wear to a morning wedding. I never wore it to a funeral, though I have attended several, none of which were from covid I'm glad to say. 

The Road goes ever on and on ... Day 263 (763)

As we move through what many hope are the latter stages of the pandemic, one writer noted that we were entering a choose-your-own-adventure period. Remember IIWTR? Is It Worth The Risk? That's how a lot of us are approaching or are going to approach things. A University of Texas epidemiologist thinks that authorities are not communicating the risk well to the extent that people are saying "screw it" because they're desperate for guidance. Another writer noted that as CDC guidelines loosen or expire, people are being told to contact their physician with questions. That's great as long as you have a regular physician. Not everyone does. 

Back to whether an activity is worth the risk. How should we discuss covid risks? What tools do we have to compare the risk of an infection to the risk some other activity carries? What does it mean to say that an average 43-year-old vaccinated last year is roughly as likely to be hospitalized from covid as a bull rider is to be hospitalized after a ride. How much of a burden is deciding the risk of something on your own? There is obviously a real amount of risk from the coronavirus; in March it remained the third leading cause of death behind heart disease and cancer. Most people don't really see that much risk with the flu. Should we view covid the same? Actually, no. The coronavirus can infect many more people at the same time. With more people more likely to get it, the probability of a not-so-good outcome rises. And let's not forget long covid as a possible outcome. 

Moving from the specifics of the coronavirus to risk in general ... the unit of measurement for risk is a micromort. One micromort is the estimated one-in-a-million chance of dying. Data nerd that I am, I have to share the table below. It's just too good not to share.

MICROMORTS for THE RISK FROM                                                

1            Flying commercially 7,500 miles                                        

1            Driving 250 miles                                                                

4            Motorcycling 25 miles                                                         

5            Scuba diving                                                                         

7            Running a marathon                                                             

10          Skydiving                                                                            

10          Anesthesia                                                                           

100        Driving for one year                                                          

210        Giving birth                                                                       

430        Base jumping                                                                     

1,020     Commercial fishing                                                         

5,000     Active service in Afghanistan in 2011                             

6,600     Baby's first year                                                                

12,000   Climbing Mt. Everest                                                     

19,700   Using heroin for one year    

Obviously, the micromorts for coronavirus are going to be different in different places at different times. Two years ago would have been riskier than one year ago or than now. Or would it? Two years ago it was all about the original virus, no variants but also no vaccines. One year ago, we'd seen some variants but at least some of us were also getting vaccinated. I also look at that list and think which ones I've done. The riskiest would be surviving my first year, but that might have been riskier in 1956 than it would be today. I've given birth (twice), driven, been under anesthesia multiple times, gone scuba diving, not to mention the more driving and commercial flying. Where would whitewater kayaking fall? I've also done that. 

Perhaps tomorrow there will be more specific coronavirus news. But maybe there won't. The Russians appear to be about to take Mariupol, Ukraine, and there were three mass shootings in the US today ... on Easter Sunday. The coronavirus may not be so newsworthy tomorrow. If having it as newsworthy as it once was would undo all that the Russians have done to Ukraine and Ukranians and slow down if not stop gun violence here, I'd take it an instant.

The Road goes ever on and on ... Day 262 (762)

Once we exited the period in which the entire front page of major newspapers was devoted to coronavirus stories (back when it was called the novel coronavirus), it's been harder to find such stories on weekends. The war in Ukraine dominates the front pages now, as well it should, and many inside pages, too. It takes a major development or insightful human interest story to see the coronavirus on the first page or screen now. 

The major news I did find this morning concerned WHO's newly reported calculation of the coronavirus's global death toll. WHO added new information from localities and household surveys. They also used statistical models to account for missing cases. The numbers in WHO's total represent "excess mortality" or the number of deaths more than what is normally seen during that time period. In the coronavirus death total WHO counted people who died directly from covid, people who died of complications due to covid, and people who died not having or having had covid but who had a potentially fatal condition go untreated due to covid. 

WHO's calculation yielded a number more than double the official toll of six million reported by individual countries: around 15 million as of the end of 2021. WHO says these data are essential for understanding how the pandemic has progressed and what steps could mitigate similar future crises.  The sticking point is that India is disputing the calculation of its death toll. It also doesn't want the WHO total becoming public (given that I found the total, it's already public). Over a third of the additional nine million deaths, about four million, are said to have come from India. India maintains that its death toll is in the neighborhood of 520,000.

Some of the members of the WHO committee issuing the report say that India's complaints have actually helped ensure the accuracy of the result. A statistics and biostatistics professor at the University of Washington who helped build the model noted that they had "gone overboard in terms of model checks," and that they had done as much as they possibly could given the available data. I'm siding with WHO on this one. 

