The Road goes ever on and on ... Day 174 (674)

Do a good deed daily? I've done mine. It seems that the website through which free covid tests (four per household) can be ordered went live a day early. I've ordered ours and alerted The Sons who have now ordered theirs. I also alerted my Internet quilt guild, and at least two of them have ordered. Tests are not going to ship until around February 1, but I don't have to worry about forgetting to order tomorrow.

When is it all going to end? Possibly not for a long time. Dr. Fauci says that we're still in the first of the five stages of a pandemic. The first stage is when "the whole world is really very negatively impacted." The other stages are (in order) deceleration, control, elimination, and eradication. That last step is rarely met. Smallpox is pretty much the only disease that has been eradicated. In terms of people wanting to catch Omicron so they gain immunity, Dr. Fauci said whether Omicron is the equivalent of a live virus vaccination is an open question. We could get another variant that can evade a body's immune response in which case the immunity from Omicron might not be usable at all. 

The Edelman Trust Barometer is a survey of 35,000 respondents across 28 countries. The 2022 results were just released. One result is the percent of respondents who believe that an entity is "purposely trying to mislead people by saying things they know are false or gross exaggerations." Some 67 percent of respondents felt that journalists were misleading. Government leaders were viewed as misleading by 66 percent, and business executives were viewed as misleading by 63 percent. In general, respondents feared that the media were becoming more sensational for commercial gain, and that government leaders were exploiting divisions for, what else, political gain. 

Although some cities in the Northeast have started to see rapid declines in their numbers of covid cases, the surgeon general claims that Omicron has not yet peaked in the US and that the "next few weeks will be tough." Elaborating, "The challenge is that the entire country is not moving at the same pace. The Omicron wave started later in other parts of the country. We shouldn't expect a national peak in the coming days." Indeed, there are models that forecast 50,000 to 300,000 more Americans could die by the time the Omicron wave subsides in early March. 

I came across a report of an observational study that both intrigues and concerns me. Hospitalized patients with covid and no prior history of dementia had elevated levels of brain injury biomarkers. Levels of certain compounds were as high or higher in the short terms among hospitalized covid patients without a history of dementia than they were among Alzheimer's patients who had never had covid. Findings were said to indicate "a profound neurological insult in these patients." A big reason I find covid so frightening is that it seems able to attack just about any organ in the body--brain, kidney, heart, liver, blood, on and on. And don't get me started on long covid. 

Internationally, Canada has approved Pfizer's anti-viral Paxlovid. Tonga is worried that as much as they need relief workers, those workers could bring covid to the island nation. Finally, the French education minister is facing calls to resign after it came out that he had announced strict covid-testing and isolation rules for schools while he was on a long weekend New Year's holiday in Ibiza. It's justifiably called a public relations disaster. The minister broke no law; there were no travel restrictions in place. Ministers had been asked to remain in Europe, within two hours of Paris. A government spokesperson says that the minister was reachable the entire time. Parents of school children affected by the new policy did not appreciate hearing about a policy starting in just a day or two not to mention that the announcement came from someone on a beach.   

The Road goes ever on and on ... Day 170 (670)

"The game has changed since the Delta wave. The challenges we are facing are really around staffing. Compounding that is that this is a much more infectious variant, taking more staff out that we have in the workforce."      ~Chancellor of Clinical Affairs at Mississippi's largest hospital 

"One of our biggest problems is just finding employees to take care of patients because we have so many employees that are out sick."     ~Doctor at Vanderbilt University Medical Center

Staffing is the new crisis in American hospitals. Oregon and Maine are the latest states to request National Guard help for overwhelmed hospitals. At least 80 percent of staffed hospital beds are occupied in 24 states. At least 85 percent of ICU beds are occupied in 18 states. The states in the  worst trouble in this regard are Alabama, Missouri New Mexico, Rhode Island, Texas, and Wisconsin. At least 60 children are hospitalized in Alabama, 13 in ICUs. One third of Mississippi's nurses have left for other jobs or to better paying jobs in other states. There are currently about 3,000 vacant positions. 

Omicron may be starting to plateau in New York and along the east coast, where it first started. Elsewhere, though, it's still spreading, working its way across the country. The Texas department of state and health services notes, "Covid has never spread this fast." It may take a while for Omicron to traverse the country, but it surely will. 

