The Road goes eve on and on ... Day 459 (959)

Happy Halloween! If the rain lets up, the friendly neighborhood inflatable T-Rex will be distributing candy here. If the rain does not let up, Rex will appear tomorrow evening, the Plan B for heavy rain tonight. We had so few kids here for so many years that they were taken in to trick or treat with friends in town. Two years ago, we had several families with kids and not wanting to see the pandemic cancel the kids' Halloween, I announced we would be setting out a bowl of candy on the porch and looking at costumes through the window. It worked, and we now have Halloween here. A lot of people even open their doors now to see the costumes first-hand.

The pandemic is not over. If it were, Shanghai's Disney Resort would not have closed suddenly with visitors stuck inside. Nor would Toronto hospitals be issuing alerts about overcrowded emergency departments. The CDC director tested negative after a course of Paxlovid but now has tested positive for a second time. I wonder, though, when they say she tested negative if they meant negative on two tests taken 48 hours apart. That is, after all, the guidance they were giving on their website. 

A study on non-mRNA vaccines and physical activity suggests that being active does help. A vaccine and low physical activity were 60 percent effective against contracting covid. A vaccine and moderate physical exercise were 72 percent effective; with high physical activity, the vaccine was 86 percent effective. Of course, more active people are probably, on average, at least a wee bit stronger than people who are not as active. 

A result of the pandemic that may or may not be good in the long run is that plans to build over 40 high-level (3 or 4) biosafety labs are proceeding in countries around the world. The argument for such facilities is that without them, certain geographic areas could not respond to the pandemic as well as they might otherwise have. India is building five BSL-3 labs and planning for nine more. Four institutions there have said that they will build BSL-4 labs. Globally, 27 BSL-4 labs are in the works in places including Kazakhstan, Singapore, and the Philippines. Not to cause any worry, a survey in the Philippines found that biosafety officers there had "only a weak understanding of biosafety." The argument that these labs are necessary for research somewhat overlooks the fact that at most labs, only 10 percent of the annual budget goes for research; the other 90 percent is needed to maintain the facility.

The coronavirus relies on our proteins to copy itself. Some researchers suggest that shutting off its access to those proteins would help slow or stop the spread. One such study has been published; the other has not yet been peer-reviewed. Some experts discount this work noting, "No matter what drug you approve, viruses will ultimately find a way around it." And to the suggestion that a drug cocktail might be developed as one was for HIV, one response is, "Trying to develop a combination therapy is more of a business challenge than a scientific challenge." 

 Looking ahead to the noted November holiday, Son #1 procured a frozen turkey; we had already procured a frozen tofurky for Son #2. The turkey is a bit larger than we usually get, but it seemed better to get it while we could than lose it by waiting for a smaller one. For the most part, the leftovers will freeze just fine.

The Road goes ever on and on ... Day 458 (958)

Only a couple of quickies today. I didn't want to resort to Twitter-news, and that's where most of the covid info seemed to be this morning. BQ.1.1 and BQ.1 are on track to become the dominant strains in the US in a few weeks; they currently account for 27 percent of new US cases. And the XBB variant is now dominant in both India and Bangladesh, but there has been no rise in cases or deaths ... as Son #2 would say, for now. 

With tomorrow's being Halloween, perhaps we can put discussion of to mask or not to mask to rest for a day. At one point, masks were illegal in Virginia for people over the age of 16. There may have been a loophole that the mask could not be worn to hide one's identity; I don't recall. In terms of identity, masks have made things interesting the past two years. I would not, for example, recognize the physical therapist I used this summer, and it is likely she would not recognize me. I have enough trouble recognizing people I do now when they are masked, but then I have a hard time with names and faces to begin with. 

Happy haunting!

The Road goes ever on and on ... Day 457 (957)

Six of the seven people working early voting's afternoon shift yesterday wore masks. No one commented that we did not need to wear masks around them. In response to that comment on Wednesday, I actually said nothing; I just got the couple the forms they needed to complete. I figured saying nothing said it all. I could have explained that given the number of people with whom I could potentially be face-to-face, I felt better with a mask on, but that would have been giving their comment some validity. As for the number of people with whom I could have been face-to-face, we had over 300 people vote in the afternoon on our way to 563 people voting all day.

Son #1 said he wasn't sure where he'd saved the reference, but there is a theory on covid's origins that combines the Wuhan lab and wet market. What if someone who worked at the lab sold an animal--dead or alive--that had been used in research there to a market vendor. Interesting theory and one I would not discount.

A covid outbreak in Zhengzhou, China has shut down the largest iPhone manufacturing plant; it produces about half of Apple's global supply. Some factory workers are in lockdown, and shops and hotels near the factory are closed. Last year, almost one-third of the $192 billion in iPhone sales was in the upcoming holiday season, making the timing of the outbreak not at all good. Apple has moved some of production to India, but it's not clear if they'll have enough iPhones to meet holiday demand.

And that's about it on the covid front, at least from me. The other items I found were retreads of info I've already posted or so technical that I wasn't going to give a Saturday to trying to make sense of it.

The Road goes ever on and on ... Day 456 (956)

New York City's official covid case numbers are holding steady at around 2,000 per day, but hospitalizations are on the rise, up to 1,100 on October 24 versus 750 in mid-September. Influenza came early this year along with RSV. Cases of both of these were down during the last two years when people were masking more and distancing themselves more. Some children's hospitals are already at capacity. Emergency room visits for children under the age of five for respiratory issues are at the highest they have been since the initial Omicron surge last winter. A children's hospital in Queens, New York that normally has 175 to 200 patients is up to 250. Some children are spending nights in the emergency room or operating room recovery units. 

A study shows that the rebound effect happens in people not taking Paxlovid. The study tracked participants in a clinical trial and found that 44 percent of those who recovered had symptoms flare up at various times during the four weeks after the infection. While 85 percent said that the symptoms were mild, the other 15 percent reported having at least one symptom that was moderate as opposed to mild. Common rebound symptoms were cough, fatigue, and headache. 

