The Road goes ever on and on ... Day 307 (807)

The morning turned out to have no resemblance at all to the morning I had mentally planned. I'm more brain-dead than alive at the moment so will retire to doing something simple, possibly repetitive. I will, however, share one bit of positive coronavirus information. Globally, covid deaths are now 90 percent reduced from the worldwide peak. I'll take 'em when I can get 'em.

The Road goes ever on and on ... Day 306 (806)

Over half the respondents in a May survey done by Monmouth University said that they are not too or not at all concerned with the coronavirus right now. Interestingly, the covid rate right now is five times higher than it was last Memorial Day. Some people thought Memorial Day 2021 was the beginning of the end of the pandemic. "In retrospect, I was far too optimistic," says a University of Iowa epidemiologist. He added, "If you believe we're at a point where we would call this endemic, it's not a place we'd want to be." With travel approaching pre-pandemic levels, the next couple of weeks could be very interesting.

Cases are rising again in North Korea and continuing to drop in China. Areas in China with no new cases for at least the last seven days will see libraries, museums, theaters, and gyms reopening. The Shanghai lockdown is set to end on Wednesday. They take zero-covid seriously. A man in his early 40s is being investigated for criminal charges. He had entered a risk area and told to isolate at home. The government says that he left isolation "many times" and moved about in the community. He and his wife tested positive five days after he was supposed to have begun isolating. In response, the government sent 258 people who lived in his building to a government quarantine center, and told over 5,000 people living in the same residential community to stay at home. No word on what the criminal penalty(ies) might be. 

I mentioned a while back that some sports teams playing in Toronto would takes buses to Buffalo, New York because no negative-test documentation was required for crossing the border on land. Individuals who test positive overseas are eating airline change fees and booking flights to Canada or Mexico for test-free entry. Part of the risk of their doing this is which variant they might be bringing in. I don't know whether there is a penalty on the US side of the border, but misrepresenting yourself entering Canada can carry a penalty of up to six months in prison, 750,000 Canadian dollars ($586,000 USD) in fines, or both. 

There is the possibility of a meteor storm tonight with 1,000 meteors per hour. It is supposed to be clear here, so The Professor and I may very well get up around 1:00 am to see what we can see. I figure for people our age, this may be a once-in-a-lifetime event. You know, kind of like the pandemic.

The Road goes ever on and on ... Day 305 (805)

Not a long post today. Between the Uvalde school shooting and response and the war in Ukraine, I found woefully little coronavirus news this morning. Perhaps that is a good thing. Perhaps it is not. I know some people have gotten numb to any new information and simply want back the pre-pandemic normal I don't think we'll ever reclaim. 

Long covid, perhaps my major worry in terms of if I were to catch covid. It seems that vaccinated people don't have much less risk of long covid compared to unvaccinated people. The risk reduction is only about 15 percent. From a University of Pennsylvania bioethicist: "How worried should people be? A lot more worried than they are. People are behaving as if the pandemic is over. The problem with long Covid is it's like the problem of hypertension or another illness that is in the future. We inherently discount the future, especially if the things we need to protect future bad effects from coming are onerous, like wearing a mask."

The area in which I live is now in the high transmission category, with masks recommended in indoor settings. I don't know how people are responding to this and have no real intention of going out to find out. The only place I might go, to visit My Mom, has required that staff and visitors wear masks since visitation resumed. If only the residents wore them as well. (Thanks, Mom, for wearing one every time you leave your apartment.)

The Road goes ever on and on ... Day 304 (804)

A study that has not yet been peer-reviewed, suggests that BA.4, BA.5, and BA.2.12.1 are both more infectious and more pathogenic than BA.2 is or was. The study is from the same lab that was first to report BA.2 was more infectious and pathogenic than BA.1. BA.4 and BA.5 show more immune escape than BA.2.12.1, and BA.4 and BA.2.12.1 can overcome immunity provided by earlier infections with other Omicron subvariants. 

Travel is recovering and nearing pre-pandemic levels. Some 39.2 million Americans plan to travel this weekend, most by road. I am not one of them. Another non-medical effect of the pandemic is that 662,000 fewer students enrolled in undergraduate programs in spring 2022 than one year earlier, a 4.7 percent decline. Enrollment in graduate and professional programs also decline but only by one percent. While part of this is likely due to the pandemic, some analysts say that students may be questioning whether college is really a ticket to the middle class and a good-paying job given the debt they may incur along the way. 

Beijing is not under an official lockdown, but not many places are open. Those that are, such as convenience or grocery stores, require proof of a recent health screening for entry. Some outdoor activities have been restricted as well. Zero covid at its finest. Some neighborhoods in Shanghai are reopening after protests by residents. Cases in both Beijing and Shanghai are declining.

I found the following interesting despite how angry it made me:

The US has 4 percent of the world's population,

                  16 percent of the world's confirmed covid deaths, and

                  40 percent of the world's guns.

The US is also the only industrialized nation in the world in which states are making abortion illegal. We have lots not to be proud of. 

The Road goes ever on and on ... Day 303 (803)

It's not yet clear how much of a worry monkeypox should be. I absolutely love the way in which one Vanderbilt University scientist described it: "This is one that I think we can nip in, if not in the bud, certainly in the flower." Virginia has its first suspected case, a woman who recently visited Africa. 

On July 15, the covid public health emergency will expire. At that point, an estimated 5.3 million to 14.2 million Americans could lose their Medicaid coverage. The wide range is due to uncertainty over how individual states will respond. Even at the low end, that's too many people to leave out in the cold when it comes to covid. 

As of Wednesday, there were over 110,000 new covid cases daily, about a 30 percent increase over two weeks. New deaths, though, have been averaging fewer than 400 daily over the past two weeks. These numbers may be influenced by the government's starting a new procedure for distributing Paxlovid to get it to more people amid the rise in cases. Requiring a prescription makes it harder for people to obtain, and the "test and treat" program proposed by POTUS never really took off. 

The covid lockdowns in Shanghai are leading to a shortage of imaging dye, or contrast, used in medical scans in the US. Some 50 million exams with contrast are performed every year. The Shanghai factory operated by GE Healthcare is one of two major suppliers. The plant just reopened, but distribution trouble could last well into the summer. Right now, the plant is operating at 60 percent capacity and will only be up to 75 percent in two weeks. The shortage of contrast is leading to delayed, deferred, or ignored screening, something that will not help the rate of excess deaths. 

The new dominant variant in the US, BA.12.2.1 spreads faster than its predecessors, is good at escaping immunity, and might cause more serious disease, as it combines properties of the Delta and Omicron variants. The same holds for the BA.4 and BA.5 variants; they, too, have virtually the same mutation as Delta. An Ohio State virologist says that the current virus "just hides in the cell and spreads through cell to cell contact. That's more scary because the virus does not come out for the antibody to work." It may take months to see just how bad these new variants might be. 

Are mask mandates going to come back? They are at the University of California at Los Angeles. I don't expect them to come back at the local university, but I've been wrong on a number of pandemic predictions, so who knows.

The Road goes ever on and on … Day 302 (802)

 Phone and Internet are out until this evening. Enjoy a blog-free day.

