The Road goes ever on and on ... Day 356 (856)

 

On this day in 1969, the Eagle landed on the moon, something we could not do now but hope to do again. I remember watching it on the television in our basement, feeling a bit wistful that they couldn't wait a couple of hours and do it on the 21st otherwise known as My Mom's birthday. I at least managed to defend my dissertation and earn my PhD on My Mom's 50th birthday. But back to the coronavirus.

The CDC has approved Novavax for primary use but not for boosters. This gives people who don't want one of the new-fangled  mRNA vaccines an option. The morning email update from CNN included a description of how the Novavax vaccine is made. I found it both fascinating and hilarious. 

Novavax scientists identified the gene for the spike protein and created a modified version of that gene, which they cloned into a baculovirus that infects insects. They then infected moth cells -- specifically, cells from the fall armyworm -- prompting them to produce the coronavirus spike protein. These virus-like nanoparticles were harvested to make the vaccine.

I have to ask, though I do not know whom to ask, whether spring armyworms are different from the fall armyworms mentioned here.

The BA.5 story continues. New cases in the US number, officially, around 120,000 daily. Given home testing and fewer official tests being done, that 120,000 could actually be a million or more. Cases in Europe have tripled over the past six weeks. There were nearly three million new cases last week alone, about half of all cases worldwide. Hospital admissions have doubled. ICU admissions are relatively low, but deaths among older people are rising. Almost 3,000 people in Europe are dying from covid each week. WHO says that the current wave could be followed by something worse and is urging countries to reintroduce mitigation measures now if not sooner.

In Guangzhou, China community workers broke into homes to look for people who tested positive for covid, picking locks to enter 84 apartments. The head of the neighborhood apologized to residents individually and promised compensation. The pandemic has enabled the Communist Party to deepen its reach into citizens' private lives, track and limit movement, and confine people to homes or businesses. 

The CDC has ended its covid mitigation program for cruise ships in US waters. Travelers must now contact cruise lines directly for information on their covid measures such as testing or isolation. Carnival will continue requiring guests to be vaccinated or apply for an exemption, and guests older than two must test negative prior to sailing. Royal Caribbean will require guests ages 12 and older to be vaccinated. Guests are strongly urged, but not required, to have received boosters. American Cruise Lines will not require vaccination but will require guests to declare their vaccination status.

The chairman of the House committee looking into the January 6, 2021 Capitol insurrection has tested positive. He urged the committee to continue its work without him. He was fully vaccinated and boosted, again pointing out that no one is immune.

The Road goes ever on and on ... Day 314 (814)

Case counts and hospitalizations continue to decline in Massachusetts, Maine, Connecticut, and New York. Every other region in the US is seeing a rise in hospitalizations, particularly Alabama and Louisiana, where hospitalizations have risen by 70 percent. Some experts have suggested that counting covid patients in an ICU is a better gauge of covid's magnitude given that hospitalization counts include patients admitted because of covid and those admitted who are then discovered to have covid. There are currently about 3,000 patients in ICUs, some 11 percent of all hospitalized patients with covid. This is actually the lowest rate since September 2020 and has held steady since May. The covid situation should improve over the summer but most sources expect it to worsen come fall and winter.

The US wasted over 82.1 million covid vaccine doses between December 2020 and May 2022, 11 percent of the total doses distributed. CVS and Walmart together are responsible for over 25 percent of the doses thrown away. Health Mart, DaVita, Rite Aid, Publix, and Costco got rid of over 25 percent of the doses they received. Two states, Oklahoma and Alaska tossed over 25 percent of the doses they received. Part of that was due to the distribution pattern. Because doses were distributed in standard quantities, more doses than needed were sent to many remote areas. Some doses expired; others were spoiled by power outages or improper storage. Because the vaccines come in multidose vials, any doses left unused in open vials at the end of a day were discarded. CDC guidance advised that vaccinations be prioritized even if it meant opening a new vial for one shot. Four states were not included in the analysis: Louisiana, Maine, Ohio, and Oregon. It sounds bad, but the overall amount of waste is not out of line with WHO estimates for large vaccination campaigns. 

The FDA has yet to authorize administration of the Novavax vaccine. Besides the vaccine, approval is needed for the manufacturing process. Novavax has had issues with this over the past two years. The US Department of Health and Human Services is said to want there to be a second non-mRNA vaccine available, meaning that the FDA likely won't delay their approval processes.

Finally, China is holding college-entrance exams or gaokao. These determine the under two percent of candidates who can enroll in the top universities. Students who have covid or who are close contacts of people with covid will test in isolation or hospital rooms. I guess that because the percentage of students "promoted" is so small, they can't just get rid of the tests for a year or two as US universities have done with the SAT and ACT. In fact, the pandemic has influenced some universities into making those tests optional or not considering them at all. 