Two not-yet-peer-reviewed studies suggest that the protection provided by the bivalent booster and the original booster was roughly equivalent. There was no real advantage to receiving the bivalent one. Don't let this discourage you from getting the bivalent booster, though; either booster is better than no booster. And as one expert put it, "Don't drop your guard just because you've been boosted."

Working at early voting again this afternoon. In the past sessions I've worked, about half of the election officials have worn masks. I was doing paperwork for one couple on Wednesday; they said they were fine with my removing my mask unless it was an issue I had. Needless to say, the mask stayed in place, as it will this afternoon. I can't say that four to five hours of wearing an N95 mask are particularly pleasant, but it beats the options of my getting it again or my giving it to someone else. At least some of us are in this together. 

The Road goes ever on and on ... Day 455 (955)

I survived a yesterday that included behind-the-wheel training on a Honda Prius and a very wide wheelchair. I am pleased to report that the passenger survived in both vehicles as did I. I served as chief for the afternoon session of early voting; we topped out at 428 on the day. I will do it again tomorrow and try not to remember how stressful last week's 493 Friday total was. 

I only saw a headline so I have no details, but apparently a cruise ship on which "hundreds of people are confined to their rooms" is headed to Brisbane, Australia. I'm having flashbacks to the cruise ships affected at the start of the pandemic. Not a cruise I'd like to be on. 

China is giving an orally inhaled vaccine as a covid booster. Administration began in Shanghai. An orally inhaled vaccine could stop the virus before it reaches the rest of the respiratory system. The vaccine was tested in five countries as well as China. Regulators in India have approved a nasal vaccine that has yet to be used. There are about a dozen nasal vaccines being tested around the world. China has confined around 800,000 people in Wuhan. Thursday was the third straight day of over 1,000 new cases being identified nationwide.  

Any quantitative-AI types out there? NIH is running the NIH Long COVID Computational Challenge. The goal is to use artificial intelligence and machine learning tools to identify covid patients with a high risk of developing long covid. The prize pool is $500,000 going to first, second, and third places as well as up to five honorable mentions.

The Road goes ever on and on ... Day 454 (954)

I know better than to try to post anything today other than the pandemic is not over. I'm giving an elderly friend a ride to the doctor this morning, after which I hope to have time to come home and take The Family Dog out for some midday business before heading to work early voting in the afternoon. 

The Road goes ever on and on ... Day 453 (953)

Feel different almost three years into the pandemic? Rather stay home than go out? Feeling stuck in a rut? The pandemic has induced some personality traits in some of us, particularly those under the age of 30. In general, we are now less extroverted, creative, agreeable, and conscientious. The sharpest drops in conscientiousness and agreeableness were in people under 30. The changes are supposedly equal to about one decade of normative change. Don't worry too much; these changes could be temporary.

If you're still feeling nervous about the research at Boston University that combined virus bits from different variants, more news has come out. It seems that the manipulated strain was really less lethal than the original. The strain of mice used in the research is very sensitive to covid and widely used in covid research. The original viral strain killed 100 percent of the mice who received it, meaning that the 80 percent for the combined strain was an improvement. 

 While the government has reprimanded Boston University, it has ignored similar research at other labs including some at NIH. The oversight policy for such research is known as Potential Pandemic Pathogen Care and Oversight or P3CO. According to a virologist at the University of Saskatchewan, "...the P3CO framework needs to be overhauled pretty dramatically. The whole process is kind of a black box that makes it really difficult for researchers." A committee of government advisors is expected to deliver updated recommendations around the end of this year. That board is also looking at risk from computer software that can figure out how to change pathogens and not in a good way. This all sounds hunky-dory except that research not funded by the government does not have to follow federal guidelines. One suggestion is that the policy be modeled on the Federal Select Agent Program. Under that program, anyone working with certain substances such as anthrax must register with the federal government no matter who is funding the research. 

After that bit of laboratory research news, another laboratory study has shown that influenza and RSV (respiratory syncytial virus) can fuse to form a hybrid virus that can evade the immune system, infect lung cells, and result in viral pneumonia. The supervisor of the research reports, "This kind of hybrid virus has never been described before. We are talking about viruses from two completely different families combining together with the genomes and the external proteins of both viruses. It is a new type of virus pathogen." Influenza usually infects cells in the nose, throat, and windpipe while RSV prefers windpipe and lung cells. The RSV tends to go lower in the lung than influenza, and the lower it goes, the more serious the resulting infection. The research supervisor notes that "influenza is using hybrid viral particles as a Trojan horse." He went on to say that the research could be extended to other viruses as well as whether it can happen with animal viruses. I wonder what level of biosafety this research will merit.

The Road goes ever on and on ... Day 452 (952)

I have no idea why yesterday's post turned three paragraphs into three way-too-long lines. It appears that my efforts to fix it worked, though I will now have two posts with the same publication date.

Less than 10 percent of people over the age of 65 have gotten the bivalent booster. That's even worse than our other vaccination stats. While 79 percent of the population has gotten at least one basic dose of vaccine, less than 40 percent has gotten any booster(s). We rank 73rd in the world for boosters per 100 residents. While those people who opted out of the basic vaccination are not going to be signing up for boosters, it should be possible to persuade those who have had the basic vaccinations to get at least some of the boosters. 

So far, covid is showing no signs of being seasonal as influenza is, meaning that an annual booster may not be an option. In fact, the leader of the FDA's vaccines operations worries that at the rate covid mutates, we may need yet another booster in the next year. He notes, "I'm not saying that's what's going to happen, but it's what keeps me up at night, because we see how fast this virus is evolving." 

And on a general note, Pfizer may charge between $100 and $130 for a vaccine dose once the government stops buying the doses being given now. The gods help those people with no health insurance. 

We continue to float atop, dangling our feet into a "variant soup." The BQ.1.1 and XBB variants are the most immune evasive variants yet followed closely by BA.1.75.2. These variants are resistant to the only monoclonal antibody left that worked well against the preceding variants. They are also resistant to Evusheld, used for prevention by immunocompromised people. In other words, we may be getting ready to slip off our raft to start dog paddling as fast as we can.