The Road goes ever on and on ... Day 261 (761)

Ever done a breath test for alcohol-impairment? Neither have I ... yet (that's Son #2 talking). A covid breath test has been given Emergency Use Authorization by the FDA. The device is about the size of an airplane carry-on meaning it could easily be taken to mobile testing sites or, in the vein of the opening question, an automobile. It's called the InspectIR Covid-19 Breathalyzer. In testing, it correctly identified 91 percent of negative samples and almost 100 percent of positive ones. It works by separating and identifying five compounds; the result comes back in about three minutes. I can't help but think that if this had been available earlier, how many more people might have gone in for testing. Blowing into a balloon is so much less invasive than a giant q-tip up one's nose. Positive tests should still be confirmed by the PCR test's giant q-tip, but negative tests are good to go.

Remember herd immunity? That utopia or nirvana we talked about reaching earlier in the pandemic? That's now just a dream. We aren't going to get there. Says Dr. Fauci, "The concept of classical herd immunity may not apply to Covid-19." This means we are not going to be without SARS-CoV-2 in the population for an unknown period of time. Using measles as an example, it takes three things to eliminate a disease. First is an extremely effective vaccine. Second is a virus that does not mutate. Finally, there has to be a successful childhood vaccination campaign. Despite having all three in respect to measles, WHO warned in 2019 that measles could become endemic again if enough people refuse to get vaccinated. 

Looking at those factors in relation to covid, well, the vaccines we have at least in the Western world seem to be effective though we're still working out the booster picture as well as a vaccine dose for children under the age of five. The measles virus may not mutate, but the coronavirus certainly does. We've had five variants important enough to have recognizable names: Alpha, Beta, Delta, Omicron, and BA.2. As for a childhood vaccination program, that won't come until there's a successful adult vaccination campaign. A parent who won't get vaccinated won't vaccinate the children in the family. Also, covid vaccines do not create sterilizing immunity in which the immune system eliminates the infectious particle before infection begins. Vaccinated people can still transmit the virus.

Have a good weekend! That sentiment doesn't mean I won't be posting tomorrow, though. Any coronavirus news I can't find can be replaced by war or weekend news.

The Road goes ever on and on ... Day 260 (760)

Children ages five through 11 may soon be able to get boosters six months after their second dose. Pfizer has asked the FDA for emergency authorization to give such shots. In testing, the booster raised fighting antibodies by 36 times. Antibodies were six times higher one month after a booster than they were one month after the second dose. 

Boosters might be the way to go if the current surge continues, 86 percent of current cases are of the B!.2 subvariant, At the same time, though, there are two new subvariants of Omicron that have been found in New York and could be contributing to the surge. Called BA.2.12 and BA2.12.1, they supposedly accounted for over 70 percent of the new cases in central New York state in March and account for 90 percent of the current cases. They do not appear to cause more severe disease, though they could have a growth advantage of 25 percent over BA.2. It is not clear if these two spread more quickly because they are more contagious or have an improved ability to beat immunity. Unfortunately, one subvariant has a mutation that has been shown to help dodge immunity.

In the opinion of one public health expert, the current climate is "what the beginning of surges have looked like" before. She notes that we are at a key point. "If we take decisive action to reduce the transmission, they we will reduce case growth.... and if we don't, then we're really leaving it to the virus to decide what's next." And from me, if testing continues to drop off as much as it has lately, we'll have no real notice when a new variant rears its ugly head. Forewarned is forearmed after all. 

Almost 400 million people, or about one third of the population, in China are under some form of lockdown. If you want an iPhone, buy one now. Two of the factories making them have stopped production. Shanghai's lockdown has led to an extreme food shortage. There have been street fights over food. This is causing people in other cities such as Beijing to begin to stockpile food. Hong Kong's wave is lessening, and some restrictions are easing. Social distancing will no longer be required. Restaurants may now stay open until 10:00 pm rather than 6:00 pm. Four people can gather in public rather than the current two. Gyms, museums, theaters, beauty salons, gaming arcades, and religious venues may reopen. Bars, however, may not. There's always something. 

The Road goes ever on and on ... Day 259 (759)

We passed a milestone yesterday, and it's not a good one. The official world count of infections was 300,000,000 in early January 2022, and 400,000,000 in early February. Yesterday, April 12, total infections passed the half billion mark, 500,000,000 for those who like to see digits rather than letters. As we all know by now, the true number is more than a bit larger. That undercount is only going to get worse as countries, including the US, scale back testing. An epidemiologist formerly at CDC and now at the University of Washington notes, "That's dangerous. If you don't test, then you don't know what variants you have." Elaborating, he notes, "What's happening globally and in the US is that people basically gave up. They just want to go back to normal life." With restrictions eased and the BA.2 subvariant out there and testing decreasing, there will be lots more cases detected and, regrettably, lots more cases missed.