The Road goes ever on and on ... Day 301 (801)

There is still no formal definition of just what "long covid" is, but it seems that as many as one in five adults who have recovered from covid have experienced at least one medical condition related to what is being called long covid. The same holds for one in four people ages 65 and older. The most common complaints among all adults were respiratory symptoms and musculoskeletal pain. Along with that "no formal definition" bit, there's also not agreement on just how often long covid occurs. The CDC estimates that five to 80 percent of people who had covid develop long covid; WHO puts the figure at 10 to 20 percent.

Has Peloton or the Mirror gotten boring? Is it safe to go back to the gym? A small study published in Proceedings of the National Academy of Sciences may make you want to re-think things. The researchers looked at the number of aerosol particles exhaled at rest and during workouts. There were only 16 subjects, so take the findings with a grain of salt if you like. At rest, people exhaled around 500 particles per minute. While exercising, the total number of particles soared 132-fold, topping out at 76,000 particles per minute. Exercising outdoors is clearly safer, but if you must go to a gym, the researchers suggest you ask the gym to open windows and crank up fans, make sure that the air conditioning draws air from outside and does not re-use the air inside the room, and install in-room air filters. It generally takes 15 to 30 minutes between classes for the air in a room to clear. Finally, if at all possible, stay away from other people in class or using machines close to the one you're using. 

Here's a line from the abstract of a not-yet-peer-reviewed article you might want to think about or just plain forget about. The results of the study were based on 1,542,510 people in England. "Contrary to the perception that recent variants have become milder, Omicron BA.2 was associated with reporting more symptoms, with greater disruption of daily activities, than BA.1" 

Now may not be the time to mention that the BA.2.12.1 variant is now the dominant one in the US.

Finally, the WHO director general was re-elected for a five-year term. There was no opposition. After the vote, the re-elected director general warned, "It's not over anywhere until it's over everywhere." He's absolutely right about that.

The Road goes ever on and on ... Day 300 (800)

Three hundred blog posts under one title following 500, under another title. I was obviously very naive when I thought this would come to an end in a matter of months, perhaps a whole year, maybe? Thinking back, it does not seem like 800 days. The time between my first post and now is compressed. Did some event happen in May 2020, or was it May 2021? My mind often thinks of the period between the month of March and the present. The only problem is that I don't recall at first that it was March 2020, and now it's May 2022. I am so not ready to go through this again with monkeypox or any other virus for that matter. 

As excitement begins over the prospect of a covid vaccine for the youngest children, the Kaiser Family Foundation's monthly polling reports that only about one in five parents with children under the age of five say that they would vaccinate their young child(ren) right away. In the January poll, one in three parents said that they would take their young child(ren) in as soon as possible. That suggests that the one in five might change by the time the vaccine is authorized. 

A new study suggests that one in eight covid patients who were hospitalized have myocarditis--heart inflammation--up to two months later. They may also show abnormalities of the lungs and kidneys. Fewer than one-third of patients with long-term covid symptoms feel fully recovered a year later. One drawback to the study was that few of the participants had been vaccinated. 

The likely Republican candidate for governor in Connecticut had a positive covid test after exposure at an unknown place or date with an unknown person. He is fully vaccinated and boosted but did spend the day before at an anti-mask picnic.

WHO released data on excess deaths, or death above normal, by country. The US ranked fifth with 15 percent more deaths than expected. The four countries above it are the Czech Republic (16 percent), Chile (17 percent), Poland (19 percent), and Romania (20 percent). That's a list on which you would hope to be as far down as possible.

The CDC revamped their travel risk list. Level 4 used to be the highest risk, but that is now reserved for special circumstances only. Countries with over 100 cases per 100,000 residents in the past 28 days belong at Level 3. Five new nations have been elevated to Level 3: Bahamas, Belize, Eswatini, Montserrat, and St. Vincent and the Grenadines. Most of the countries in Central Europe remain at level 3, as does Canada. 

So, if today is Day 800, some rough math suggests Day 1,000 would be in December. As that day approaches, assuming I'm still posting about covid and not monkeypox, I'll have to think of a new heading. The Road led from the Hermitage. Where is the Road going? At this point, who knows?

The Road goes ever on and on ... Day 299 (799)

North Korea is boasting of "a positive trend" in what the world views as its covid situation. Monday only saw 2.8 million cases of an unknown "fever" along with only 68 deaths. It will be interesting to see if any superspreader activity emerges from the funeral of a top official who helped Kim Jong Un prepare to follow his father at the top of the totem pole.

The Journal of Sleep Research reports that eight percent of people with a covid diagnosis regularly experience something known as REM sleep behavioral disorder also known as dream enactment disorder. This means that the person dreaming physically acts out what they are dreaming--walking, punching, getting up and moving somewhere to sit down, and so on. Apart from covid, this occurs in two to three percent of people over the age of 60, and in cases serves as an early indicator of Parkinson's disease. The Sleep Foundation recommends removing sharp objects, clutter, and furniture from around the bed of someone suffering from this. If the person sleeps with a partner, separate beds may help in terms of possible disturbance of or injury to the partner. The disorder can improve if contributing factors such as PTSD or stress are addressed. 

Pfizer says that its preliminary results for the youngest children--ages six months through four years--show that three doses, with the third at least two months after the second, do produce a strong immune response. That response is strong enough to qualify the drug for regulatory authorization. The FDA panel of outside experts will meet on June 15 to discuss the subject. Pfizer may have comprehensive results by then.

Philadelphia is reinstating a mask mandate in schools and on school buses and vans. They say this is in line with CDC recommendations given the rising number of cases. 

According to an article in the Journal of the American Medical Association, during the eight-week Omicron wave, the excess mortality rate in Massachusetts was higher than during the state's entire 23-week Delta wave. Mortality here reflects people who die because of covid, not from covid.

There have been more monkeypox cases around the world including a possible third case in the US. Doctors have been warned that some cases are not beginning with fever and general malaise but progress straight to the stage at which the blisters start to appear. There is also some discussion about the possibility it has become airborne. Good thing I have not put my masks away.

The Road goes ever on and on ... Day 298 (798)

Let's get monkeypox out of the way up front. There appears to be a theory circulating that monkeypox has grown out of the coronavirus; I have read several doctors debunk this thinking. POTUS did call monkeypox something "to be concerned about," adding, "It is a concern in that if it were to spread it could be consequential." 

Three Air Force Academy students who have refused to be vaccinated against the coronavirus will be awarded their degrees but will not be commissioned "as long as they remain unvaccinated." It has not yet been decided if they will be required to refund to the government their tuition for four years. A fourth cadet who initially refused vaccination did get vaccinated and will be commissioned.

Shanghai has reopened part of the world's longest subway system in preparation for lifting the lockdown as of June 1. Some businesses have reopened, and some people are now allowed outside their homes. Community transmissions have largely been eliminated. There are some parts of the city that are still under tight control, but there has at least been progress.