National Assessment of Educational Progress results have been released, the first results since before the pandemic began. Math scores for eighth graders fell in nearly every state. Only 26 percent of eighth graders are proficient, compared with 34 percent in 2019. Math scores for fourth graders fell in 41 states. While 41 percent of fourth graders were proficient in math in 2019, only 36 percent are now. Reading scores declined in over half the states, with no state showing a sizable improvement. Only one in three fourth graders were proficient in reading. The Secretary of Education summarized the results: "I want to be very clear: The results in today's nation's report card are appalling and unacceptable. This is a moment of truth for education. How we respond to this will determine not only our recovery, but our nation's standing in the world." I'm actually not sure what our standing is now, so that last part may or may not be true. Scores for students in the state in which I live, Virginia, were roughly the same as the national averages.

As people start to declare the pandemic over, the time is running out to lay any groundwork to prepare for future pandemics. There are three vital areas to consider: (1) disease surveillance, (2) strengthening the global healthcare workforce, and (3) ensuring equitable access to treatments and vaccines. The White House's pandemic preparedness plan warns that "future pandemics could be far worse." In the wide area of pandemics, it is worth keeping in mind that "you can't see what you're not looking for." I am afraid that if the Republican party gains control of both houses of Congress, the government will stop looking while the next pandemic creeps up on us.

The Road goes ever on and on ... Day 451 (951)

The CDC director, Rochelle Walensky, has tested positive for covid. I’m waiting to see if she abides by the CDC guidance to consider yourself ready to rock and roll after only five days if symptoms are improving or gone and there’s no fever. I’m sure she’s been vaccinated, but I’ll go ahead and throw out the figure that there is a 96 percent reduction in death for two boosters versus unvaccinated.

“It’s going to be a rough winter” says one of the medical talking heads. Influenza cases are rising earlier than usual and are expected to soar in the coming weeks. The travel and crowds associated with winter holidays are certainly not going to help; flu cases are predicted to soar in the coming weeks. Besides covid and influenza, experts are also watching a surge in Respiratory Syncytial Virus (RSV), which can be fatal in children and those over the age of 65. An infectious disease expert in Seattle notes, "We're seeing everything come back with a vengeance." This means that, according to an evolutionary microbiologist at Penn State, "We're in uncharted territory." Masks and social distancing sent influenza waning in the last two years. Sadly, those no longer fit into the equation. The twindemic some experts have warned of could become a tridemic. On a related note, there is a new proprietary genetic test that can identify SARS-CoV-2, influenza, and RSV A and B varieties in one PCR test. Someone may be laughing all the way to the bank on that one.

I have no idea how many children have been given flu shots, but fewer than one in three children ages five through 11 has finished even the basic series of covid shots. Yep, it's going to be a rough winter.

The Road goes ever on and on ... Day 450 (950)

Here I am with a fairly stable Internet signal, and no real news to report. Our governor has promised parents that the CDC's covid vaccination "mandate" will not be applied in Virginia. He of course neglected to say that it is a recommendation and not a mandate. One of the principles he campaigned on was parents making educational decisions, so letting his supporters know that they did not have to follow the CDC recommendation fit right in.

The usual variants are still out there, Ukraine is still at war, and the head of lettuce lasted longer than the British Prime Minister.

The Road goes ever on and on ... Day 449 (949)

This will be quick. The Internet is going in and out, and I'm not going to try to post from my iPhone. There are multiple variants out there in a multitude of places. Experts say multipole varinats operating at the same time may be a new phase of the virus. So far, there is no indication that the variants can bypass boosters or Paxlovid.

A CDC advisory panel unanimously endorsed adding covid shots to the routine vaccination schedule for both children and adults. This does not mean that vaccination will be required for school attendance. Flu shots are on the recommended list but are not generally required by schools. Some pundits note that this is a sure sign that covid "is here to stay."

And now to try to get one of the Internet-on moments.... 

The Road goes ever on and on ... Day 448 (948)

If you were scared after reading yesterday's report of the research done at Boston University, said research is under investigation. You can read about that here. One thing the article just linked mentioned that concerned me is that the research was only done at biosafety level three, one level down from the most secure level. A molecular biologist at MIT explained, "This highlights the lack of oversight for research of this kind. If there is even a small chance that you might get something surprising from these experiments you would want to have been doing them offshore and at biosafety level four, not a 10-minute drive from downtown Boston."

Since I let today get away from me, forgetting that I had told The Professor that I would make bread, I'm sticking with a few quick notes today. The FDA has given the Novavax vaccine emergency use authorization as a booster given six months after the initial series. Covid cases in Beijing have quadrupled in several weeks. The numbers are small but still concerning. Ten days ago there were 49 new cases; now, 197 new cases. Some neighborhoods have been locked down with residents required to be tested frequently. Shanghai clearly thinks the pandemic is not over; the city is planning to build a 3,250-bed quarantine center on a small island near the downtown area. 

The XBB Omicron subvariant has caused the number of cases in some Asian countries to double in one day. The BQ.1 and BQ.1.1 subvariants now account for 11 percent of US cases, up from three percent two weeks ago. Other subvariants are surging in Singapore, including BA.4.6, BF.7, and the aforementioned XBB. Some of these may be getting around the natural immunity from past infections, even Omicron infections. Fortunately, there is no evidence the new subvariants cause more severe disease, and Paxlovid does work on them. 

The wi-fi has been going in and out here, so here's hoping I can get this post published.

The Road goes ever on and on ... Day 447 (947)

How about a bit of good news? For the first time in five months, US covid hospitalizations have dipped below 25,000. Bivalent boosters are available to children as young as age five. The pandemic or, perhaps, working remotely, contributed to a mini baby boom in 2021. The birth rate for US mothers was up 6.2 percent relative to 2015-2019. The increase was more pronounced for first-time mothers and college-educated women. Women with less education showed a decline in birth rate. 2022 numbers from California suggest that the boom is continuing. 

Some not-so-good news. The US high school class of 2022 had the lowest average ACT score in over 30 years. The pandemic affected three academic years, and it may take more years than that to recover. The Professor has continued last year's complaints that the second-year engineering students in his physics class just do not have it compared to the ones he taught in pre-pandemic years. Mental health is also declining among teenagers. 

The Party Congress is meeting in Beijing, and the party line is sticking with long covid. There have even been some public demonstrations, and the government response was severe. Many social media accounts have been blocked in an effort to stop the protesting.

