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

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

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

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

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

The Road goes ever on and on ... Day 192 (692)

Yesterday, I mentioned that the US had recorded at least 900,000 covid deaths. Imagine if Indianapolis, San Francisco, or Charlotte (North Carolina) became empty overnight. That's what losing 900,000 people in one fell swoop would resemble. I wondered how long it would take to hit the one million mark. The dean of the Brown University School of Public Health explains, "We got the medical science right. We failed on the social science. We failed on how to help people get vaccinated, to combat disinformation, to not politicize this. Those are the places where we have failed as America." Never underestimate the what? Stupidity? Gullibility? Nonchalance? of the American people. I would invoke my brother-in-law's "Half the population has an IQ under 100," but I don't believe that all vaccine-hesitant or vaccine-resistant people are idiots. Some are, but not all. That said, we may never move far beyond our current 64 percent full vaccination rate.

A new push is on to protect immunocompromised people from covid. The CDC has shortened the waiting period between the third and fourth doses of Pfizer or Moderna from five months to three. Someone who originally got the Johnson & Johnson vaccine should now get two additional doses rather than one. This follows seeing a large number of breakthrough infections in immunocompromised people. The CDC also gave doctors permission to give immunocompromised patients the Pfizer or Moderna vaccine outside the recommended schedule "where the benefits of vaccination are deemed to outweigh the potential and unknown risk."

CDC data suggest that boosters are most beneficial to older people. The booster does not seem to add much benefit to younger Americans; their first shots greatly decrease the risk of hospitalization and death. The caveat is that the data only go through the end of December and so miss most of the Omicron surge. Boosters aside, a virologist at Weill Cornell Medicine in New York explains, "The real problem is the carnage among the unvaccinated." I do like the use of the word "carnage" there. 

A recent study used self-reporting but found that people reporting that they always wore face masks or respirators such as N95 masks in public indoor settings were significantly less likely to test positive later. In other words, "...wearing a mask, wearing it consistently, will reduce your risk and the higher quality mask that you wear, the better protection that you have." 

Several members of Congress are pushing for a "high-level independent" commission to investigate the origins of the coronavirus and the response to it from both the previous and current administrations. It would be similar to the commission that investigated the events of September 11, 2001. It will likely take a while for the proposal to be formally put forward, but so far it does have bipartisan support. It may be the only thing that has bipartisan support, at least that I know of.

Olympic update: Around 71,000 covid tests were conducted at the Olympics on Thursday. There were 21 positive tests. To the extent that the closed loop is working, the number of cases within it should fall as time goes by. 

The Road goes ever on and on ... Day 53 (553)

Arrgh! I hope ye be havin' a merry Talk Like a Pirate Day, though Son #2 says what day isn't Talk Like a Pirate Day. He may have a good point there. I didn't make many notes today; once The Professor and The Sons returned from their 100-mile ultra-marathon, I got busy with the aftermath. I like to tell people that I don't make heirloom quilts. I somewhat feel that way about clothes and haven't really made any clothes in years. This afternoon I hemmed the suit pants Son #2 needs for next weekend. DiL= is a bridesmaid in a wedding, and Son #2 needed suitable clothes for the occasion. The bride didn't think her mother would approve of Son #2's joker suit with the, if I remember correctly, green pants and long purple jacket. We got it for him as a birthday present the year we were in Hue, Vietnam for the birthday. Said suit is made of raw silk.

Anyway, why did the FDA advisory committee not recommend booster shots for all people older than 16? I found five reasons cited. First, they think it's too soon and it might be better to wait a bit longer for people at less risk. Second, there's not a lot of evidence out there; as one expert put it, there is a "sparcity of safety data." Related to this, they'd like more data and the chance to look through it for mistaken conclusions. For one, much of the data have not yet been peer reviewed. Also, most studies looked at antibodies at the exclusion of other important immune responses. Fourth, safety of younger adults and teenagers suggests waiting. People ages 16 to 29 are at higher risk of myocarditis; would a booster make this more probable? Finally, getting those who are not yet vaccinated, vaccinated will have more impact than boosters for already-vaccinated people. 