As pandemic restrictions are eased and people go out more frequently, pedestrian fatalities are on the rise. Comparing incidents occurring between January and June 2021 with those occurring between January and June 2020, pedestrian fatalities were up 17 percent nationally. The biggest state increase was in Maine, with 2021 up 200 percent over 2020. In the opposite direction, Nebraska was down 67 percent. Only 10 other states showed any sort of decrease: Hawaii, Rhode Island, New Mexico, Missouri, Virginia, North Carolina, Delaware, Connecticut, New Hampshire, and Kansas.

POTUS has announced that the federal state of emergency due to the coronavirus pandemic will last at least another 90 days. The CDC plans to extend the federal transportation mask mandate for 15 additional days, until May 3. Given the mask mandates coming back, this is probably a good idea. Yes, it will make some people angry, but they were probably already that way. Catching a possible surge before it starts is the only way to avoid it. 

More companies are instituting hybrid working arrangements in which employees shuttle between a home office and a "real" one. The effect on a city's economic climate may be significant. The average New York City office worker before the pandemic spent $13,700 connected with their time in the office--commuting, eating lunch, dry cleaning, and more. Under new arrangements, that amount is projected to go down by $6,730. Some companies are adding incentives to get employees to sign on to an RTO or return to office. The company for which Son #1 works closed their physical office at the start of the pandemic and has no plans to reopen it. Most of the staff already was working remotely. 

A couple of quick ones: Australian citizens and permanent residents may now go to New Zealand. New Zealand has abandoned its mask mandate in many settings and is encouraging some businesses to return to the office. Prime Minister Boris Johnson and his wife have been fined in connection with the parties they hosted or allowed to be held at their residence during the lockdown period. On a more serious note, 200,000 US children may have lost a parent to covid. In many cases, grandparents have stepped in to fill the gap in some cases abandoning their plans for retirement. 

The Road goes ever on and on ... Day 258 (758)

Ready for a new variant or two, something to follow Omicron XE aka BA.2.2? It seems that new Omicron subvariants so far known as BA.4 and BA.5 have been detected in South Africa, Botswana, Belgium, Germany, Denmark, and the UK. The good news is that so far there have been no major spikes in cases, hospitalizations, or deaths in South Africa, where these subvariants have been the longest.

The situation in Shanghai gets a bit dicier. The US has told all nonessential staff members to gather their families and leave Shanghai "due to the ongoing Covid-19 outbreak." Last week they were told they could leave; now they are being told they must leave. One concern is that China separates parents and children when a positive case is found within a family.

On the home front, things could be getting dicier as well. Philadelphia is the first major city to reinstate an indoor mask mandate in response to a sharp increase in cases. Cases rose almost 70 percent in 10 days; the threshold for reinstating the mask mandate is 50 percent. One concern is that if they don't act now, as cases continue to rise so will hospitalizations and deaths. The mask mandate ended on March 2; the city will start enforcing the new mandate on April 18. New York City is averaging three times as many cases daily as they were in early March when restrictions were eased.

Some universities are reinstating mask mandates. American University will require masks in all campus buildings; professors may remove masks in order to teach. Columbia University will require non-cloth masks in classrooms for the rest of the semester. At Georgetown University, masks are required in any campus building until further notice. Johns Hopkins is going big-time. Masks are required indoors, and students will be tested twice each week. Almost 100 students have tested positive there since April 1. Rice University will require masks in classrooms regardless of vaccination status; unvaccinated people must wear masks in all indoor areas.

It is not clear how long the surge happening in the Northeast will continue and how high the peak might get. A Harvard epidemiologist describes it: "There's definitely something coming but depending on all the moving parts, it might be a ripple relative to previous waves." The new White House covid response coordinator says that he doesn't think we have to be "excessively concerned." Another writer suggests that this surge could be our first "so what" wave, "a surge it cares to neither measure nor respond to." The next couple of weeks will be interesting ones. We should remember, though, that "may you live in interesting times" is actually a curse.

The Road goes ever on and on ... Day 257 (757)

I survived the weekend, though my fatigue level says I'm still in recovery. As I read that the number of positive covid tests to come out of the Gridiron Club dinner is up to 72, I can't help but wonder if covid was lurking in the crowds at the quilt show. At any one moment, I could see only three or four other people wearing masks, and some were of the cloth kind that offer little real protection. A person who saw me Saturday morning said my mask was inspiring her to put hers on. I guess she didn't want to be a loner. Two years until the next quilt show; I'll likely have recovered by then and hope not to be wearing a mask.