The Road goes ever on and on ... Day 184 (684)

The US has now donated over 400 million vaccine doses to 112 countries. While this total falls short of the 1.2 billion doses the US has promised to donate, it is said to be more than five times larger than that of any other country. Vaccine inequity remains an issue even though 10 billion doses of vaccine have been administered globally. The US has administered five times as many extra doses (86 million) as the total number of doses given in all of Nigeria, Africa's most populous nation. In the UK, over 300 leading scientists have criticized the prime minister for not doing enough to boost vaccination levels worldwide. So many people not being vaccinated increases the opportunities for new variants to arise.

Dr. Fauci says that scientists are working on a "pan-coronavirus" vaccine to induce "broad and durable protection against coronaviruses that are known, and some that are even at this point, unknown." Don't hold your breath, though. Such a vaccine is still years away.

The head of Paris hospitals has asked whether people who refuse to be vaccinated should continue to have their covid treatments covered by public health insurance. That mere suggestion is not going over at all well. There are currently about 30,000 covid patients in French hospitals. Seventy percent of the patients in Paris and Bordeaux ICUs are unvaccinated. In Marseille and Nice, over 90 percent of ICU patients are unvaccinated. The cost to French taxpayers of one day in an ICU is $5,615.17 while the cost of one dose of vaccine is $22.32. As several people I know would say, "Do the math." An ambulance driver calls for the national health service to continue to cover all covid patients, noting, "If we enter the spiral of patient selection, are we to make smokers pay for the lung cancer treatment or punish the obese because they eat too much?"

As a result of the pandemic, American adults and adolescents have missed more than 37 million routine vaccinations for ailments such as flu, hepatitis, and chickenpox. There are state legislators of a political party I will not name who have actually suggested doing away with all the vaccinations required for school attendance. If passing on the covid vaccine is okay, why not pass on all the other vaccines? 

Sarah Palin has been going out for dinner despite having tested positive for covid. I can't help but imagine that her words of a month ago might prove to be prophetic. "It'll be over my dead body that I'll have to get a shot."

Finally, I found a fun word in today's stroll through the news. It's the opposite of "immunocompromised," that is, "immunocompetent." It sort of rolls off the tongue with a bounce on the final "t." Being competent at being immune. Is that something we need to learn to be? An interesting word to think about while watching the snow fall.

The Road goes ever on and on ... Day 139 (639)

Shades of spring 2020, Cornell University in Ithaca, New York is shutting down for the semester. Students and staff are being sent home. The remaining final exams will be moved online. They had almost 500 new student cases at one time, and that was too many. They also had a percent positivity rate of 3.01. Ha! The percent positivity rates of the local university are 4.56 for students and 4.92 for faculty and staff. Finals here end on Friday, and numbers of cases are about what they've been all semester, so we may be okay. There was no word in the Cornell press releases about spring semester, so the best may be yet to come.

Happy first anniversary! One year ago today, the first dose of covid vaccine was given to a front-line nurse. That seems so short time ago at the same time as it feels longer than one year. Last week was two years since the first confirmed case; now we're one year since having vaccines that help prevent it. Early on, the demand for vaccines greatly exceeded the supply. As the pandemic appeared to lessen and restrictions were relaxed, the demand for vaccines plummeted. 

The Air Force dismissed 27 service members for refusing to get vaccinated. Each branch of military services set their own vaccination deadline, and the Air Force's was the earliest, November 2. All 27 had fewer than six years of service. The military has granted no religious exemptions, though it has granted medical ones. It also has allowed those members whose service is ending within a certain time frame not to be vaccinated. The Pentagon has not yet declared whether boosters will also be required. 

Omicron is expected to become the dominant strain in Denmark this week. England has seen the first death from Omicron, and 10 people have been hospitalized. If even a small percentage of people with Omicron need to be hospitalized, it could overwhelm the health system. South Korea just saw its deadliest day of the pandemic. Ninety-four people died in 24 hours; some died waiting for hospital beds. Another 906 people are in serious or critical condition. 

Here, a senior official in the Biden administration warns, "Everything points to a large wave. A large wave is coming. It will be fast. It won't be as severe, but regrettably, there will be plenty of hospitalizations." One article described Omicron as a dress rehearsal for the next pandemic. Yes, we already have vaccines and treatments. But the next pandemic will come on as rapidly as Omicron did and without warning. Are we ready? I hope so, but my gut reaction is that we probably are not. 

If you're looking for a good read relating to the pandemic, get The Premonition: A Pandemic Story by Michael Lewis. I'm about halfway through it, and it is spell-binding. 

The Road goes ever on and on ... Day 134 (634)

Omicron is out there, still somewhat lurking, while here in the US we continue to deal with the dastardly Delta variant. In the last two weeks, cases went down more than 20 percent in only one state, Wisconsin, where cases dropped by 22 percent. Cases went up over 20 percent in seven states: Rhode Island (a 40 percent increase), Massachusetts, Connecticut, Delaware, Kansas, Illinois, and Indiana. Cases in Alaska and Montana decreased between 10 and 20 percent. As a country, we are averaging over 120,000 new cases per day, a 27 percent increase over two weeks ago. Deaths are up 12 percent to an average of 1,275 per day. 