Around the world, China has shut down Anyang, a city of 5.5 million people after finding two covid cases there. That was not a typo. Two (2) cases have led China to lock down 5.5 million people. Sweden's prime minister has tested positive and is working from home. Italy has reintroduced an outdoor mask mandate. It never got rid of an indoor mask mandate even when cases dropped during the summer.The police enforcing those mandates are protesting that the office of national covid-19 emergency commission sent them pink masks. They claim the color is "eccentric" and ill-matched to their uniforms. The color risks jeopardizing the image of the institution. Finally, the British Prime Minister's office is apologizing for two separate parties held the night before Prince Philip's funeral. The parties were for people leaving positions. Number 10 Downing Street is having lots of problems with parties during the pandemic.

The Marine Corps has given its first religious exemption from a vaccine mandate in at least 10 years; in fact, it granted two, both for the covid-19 vaccine. The fact that there were 3,350 requests (3,212 have been processed) makes those two exemptions pretty special. Details of the basis for the exemptions was not given for privacy reasons. 

The Professor's covid test came back negative. I can't help but wonder, though, just how many times he will need to get tested as the semester proceeds. As the supervisor (in name only) of all the department's teaching assistants, he gets notified if one of them tests positive. He got another one of those emails this morning. Fortunately, he'd had no personal contact with that student. It could be an interesting semester.

The Road goes ever on and on ... Day 167 (667)

In a survey of 1,759 vaccinated adults who said they'd had covid, 55 percent said they'd had it before they got any vaccination. Four percent said they'd been partially vaccinated when they got it, and 36 percent said they'd been fully vaccinated at the time they were infected. As to the end of the pandemic, 53 percent of respondents said that they believed it would be more than a year, or never, before we can return to normal, pre-covid lives. Will we ever return to pre-covid behavior? Some people might, at least within some group of people with similar belief structures. I'm not sure I will. I have the feeling I'll always be looking at strangers or people I know only slightly and wondering what they might have that I don't want to have. The number of people I'm willing to hug will certainly be smaller. I avoid large crowds already at least as much as I can given the panic attacks I tend to have, so that's not an issue. 

The daily case rate in the US hit 1,350,000; the seven-day average has tripled in two weeks and is now over 700,000 per day. Only seven states have not yet set case records in 2022: Arizona, Idaho, Maine, Montana, North Dakota, Ohio, and Wyoming. There are 145,982 covid patients in hospital, more than last winter's peak. A New York Times comparison of New York City and Seattle showed cases rising for both vaccinated and unvaccinated people with a relatively low death rate for vaccinated people in both cities. The bottom line? Vaccination is highly effective at preventing severe covid, but the risk of getting covid is not zero even for generally healthy people. Dr. Fauci quantified it for a Senate committee. Being unvaccinated means a person is 10 times more likely to test positive, 17 times more likely to be hospitalized, and 20 times more likely to die. I can't help but think of that last bit--"more likely to die" or "20 times more likely to die"--as the title of a James Bond movie. 

Beginning Saturday, private health insurers in the US will cover the cost of up to eight at-home covid tests per month for each person covered by a policy. At the same time, misinformation about what those tests might show is growing on social media. Some videos demonstrate tests yielding positive results after exposure to tap water or juice to suggest that at-home tests don't work. Other tidbits of misinformation include that PCR tests are vaccines in disguise or don't work at all, covid counts publicized include cases of influenza, and that at-home tests are pre-treated to give a certain result. I guess it had to come to this with earlier misinformation campaigns concerning masks, vaccines, and the severity of covid; tests had to be next.  

WHO suggests that half of Europe's residents could get Omicron in the next six to eight weeks. While WHO previously complained that boosters would increase vaccine inequity, they now say that boosters could be essential in protecting the most vulnerable as well as protecting essential personnel such as health care workers and teachers. WHO also says that it's too early to think of the coronavirus as endemic. A key factor in its becoming endemic would be a sense of predictability, something Omicron showed us we do not yet have. 

A not-yet-peer-reviewed study shows that coronavirus loses 90 percent of its ability to infect within five minutes of becoming airborne. If true, this would suggest that improved ventilation is less of a preventive factor than masks or distancing. Research has shown that Omicron is milder than Delta. Will the next variant be even milder? Unfortunately, not necessarily. Some viruses, such as Ebola, have become more dangerous over time. One variant does not evolve from another; each variant has evolved independently.