In late September 2020, covid was discovered in mink at a Michigan mink farm. Last month, the CDC confirmed that four people there were infected with the same unique covid variant found in the mink. This is the first, and so far the only, possible animal-to-human coronavirus transmission in the US. Scientists are worried that mink could become a long-term reservoir and help in the creation of new variants. The Netherlands and Denmark had this worry as well in the early days of the pandemic. They closed all their mink farms and killed all the mink. At the time, the US developed a set of voluntary guidelines; there is still no national screening, just self-reporting. Covid has now been detected on 18 mink farms; the CDC has visited eight. At the Michigan farm, 159 mink were tested with the result being that all but two were actively infected. One dog had covid antibodies. Interestingly, some herds of mink have since been vaccinated. I saw nothing to indicate how many doses of vaccine a mink gets nor if it would need a booster. 

It's probably not the news you'd like to hear, but Omicron and its variants suggest that people could get covid three or four times in a year, similar to the common cold. A Columbia University epidemiologist says that it is "not going to simply be this wintertime once-a-year thing and it's not going to be a mild nuisance in terms of the morbidity and mortality it causes." Since jumping out of a moving car is generally not a good idea, I guess we'll have to buckle our seat belts and see where this ride takes us. 

The Road goes ever on and on ... Day 297 (797)

The stats on monkeypox are around 80 confirmed cases in 12 countries that would not necessarily be expected to have the virus. Lots of questions have come with it including how are people with no connection to Africa getting it? So far, older people don't seem to be catching it to the same extent young people are. Those smallpox vaccinations we had as children may still be working. Given that the recommended treatment for monkeypox is to administer a smallpox vaccination, that should not surprise me.

Coronavirus infections and hospitalizations continue to rise here in the US. Infections are up some 50 percent in two weeks. Rates are rising among children as well as adults. It's not clear how helpful the booster shot for children ages five through 11 will be; only 30 percent of American children in that age range have even gotten a first shot. The booster comes at least five months after the second shot. Experts point out the expectation that new strains will circulate in the fall and urge parents to be ready. 

North Korea reported 263,370 new cases Friday and two more deaths bringing the overall totals to 2.24 million cases and 65 deaths. I agree with the many experts who say those numbers are understated to make it look as if the country's response is being effective. They still have not accepted help from any other country including their neighbor, China.

Finally (it's a weekend; news is always slow then), BA.4 and BA.5 have been labelled variants of concern in the UK. Some of that concern is that their growth advantage could be due to some degree of immune escape. If that escape strengthens, boosters may not be sufficient to slow or stop it.

The Road goes ever on and on ... Day 296 (796)

I do not want this to become a blog on a monkeypox pan- or epi-demic, but it actually is easier right now to find news about it than covid. The CDC is calling monkeypox "an emerging issue." There are now around 75 cases in 11 countries, including Australia. To make this short, a UCLA epidemiologist notes, "This is the most important outbreak in the history of monkeypox in the Western Hemisphere." When I reported the computer simulations that had monkeypox at the top of possible new pandemics, little did I know...

Around 190,000 new cases of covid were confirmed yesterday, meaning that there were actually around one million new cases. Cases are rising in almost every state. Hospitalizations are rising in all but five states and territories; they are still below peak levels, though. One-third of all Americans now live in areas of medium to high levels of virus transmission. Have any been told to wear masks? Not that I know of, but masks have been recommended by some civic leaders.

The CDC has given its approval to vaccine boosters for children aged five through 11. I do wonder what percent of children will get them. Since parents will determine which children get boosters, I wonder if the children of vaccinated-but-not-boosted parents will also be vaccinated-but-not-boosted.

An article in the Canadian Medical Association Journal reports that one in nine hospitalized covid patients dies or get readmitted within 30 days of going home. These outcomes, though, are consistent with admissions for other medical diagnoses such as influenza, diabetes, or pneumonia. Deaths following covid are higher among men, older people, people with comorbidities, and people with a history of prior hospitalization stays. Almost half of covid patients returning to hospital are returning due to lung problems. 

I had lunch--outdoors--downtown with a friend and her father today. Walking from parking to the diner, I noticed very few people wearing masks. (I was wearing one.) It made me wonder about the motivation of those still masked. Are they protecting themselves, others, or both? Early on in the pandemic I would have said I was trying to protect both, but I admit that now it is to protect myself. Those not wearing masks aren't interested in protecting me or themselves for that matter. If my wearing a mask helps them, I'll feel good about it. Beyond that, they're on their own.   

The Road goes ever on and on ... Day 295 (795)

I'd taken a couple of notes from a couple of sources before life struck in the form of a person who shall remain nameless,a total jerk who caused me enough extra work that if I now get back to taking notes and then start writing, the day will be gone. I'll keep the notes for tomorrow unless they're displaced by new news. I'll just note that there is now a monkeypox case in Massachusetts. Says a professor of evloution and genomics, "It's either a lot of bad luck or something quite unusual happening here." I'm voting on the something quite unusual option.

The Road goes ever on and on ... Day 294 (794)

I ended with monkeypox yesterday, so let's start there today. It's now spreading in Portugal and Spain in addition to the UK. So far, cases seem to be concentrated among gay and bisexual males. 

I mentioned a while back that there seems to be a lot more bad driving out there now than there was before the pandemic, when I used to go out in the world on a more regular basis. I also mentioned a very short while back that gunshot, overdose, and sexually-transmitted disease deaths were up? While road deaths did not reach a new all-time high, in 2020 they were the highest they've been since 2005.

North Korea's new report mentions 62 deaths and 1.7 million cases. The report also includes that one million people have recovered. Blame for the outbreak is spreading. Kim Jong Un ordered the execution of two people for covid-related crimes. One was a customs official who allegedly did not follow virus prevention rules when importing goods from China. 

The levels of cases and hospitalizations in New York City is now at high alert, a level that comes with the recommendation that the city government require masks in all public indoor settings. The mayor replied, "We're not at the point of mandating masks." City health officials are recommending that masks be worn in offices, grocery stores, and other public indoor settings. Unfortunately, "recommended" and "required" have very different definitions.

Public school systems nationwide are losing students due to the pandemic. All together, there are now at least 1.2 million fewer students than there were in 2020. One possible cause is that in response to virtual or online learning, some parents switched to homeschooling or moved their children to private or parochial schools that chose not to stay closed as long as the public schools did. In some cases, the children just dropped out. Older teenagers may be staying at jobs to help offset income parents have lost. Parents may have simply stopped making younger children attend. Most interesting is that in some states, including Florida, that eschewed virtual learning, enrollment rebounded and is still on the robust side.

Senior citizens have been especially hit by the coronavirus. Now it seems that 32 percent of those older adults who survived covid had symptoms of long covid up to four weeks later compared with 14 percent of adults between the ages of 18 and 64. The difficult part is that many of the symptoms of long covid are the same as changes that occur with aging. It may be hard to identify to which group individual symptoms belong. Being able to know that would obviously help the people who care for those elderly.

The Road goes ever on and on ... Day 293 (793)

Found lots of news this morning, so let's start with the quickies. 

The FDA has authorized boosters for children ages five through 11 years. 

Well-trained scent dogs can detect covid. Attempts may be made to see if they can differentiate different variants. 

Shanghai health officials say that the outbreak there is under control and the goal is to reopen fully by June. 