Alabama had more deaths than births in 2020. The 2020 counts were 64,714 deaths with 7,182 of those officially attributed to covid, and 57,641 births. There was no such gap during either world war nor during the flue pandemic of 1918. According to a University of New Hampshire study, half of the states joined Alabama in having more deaths than births in 2020. Only five states did so in 2019. Nationally, the birthrate has been declining for six years; the pandemic may be speeding that up. I'd ordinarily think of keeping the population  explosion under control as a good thing, but not if it's because so many people are dying of a mostly preventable disease. 

I start working early voting tomorrow, so getting practice at shorter posts may be a good thing. With the June primary, the crowds were so sparse that I could sit and take notes using my phone or a laptop. Crowds for a non-primary election will be larger. I heard that around 100 people voted in four hours Friday morning. It will be interesting to see if the crowds continue tomorrow.

The Road goes ever on and on ... Day 51 (551)

The Vaccines and Related Biological Products Advisory Committee of the FDA discussed covid booster shots today. One source described this as a straightforward question: Is immunity waning, and will boosters restore it? This is actually a two-part question, and the research so far seems to have concentrated on the second part. Yes, boosters do increase the production of antibodies. It is not clear. though, if that is really needed. Dr. Fauci says that immunity is waning in the fully vaccinated and may offer less protection against the more severe variants of covid. Other scientists do not agree. Recommending boosters for immuno-compromised or the elderly is much less controversial. A CDC advisory committee will discuss this issue next week. Meanwhile, Israel is already contemplating a fourth shot, a booster booster.

 News Flash: FDA overwhelmingly (a vote of 16 to 2) recommended against approving a Pfizer booster for people ages 16 and older. One committee member explained, "It's unclear that everyone needs to be boosted, other than a subset of the population that clearly would be at high risk for serious disease." That sounds as if boosters for certain populations may still be open to discussion. Newer News Flash: The panel has voted in support of boosters for people 65 and older or who are at high risk of serious illness. I'm 65 now, so I guess that includes me.

New cases and hospitalizations across the US are starting to show signs of decline but remain much higher than earlier in the summer. Death numbers are still rising, averaging 1,900 per day, up almost 30 percent over the last two weeks. Vaccination rates have slowed; only 64 percent of eligible people in the US are fully vaccinated. There are new outbreaks in the Mountain West and West Virginia. Seven months ago, West Virginia was the vaccination pacesetter. Now, it has the lowest percent of people 18 and over fully vaccinated, just under 48 percent. Cases are nearing record levels, hospitalizations are approaching the state's pandemic high, and occupancy records are being set in ICUs across the state. The governor says the worst may be yet to come: "Maybe we won't peak until Halloween or Thanksgiving, and in all of that how many more are going to die, and die a horrible death, a death where you can't breathe?" Cheery, he is not.

As of October 25, in Seattle and its suburbs people attending recreational activities in most public places will have to show proof of vaccination or a negative test. This will apply to outdoor events with 500 or more people and indoor activities of any size--performances, movie theaters, conferences, restaurants, bars, and so on. New York City and San Francisco have similar restrictions already in place. As to whether they work, in France close to 90 percent of adults have gotten at least one dose of vaccine. The vaccination rate took a large upturn when it was announced that vaccination would be required for visiting a cafe.

The UN's General Assembly is about to have its annual meeting. The UN requires all its staff to be vaccinated, but lets foreign dignitaries and diplomats use the honor system. Since the meeting of the General Assembly counts as a "convention center," all those attending must prove they are vaccinated. They must also show proof before dining indoors, drinking, or exercising within the 16-acre UN campus. Russia's ambassador has said that the rules violate the UN Charter in that they are discriminatory. Brazil's President Bolsinaro has been outspoken about refusing to be vaccinated but is scheduled to address the Assembly early in the meeting. The chief UN spokesman says that discussions are underway to continue the honor system "in a way that is acceptable for all."

International quick takes: France's vaccination rate has gone up, but weekly demonstrations against the vaccine mandate continue. There are 180 expected across France on Saturday. New Zealand is keeping its travel bubble with Australia closed for at least eight more weeks. While cases in New Zealand are declining, they're still rising in Australia. Alberta is home to the worst outbreak in Canada and putting in "sweeping" new restrictions. The health care system there is said to be on the verge of collapse. In the week ending September 11, one in 45 people in Scotland had covid.

Two new words I saw for the first time this week (I may be very behind the times): scamdemic and plandemic. These are apparently terms from the conspiracy theory camp.