As I said, the Gridiron Club dinner covid count is up to 72. A third Cabinet member is among them. The mayor of New York City has also tested positive. He was at the dinner but also attended other events at which he might have been exposed. The 72 accounts for about 10 percent of the people at the dinner. POTUS was not at the dinner, though the number of people around him who have tested positive continues to increase. Asked about the possibility of POTUS's becoming infected, Dr. Fauci said that the covid protocols protecting POTUS are "pretty strong."

Mask-wearing is at its lowest level since April 2020. Meanwhile, a new report suggests that of every 100 covid cases, only seven are recorded in official tallies.  The associate director of global health policy at the Kaiser Family Foundation offers, "We're fighting smaller fires instead of a raging blaze across the country and those smaller fires can be disruptive. It leaves everyone to choose their own adventure when it comes to pandemic response and individual behaviors." I don't mind if I do ... continue masking, that is.

The covid surge in China continues. Guangzhou, a manufacturing center, is closing to arrivals and moving elementary and middle schools to virtual instruction. The entire city will be tested. For now, people can only leave the city if they have a "definite need" and test negative before they leave. Shanghai is starting to reopen even as cases there continue to rise. "Appropriate activity" will be allowed in neighborhoods in which there have been no cases for at least two weeks.  

A study of breakthrough Omicron infections found the viral load to be lower in people who had gotten boosters. There was no difference in viral load, however, between people who had been vaccinated but not boosted and people who had not been vaccinated. In other words, boosters make a big difference.

The Road goes ever on and on ... Day 256 (756)

Today is looking busier than I thought, so take a break from the coronavirus. I'm just trying not to wonder if a quilt show could be a superspreader.

The Road goes ever on and on ... Day 255 (755)

The quilt show has started, and hopefully at least the raffle table is going well. My phone has not rung with questions, so there have been no issues serious enough to get a ruling from the Raffle Czarina.

Quickies: Last weekend's Gridiron Dinner of political bigwigs has now produced 53 positive covid tests. There were around 700 people there, though about 50 were working, not sitting at a table.

The State Department is allowing non-emergency US government employees and all family members of US government employees to leave Shanghai. The strict lockdown there continues as cases continue to rise.

The Professor and I went to an iftar last evening. An iftar is the post-sunset meal during Ramadan. I think there was surprise that this non-Muslim knew the five pillars of faith for Muslims; I explained that a very good friend is Muslim. Related to the Muslim faith, Saudi Arabia will let one million foreign and domestic Muslims travel to Mecca for Hajj. Only 1,000 Saudis were allowed in 2020, and 60,000 Saudis, in 2021. Pilgrims must be vaccinated, under 65, and test negative within 72 hours of departing for Saudi Arabia. The number of pilgrims from each country will be capped and based on quotas and other health considerations. 

And that's it for today. If I move the laundry to the dryer now, I may be able to get it out and folded before I have to leave for an afternoon shift at the quilt show.

The Road goes ever on and on ... Day 254 (754)

Dr. Fauci hasn't said much lately or not much has been reported about what he has said. He's saying now that cases could rise over the next few weeks (which indeed they are as will be discussed  in the next paragraph) and a surge in the fall is "highly likely." He cites the waning of immunity (got my second booster this morning!) and relaxation of restrictions (I'll be wearing a mask at the quilt show) as major factors. 

It seems that the caseloads across the US are evening out and starting to rise. Swift rises are the case in Washington, DC and New York City. More moderate rises are happening in Alaska, Vermont, Colorado, Rhode Island, and New York State. Every mention of caseloads that I see has a caveat, so let me cite it here. With the growth of home testing, any caseloads reported are undercounts. This means any rises seen are likely going higher and faster. 

The list of politicos testing positive continues to rise. So far POTUS and VPOTUS (or would that be plain old VICE?) are testing negative. So far, we're talking at least four members of the House of Representatives including the Speaker, at least one Senator, two Cabinet members, FLOTUS's press secretary, and POTUS's sister. The sister is not really a politico, but we'll go with guilt by association or relation.

Three local officials in Shanghai have been fired in response to the growing covid wave there. When the Chinese government says "zero covid," they mean "ZERO covid." The lockdowns that started out as having fixed end dates no longer seem to have any. Residents are running low on or out of food. While groceries can be delivered by phone order, the day's allotment runs out very quickly.

A federal appeals court reversed an earlier decision that blocked the White House from requiring federal workers to be vaccinated. Two steps forward and one step back?