New York City is moving to a high covid risk level. Masks are recommended though not required ... yet. 

A growing body of scientific evidence suggests that long-term exposure to air pollution leads to worse outcomes for people exposed to covid. Even short-term exposure can have an impact, just not as strong.

Dr. Fauci, when asked, replied that were our ex-POTUS to become POTUS a second time, he would not continue to work in that POTUS's administration. 

The government is providing more covid test kits. This time, they will send two packs of four tests each. Lots of people may end up needing them. The seven-day rolling average number of cases Sunday was the highest in almost three months and 150 percent up from one month ago.

North Korea is up to 56 deaths and 1.5 million cases. Experts differ in assessments of what North Korea needs most right now. It may not be vaccines since so many people have already gotten covid; however, a South Korean professor of preventive medicine counsels that vaccines might be good to send if they can be given to elderly people and people with pre-existing conditions. North Korea could probably also use fever reducers, test kits, masks, and daily necessities. I don't think it's going to end at all well there.

The CDC is urging all domestic travelers to "consider getting tested as close to the time of departure as possible (no more than three days) before your trip." Consider? I'm thinking the language used there should be a little bit stronger. How about replacing "consider" with "plan on"? Or drop "consider" and change "getting" to plain old "get"? In terms of international travel, the CDC has added four countries to its highest level of risk: South Africa, Lesotho, Antigua and Barbuda, and Taiwan. 

More than one scientist will tell you that the coronavirus is here to stay, that it is adept at dodging defenses, and that it may come in waves two to three times annually. Some people who had Omicron BA.1 already have had a reinfection with BA.2, BA.2.12.1, BA.4, or BA.5. These people could actually have a third or even fourth infection before 2023 rolls around. Says a South African epidemiologist, "The virus is going to keep evolving, and there are probably going to be a lot of people getting many, many reinfections throughout their lives." A virologist at the Scripps Research Institute adds, "If we manage it the way we manage it now, then most people will get infected with it at least a couple of times a year. I would be very surprised if that's not how it's going to play out. ... Every single time we think we're through this, every single time we think we have the upper hand, the virus pulls a trick on us. The way to get it under control is not 'Let's all get infected a few times a year and then hope for the best.'"

Could I post something without referring to monkeypox? Not today. There are new cases in England not linked to Africa. People suspected of having monkeypox should be isolated in a negative pressure room as soon as possible. They should be masked and their lesions covered for any interaction. The last case in the US was in November 2021, so within the time frame of the pandemic. The first time monkeypox was found outside Africa was in the US in 2003. There were 47 cases. The infection came from animals imported from Africa including two African giant pouched rats, nine dormice, and three rope squirrels. These African animals passed it to US lab animals who then passed it to humans. 

Intrigued by African giant pouched rats, I lifted the photo below from National Geographic:

They're actually kind of cute if they don't have monkeypox.

The Road goes ever on and on ... Day 292 (792)

Delaying coronavirus news, two new cases of monkeypox have been found in London and appear to be unrelated to the first case. Possible new pandemic? Who knows?

The European Centre for Disease Prevention and Control has labelled BA.4 and BA.5 as variants of concern. Both, along with BA.2.12.1 have minimal cross immunity with BA.1. This means that the Omicron-specific vaccines due out in July may not provide as strong protection as hoped. A reduction in vaccine effectiveness could mean more breakthrough infections even after four doses. There could also be more breakthrough infections in the one or two weeks after an injection when the protection should be the highest. Under Delta, vaccinated adults accounted for 23 percent of deaths; under Omicron, 42 percent. If that's not unsettling enough, the family of Omicron variants is evolving more rapidly than any other variant family has. 

North Korea now reports 50 deaths and over 1.2 million cases. Experts note that the death toll is likely understated to protect Kim Jong Un's dignity as leader. Over 564,860 people are reported to be in quarantine. A South Korean analyst calls the case total an "outright lie." While North Korea reported 390,000 more cases and eight deaths in one day, South Korea had 25,000 more cases and 48 deaths. Another analyst estimates that the real number of cases is at least three times larger than reported. 

What test kits North Korea has are likely reserved for people in leadership positions. Kim said during a ruling party Politburo meeting that medicine not getting to pharmacies in time is due to pharmacies' "irresponsible work attitude." Meanwhile, South Korea has indicated its willingness to send vaccines, medicines, equipment, and even health personnel to North Korea if it is willing to accept them.

Students at high-profile Peking University are protesting lockdowns calling them poorly communicated and unfair. While students are required to isolate and are unable to order food, teachers and their families are allowed to move freely. There was even an attempt to erect a wall to separate students from faculty and staff members. Needless to say, this too caused a protest. 

Scientists are working to pull together a nasal spray vaccine. People may be more receptive to this than they are to an injection. More importantly, whereas an injectible vaccine combats a virus once a person is infected, a nasal vaccine can capture a virus before it can attach to cells, a process called sterilizing immunity. That certainly sounds like a good thing. 

US cases are up 60 percent from two weeks ago, and up even higher considering home testing. Hospitalizations are up 23 percent from two weeks ago. Many counties are moving to medium or high risk on the CDC's scale. High risk is where masks are encouraged. 

The Road goes ever on and on ... Day 291 (791)

As the US covid death toll exceeds one million, the Johns Hopkins University Coronavirus Resource Center reports the US death rate at 291 per 100,000. Only two countries--Brazil and Poland--have higher mortality rates. Already thinking about how the US can say it's so good yet look so bad, I came across an article comparing the US and Australia in covid terms. Australia's death rate is about one-tenth of ours. Both countries are English-speaking democracies and have similar demographics. The median age in both countries is 38. The 83 percent of Americans living in urban areas compares well to Australia's 86 percent urban. So why the big difference? Dozens of interviews, surveys, and scientific studies point to one thing: trust. That would be trust in science and institutions but most importantly, trust in one another. 

The first positive covid case was found in Australia on January 25, 2020. The first in the US was January 31, 2020. On that very day, the now-ex POTUS noted, "We think it's going to have a very good ending for us." The same day, Australia's health minister reported, "Border isolation, surveillance, and case tracing mechanisms are already in place in Australia." Australia closed its border with China on February 1 despite its being their largest trading partner. Two days later, they brought Australians in China back to Australia where they spent 14 days in quarantine. There were other factors besides Australia's taking action faster, including differences in the health care system, obtaining and used personal protective equipment, and a smaller gap between the rich and the poor. A final factor and, to me, perhaps the most important was that following rules was the social norm in Australia. We in the US are much more every-person-for-themselves. Currently, 95 percent of Australian adults are fully vaccinated and 85 percent of the total population has gotten two doses. The US is holding steady at 66 percent being fully vaccinated. 

I noted a day or two ago that deaths from guns and drug overdoses hit new highs during the pandemic. It seems that deaths from sexually-transmitted diseases also peaked. The only remotely causal factors I can think of are reluctance to see a doctor to be tested and a reluctance to go to a pharmacy for medicine. 