A couple more US and global notes. Data in some of the first cities hit by Omicron show deaths spiking sharply. While they are not rising as quickly as cases are, they are rising fast enough to worry about. There is speculation that the CDC may recommend N95 or KN95 masks for the general public. China has now locked down three cities. About 20 million Chinese are now confined to their homes. House arrest? Japan will continue its ban on nonresident foreigners until the end of February. And while not totally related to the pandemic, both Rolls-Royce and Bentley posted record sales in 2021.

The Road goes ever on and on ... Day 148 (648)

Word came today that the New Year's Eve celebration would still go on, though that might change before December 31. Instead of 58,000 people, though, there will be only 15,000. I have not yet heard how those 15,000 people will be chosen. They must have proof of full vaccination, wear masks, and practice social distancing. I'm not sure of the specifics on distancing--family groups, maybe? The last New Year's Eve on which The Professor and I saw midnight was December 31, 2018, aboard MS Lofoten anchored outside Tromso, Norway. The fireworks display was the best I've seen. 

The graph showing case numbers in the District of Columbia shows a vertical line. Cases on Saturday nearly tripled the previous record high. An ER nurse in the District comments, "What do you do when you have a tidal wave coming at you in a little paddle boat? There's going to be a huge uptick. Our entire waiting room is going to be all Covid-positive." 

Data from the UK suggest that Omicron appears to reduce the chance of a hospital visit 20 to 25 percent and an overnight admission by at least 40 percent. The data were based on 56,000 Omicron cases and 269,000 Delta ones. Still, new daily cases just went over 100,000 for the first time. There were 301 hospital admissions on December 20, up 78 percent in one week and the highest single day number since February 7. For unvaccinated people who had not had a case of covid, risk of hospitalization was about 11 percent lower for Omicron than Delta. Modeling suggests that there could be 3,000 hospitalizations per day at the peak of the wave in January if no new restrictions are put in place. 

Meanwhile in Europe, the continent, Spain is responding to a daily all-time record of almost 50,000 new cases in one day and enacting an outdoor mask mandate. Italy is considering an outdoor mask mandate as well as making the health pass valid for six months rather than nine, and banning parties or events, indoors or out, until the end of January. In Greece, all outdoor and indoor areas not currently requiring masks must start to require them. There will be no public events until January 3 at the earliest. Data from France suggest that unvaccinated children are helping drive the surge there. Vatican City now requires all workers to be vaccinated or recovered from covid. Regular testing is no longer an option. Finally, Putin has said there will be no vaccine mandates. Russians, he says, are "inventive people" meaning "whatever you start to push, they find ways to circumvent it." 

There's more news I could include, but Son #1 asked for my help with his Christmas present to Son #2, and I have a bit more to do tonight so that I can hand it off in the morning for him to finish. The Professor is making butter tarts tonight, and I've already been called into the kitchen for a consult. Multitasking may be my middle name this evening. 

The Road goes ever on and on ... Day 144 (644)

How are things going in the Netherlands? The prime minister explains, "We have to act now to prevent a worst-case scenario. Without measures, we could be witnessing an uncontrollable situation at the start of January." What measures? The country is in nationwide lockdown. All but the most essential stores plus restaurants, hairdressers, gyms, museums, and other public spaces are closed until at least January 14. Schools and universities are closing a week early for the Christmas break and will stay closed until at least January 9. If that doesn't sound like enough, households are recommended to have no more than two visitors, though four will be allowed for Christmas and New Year's. Outside gatherings are limited to two people. Omicron will become the dominant strain by year's end. Hospitals have been canceling regular care for weeks and are still running out of beds. Cases are at record highs, though there is likely some error in the counts for the early days of the pandemic. 

The UK's health minister is not ruling out more restrictions there. London's mayor says that new restrictions are "inevitable" and could affect social distancing and household mixing. Cases in Greater London are up 200 percent over the last two weeks. There were 65,525 new cases last week, and 26,418 in the last day of the week. Paris has canceled the New Year's Eve fireworks. Denmark has closed theaters, concert halls, amusement parks, and museums. Ireland has imposed an 8:00 pm curfew on pubs and bars and limited attendance at events both indoors and out. 