Finally, there were reports--which I had not heard--that researchers at Boston University created a new and deadlier strain of SARS-CoV-2. Some reports said the new strain had an 80 percent kill rate. The university says that the research was not gain-of-function, but that "...this research made the virus replicate less dangerous." Researchers were looking at the Omicron spike protein and its role in the variant's high transmissibility. Combining the Omicron spike protein with an ancestral coronavirus strain did yield an 80 percent mortality rate in 10 mice. Researchers suggest that while vaccine escape is defined by mutations in the spike protein, the pathogenicity determinants are outside the spike protein. One of the funding agencies, the National Institute of Allergy and Infectious Disease, has said it was not informed of the specific research question. The university responded that money from NIAID was not used for the steps specifically leading to the creation of the high-mortality strain, and noted that the determination of viral proteins "...will lead to better diagnostics and disease management strategies."

The Road goes ever on and on ... Day 446 (946)

Germany has reported 150,052 new covid cases in one 24-hour period. Hospitalizations "for covid" there are the highest they have been. Speculation is that Oktoberfest turned out to be a superspreader event. It does not help, either, that the booster rate among Germans ages 60 and older is one of the lowest in Europe. ICU admissions are also rising, and 30 percent of ICU patients are on ventilators. No specific variant or subvariant was identified.

The Philippines, meanwhile, are watching cases of the XBB variant rise. The XBB variant surge in Singapore will soon become their second highest surge of the pandemic. Before XBB, the covid reinfection rate was five percent. It is now 17 percent thanks to XBB's immune escape properties. The XBB variant is in the US but not in such large numbers ... yet.

Continuing with potentially disturbing news, preliminary data in a very small study suggest the cellular mechanisms of the BQ.1.1 variant are moving closer to Delta severity. Remember how wicked Delta was. Now picture the Terminator. "I'll be back."

Meanwhile, Ebola in Uganda has mutated; there is no evidence the mutation is more transmissible. And cholera is on the rise in a region in India. 

Not much news today. I had some errands to run this morning, and by the time I got to this, dinner was looming. Pasta tonight so that there are leftovers tomorrow when I work at early voting until after 5:00.

The Road goes ever on and on ... Day 445 (945)

It's Monday, and the coronavirus news is definitely of the Monday variety. The BQ.1 Omicron variant now accounts for 25 percent of covid cases in New York City. While case numbers there have been flat over the past month, hospitalizations are rising significantly. Unless things take a radical turn in the next two months, 2022 could be a single-variant year. The only "new" variants this year are all offshoots of Omicron. Another quickie: Respiratory infections in children have been associated with the onset of diabetes. The likelihood of the onset of diabetes is higher in children whose respiratory infection is covid. 

An article in Nature concerns how SARS-CoV-2 is associated with changes in brain structure. The researchers looked at 401 people who had had covid and 384 people who had not. All had had MRI scans done before the pandemic and again, during. Those who had had covid infections showed a greater reduction in grey matter thickness and tissue contrast in the orbitofrontal cortex. They also showed tissue damage in regions functionally connected to the olfactory cortex. Given covid's effect on the senses of taste and smell, this result is not that surprising. Finally, people who had had covid showed a greater reduction in global brain size. 

Unvaccinated people who get covid during pregnancy run a greater risk of stillbirth. Pathologists are reporting that covid can directly infect the placenta. This can happen even if the covid case presents with mild or nonexistent symptoms. In people with severe symptoms, the mother's lungs can be damaged and blood, somewhat clotted, ill effects that can be passed to a fetus. These, says a researcher at the Cleveland Clinic, "are pregnancies that should not have ended." Pregnant or breastfeeding people were generally excluded from the vaccines' clinical trials, though there seemed to be little effect on pregnancies in rats. Parental high blood pressure, age, and diabetes status also raise the risk of stillbirth but are not as risky as being unvaccinated. Infants too young to be vaccinated, that is, 5 months old or younger, are hospitalized with covid at higher rates than any age group other than adults ages 75 and older. 

Dr Fauci has called long covid a public health emergency for millions of people, saying, "It's a very insidious beneath-the-radar-screen public health emergency. It isn't that you have people who are hospitalized or dying, but their function is being considerably impaired. For reasons that are obvious, that doesn't attract as much attention as a death rate." Describing the big picture of long covid, he notes, "There are more unanswered questions than there are answered questions." Finally, does Dr. Fauci think the pandemic is over? "If you declare victory, you're declaring an emergency victory because we haven't won the battle yet." 

Happy Monday!

The Road goes ever on and on ... Day 444 (944)

It's a slow weekend on the coronavirus front. Pittsburgh Public Schools are reacting to a rise in covid cases locally by recommending that masks be worn. This of course raises the question of how many parents or staff will actually comply. "Recommend" is not "require." I suspect the mayor, city council, or whoever would be able to require rather than recommend is, for now, taking the easy way out. Something will likely hit the fan the first time an official at some level somewhere reinstates a mask mandate.

While I recognize that a model is by no means a representation of what will come to pass, it is still worth thinking about a model I found this morning. It showed the decline of the BA.5 subvariant in the US and showed BQ.1 and BQ.1.1 "going parabolic" as Thanksgiving approaches. Since Thanksgiving is the year's busiest travel weekend, things could get dicey if the model is even almost valid. We've had winter surges before; why should this year be any different?

Israel is reporting a potential Ebola case in a citizen who fell ill after arriving from Uganda. We have become so global that it's easy for this to happen. If the case was caught early enough, it can likely be contained. Ebola is not respiratory, fortunately, and is spread through bodily fluids, making it harder to transmit than covid. I'm not wishing ill on Uganda, but I'd rather cases be confined there than loosed onto the world.

The Road goes ever on and on ... Day 443 (943)

There were seven election officials working yesterday afternoon. Five of us wore masks. As one female voter entered, she asked if she had to wear a mask. I politely said, no, masks were optional. She removed her mask and noted that anyone wearing a mask must be immuno-compromised, which she wasn't. I handed her a pen and directed her to an electronic poll-book for check-in. I bet I know for which party she voted.