Covid. The disease that keeps on giving even more than we thought already? A new article in the Lancet with the title " Severe acute hepatitis in children: Investigate SARS-CoV-2 superantigens" posits a relationship between covid and the cases of severe hepatitis in children that have are cropping up. The suggestion compares to covid's loading a gun, the trigger of which is then pulled by an adenovirus. As you might expect, this is somewhat controversial. It's been pointed out that not all children with the new hepatitis have tested positive for adenovirus. At the same time, 76 percent of children with hepatitis have covid antibodies. I hope to see more on this in the near future.

Both WHO and China have offered help to North Korea. China, especially, has a priority of keeping its neighbor stable. At the same time, though, it is not at all clear that North Korea wants aid agencies in the country. Some sources suggest there may be another nuclear test as a distraction. Should North Korea decide to lock down as tightly as Shanghai, starvation is a real concern. Eleven million of the total population of 25 million are already undernourished. A US vaccine expert offers, "They really have only one option. They've got to find a way to bring in vaccines and to rapidly vaccinate the population. The world is ready to help North Korea, but they have to be willing to invite that help." And not wait until the last minute to invite it, I might add.

The Road goes ever on and on ... Day 290 (790)

North Korea confirmed 21 new deaths and 174,440 more people with fever symptoms, bringing the overall totals to 27 deaths and 524,440 cases. State media also said that 243,630 people have already recovered while 280,810 remain in quarantine. The emergency epidemic office has blamed the deaths on "mistakes like overmuch taking of drugs, bereft of scientific medical treatment." Kim Jong Un has declared the outbreak both a "great disaster" and a "huge disruption." He is said to be donating some of his private medicine supplies to help in the fight. He also said they would follow the Chinese model of virus protection. Now, that will be interesting to hear about should they decide we will hear about it. How bad are things really there? A professor in South Korea said that the public acknowledgement of covid meant "the public health situation must be serious."

The prime minister of New Zealand has tested positive and will be spending another week in quarantine. She's been in quarantine for a week already after her partner tested positive a week ago. New cases in South Africa continue to rise, from about 360 per day in early April to about 8,000 per day now. Experts say the counts are likely undercounts. Because the symptoms can be very mild, many people just don't get tested.

England opened vaccinations to children ages five through 11 about six weeks ago. In that time, seven percent of eligible children have been vaccinated. In the first six weeks of vaccine rollout for children between 12 and 15, 24 percent got a first dose. Some parents think that covid poses little risk to younger children. Others worry about the risk of rare side-effects. Many of the parents who did get their children vaccinated cited a fear of long covid as the reason. In other cases, someone in the household was immuno-compromised or otherwise at risk of serious illness. 

 Closer to home, four cadets at the Air Force Academy may not graduate or be commissioned due to their refusal to be vaccinated against covid. They may also have to pay back about $200,000 in tuition and fees. There are two weeks until graduation, so there is still time for that first vaccination. So far, there are no similar incidents at the Army's West Point or the Naval Academy. The Air Force Academy also has two juniors, 1 sophomore, and 6 freshmen who have so far refused to be vaccinated. 

The Road goes ever on and on ... Day 289 (789)

I had several sets of notes taken for today's blog and then sat down and followed a tweet from Eric Topol that sucked me down a rabbit hole of sorts. The original reference requires no technical background to understand, but if you don't want to check for yourself, here are a few key points:

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"The Delta variant that caused devastating surges around the world in 2021 had mutations in L452 as well, so many scientists have been watching this hot spot carefully, including Yunlong Richard Cao of Peking University. On 11 April, Cao says, he and his colleagues noticed a pattern: New Omicron sublineages from New York, Belgium, France, and South Africa all had changes in L452. 'The independent appearance of four different mutations at the same site? That's not normal,' Cao says.

"...the new variations apparently helped the Omicron subvariants evade those previously powerful antibodies."

"Based on its immunological profile, it 'should be called SARS-3,' he says--an entirely distinct virus. ['He' is Linfa Wang, a bat coronavirus researcher.] "The limited protection that BA.1 provided against the new subvariants in lab studies has already raised questions about how useful the new Omicron-specific vaccines might be. Wang says the virus is evolving too quickly for strain-specific vaccines to keep up. Instead, a broad cocktail of monoclonal antibodies targeting different strains might be the best way forward, he says."

"Kristian Andersen, who studies viral evolution at Scripps Research, draws a sobering lesson from the newest Omicron variants. Although we don't know what future variants will look like, he says, 'we can be certain that they'll continue to be more and more capable of immune escape,' possibly leading to lower protection against nor just infection, but also against severe disease. 'We need to focus on broadening out immunity,' he says.

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Son #1 says this is all hype despite its having been published in Science, a quite reputable journal. He reads it as the variants not being an "entirely distinct" virus, but just a mutated, milder form. In my Twilight Zone, dystopian mind, I find it well worth concrete investigation. Maybe covid-19 should be covid-21 since Omicron emerged in late 2021. In terms of immunity, I've read that people with antibodies to the older, "original" version of SARS have some immunity to the novel version of SARS. In that case, having had SARS-2 should give some immunity to SARS-3. Stay tuned. News at 11:00?

As for the other notes I made, the state media in North Korea is now saying "covid" instead of "fever." Six deaths have been reported in the 350,000 cases. It seems that while the entire country is essentially locked down, 187,800 people are in formal quarantine. Kim Jon-Un has been seen wearing a mask. He criticized health officials saying that the outbreak "shows that there is a vulnerable point in the epidemic prevention system." (If I were one of those health officials, I'd be worrying about how to get my ass and those of my family out of the country without delay.) Analysts are warning of a major humanitarian crisis. One says, "We are in the early stage of the spread of vast human misery. The nature and scale of the illnesses, deaths, hunger, and starvation can only be established much later." Some people are wondering whether the new publicity is really a request for help. China has formally offered help. South Korea and the US have made it known that they are open to dialogue. 

After the director of WHO called China's zero-covid policy "unsustainable," all photos and references to him have been removed from the Chinese internet. The government has called the WHO director's remark "irresponsible" adding that WHO did not have a "proper understanding of the facts." As Dragnet's Sgt. Friday used to say, "The facts, ma'm. Nothing but the facts."

The Road goes ever on and on ... Day 288 (788)

If you thought the lockdowns of city sections or even entire cities in China were bad, North Korea has locked down the country. That's right, the entire country. They just reported their first covid outbreak, declaring it a "maximum emergency." I find it difficult to believe that they made it over two years without any cases, though they do keep their borders tightly controlled. First outbreak or not, it's not going to be pretty over there. It's not clear how many people there have been vaccinated, but it's clear that not many have. I'd bet those who have been vaccinated are in the political elite while the general population sits unimmunized. 

As for Chinese lockdowns, the ones in Shanghai closed a General Electric Healthcare factory that makes medical imaging contrast material aka dye. Doctors here in the US are having to prioritize patients, doing scans on the most serious ones while postponing scans for those who can safely wait. The Shanghai plant is now up to 25 percent capacity. The goal is to have the normal flow back by the end of June. GE is also using a plant in Ireland to meet the need.