So much for how Europe is handling Omicron. Here, only 30 percent of vaccinated Americans have gotten a booster. Just over half of Americans ages 65 and older have gotten boosters. New York saw 3,909 covid patients enter hospitals on Friday, an increase of 70 percent. Test positivity was 7.53 up from 2.6 percent on September 22. The number that floored me was that in Tompkins County, home to the city of Ithaca and Cornell University, cases rose 640 percent over a 14-day period. No, that is not a typo. The only decimal point would be one after the zero. They are seeing 224 cases per 100,000 people; the rate in New York City is 61 per 100,000.

Harvard University has announced that they will be offering remote learning for the first three weeks of January. The Professor is worried that the local university might go the same route. Having taught remotely for several semesters, he does not want to do it again. We appear to be lagging behind Europe in terms of Omicron's impact. Are we willing to reinstate stronger restrictions as several European countries are? I know that we likely won't here in Virginia unless there is a federal order. Our governor-elect is a conservative who has been mentioned as a potential running mate for He Who Shall Not Be Named in 2024. I don't expect any mandated mitigation measures here. [Yes, I have reverted to my original way of referring to a certain orange someone.]

The Road goes ever on and on ... Day 143 (643)

New York City is becoming pandemic ground zero as it was at the pandemic's 2020 start. They recorded 21,027 cases Friday. If you ignore the fact that many cases were probably missed in the early days, this is a record for the entire pandemic. Cases have gone up 56 percent in 14 days, while hospitalizations are up 25 percent. The current percent positivity is almost eight percent. Probably in response to Omicron's ability to bypass two doses of vaccine, New York State is changing their definition or "fully vaccinated" to include the booster dose. At Cornell University in Ithaca, 99 percent of the student body was vaccinated (under the two-dose standard). The university still saw 1,567 cases arise in the seven days ending Thursday out of a student body of over 26,000 students. In New York City, Broadway shows have closed temporarily as has Radio City Music Hall, home of the Rockettes. 

A federal appeals court has reinstated POTUS's executive order requiring companies with at least 100 employees to require employees be vaccinated, have a valid exemption, or agree to be tested weekly. The school system in Prince George's County, Maryland, home to some 131,000 students, will go to remote learning for the four days they are open next week as well as for the first two weeks in January. Not what anyone wanted, probably, but out of an abundance of caution likely the right thing to do. The CDC just endorsed a strategy already in use by some systems, Test to Stay. Unvaccinated students who are explosed to covid can remain in school as long as they're tested twice in the following week and both tests are negative. A caveat is that the tests underlying this strategy were carried out before the arrival of Omicron. 

Pfizer has been testing its vaccine on children between the ages of six months and five years. With two doses of a low-dose vaccine, about one-third of the adult dose, children between the ages of six months and two years showed a immune response equal to that shown by adults between the ages of 16 and 25, to  adult doses. Children between the ages of two and five did not show this increase. Pfizer will also test using one-third the adult dose as a booster for children between the ages of five and 11.

WHO gave emergency authorization to Novavax, a vaccine developed by US company Novavax and the Serum Institute of India. Novavax has promised to deliver 1.1 billion doses to Covax. Novavax is not an mRNA vaccine and does not need the cold storage required by the Pfizer and Moderna vaccines. It does, however, require two doses, meaning there may be extra coordination needed in rural areas. 

Are South African and the UK sending warning messages to the US? Both have been dealing with the surge in Omicron cases that the US presumably will suffer all too soon. The research released regarding their experiences with Omicron say that it is more transmissible but is less likely to cause severe disease. There is, of course, a cautionary "BUT." The US lags both the UK and South Africa in terms of the average immunity people have from being vaccinated or having had covid. They are not dealing with the vaccine-hesitance or -resistance we have here. It doesn't help that some of the vaccine-deniers claim that the fact someone who is fully vaccinated and boosted can catch Omicron suggests the vaccine doesn't do anything, so why should they take it. They don't look at the next card on the table, the one that mentions protection against severe disease, hospitalization, or even death. They need to stay at the table until Mother Nature plays the rest of her hand.  

Christmas is but one week away. If you are traveling to visit family and/or friends, be careful. Find some rapid tests to have on hand just in case. Stay masked in public settings or on public transit. If you have a feeling you should not do something, don't do it. You'll never know if you made the right decision, but that's better in this case than learning you didn't.