Finally, US life expectancy has fallen for the second year in a row. The overall expectancy is now 76.6, the lowest in at least 25 years. Personally, I'm hoping I have more than ten years left in me, but that's all I'll say to avoid jinxing myself.

The Road goes ever on and on ... Day 253 (753)endemic in the US by

I was pleasantly surprised to see the results of a recent poll showing that 59 percent of the respondents thought "people should continue to wear masks in some public places." Most Americans say that the way they conduct their lives is still affected somewhat by the pandemic. Forty-two percent say that they are now doing some but not all of the activities that they did before the pandemic. On the flip side, 17 percent say they are doing very few. The other 40 percent say that they have basically returned to normal (27 percent) or never changed their activities (14 percent). I won't go in to how these relate to political party affiliation or governmental philosophy.

Thinking about the concept of returning to normal, it's really not clear what endemic covid might look like. The basic definition of "endemic" is that the disease has a constant, predictable, or expected presence; it is a disease that persists. Some endemic diseases infect millions and kill hundreds of thousands. Some can be treated and vaccinated against. An endemic disease is by no means harmless. Endemic diseases must be watched carefully; they could become epidemic again. Malaria is considered endemic. The common cold and influenza are endemic with seasonal epidemics. The mitigation measures we took against covid also protected us from colds and flu. HIV is endemic in the US but epidemic in some subpopulations. "Endemic" has nothing to do with an "end." Living with and managing a disease that has not been or cannot be stamped out is all about control. There is general agreement that covid cannot be eradicated; an endemic state could be a yearly Omicron-like wave of cases or even deaths. That's the "predictable" or "expected" part of the definition above. We know it's coming and we know when.

Covid cases are rising in half the states even as the nationwide total is falling. New York, Massachusetts, and the District of Columbia show increases above five percent, led by New York's seven percent. Idaho, Kentucky, Arkansas, and Texas are down over five percent, led by Arkansas's 18 percent, 

There are a couple of interesting--at least to me--new research findings being reported. A publication in the British Medical Journal shows a five-fold increase in the risk of deep vein thrombosis and a 33-fold increase in the risk of potentially fatal blood clots in a lung in the 30 days after becoming infected. This puts the small risk of clots associated with vaccines in a new light.

Preliminary work to be presented at the annual meeting of the American Academy of Neurology reports a "inflammatory signature: in people having brain fog 10 months after they had covid. These people show high levels of two inflammatory markers--c-reactive protein and serum amyloid--and an overstimulated immune system. It may be triggered by ongoing vascular injury and repair. There was brief mention that these neurological or immune responses seem to happen more often in people who had mild cases of covid. I can't help but wonder if those cases were mild because the immune system shifted into overdrive but then couldn't slow down after the checkered flag.

The next three days are going to be busy ones. I may just be reporting on one or two things I read first thing in the morning. The quilt guild to which I belong is having its biennial show this weekend; tomorrow is setup day, with the show the next two days. On Saturday evening, I'll bake the German chocolate cake for Sunday's joint birthday celebration for The Professor and Son #2. I expect fun will be had and there will be laughter.

The Road goes ever on and on ... Day 252 (752)

The big thing in what I've read today is coronavirus surges or waves. Questions such as why are cases of the BA.2 Omicron subvariant surging in Europe and not in the US? One argument is, of course, the addition of the word "yet." Some experts say we're not yet at a stage to "trip alarm bells." BA.2 currently accounts for 70 percent of US cases, just a bit above the proportion from which other countries took off. We may get there ... yet. Four reasons were cited to explain the current difference in surges between Europe and here.

First, Americans may have more immunity. It looks as if 45 percent of Americans have had covid from Omicron, which would strengthen their immunity against the variant. Our slower vaccination rate means that more people here have probably gotten covid if only asymptomatically and have natural immunity rather than immunity from vaccination. A Harvard epidemiologist described Europe as "covid averse" in that more people have been vaccinated with the intent of avoiding acquiring covid. The US, on the other hand, is "covid curious" leading, perhaps not intentionally, to higher covid rates. The same epidemiologist thinks that cases will soon rise here but will not get as high as they have in Europe. 

Second, take it from the former President, "If we stop testing, we'd have fewer cases." Who would ever have thought that that was a serious statement. Over the last few months, testing in the US has become more and more at-home. People who test positive but have no or only very mild symptoms may not report their result. With the end of testing paid for by the government, some uninsured people may not be getting tested at all. 

The final two explanations cited were short and sweet, such as "just wait." If 45 percent of Americans have had Omicron, 55 percent have not. Immunity, either from vaccination or having had the virus, only lasts so long. Finally, "another mystery" in that there is likely more we don't know about the coronavirus and its variants than we do know. The authors noted that cases are likely to rise, but that statement is less certain now than it was a few weeks ago. 