POTUS has ordered federal flags to fly at half-staff until next Monday to mark the one million deaths from covid. We're oh so very close if we aren't already there. The CDC puts the death toll at over 995,000, while The New York Times has it at over 997,000. While we're on numbers, there were around 159,000 confirmed new cases yesterday along with 800 new hospitalizations; both of those are the highest in several weeks. Deaths were at almost double the seven-day average, 585 deaths compared to the average of 308. If we're gaining ground on covid, we're doing it slowly.

Moderna has asked the FDA for authorization to give its vaccine to children ages six through 11 years. It's not clear how much authorization will help get children vaccinated. Right now, only 28.5 percent of children in the six-through-11 age group have gotten two doses of the Pfizer vaccine. I'm not sure offering a second vaccine will get any more parents to vaccinate their children at least in the short term. 

The EU says that member countries no longer need to require masks on planes and in airports. Airlines can continue to require masks if they want to. It was recommended that masks still be required by airlines for flights to and from countries that still require masks. 

Finally, there are data suggesting that long covid might be linked to viral fragments left in a person's gut. One researcher calls these fragments "ghosts." Researchers have already found viral fragments in hearts, eyes, and brains. These fragments have been detected up to 230 days after the original infection. I admit that in the back of my mind is that all this could be a Twilight Zone episode in which everyone who gets infected retains some viral fragment that activates after some time period with appropriately eerie results. Here's hoping ... not.

The Road goes ever on and on ... Day 287 (787)

A new study (peer-reviewed and published in Nature) claims that China's lifting its zero-covid policy would result in a "tsunami" of infections and close to 1.6 million deaths, due in large part to the low vaccination rate for the elderly. The gory details include predictions of over 112 million symptomatic cases, five million hospitalizations, and 1.55 million deaths. The ICU demand could be 15.6 times the existing capacity. The Chinese government may be backed into a corner. Holding on to zero-covid will not be easy, but it may well be better than the alternative. Still, WHO has told them that they do not think the policy is sustainable. 

First thing this morning, I read about gun-related deaths being up 35 percent in 2020, the first year of the pandemic. Deaths hit a new record, over 45,000. Was this due to more people being at home together and under additional stressors? Were there more robberies or other crimes? I don't know. Second thing this morning, I read about another death record, this one in 2021 for deaths from overdoses, at 108,000. I'm not sure the two records are related, but both are likely outgrowths of the pandemic. 

Female college graduates with babies and toddlers were significantly more likely to work for pay during the pandemic, perhaps because it allowed them to work from home. I wonder how this might change as more businesses or government agencies require employees to return to a physical office. Women without college degrees ended up working less during the pandemic, possibly because many were in jobs requiring on-site work such as service jobs. 

And that's it from Lake Wherever this early evening. It was a busy day, but a good one. Here's to another good day tomorrow.

The Road goes ever on and on ... Day 286 (786)

The people who railed at mask mandates and the other mitigation measures used here in the US should be glad they don't live in China. The daily count of cases in Beijing is dropping, and is now at the lowest since mid-March. Still, the restrictions there are being tightened, not loosened. Schools are closed indefinitely, and many of the city's office workers are working from home. Shanghai has essentially been locked down since April 1. There, it only took one positive test for all the residents of an apartment building to be sent to a quarantine camp. It had been just the floor on which the person testing positive resided, but that, too, has been tightened. Sort of puts mask mandates in perspective, eh?

As one school year draws to a close, people are already looking forward to the next one. Both the mayor of New York City and the governor of the state of New York say that they support making vaccination required for public school students. It likely won't happen, though. The FDA has yet to grant full approval for a vaccine for children under the age of 16. The vaccine also seems not to work as well in children under the age of 12. Right now, there are striking differences in vaccination rates between groups of students--ethnicity, religion, socio-economic status. Trying to get around all those would not be easy.

Attention is being given to what's been termed "Paxlovid rebound," a resurgence of covid seen after finishing the five-day course of Paxlovid. The latest "name" to suffer from this seems to be Stephen Colbert. Pfizer, maker of Paxlovid, says this happens in only 0,005 percent or less of cases. They also note that in clinical trials, two percent of patients had a rebound infection regardless of whether they were in the Paxlovid or placebo group. Some experts suggest starting a second five-day course of Paxlovid when the rebound infection starts, especially for high-risk patients such as immunocompromised patients. Unfortunately, there is no real data that says the second course works. 

POTUS is holding a covid-19 summit of world leaders on Thursday. The call from other world leaders for additional global aid from the US is likely not to be answered. There was talk of working such aid into a bill for military aid to Ukraine, but its presence would slow approval of the military aid needed as soon as possible. 

Who are the latest "names" to test positive? Try Presidential aide Susan Rice and Golden State Warriors coach Steve Kerr. More are coming, I am sure.  

The Road goes ever on and on ... Day 285 (785)

Some school districts in Virginia are running into trouble over their covid numbers. That's not in terms of how large or small those numbers are but in how and to whom they are reported. The Virginia Department of Health says that knowing the level of covid spread within K-12 schools is critical to preventing transmission. The Department, though, has stopped contact tracing, and some school districts have followed suit. One father complained that he heard from his daughter that she had been exposed by a classmate's testing positive. He said that he never heard from the school or district.

Taiwan continues to move from zero-covid to "living with the virus." Meanwhile, the People's Republic of China continues with zero-covid, and it's not looking good there. Some Chinese fear that the government is using the pandemic and lockdowns to expand its power and control. Similarities do exist between the Shanghai lockdowns and the situation with the Uyghurs and Kaakhs in the western province of Xinjiang. Shanghai's quarantine camps are apparently not that different from the re-education camps in Xinjiang. One source expressed the view that the pandemic has done "a huge favor to the Chinese Communist Party." An activist from Human Rights Watch commented, "I think the Covid control is almost like a milestone toward deepening repression." 

It seems that global covid efforts are looking more like global HIV efforts 20 years ago. Rich nations have, and other nations don't. Low-income countries currently account for less that one percent of global testing, as a WHO official notes, "If you're not testing, you can't sequence, you can't isolate, you can't treat. Everything else unravels."

As for sequencing and isolating, here's an advisory from CNN medical analyst Dr. Leana Wen: "These new variants are so contagious that a cloth mask just isn't sufficient. You really should be wearing a high-quality respirator mask, like an N95, KN95, or KF94." That is, if you're wearing a mask at all.

The Road goes ever on and on ... Day 284 (784)

Happy Mother's Day to all who "mother" anyone in any way. In the interest of marking the day, there is very little coronavirus news out there. There is, though, a confirmed report of a case of monkeypox in the UK. Remember monkeypox? A computer model cited it as a potential new pandemic. What I've read suggests that it does not spread easily between people. You can read more about it here, thanks to the BBC. Scroll down a bit, and there's a section on what the symptoms are and how someone might catch it. 

Other news bits include clear signs of a fifth wave in South Africa. The test positivity rate there right now is 31 percent. Here in Virginia, the test positivity rate is over 10 percent for the first time since February. The hospitalization rate for unvaccinated people is twice that for fully vaccinated people, and the death rate is 14 times higher.

Listen to a/your mother: Get vaccinated. Stay boosted.