The Road goes ever on and on ... Day 137 (637)

The Professor somewhat pooh-poohed the thing in this morning's news that most concerned me. News from the CDC on Friday was that most of the Omicron cases in the US--34 out of 43--were fully vaccinated. Fourteen of those had also gotten a vaccine booster, though five of those were within the two-week post-injection period in which the experts say the vaccine is not at full strength. The bottom line is that nine out of 43 people, or 21 percent, were as fully vaccinated as one can get right now. So far it seems as if any symptoms for Omicron are mild, but that's not what scares me. It's the long-term effects, both long covid and the problems like heart inflammation that can pop up later. It's also the possibility of transmitting Omicron to someone more vulnerable, like an 89-year-old parent. 

Tuesday is the first anniversary of the first covid vaccination in the US. Since then, 200 million people have been fully vaccinated. At the same time, the US could this week pass 800,000 deaths. I expect that in 2022, that number will pass one million. How soon in 2022 that happens is up to us. An article in today's Outlook section of The Washington Post lays out just how we are our own worst enemy in fighting covid, or at least many or most of us are. In Bangor, Maine, the organization sponsoring the Christmas Parade decided to cancel it this year as it did last year. After a public outcry, another organization took over holding the parade. As it turned out, the weather the day of the parade was cold and rainy which may have lessened the number of spectators. Do the people who protested the initial cancellation not understand the role crowds play in the transmission of any virus, let alone this one? Do they think covid can't or won't happen to them? I do not understand. 

It seems that Omicron developed from the original coronavirus not one of the variants. One theory behind this is that Omicron arose in a remote region of southern Africa and only recently spread. That seems a bit far-fetched to me. Another theory is that the virus mutated in an animal infected with covid (more on animals with covid coming) and then was transmitted back to humans. The final theory is that Omicron arose in a person with a weakened immune system, someone like a person undergoing cancer treatment or who had received a donated organ. Given that sub-Saharan Africa is home to two-thirds of the global population living with HIV, Omicron could also have arisen in a person with HIV. Under this scenario, the virus mutates in an HIV patient's body until it gets the right mutations to burst out and infect others. Viruses have been known to live in the body of an HIV-infected person for 216 days. My money is on this third theory.

Still, the coronavirus has been confirmed in a number of animals including hippos, snow leopards, gorillas, lions, tigers, cougars, ferrets, hamsters, minks, dogs, and cats. Research is ongoing to develop a vaccine suitable for animals. The worry is that the virus can mutate in animal(s) and then be transmitted back to humans. Early in the pandemic, mink farms were shut down and minks slaughtered because of the disease coming back to humans. In the Netherlands, scientists visited the homes of pet owners who were infected with covid. In 20 percent, the pet cats and dogs had antibodies for coronavirus. 

Other random notes: Across US prisons, 34 of every 100 people are known to have been infected with covid. That's roughly four times the infection rate of the general US public. The major factor? Crowding. Scientists are advising the government of the UK that Omicron could cause between 25,000 and 75,000 deaths in England in the next five months if no additional mitigation measures are taken. Taiwan found the first Omicron cases there in three people who had traveled abroad. And protests continue in Vienna against the extra restrictions imposed on unvaccinated people.  

The Road goes ever on and on ... Day 133 (633)

An outright theft from Axios:

10 key dates in our pandemic journey:

1. Dec. 8, 2019: The World Health Organization's official date for the onset of the first cases in Wuhan, China, that were later confirmed to be COVID-19.
2. Feb. 23, 2020: Italy becomes the first country outside China to impose a lockdown.
3. March 11, 2020: The WHO declares a pandemic. 4,616 deaths have been recorded.
4. April 2020: School closures affect 82% of the world's students, according to UNESCO.
5. Sept. 28, 2020: The world crosses 1 million deaths, with the U.S. and Brazil recording the most.
6. December 2020: The FDA authorizes the Pfizer vaccine for emergency use Dec. 11, followed by the Moderna vaccine Dec. 18.
7. Early July 2021: After falling sharply in the spring, cases begin to rise again in both the U.S. and E.U., with the unvaccinated hit hardest.
8. Nov. 1, 2021: The official worldwide death count hits 5 million.
9. Nov. 5, 2021: Half the global population has had at least one shot.
10. Nov. 24, 2021: South Africa reports the Omicron variant.