In terms of counts, whether rising or falling, national numbers are too big to draw any real conclusions such as which region or state needs more support. Any national map of where the virus is moving is going to be full of holes. Wastewater monitoring is only being done in some cities or states, not in all by any means. It is probably worth acknowledging what one expert said which is that there can be a good side to a surge or wave. It might be the impetus some people need to get vaccinated. Using case numbers as an indicator is also troublesome given testing and counting issues. Hospitalizations and deaths, while lagging indicators, are not going to have the missing data case numbers do.

Finally, a peculiarity of a wave--or no wave--may be less about the virus and more about how we do or don't respond to it. Human actions such as mitigation measures can slow the development of cases. They can also accelerate them as with the removal of mitigation measures. How many balls (or chainsaws) can a juggler keep up at a time? I would rather not find out given what happens when one, especially a chainsaw, finally drops.  

The Road goes ever on and on ... Day 251 (751)

It looks as if another federal covid aid package will be approved. The deal in the Senate is for less than half the amount requested by POTUS but does offer enough to maintain testing capacity and continuing ongoing research. It specifically does not cover global aid nor would it continue a program of testing, treating, and vaccinating uninsured Americans. Part of the total amount will use unspent funds from the March 2021 aid package. 

The CDC will undergo a month-long comprehensive review and evaluation with the aim of modernizing its systems and processes and changing for the future. The program's announcement contained some great examples of business-speak. The review will "solicit suggestions for strategic change." After the "collective effort," the agency will develop new systems and plans for how it should be structured. And in the best one I read, the goal is to find "new ways to adapt the agency's structure to the changing environment." I read that and immediately posed the question (to myself) of whether a bureaucracy, especially a federal one, could change fast enough to keep pace with changes in the environment. The proposal noted that the CDC's infrastructure has been neglected for decades and that "never in its 75 year history has CDC had to make decisions so quickly, based on often limited, real-time, and evolving science."

After 750 days or just one day less than I've been writing this blog, South Africa is ending its national "state of disaster," otherwise known as a "state of emergency." "The end of the national state of disaster is a firm statement of our determination to live our lives and rebuild our country, even as this virus remains in our midst." Sounds like the "live with the virus" coming out of a growing number of other countries. Just over a third of the South African population is fully vaccinated. While this is a high rate for Africa, it is not at all up to the level of most developed countries. Looking at vaccination as well as recovery from covid, 60 percent of the population have some form of immunity. In recounting the state of disaster, one article noted that early on there were limits on the types of clothing and footwear that could be purchased, a policy intended to keep people from leaving their homes. I'm having trouble wrapping my head around that one. 

A short post but one that means I don't need to feel pressure to write something when I get back from the orthopedist about my knee. I really hoped I would not see the othopods again for a year, which would be my replacement right knee's fifth birthday. In the meantime, wrap your head around the fact that The Professor asked for a German chocolate birthday cake and neither the (in)famous Joy of Cooking or the Good Housekeeping Cookbook had a recipe for one. Betty Crocker did, though, have one online. Guess what I'll be doing Saturday night after a day at the quilt show. We'll have a joint birthday celebration for The Pofessor and Son #2 on Sunday evening ... after another day at the quilt show. 

The Road goes ever on and on ... Day 250 (750)

Having a good day? Need something to distract you though perhaps not in a good way? I'll start with the last item I found before taking The Family Dog for her afternoon walk, a walk that took longer than usual because of the number of Nice Day Drills she did. A Nice Day Drill is when the dog lies down the better to savor the breeze or other weather.

A new covid variant has been found in England and China. It's being called XE in England and Voc/Omicron variant BA.1.1 in China. It's a recombinant form of BA.1 and BA.2 and unidentified in previously found strains worldwide. There are 637 cases so far in England. The early growth rates are not significantly different from BA.2. There's not much data so far, but some suggest that the growth rate of the new variant could be 9.8 percent above that of BA.2. So far, though, there haven't been enough cases to draw conclusions about transmissibility, severity, or vaccine effectiveness. When that information does come out, I'll let you in on it.

China is sending 2,000 military medics and 10,000 medical workers to Shanghai, where there have been over 60,000 cases in the last month. There were 9,000 on Monday alone. Those numbers may not seem large when compared to some other cities, but in zero-covid China, they're humongous. Taiwan, meanwhile, is relaxing restrictions in the middle of an outbreak. They've shortened the quarantine period for people testing positive or in close contact. Borders are still open only to international business travelers, though. 