News items I've found almost seem like bookends to the pandemic: new, worrisome variants and long covid. The couple of posts written by people suffering from long covid were frightening. My Aussie friend is very slowly getting better but still has good days and bad ones. One of the good days may tire her out and be followed by a bad day. She is happy that the brain fog and constant headache have eased up.

On the variant front, Omicron's BA.5 is still the dominant variant in the US, but BQ.1 and BQ.1.1 now make up over 10 percent of new cases, around 20 percent in New York and New Jersey. Those states are also seeing a rise in hospitalizations and nursing home infections. BA.4.6 makes up 12.2 percent of cases in the US but will soon be passed by the BQ pair on their way to overtake BA.5. Dr. Fauci offers, "When you get variants like that, you look at when their rate of increase is as a relative proportion of the variants, and this has a pretty troublesome doubling time." He also notes, "As much as you want to feel good about the fact that cases are down, hospitalizations are down, we don't want to declare victory too prematurely. And that's the reason why we've got to keep an eye out on these emerging variants." BQ.1 variants are also outpacing other variants in places. England and Germany already have BQ.1 surges building. 

The BQ.1.1 variant poses an added danger in that it seems to be able to elude important monoclonal antibodies, cutting the number of treatments possible. Because BQ.1.1 evolved out of BA.5, the bivalent vaccines may offer some protection. Still, only seven percent of eligible Americans have gotten that booster. I actually wonder from time to time if it will still be offered around the end of the year when I will be looking to get it. 

Aside from BA.5 fading and BQ.1.1 gaining steam, the XBB variant is surging in Singapore. Its wave may be higher than the BA.5 wave was. Singapore is among the best-vaccinated countries in the world. Around 90 percent of people have gotten the basic two doses of vaccine, and around 78 percent have gotten some boosters. In other words, they're about as vaccinated as a country can be, and they still have an active wave building. My mask isn't coming off anytime soon; that's for sure.

The Road goes ever on and on ... Day 442 (942)

Not much news today, but then not much time. Working early voting this afternoon calls. The German Health Minister has called for the reintroduction of mask mandates, citing the "sharp increase" in the number of covid cases there. That said, "called for" means just that: He'd like to see them reinstated but does not have the authority to do so himself. 

We people on the north side of the age of 65 know that we should get the bivalent booster, but what's the deal for younger people? There are both risks and benefits to consider in making the choice. For males between the ages of 18 and 39, there is a very low risk of myocarditis or the inflammation of the heart muscle. Cases of myocarditis after vaccination tend to be mild ones, and there are only five to 10 cases per one million doses administered. Getting boosted may also involve some inconvenience. Some people experience side effects such as fever and fatigue. Not everyone can afford to miss work to get boosted either.

Then there are the benefits, the first one being that the booster will help prevent hospitalization and death. It will also potentially prevent myocarditis, a possible side effect of a case of covid as well as vaccination. The myocarditis after infection is usually more severe than that after vaccination. There is also some evidence that vaccination may help reduce the risk of long covid. Besides offering broader protection, the booster helps prevent infection and transmission and shorten the duration of the illness. 

The Road goes ever on and on ... Day 441 (941)

Nearly 200 million Chinese are in some form of lockdown as the party congress looms. Travel into Beijing is being regulated. Zero covid will be celebrated at the congress, treated as a success despite its contribution to economic pressure within China. China will bill itself as one of the few countries to protect the public from widespread illness and death, and because there is so little covid, there is no long covid in China.

A large long covid study considered a list of symptoms and then compared people who had had covid to people who had not on each symptom. Thirty-eight percent of the people with covid had a long covid symptom between 30 days and one year after infection compared with 16 percent of the people who had not had covid. In other words, covid increased the chances of showing at least one long covid symptom by 22 percentage points. For patients aged 18 through 64, a covid diagnosis upped the risk of a long covid symptom by 21 percentage points. For patients over the age of 64, a covid diagnosis upped the risk by 27 percentage points. Having a mild case of covid only partially protected against long covid. Of people hospitalized for covid, 54 percent had a long covid symptom later. For people who had covid but were not hospitalized, 34 percent showed a sign of long covid. Women who survived covid had a 54 percent chance of showing signs of long covid compared to 37 percent of men. In terms of vaccination status, a recent study of US Veterans Affairs data showed that 32 percent of those who had been vaccinated but suffered a breakthrough infection developed a long covid symptom compared with 36 percent of unvaccinated veterans. No data was collected by race.

Long covid symptoms have a high correlation with four factors: high levels of virus RNA in blood, pre-existing type 2 diabetes, high levels of Epstein-Barr virus DNA in blood, and the presence of "autoantibodies" that attach a person's own body. More definitive research into long covid is clearly needed given that Harvard researchers estimate an eventual cost of $2.6 trillion or one-tenth of the annual gross domestic product. 

My Mom's assisted living facility is giving bivalent boosters and flu shots next week at the same time it is doing away with all its covid restrictions that have gradually loosened over time. No longer must staff or visitors wear masks. No longer must visitors answer a series of covid-based questions in order to enter. Visitors must still check in and out at the front desk, but that's all. Needless to say, this does not please me at all. I shall continue to wear a mask there, just as I do in any indoor setting with people I do not know. As I told The Professor, I did not need to hear that news on a day when I'd written here about case numbers rising in Europe. The 20 self-testing kits I ordered arrived today; I still hope not to need them, but it pays to be ready. 

The Road goes ever on and on ... Day 440 (940)

Got up this morning, and my first look at the news yielded some charts showing the rise of covid in Europe and also in the US. Cases are up eight percent over last week in the EU., not including home tests. Then there was this from the White House Response Coordinator: "Our next message is very simple: Don't wait. Get vaccinated. Go get vaccinated now, get it before Halloween so you are ready before Thanksgiving and Christmas and the holidays." He noted that getting the bivalent booster was the "most important" thing someone could do for their health today. Good thing I ordered my at-home tests yesterday because the US government doesn't have an "adequate" number of tests for winter due to a lack of funding from Congress.