Yes, two years ago today the coronavirus took root. I can't say it has blossomed; it's more like an overgrown ground cover than a flower. Of course, most of us knew nothing of it until February 2020. I first heard about it when I was at a meeting of what I call my online quilt guild in San Marcos, Texas. I flew in and out of San Antonio. When it turned out that one of the early cases in the US was someone flying into San Antonio for some sort of military boot camp, this thing then called the novel coronavirus got my attention. I would add an item numbered 3.5, but the automatic numbering makes that difficult. The added item would be March 16, 2020 ... Jean Lightner Norum starts a daily pandemic blog. 

Some experts are starting to warn of a covid-flu "twindemic." Sixty percent of Americans are fully vaccinated against covid. On the flu side, 41 percent of adults and 39 percent of children have had a flu shot. The CDC says that the dominant strain this year is A (H3N2). In previous years, this has meant more hospitalizations and deaths among people ages 65 and older. I'm sure there are places that will give the covid booster and a flu shot, one in each arm on the same visit. The Professor and I doubled up on shingrix and flu shots.

It appears that Omicron partly evades the immunity provided by two injections of the Pfizer vaccine. Blood samples of people who had gotten two doses of the Pfizer vaccine showed a 25-fold reduction in antibody levels against Omicron. Two weeks after a booster injection, the neutralizing antibodies against Omicron were comparable to the levels of antibodies against previous covid variants. People who had a case of covid before they were vaccinated seem to have more protection. I would not, however, recommend that as a vaccine strategy. And Dr. Fauci warns, "We shouldn't be making any definitive conclusions, certainly not before the next couple of weeks." 

Omicron is doubling in the UK every two or three days such that it could be the dominant strain before Christmas. Scotland has called for working from home. England is expected to announce new restrictions this evening (which is pretty much right as I'm typing this) that may also require working from home where possible. Various places around the world are canceling or cutting back their New Year's Eve celebrations. Rio de Janeiro has canceled the celebration planned for Copacabana. Baltimore has scaled back their celebration. I haven't seen anything about Times Square and actually don't expect to. I don't think they'll cancel or limit it a second year in a row, though requiring vaccination to be there is something of a limit. South Korea is shutting unvaccinated students out of study rooms, libraries, and private cram schools known as hagwon.

WHO's top official in Europe says that since Omicron has now been detected around the world, travel bans will not contain it and should be lifted. He called for five "pandemic stabilisers:" increasing vaccination rates, giving boosters to the most vulnerable, doubling mask-wearing rates indoors, ventilating crowded spaces, and providing "rigorous therapeutic protocols for severe cases." 

Here is a link to the top 10 emojis of 2021. Spoiler: the poop emoji is not one of them. If you happen to be in Des Moines, Iowa, check out their Canada geese management plan. They are trying to make Des Moines less habitable for geese by installing tall plant buffers and riprap along riverbanks and reducing winter water aeration to create more freezing. Let us know if those work, Des Moines. We could probably use our own Canada geese management plan here.

If your mind wants to wonder, try to imagine what the third year of the pandemic will be like. I expect I'll be doing a bit of that.

The Road goes ever on and on ... Day 132 (632)

It is not surprising that people in counties that voted for the former president are nearly three times as likely to die from covid than those in counties that voted for POTUS according to a study conducted by National Public Radio. The study started with May 2021 or roughly when vaccines became universally available to adults. Counties that went for the former president by over 60 percent had lower vaccination rates and higher covid death rates. The tenth of the counties that were the most Republican had death rates six times higher than the tenth that were the most Democrat. Hawaii, Nebraska, and Alaska were excluded because they don't report election results and/or vaccine results by county. Underlying much of this is that while 91 percent of Democrats are vaccinated, only 59 percent of Republicans are. Finally, 94 percent of Republicans think at least one false statement about covid and vaccines might be true, and 46 percent believe that four or more might be true. Only 14 percent of Democrats believe four or more might be true. The most widely believed false statement? That the government is exaggerating the number of covid deaths. 