The top groups hit hard by the pandemic are older people, residents of nursing homes, and diabetics. The last group accounts for 30 to 40 percent of all covid deaths. Diabetes impairs the immune system but also has risky underlying conditions such as high blood pressure and obesity. Diabetics in ICUs are more apt to be intubated and more apt to die. Thirteen percent of American adults have diabetes, offering the coronavirus a nontrivial number of potential patients.

The UK has expanded their list of covid symptoms from three to a dozen. The three that were (and remain) on the list are fever, new and persistent cough, and loss of or change in taste or smell. The nine new ones are shortness of breath, feeling tired or exhausted, aching body, headache, sore throat, blocked or runny nose, loss of appetite, diarrhea, and feeling or being sick. I don't know about you, but those sound quite general to me. They do come with the note that "the symptoms are very similar to symptoms of other illnesses, such as colds and flu." The lead scientist of the Zoe Covid-19 symptoms tracker app adds, "Pity they have the order wrong, but it's a start and could help reduce infection." 

Maybe it's not a bad thing that a new variant may be cropping up just as restrictions are being relaxed en masse. It's a reminder of why we had those restrictions in the first place and may need them again. And it makes me feel better about that second booster shot on Friday.

The Road goes ever on and on ... Day 249 (749)

Any coronavirus news was good news today; it distracted me from the genocidal images coming out of Ukraine. Even the verbal descriptions of the images sickened me. I am at a loss for what little I can do to help. We have donated generously to several humanitarian efforts, but what I'd really like to do is help pay for whatever weaponry can hurt the Russians the most. The Professor made an interesting comment about the fact that in the very early days of World War II, German soldiers had to be ordered to commit atrocities such as mass killings. I wonder if the Russians had to be commanded or did it willingly.

Okay, back to the pandemic, the other matter of global importance I feel powerless to help. I read a quick blurb that noted that in Massachusetts, the case incidence rates right now are higher in wealthier suburbs with higher vaccination and booster rates. This seems a bit counter-intuitive until the point is made that the wealthier suburbs are dropping pandemic precautions faster than lower-income areas are. I wonder if there's a sense that financial security itself offers additional protection. 

In the vein of "I never would have thought of that," the pandemic has led to a shortage of surrogate mothers meaning, among other things, that the price to be one is rising. One issue is vaccination. A potential surrogate may not want to be vaccinated, but vaccination might be a requirement of the parents-to-be. The surrogacy contract may now contain other conditions such as crowd avoidance. As travel becomes safer, many potential surrogate mothers may not want to commit to the nine months to one year that surrogacy requires. Finally, as if the other bits weren't interesting enough, by some estimates the largest surrogacy hub in the world is Ukraine. Right now it is said that there are around 20 surrogate-born babies hiding with in Kyiv with the nannies who, were it not for the war, would be taking them to their future homes.

In Massachusetts and other states, protests against pandemic precautions are still happening outside the homes of local and state government officials. Nova Scotia and Alberta in Canada are seeing similar protests. Protesters outside the home of the Boston mayor have called her "Hitler" and yelled to her children that their mother should be in prison.

The British government has shut down or cut back its covid surveillance programs. The data from these were used by the US and other countries to track the emergence and strength of variants as well as the strength of vaccines. As covid monitoring systems become weaker, it will be harder to predict new surges and assess new variants as they emerge. The key to tracking change in Britain has been the testing of thousands of people randomly each month. This turns out to be the most rapid indicator of the appearance of new variants. 

An average of 11,860 Americans were hospitalized with covid in the past week, the lowest value since 2020 and down from a peak of over 145,000 in mid-January. The previous low was 12,041 in June, before Delta took hold. 

Finally, a little food for thought from an Irish researcher: "For us, living with Covid  does not mean ignoring Covid." As much as we might wish we could, there is no ignoring either the pandemic or the war.

The Road goes ever on and on ... Day 248 (748)

It's been another slow day on the coronavirus front. I'd count that as a positive except for the fact that the first stories I found were about mask mandates not being relaxed as announced or being reinstated if just for a few days. With cases rising in New York City, the mayor announced that the mask mandate for children under five--too young to be vaccinated--would stay in place. In early March, there were around 500 daily cases; now, there are around 1,250. Public health officials note that the number may be much higher due to the use of home tests and not reporting positive results. On the side of good news, January saw an average of 1,000 daily hospitalizations; that 1,000 is now down to 13. 

Two New Jersey high schools are reinstating mask requirements for at least a few days. Cases in New Jersey have risen 45 percent in two weeks, and the governor this week tested positive. There were 74 cases in one school. The same school had a classroom with five cases go virtual yesterday and Monday. I was pleased to see this response to increasing cases. When it comes right down to it, masking and distancing are probably the easiest mitigation measures to implement. Other measures such as capacity controls or event cancellations may not be needed if masking and/or distancing work.