The Commonwealth Fund warns that if the current low rate of bivalent vaccination continues, thousands of people could die in fall and winter. If 80 percent of those eligible got boosted, it would prevent around 90,000 deaths and over 936,000 hospitalizations plus avoid $56 billion in medical costs. Those sound like pretty good reasons to me.

Soon-to-retire Dr. Fauci says, "We rank very poorly in our acceptance of vaccines. Somehow we've got to get down to the root cause of that, and I know it's going to be very complicated because a lot of it is because of political divisiveness." Apart from political issues, many people are experiencing vaccine fatigue and confusion over the types of vaccine. Should they get the third booster if they did not have the first two? Or just the first? I can see how it could be confusing to someone who does not follow the day-to-day or even week-to-week course of the pandemic. Missing something--such as what a bivalent booster is and why we should get one--can have consequences down the line.

A short post, but early voting calls, and I have a couple of things to do before I go to work. Given all those rising lines I woke up to, I need to make sure my mask and a couple spares are in my bag with the election handbook.

The Road goes ever on and on ... Day 439 (939)

"We can no longer guarantee the safety of our patients." These are not exactly the words one wants to hear or read about a medical facility. They are supposedly the words put out by a clinic in Munich, Germany, after half the medical staff went out with covid. Germany just hosted Oktoberfest, where covid was likely a chaser to beer, an Autumn superspreader, not unlike the coming Thanksgiving, Christmas/Hanukkah, Kwanzaa, and New Years. I just ordered more rapid antigen tests, hoping, of course, that I eventually have to discard them as too far out of date. The covid situation here typically follows that in Europe by several weeks. I figured we should be ready. Another reason is the increase of covid in wastewater analyses. Covid was up 3.1 percent over the past week in Boston, and up nearly 100 percent over the past two weeks.

Here's a troubling statistic. While 40 percent of Americans got the first covid booster, only four percent have gotten the latest, bivalent booster. Interestingly, I have spoken with three people yesterday and today who have been trying to find somewhere locally that they can get the booster. The usual drugstore or grocery store pharmacies have not gotten it yet, got it labelled as expired, or just don't answer the phone. I hope that explains some of the low percentage, but I doubt even 40 percent of Americans would line up for shots were they readily available. 

There is a growing body of evidence linking SARS CoV-2 with maternal complications. Pre-eclampsia rates have increased during the pandemic. And while fertility appears unaffected, the vaccine appears to cause a slight, temporary change in menstrual cycles. It seems that the placenta after a miscarriage or stillbirth, appears radically different if the mother suffers from covid. Most of the women who miscarry with covid are in their second trimester, unvaccinated or only partially vaccinated, and were infected with covid within two weeks before the miscarriage. Interestingly, cases of stillbirth or miscarriage somewhat disappeared with the arrival of Omicron. 

China is seeing its largest surge of cases in one month as daily counts have more than doubled in the past week. Just as Oktoberfest likely contributed to the surge of cases in Germany, China's week-long National Day holiday began on October 1. The concern now is whether the surges will move into Beijing before the party congress starts on October 16.

Don't blame Bill Gates for covid, but the pandemic has given new life to personal computers. The pandemic has seen a 20 percent monthly increase in the use of Windows. While Windows remains dominant, Apple also gained significant ground. Chrome OS is also growing, especially in educational settings. 

Finally, three in five Americans said that they either misled others about an infection or vaccination status or did not follow public health guidelines. Out of a sample of 1,733 people, 41.6 percent said they had either misrepresented and/or not adhered to at least one of nine public health items. Also, 24.3 percent said that they had been taking more precautions that they really were; 22.5 percent admitted having broken quarantine; 21 percent had avoided testing when they had or thought they had covid; and 20.4 percent said they had not mentioned having had or possibly having had covid during a screening at a doctor's office. Being adherent or truthful increased with age. I'll give a big "Doh!" to the finding that misrepresentation or non-adherence was more commonplace among those with a greater distrust of science. No relation was seen between misrepresentation or adherence and gender identity, political affiliation, attitude toward vaccination, race or ethnicity, education level, or wearing a mask in stores.  When asked where they had gotten their information about the coronavirus, 62 percent cited medical personnel, 53 percent cited the CDC, 51 percent cited the local health department, 7 percent cited a certain population, and 5 percent cited a certain celebrity. I wonder if they counted the former President as a celebrity.

The Road goes ever on and on ... Day 438 (938)

Japan boasts the fewest cumulative covid deaths per capita of any major country, one in every 2,758 people. We aren't doing nearly as well clocking in at one in every 315 people. The number one risk factor for covid death is advanced age. In that regard, around 25 percent of the Japanese population is age 65 or older. Here? Only 15 percent, and they still are leaving us in the dust. Given their much higher population density, we look even worse. The Japanese government never mandated masks, though wearing them is much more the norm there than it is here. The government did begin distributing masks very early on in the pandemic, in spring 2020. At the same time, they started the 3Cs campaign. Those Cs would be CLOSED SPACES with poor ventilation, CROWDED PLACES with many people nearby, and CLOSE-CONTACT SETTINGS such as close-range conversations. They even had a graphic showing a Venn diagram noting that the union of the three Cs was the most dangerous place to be. 

Looking ahead, at least half the people in Japan plan to use masks indefinitely. On the vaccine front, 83 percent of the population got vaccinated "promptly," compared with our 68 percent over a much longer time. Booster-wise, 95 percent of the Japanese population has been boosted. Here, some 40.8 percent of people have gotten one booster, and 42 percent have gotten two. It's a good thing it's not a race unless it turns out really to be one.

Several infectious disease and epidemiology folks were asked about the pandemic's being over. One answered by posing the question of whether we are in a manageable pandemic and noting that what happens this winter will be telling. The important metrics were said to be healthcare capacity, deaths, and predictability. Another person said that he would look at all-cause mortality and ask whether more people are dying than usual. This metric was often cited in the pandemic's initial months but not so much lately.

A report on the JAMA Network said that with Omicron, the five-day isolation period after symptom onset was totally inadequate for most people. It is essential to have negative antigen tests. In other words, my playing hermit for the three weeks of positive tests while waiting for two negative tests 48 hours apart was the right thing to do. I am lucky, being retired and somewhat anti-social. Staying out of circulation for three weeks was not the issue for me that it would be for some people. 