The European Union health commissioner is urging countries to increase vaccinations and use non-pharmaceutical mitigation measures such as masking or distancing when appropriate. Meanwhile, the head of WHO Europe division sees mandatory vaccinations as an "absolute last resort" and says that vaccine mandates should not contribute to inequalities in accessing health care. He also offered a reminder that much about the Omicron variant remains unknown.

While much does remain unknown, the evidence so far for how fast Omicron spreads continues to grow. The first of two plausible reasons for the speed of the spread is that Omicron spreads faster in people with no immunity than earlier variants did. It may also evade immunity from a previous case or from vaccination. So far, Omicron appears to be causing only mild symptoms; however, it can take over a week to develop severe covid illness, and Omicron has only been recognized as being out there for less than two weeks. The initial patients in South Africa were, for the most part, young with some having immunity due to the Delta variant. It's not clear how Omicron is going to affect older and more vulnerable people. Here, Dr. Fauci says that the signals are a bit encouraging. What risk does Omicron pose to vaccinated people? There is so far no sign that the illness of vaccinated people will be more severe, but as before, it is important to see what happens with or to unvaccinated people and those with waning immunity. 

A Harvard scientist says that the world is seeing "what appears to be a signal of exponential increase of Omicron over Delta" and that Omicron could take over from Delta as the dominant variant in a matter of weeks. The current surges in the US are due to Delta; scientists say that it will take a couple of weeks to know if Omicron will replace Delta. Experts in the UK say that in 10 days the UK could have more cases of Omicron that some of the countries on the UK's travel red list. Omicron could overtake Delta there in several weeks.

The CDC has added Portugal and France to its highest-risk travel level reflecting the surge underway in each. The Netherlands is bringing in soldiers with medical backgrounds to help support hospitals. The aim is to ensure that no hospital has to say no to a patient. This is the second time the military has been called in. The first was October 2020 to June 2021. There are currently 2,143 covid patients in Dutch hospitals, 611 of whom are in ICU. Covid patients currently occupy 59 percent of all ICU beds in the country.

As a secondary result of the pandemic, the blood pressure measurements of nearly 500,000 people show a significant rise. During the pandemic, people have been exercising less, getting less regular medical care, drinking more, and sleeping less all of which affect blood pressure. Larger increases were seen in women than men. One drawback to the study is that the researchers did not include data on the race or ethnicity of the subjects. 

Dictionary.com has unveiled its word of the year for 2021, "allyship." The word of the year for the Oxford English Dictionary is "vax." I think I mentioned some days ago that Merriam-Webster's word of the year is "vaccine." Finally, Collins, a dictionary coming out of Scotland, chose "NFT" (non-fungible token). I'll leave it to readers to look up the words they don't know. I expect that "vax" and "vaccine" will not be among the unknown. We probably know more about vaccines now than we ever expected to know.

The Road goes ever on and on ... Day 128 (628)

Let's see if I can get this written and remember to publish it on the same day. It seems as if there have been so many little things to deal with lately that some are bound to fall through the cracks. Publishing a blog post is a relatively minor little thing so if something had to go yesterday, the blog post was a good one. I wrote the one I posted this morning yesterday; I just got distracted and never hit the "publish" button.

It's getting nigh near impossible to keep a running count of the nations and US states in which Omicron has been identified. In some cases, there is a travel history to "blame." In others, community transmission is the only way someone could have contracted it. It's looking more and more as if Omicron laps Delta in the foot race of transmissibility, though solid proof is still lacking. In mid-November, South Africa was seeing about 260 new cases per day. On Tuesday, there were over 4,300 new cases; on Wednesday, over 8,600. Thursday, there were over 11,500 new cases. Over 75 percent of the new cases in South Africa are from Omicron, not Delta. 

Over 120 people attended a Christmas party in Oslo on November 26; over 60 of those people have tested positive for covid. Omicron has been identified in 14 or 15 of those cases so far. One person at the party returned from a trip to the company's South African office before Omicron was announced. The date of the party was the day on which Omicron was labeled a variant of concern. This superspreader has led to additional restrictions in and around Oslo. Masks are now required where distance cannot be maintained, such as on public transport and in shops. People have been urged to work from home if possible. Crowds of more than 100 people are banned with the exception of theaters and other places with fixed seating; the limit there is 600. Only table service can be used to serve alcoholic drinks. Finally, restaurants and events need to register attendees. I'm thinking this last one is to help with contact tracing. 