Two new studies published in the Lancet suggest that covid vaccines provide significant protection for previously infected people. One, conducted with 22,000 patients in Brazil, showed the vaccines as providing protection against symptomatic reinfection and severe outcomes such as hospitalization or death. The second, done in Sweden with almost 3 million patients, shows vaccines offer additional protection for at least nine months. Both studies do have some limitations, the principle one being the risk of bias due to the observational nature. Further, neither study included reinfection with Omicron.

I've been thinking back and forth about the whole second booster question. Get one now, almost six months out from my first booster, or wait. It's not as if The Professor and I have any plans for a summer trip that might suggest getting the booster right before. Checking several references that suggest the effectiveness of the first booster is pretty gone after six months, and reading several sources I've come to trust doing this whole blog thing saying that they were going to get the second booster six months after the first, I decided what the hey. The earliest appointment available was not until the coming Friday, but I took it. I decided to spread the immunity wealth and am going with Moderna this time. Also playing into getting the booster now is that some sources say that by the time an Omicron-directed vaccine comes out, we may be well past Omicron and working on entirely new variants.  

The Road goes ever on and on ... Day 247 (547)

A Facebook friend posted that she just got her second booster. Wow! Besides waiting a bit, I'm looking into mixing mRNA vaccines. It seems that the Pfizer and Moderna vaccines affect the immune system in slightly different ways, and mixing the two  might increase one's range of immunity. Another Facebook friend mentioned that he'd gotten a Moderna first booster after two Pfizer doses for the same reason. Maybe I'll go for Moderna for my second booster. I'm still going back and forth on the when part. I got my first booster early on and ended up nervous that I'd gotten it too soon for it to be maximally effective once Omicron hit. 

In a similar vein, The New York Times today had an article on seven steps to prepare for the BA.2 wave that might be looming. The first recommendation was to pay attention to local indicators. I therefore checked how my county is doing and learned that the risk level has risen to medium from low. We currently have 394.22 cases per 100,000 people; 83 new hospital admissions per 100,000 people; and 2.4 percent of staffed beds occupied by covid patients. The second recommendation was to have high-quality masks on hand. With mask mandates falling, it's going to be up to individuals to have their own supply, which I do. Further advice was to start masking when the case numbers start to rise not after. Third, have home tests on hand. Fourth, get a booster when eligible to get one. I've already got the fifth one covered--get and use a pulse oximeter. If the reading gets down to 92, you might be in trouble. Have a plan for where to get anti-viral drug treatment if you need it, and have backup plans for social events and travel. 

Congress appears on track to passing a coronavirus response package but only after cutting five billion dollars in aid for the global vaccination effort. Voting may not be for a couple of weeks, so perhaps they'll find a way to keep the global good in play. As the Speaker of the House noted, "This is shameful--we have to get the money. Everyone knows that none of us are safe until all of us are safe."

The land border between Malaysia and Singapore has reopened after being closed in March 2020. In 2019, it was one of the world's busiest border crossings with over 300,000 travelers going through daily. Full vaccination is required for all people ages 13 and older. Limited travel re-started in August 2021, requiring testing and quarantine. Travel re-opened further in November 2021, with full vaccination and testing but no quarantine. A reservation was also required to go through the crossing. 

According to a CDC report, states are far short of public health workforces needed. Public health workers across the country may be less equipped to respond to a pandemic now than they were at the beginning of 2020. According to the report, "The Covid-19 response has strained the U.S. public health system. Workforce and capacity needs remain unmet." This may be a good time for students to think about changing their major. The CDC looked at epidemiology positions only in state health departments and not other state agencies. The shortest staffing is in the areas of genomics, mental health, oral health, and occupational health.

In May 2020, over one-third of US workers were working at least partially remotely. This was down to 22.7 percent in February 2021, and 10 percent last month. Some companies are allowing workers to continue working remotely if they want to.

Some 55 percent of teenagers responding to a CDC survey said that they had suffered emotional abuse from an adult during the pandemic, while 11.3 percent said they had suffered physical abuse. Emotional abuse was defined as swearing, insulting, or belittling. Physical abuse included hitting, beating, kicking, or physically hurting. In 2013, 13.9 percent of teenagers ages 14 through 17 reported emotional abuse, and 5.5 percent reported physical abuse.   

No April Fool's jokes, but here's a bit of humor since it's Friday. The anti-vaccination protesters in New Zealand seeded cannabis outside Parliament. Parliament's speaker reports, "We are weeding out the weed."