The Road goes ever on and on ... Day 437 (937)

Having taken some time to make blueberry muffins, I'm taking a pass on a blog post today. I do have some general notes, but they'll be just as relevant tomorrow as they would be today. I descend now to the basement where I am attempting, so far in vain, to wrestle the office back into usability. 

The Road goes ever on and on ... Day 436 (936)

A quickie today in hope that I can afterwards retreat to my sewing room and do some, well, sewing. I had a couple of things crop up or otherwise take more than the intended amount of time today, which have slashed the amount of time I thought I'd have this weekend for me-stuff. 

I read part of a report from the UK Health Security Agency titled "SARS CoV-2 variants of concern and variants under investigation in England." The summary introduces the rapid development of several new Omicron variants starting to appear in the UK. These have characteristics "likely to produce a degree of escape from current immunity in the UK." These variants are contributing to the increase in covid; however, there are potentially other factors contributing.

In a US cohort of 200,000, vaccination reduced the risk of long covid by 30 to 40 percent. Not only that, the protection persisted through breakthrough infections. Reducing the risk doesn't mean you won't get long covid, but the odds you won't are better than if you hadn't been vaccinated. 

Short and not necessarily sweet, but that's it for today. There's a quilt awaiting quilting,

The Road goes ever on and on ... Day 435 (935)

Evidently, hundreds of people may be dying each day because Paxlovid and monoclonal antibodies that reduce the severity of a case of covid aren't given. There are two main reasons. First, public discussion of the therapies focuses on caveats and concerns rather than on risk reduction. Second, many Americans, especially Republicans, still don't take covid seriously. The White House response coordinator noted that if every American aged 50 and older with covid got treatment with Paxlovid or monoclonal antibodies, daily deaths in the US could fall to around 50 from the current around 400. 

Paxlovid is said to be one of the most effective anti-virals ever. The covid death rate for people under the age of 50 is so close to zero that reducing it in any statistically significant was is difficult. For people 50 and older, the case is very different. In a not-yet-peer-reviewed study of 560,000 patients 50 and older, 0.016 percent of the patients who received Paxlovid died. The death rate for patients not getting Paxlovid was frighteningly higher at 0.07 percent. It seems, however, that only about a fourth of the patients eligible to get Paxlovid actually got it despite its availability and no cost. Results were pretty much the same for both vaccinated and unvaccinated patients. 

The White House response coordinator called it "shocking" that a smaller share of American 80-year-olds (fewer than 30 percent) with covid were getting Paxlovid than American 45-year-olds. Many doctors say that they worry about possible side effects or rebound cases. While there are studies showing that patients who got Paxlovid were more apt to have a rebound cases, another found that one out of eight patients not getting Paxlovid also had rebound cases. A physician at the University of California, San Francisco explains, "Medicine is about weighing costs and benefits. The recommendation should be clear and unambiguous for people at high risk: The benefits of the drug outweigh the downsides."

It's been shown that there are concentrations of covid deaths in Republican communities, a phenomenon known as "red covid." It was thought that Republican communities would end up with more natural immunity because more people would get covid there. The gap between deaths for each political party did narrow for a while, but is now widening again. Paxlovid use is much lower in these areas. Of 20 states with the least Paxlovid use between late August and late September, looking at a per 100 diagnosed cases figure, 18 were won by the former president in 2020. People in these states need to be informed, possibly multiple times, that covid is not the same as influenza, and needs to be taken seriously. Really.

The Road goes ever on and on ... Day 434 (934)

It is estimated that bivalent vaccines could prevent around 90,000 deaths in the US. Obviously, this will not come to pass unless enough people get the booster. Although two-thirds of the US population is fully vaccinated with at least their initial series, only one-third of the population has gotten a booster dose, according to the CDC.

Nearly 24 million US adults have long covid, and over 80 percent of them have some trouble carrying out daily tasks. Over 25 percent report significant limitations on daily activities, and up to four million people are estimated to be out-of-work because of long covid symptoms. Almost 30 percent of adults who had covid have reported having long covid symptoms at some time. We know the concept of long covid and the wide range of symptoms, but it's still not clear how to treat it. There also are no diagnostic tools for it. While it is classified as a disability, qualifying for Social Security benefits requires proof that it has lasted or will last for over one year. 

The 25 percent of adults with long covid who report significant limitations? About 40 percent of Black, Latino, or disabled respondents reported significant limitations. Those groups have been hit harder than others in many pandemic-related ways. Age, race, gender, or previous disability don't seem to figure when it comes to developing long covid, but some of those factors may come into play in how severe one's case of long covid is.

There were seven of us working the early voting polls yesterday afternoon; three of us wore masks. One worker said she did not need a mask since she was a nurse and had had all the boosters as well as a mild case of covid some months ago. I did not want to get into an argument over breakthrough infections and whether mask-wearing might be worthwhile. A fair number of voters came in who were wearing masks; most appeared to be in the age 60-plus group. I'll be working again tomorrow afternoon, and will see how things might change on a Friday. 

The Road goes ever on and on ... Day 433 (933)

Some quick notes, and the news they offer would not be called "good." Variants are evolving faster than vaccines. BA.2.75.2 is no longer the most immune-evasive variant out there. Several others such as BR.2, BM.1.1.1, and CA.1 have passed it. The one to watch, though, is XBB. It is even more immune-evasive and may actually work against the protection offered by the BA.5 bivalent vaccine. 

In terms of an autumn wave, numbers have been going up in Europe. It is not encouraging to see that Germany is reporting hospitalizations "for covid," not "with." This suggests that serious covid is on the rise along with infections. BA.5 is still the dominant variant, but the weather is changing, immunity is waning, and behavior is changing. Some evidence for weather being a principal factor is that no increases have yet been seen in Israel, where the weather is still on the warm side.

Finally, how does it feel to be flying blind? We really are as it relates to covid. Over 90 percent of testing and sequencing has stopped around the world. So besides not having a good feel for how many people have covid, we can't tell which variant they have. Another stealth variant might arise and go haywire before it's identified. This does not make me at all happy. 