The Road goes ever on and on ... Day 283 (783)

Happy Mother's Day Eve! I have blueberry muffins in the oven to take to My Mom tomorrow. I may add some French fries; she's craving those, and they don't serve them at her assisted living facility. If you're a mother, I hope your youngin's treat you right tomorrow. If you're a son or daughter, treat your mother right tomorrow. You should actually do that every day, hard though it may seem.

Public Service Announcement over, it's back to the coronavirus. Some of the demographics of the one million Americans dead from covid are not at all surprising. Three fourths of the dead were over the age of 65. An elder care expert notes, "A million things went wrong and most of them were preventable." On average, more men died than women. Overall, more Whites died, but Black, Hispanic, Pacific Islander, and Native American people suffered disproportionately more than other groups. Mississippi was the state with the highest per capita death rate. 

The White House is warning of a fall surge and developing plans on how to provide vaccines if covid aid stops. The possibility exists that 100 million Americans--30 percent of the population--will get covid this fall or winter in a model that assumes the virus stays an Omicron family variant and not a brand new variant. The wave is actually predicted to start in the summer as people in the South spend more time indoors to escape the heat. Right now, the government can't provide enough booster for the general population without more funding. Older and immunocompromised  people would likely be given priority.

Will long covid be the next phase of the pandemic? Right now, there is no treatment and some difficulty precisely defining it. As many as 24 million Americans may have experienced long covid symptoms. Women are 33 percent more likely to have symptoms than men. Symptoms include brain fog, fatigue, organ damage, chest and joint pain, loss of senses of taste and smell, cough, headache, and gastrointestinal and cardiac issues. Insurance companies often decline payment because it cannot be precisely diagnosed. The demand for long covid care right now far outstrips the current capacity. That better change if it is the next phase.

The Road goes ever on and on ... Day 282 (782)

Covid has at last hit close to home. Son #2 emailed last night to say he and his partner would not be coming Saturday for a Mother's Day eve dinner as she contracted covid either at work or at a jiu jitsu tournament she attended. He's so far testing negative, but they're taking no chances, which I greatly appreciate. They're both vaccinated and as boostered as 30-somethings can be, so fingers crossed her case is asymptomatic or otherwise mild. It had to happen sooner or later. 

The FDA is putting limits on the Johnson & Johnson vaccine. Only people ages 18 or older and otherwise unable to get vaccinated will be allowed to get it. "Otherwise unable to get vaccinated" includes things such as being allergic to some component of the two mRNA vaccines. The Johnson & Johnson vaccine raises the risk of thrombosis with thrombocytopenia, a dangerous clotting condition, after getting vaccinated. 

An article in Nature reports that infection with Omicron BA.1 gives unvaccinated people narrow immunity to future BA.1 infections. For vaccinated people, it provides cross-immunity to Delta and other variants. I'm assuming that the researchers did whatever was needed to rule out that the vaccinated people already had the cross-immunity so as to ensure that it was coming from the infection. At least if it's been published in Nature, they should have.

Also just out is a piece in the Lancet on the phase coming after covid-19, advising that it would be a "grave mistake" to forget about certain characteristics of this pandemic. First, the situation is by no means the same everywhere. Different factors influence the coronavirus in different places and at different times. Second, the global vaccination strategy is far from on track. Vaccine inequity is real. Over 40 countries have fewer than 20 percent of residents completely vaccinated. This vaccine inequity has been mirrored by treatment inequity, specifically the availability of Paxlovid. This inequity is meaningful given that Paxlovid reduces the risk of hospitalization and death by 89 percent. Finally, besides continuing to prepare for future pandemics, we also need to catch up on regular care such as childhood vaccines that may have been put off so far. 

Just an FYI, the 14-day changes in the US as of yesterday: Cases are up 59 percent; hospitalizations are up 20 percent; and deaths are down three percent. Hospitalizations include those for covid and those found to have covid while being admitted for another reason.

Finally, some philosophical advice from Chinese president XI Jinping on the zero-covid policy in China: "Persistence is victory. This is far from the time to rest and take a breath ... Resolutely fight against all words and deeds that distort, doubt, and deny the country's pandemic policies." In other words, you have been warned.

The Road goes ever on and on ... Day 281 (781)

Between the leak of the Supreme Court's Roe v. Wade draft and the continuing war in Ukraine, there wasn't a lot of coronavirus news out there this morning. The number of people who were at the White House Correspondents' Dinner Saturday night and have since tested positive for covid continues to grow. Besides multiple journalists, few of whose names I even recognized, the Secretary of State tested positive. Given his recent international travel, though, he might have contracted covid elsewhere. I again cross my fingers that POTUS doesn't get it. 

WHO again announced a revised covid death toll based on excess deaths rather than numbers reported by countries. As before, that number is about double the sum of all the national numbers. The reported numbers total in the neighborhood of six million, despite there being 15 million more deaths than normal in the time span of the pandemic. Excess deaths in Mexico are roughly twice their reported covid toll. Pakistan's excess deaths are about eight times its reported covid toll. Topping both of those countries, Egypt's number of excess deaths was roughly 12 times its reported covid death toll. Between home tests complicating case numbers and how deaths are counted country to country, we will never know just how bad the last couple of years have been.

The BA.2.12.1 subvariant will likely be dominant in the US in a matter of weeks. In the week ending this past Saturday, it accounted for 36 percent of new cases compared to 26 percent one week earlier, and 19 percent in mid-April. Fortunately, there's no indication so far that it's more serious than the original Omicron.

One reporter described China as "prisoners of their own narrative" in regard to their zero-covid policy. They can't change course now much as they might want to. The effects of zero-covid have hurt China's competitiveness as a global manufacturing center. Countries are less willing to invest there given the uncertainty and instability accompanying the lockdowns that support zero-covid.  

Research is ongoing to develop a covid vaccine nasal spray. Injected vaccines prepare the immune system to fight covid after it has entered the body; they don't keep it out in the first place. The hope is that as a nasal spray, a vaccine would produce a strong immune reaction in the nose and throat where most covid infections start. Over a dozen clinical trials are underway.  

The Road goes ever on and on ... Day 280 (780)

Back to long covid, a British study found that only about a third of patients who experienced symptoms after being hospitalized felt fully recovered one year later. Most patients saw little improvement in areas such as physical function and cognitive impairment. Some showed lingering cognitive decline similar to that measured after 20 years of aging. The degree of impairment seemed linked to the severity of illness. I found one aspect of the researchers' method quite interesting. Each of the 46 subjects were matched with 10 people matching them on characteristics such as gender, age, education, and first language; the 10 matches had not had covid. 

Top FDA officials say that we may need to update covid vaccines every year and progress to annual covid vaccination similar to the seasonal flu shot we are now advised to get. That states are scaling back what covid statistics they report and how often they report them means it may be harder to identify outbreaks and new negative effects stemming from the virus. 

As researchers delve deep into the variants of concern such as Delta or Omicron, we should not forget that the variants of interest that did not progress to concern may also yield important information. Learning what mutations in Gamma, Iota, Lambda, and Mu did not work and why will add to the study of the more concerning variants. It is also important to investigate variants that may not "work" in a certain place at a certain time but may thrive in others.  