Can you imagine such measures coming back in the US? While POTUS's press secretary says that nothing is off the table, the course of action put forward by POTUS includes only a nationwide campaign for booster shots, expanded availability and use of at-home tests, and tighter restrictions on international travel. POTUS notes that, "In order to beat Covid, we have to shut it down worldwide." I'm not seeing that the measures proposed for the US will be as effective as some of the courses of action taken in other countries. Experts say that travel bans won't accomplish anything unless they are done in conjunction with expanded vaccinations, mask-wearing, and distancing. 

Did you know that there is a profession or at least a job of international travel risk analysis? One such person at the University of Denver says people thinking about international travel need to consider whether the travel can be postponed and how flexible they think they can be. They need to think through all scenarios that could happen and think about whether they could or would want to handle what arises in each. A physician who advises organizations on how to manage health risks advises taking along a supply of at-home rapid antigen tests.  

According to a study published in The Lancet, it probably doesn't matter which vaccine a person gets as a booster. The study looked at seven different vaccine brands as boosters. All gave strong immune responses with Pfizer and Moderna giving the highest. All the patients in the study had first doses of either AstraZeneca or Pfizer. 

Because it's Friday and the weekend awaits, here's some relevant info about alcohol consumption. The French drink the most times per week--three--but the Australians are the champions when it comes to getting drunk. They average 27 times per year, almost double the world average of 15. Aussies drink an average of twice each week and become heavily drunk once every two weeks. The runners-up in terms of getting drunk are, in descending order, Danes and Finns, Americans, British, Canadian, Irish, French, Swedes, and the Dutch. The Professor was surprised to hear the Danes, Finns, and Swedes were in the top ten given how expensive alcohol is in those countries. Maybe the weather has something to do with it. It may take alcohol to get through those long, dark, cold winter nights and even days. Above the Arctic Circle, winter days greatly resemble winter nights, as we learned first-hand off the Norwegian coast for New Year's 2018-19.

The Road goes ever on and on ... Day 126 (626)

Another day that did not go as planned. My quilt must hate me by now. On the better side, a friend left a comment with the URL of a how-to-make-a-decent-binding website. I shall definitely read it again (I've read through it once so far) before I get back to the binding.

Omicron has been identified in the US, specifically in California. What does that mean? That it's likely present in multiple other states and spreading its range even as I type. Nigeria announced that they had found Omicron in a sample from October then later announced that they'd made a mistake. So there's still no precise date for when Omicron first reared its ugly, spiked head, in the world or here.

And now for some general, non-Omicron-specific coronavirus news. On the political front, four Republican states have started expanding unemployment benefits for employees who are fired or quit over vaccine mandates. In other words, they will pay people for not getting vaccinated. The states are, so far, Iowa, Tennessee, Florida, and Kansas. There are 30 other states with Republican-led legislatures that could do the same. Missouri is considering it. Also on the political front, a judge appointed by the previous president backed a ban on the federal vaccine mandate for healthcare workers. Personally, if you're not willing to get vaccinated when scientific evidence suggests you should, you should not be in healthcare. 

Experts warn that Germany could have 6,000 people in intensive care by Christmas. The previous ICU high was 5,745 on January 3. There are fewer ICU beds available now than then because of a nursing shortage. Also in Germany and not at all related to the pandemic, burglars broke through the wall of a toy store to steal dozens of Lego sets. They took the plastic bags containing the Lego pieces but left the boxes behind. There was no word on if the thieves also took the instructions.

According to an article published in Frontiers in Medicine, patients who survive severe covid are more than twice as likely to die over the following year than those not infected or who had a mild case. The increased risk of dying was greater for patients under the age of 65. Only 20 percent of those who died did so because of typical covid complications such as respiratory failure. A previous study showed that recovered patients had a significantly greater risk of being hospitalized in the six months following their infection. 

An FDA committee voted Tuesday to recommend that the government authorize use of the Merck antiviral molnupiravir. There was concern expressed over potential birth defects, especially delayed effects on males. How many senior citizens are having babies these days? I can see the birth defect possibility to be a reasonable concern for younger people at extra risk due to preexisting conditions, but it seems like a no-brainer to offer the drug to senior citizens. 

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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