I will leave in a half hour to go work at early voting. I plan to wear a mask. Masks were required last year but are not this year. I wonder if anyone else will be wearing one. I'm guessing no more than one other person.

The Road goes ever on and on ... Day 432 (932)

Another slow news day, or maybe I just didn't look deep enough. A lot of what I see is of the "same old same old" variety such as China's continuation of zero covid. Speaking of China, the first covid-specific travel notice was issued for China in January 2020. Since then, the CDC website has maintained a country-by-country list of covid travel advisories. Not any longer. Now, they will only post a country if there is a new variant or special situation severe enough to warrant an advisory. The coronavirus is becoming endemic at least in the perception of some entities and many individuals.

An analysis of surveillance data for almost 1,000 covid exposures found that students accounted for a higher proportion of onward transmission than did the general public: 46.2 percent vs. 25 percent. Said one of the study's authors: "Our analysis suggests that younger age groups were deeply involved in the spread of the infection." I can't say that this surprises me. Children in general gravitate to each other, traveling in packs so to speak. They also have much lower vaccination rates than adults or even older "children" such as teenagers.

I start working early voting tomorrow afternoon; I'll be doing that Wednesday and Friday afternoons until the formal election on November 8. I'm not sure how much I'll get written and published on those days since pulling out my own laptop doesn't really look good for the precinct chief which is the wole I'll be filling. There's only one race on this year's ballot, for the House of Representatives. That will likely mean a lower turnout, but we'll see. 

The Road goes ever on and on ... Day 431 (931)

Another slow day on the coronavirus news front. Despite spending a good amount of time searching website after website for something new, I found only one thing to report here, and it's not all good news. We may be starting into a fall or fall-winter surge. At least New York City is starting to record increases in covid cases. It does not bode well that scientists have identified even more Omicron subvariants. While some of those have not been found in the US ... yet ... knowing that they are out there does not lift my spirits. I've mentioned BA.2.75.2 before. Dr. Fauci says that BA.2.75.2 "looks suspicious--that it might start to evolve as a [troublesome] variant." BA.2.75.2 has been identified in the US but accounts for only a small percentage of total covid cases so far. 

Another subvariant, BA.2.3.20, could be worse due to the number of mutations it carries. Evidently, a fourth mutation, XBB, is well worth watching. It seems that all these new subvariants have a "growth advantage." They carry more immune escape and may be more transmissible. BF.7, otherwise known as BA.5.2.17, could be contributing to a significant share of the new cases in Belgium and other European countries. One worry is that it may be able to evade the natural immunity coming from a BA.5 infection.

Post-covid-wise, I still tire very easily. Walking the dog twice each morning (anywhere from 1 to 1.5 miles each) eats up any energy I might be tempted to expend on other exercise. That means it helps keep me from overdoing it. If there's a new subvariant out there that can evade whatever immunity I retain from my September infection, I do not want to meet it. You don't want to either.

The Road goes ever on and on ... Day 430 (930)

Given what we've learned during the coronavirus pandemic, how ready are we for another? A 2019 assessment of global health security ranked the US first at preventing and detecting outbreaks, the most adept at communicating risk, and second only to the UK in terms of the speed of a response. This analysis did not account for the then-president's administration. Besides the attitude of the administration, the national response was hampered by a lack of data-sharing between states or between states and the federal government. Some states, it seems, even have laws that forbid data sharing. Dr. Fauci calls what we have a "patchwork" system. That's a big reason we ended up getting and using pandemic information from the UK, Israel, or South Africa.

But maybe there won't be another in the near future. Or will there? The Rockefeller Pandemic Prevention Institute carries out pathogen surveillance that suggests there will be another and it could be sooner than we might like. From 2012 to 2022, Africa saw a 63 percent increase in outbreaks of pathogens jumping from animals to humans compared to the period 2001 to 1011. The director of the Pandemic Center at Brown University's School of Public Health says that this could be the new normal. The house in which I live sits in the 100-year flood plain of a large creek; what if one of those floods came every three years? That could be what we're looking at in terms of pandemics. The CDC director during the Obama administration notes that the US spends 300 to 500 times more money on military defense than on health systems and yet "no war has killed a million Americans."

A late September survey by the Kaiser Family Foundation found that nearly half of adults had heard little or nothing about the bivalent booster. This is certainly not going to help prevent any winter covid surge. The president of the Foundation  said that the country "seems to have mostly moved on." Do we have covid information overload? Have people just heard too much? That attitude contributes to decision-making fatigue. Adults ages 65 and older are the most informed; ages 50 through 64 are not far behind them. At least the groups that most need the bivalent booster know the most about it. 

Zero covid is still alive and well in China. Because of this, the use of propaganda is more apparent than usual. At least 120 covid-related propaganda  phrases have been created. For example, "lockdowns" are now "static management" or "working from home." At least "working from home" here has never meant a "lockdown" of the extent used in China.

Remember my comment about how the US benefited from pandemic information from the UK? Eight UK hospitals have declared a "critical incident" or asked people not to come to Accident and Emergency unless they are seriously ill. Covid is up almost 37 percent in one week. While it is too soon to declare an autumn wave, the issue does need to be addressed now. The incoming president of the Royal College of Emergency Medicine calls covid "a very heavy straw on the camel's back." Adding influenza to covid to create a twindemic means that winter "could become even grimmer ... like two playground bullies getting together and forming a gang." We've depended on news from the UK throughout the pandemic; let's not stop now. 

The Road goes ever on and on ... Day 429 (929)

I actually planned to write about a couple of reports I read last night. Thanks (or no?) to remnants of Hurricane Ian, we lost landline phone service last evening which meant no DSL and no internet. I refuse to do significant typing on my phone. Besides auto-complete, my fingers revolt. We now have DSL and internet, but after an afternoon of pinning together the layers of a large quilt only to inspect the back and realize I needed to take all the pins out and re-do it tomorrow, I'm going to go sit. I had flippantly said somewhere that if the pinning went well today, I would get brave and try to warp my loom tomorrow. I do not know why warping scares me so much, but it does. I don't think I need to worry about that now since tomorrow afternoon is booked for re-pinning.

Anyway, no blog post today. We'll see how tomorrow goes in that regard.