About a fifth of parents of children under the age of five say that they're "eager" to have their child vaccinated. Some 38 percent say they will wait and see how things go before deciding. I'm wondering if the other 42 percent are in the "hands off my kid" camp.

I once briefly wondered about covid and organ donation but never dug into the subject. Fortunately, someone else did. Between March 2020 and March 2021, nine covid-infected donors donated organs to 19 recipients. The three recipients who received bilateral lungs acquired covid. One died, while the other two transmitted covid to others. the 16 recipients of non-lung organs did not acquire covid. The three lung specimens tested negative for covid pre-transplant but post-transplant lung specimens came back positive. If you need lungs, be careful out there!

According to one "official" tally, as of this morning, the US had recorded 81,553,778 cases and 995,622 deaths. Another "official" tally has the number of deaths high enough that it could go over one million today. That's a number that should be marked but by no means celebrated. 

The Road goes ever on and on ... Day 279 (779)

Here's something not too heartening: During the Omicron surge in January and February, 42 percent of the people dying of covid had been previously vaccinated. If you're younger than I am, you may not have to worry so much. Those deaths were concentrated among the elderly (I'm still wondering if I am), for whom vaccines are less effective. It seems that the potency of the vaccines may wane more quickly for older age groups. 

If you're purchasing home covid tests over the counter, give the packaging a close look. There are now counterfeit at-home test kits that look very similar to the legitimate ones. The counterfeit ones may have spelling or grammar errors on the labels, though. So far, there have not been counterfeit ones detected among the test kits shipped as part of the government's free test program.

Cases and hospitalizations are rising in a majority of the states. We're also about to hit one million deaths. Vaccinations still matter even if the potency wanes over time. Right now, 77.6 percent of Americans have gotten at least one dose of vaccine, while 30 percent have gotten a booster. The addition of boosters to the shot regimen has led to a move away from the "fully vaccinated" label. Now, if you've had the full initial vaccine dose and at least one booster, you are said to be "up-to-date" on your covid vaccinations. 

Beijing is refurbishing a 1,000-bed facility built for the 2003 SARS outbreak to equip it for covid. They are also setting up a 10,000-bed quarantine facility for people who test positive and their close contacts. I can't help but think that any close contacts who have not yet contracted covid will certainly contract it in such a crowded facility. 

Vice President Harris has tested negative and will be returning to work. As advised by the CDC, she will wear a "well-fitting" mask for ten days. She was given Paxlovid after testing positive, just as POTUS's Test-to-Treat program advises. 

I saw a new type of variant mentioned, actually two types. The terms "variant of interest" and "variant of concern" have been around for quite a while. Today I saw "variant being monitored" which is less serious than even a variant of interest. On the other end, there is "variant of high consequence." I assume that is something like Delta or Omicron, something that has graduated through the other levels. 

On the subject of variants, I found an interesting passage from Science Writer Carl Zimmer: "Scientists have been trying to figure out what those mutations do for the variants, and it looks like it helps them evade immunity from earlier forms of Omicron. A year ago, we were amazed at how fast Delta was spreading at the time. And in a year, we've gone through several upgrades of this virus, and now it spreads way faster. It's on a par with measles." I find the last thought disconcerting. On a par with measles, one of the most contagious common diseases out there. Remember R-naught, the number of people one person infects? It's somewhere between 15 and 20 for measles. If covid is getting to that point, we could be in trouble even with vaccines.

The Road goes ever on and on ... Day 278 (778)

Remember Deborah Birx? The former White House Coronavirus Response Task Force coordinator under the man who used to be president? She advises that the US should prepare for a summer surge across the South. She might be right. On Saturday, the national seven-day average number of new cases was 54,000. A week ago, it was 49,000, and a month ago, 31,000. New York City is entering a higher risk level as cases keep rising. Depending on how high it goes, it could mean some public health restrictions come back. Recorded case levels are currently as high as they were for Delta but still lower than for Omicron. The qualifier here is that the growth of home testing means case levels are surely higher than officially reported. 

As mentioned a couple of days ago, South Africa is seeing a surge from BA.4 and BA.5. Preliminary data suggest that these subvariants evade natural protection produced by infection with the original Omicron. The result is symptomatic infections with the new subvariants. The original Omicron often appeared as asymptomatic infection. A physician who led the pandemic preparedness response for the H1N1 swine flu virus observes, "We're at an awkward global moment where the past can't really predict the future." As for that future, climate change is putting pressure on species to migrate. Unfortunately, this offers new chances for viruses to jump from one species to another, and the receiving species could be us. As for today, BA.4 and BA.5 are present in the US but so far at low levels.

Italy is relaxing restrictions. It is now possible to enter restaurants, theaters, and gyms without presenting proof of full vaccination, recovery from covid, or a recent negative test. Mask mandates have been dropped in select venues, though people are encouraged to wear masks indoors or in crowded place even where they are no longer required. 

I've mentioned to people and maybe even here that one of my big pandemic fears is long covid. I read today that a small portion of people with long covid may have shown no covid symptoms or only very mild ones. Not exactly what one wants to hear. Covid is considered an "acute illness," while long covid is considered a "subacute chronic illness." "Acute" means something lasts one to two weeks. "Subacute" implies two to four weeks. As for "chronic," that's four to six weeks or longer. I am not at all sure what "subacute chronic" means. Woman and older adults are more likely to develop long covid than men and younger adults. Of course when I read something like that I wonder how the author is defining "older." Am I considered "older" at 65? Will I not be so considered until I reach 70? I'm not sure I want to know. Ignorance can, indeed, be blissful. 

The Road goes ever on and on ... Day 277 (777)

Not a lot of coronavirus news out there today. There may be in a few days, though. Each of the 2,600 guests at the White House Correspondents' Dinner last night had to prove they'd been vaccinated, boosted, and negative on a covid test in the 24 hours preceding the dinner. Watching some of the highlights, I can't help but wonder how much of a superspreader event this might turn out to be. I saw no masks. POTUS did not put one on after he finished speaking. Please, pretty please, let him not have gotten it.

China is entering its five-day Labor Day celebration. It's normally a big travel time, but likely not this year. Beijing is tightening things even more. A negative test is now required to enter some public areas and sporting events and to use public transit. Even restaurants will require a negative test for entry. The time period within which the test must happen varies. For public transit, it is one week. For sporting events, group travel, malls, shops, and scenic spots, the test must be within the previous 48 hours. Covid testing will be free as of Tuesday so not being able to afford a test can't be used as an excuse. 

US hospitalizations are declining, but there are still many, many unmet needs from poor and uninsured patients who delayed seeking care during the earlier days of the pandemic. Some patients were afraid to go to the hospital or had trouble finding transportation. People waited months to get care for things such as a broken wrist or torn rotator cuff. The delays made the injuries worsen and become harder to treat. Federal programs that paid for covid care for uninsured people are ending. Such programs also gave financial aid to hospitals that offer the poor extensive uncompensated care for things such as the broken wrist or torn rotator cuff just mentioned. Health care in the US needed help before the pandemic and needs even more now. 

I wonder if there is an over-under for the number of positive tests to come out of last night's dinner. Any guesses?