New Hampshire, New York, and Maine are calling on the National Guard to help health systems overwhelmed by rising numbers of cases. Right now, there are 15 percent more hospitalizations than there were two weeks ago. Michigan leads in hospitalizations per capita. Maine has 73 percent of residents fully vaccinated, behind only Vermont and Rhode Island nationally, and just saw cases reach a pandemic peak. Maine Medical Center, the state's largest hospital, has at times this week had no critical care beds available. On November 8, there were 980 people hospitalized with covid in Missouri; there were over 1,600 people on Wednesday. Missouri's University Health system had 10 covid patients in early November and had 39 on Wednesday. Says the system's chief medical officer, "What we're seeing now is still overwhelmingly the Delta variant." 

The Global Health Security Index developed by the Nuclear Threat Initiative and the Johns Hopkins Center for Health Security showed no country as being prepared for various health emergencies and problems such as the next pandemic. The US ranks at the top of the list but is still considered unready. Maybe Omicron will be a good motivator for countries to start looking ahead. 

Omicron is spurring wealthy nations to push booster shots even harder, causing WHO to express concern over vaccine equity, and not for the first time. Booster shots are now outpacing first shots globally. Only 8 percent or 103 million of 1.3 billion Africans are fully vaccinated. Some 73 percent of the vaccine shots globally have been in high- or upper-middle-income countries. Only 0.8 percent have been in low-income countries. Some wealthy countries have offered poorer countries vaccine doses about to expire. Countries have had to turn them down because they lack the capability to get them to people before they expire. 

An epidemiologist at the University of Pennsylvania sees some value in the Omicron variant, saying that it "is pulling the fire alarm. Whether it turns out to be a false alarm it would be really good to know if we can actually do this--get a new vaccine rolled out and be ready." WHO has appointed an independent scientific panel to advise on whether vaccines need reformulating. For now, boosters are taking the place of new vaccines. The FDA has authorized Pfizer boosters for teenagers ages 16 and 17 on an emergency basis. The CDC is expected to endorse the FDA's recommendation. 

Over 167,000 children have lost parents or in-home caregivers to covid in the US. That should not surprise me given the overall number of deaths, but it still somewhat slaps me in the face. The number internationally is in the area of two million. I looked for a corresponding number of parents who have lost children to covid, but the only reference that Google gave was from the Wall Street Journal and required an $8.00 per month subscription to read. I go back and forth wondering about the toll paid by each group. I cannot imagine losing a child, especially a young one, but at the same time, I cannot imagine what it is like for a young child to lose their principal caregiver, the one who ideally takes care of and teaches the child about life and the world in which they live. I never experienced the latter and now pray I never experience the former.

The Road goes ever on and on ... Day 116 (616)

I visited my mom this morning, and the entry questions at her assisted living facility once again include a series on vaccination. The first question asks if you are fully vaccinated. The second question asks whether you have received all but the booster shot. The times, they are a'changing.

Protests continue in Europe even as it continues to be the pandemic's epicenter. The national lockdown in Austria starts tomorrow. Rather than hit the grocery store to stock up on munchies, some 40,000 people (a police estimate) protested in Vienna. There were also protests in Italy against the health pass. Attendance there was nowhere near what it was in Austria. With the health pass required for entry to clubs and bars, 84 percent of Italians ages 19 through 29 are vaccinated. There may be new or tightened restrictions in Germany where case numbers have soared, largely among children, teens, and unvaccinated adults. Portugal has one of Europe's highest vaccination rates but is still adding some restrictions. Finally, the president of Slovakia has raised the prospect of a nationwide vaccine mandate.

The state legislature in Florida passed and the governor signed a bill blocking covid vaccine mandates. The governor said that he wants to protect workers who could lose their jobs for not getting vaccinated. The law prohibits employers from enforcing strict vaccine mandates; Disney, for example, has put its staff vaccination mandate on hold. Weekly covid testing can be required but must be at the expense of the employer not the employee. Fines could cost  $10,000 per day per employee for businesses with fewer than 99 employees or $50,000 for larger businesses. The mandate ban also applies to government entities and school districts. 

A fully vaccinated but also immuno-compromised Canadian senator died from covid just days after getting home from the hospital. In a statement released after her death, she urged people to get vaccinated noting how different her fight would have been had she not been vaccinated. 

As holidays and winter loom, Americans are desperate for normalcy even as covid cases climb. Boosters have been approved for all adults, though are only urged for people over 50 or with underlying medical conditions. Pfizer has asked the FDA to authorize its antiviral Paxlovid. Paxlovid is geared toward older people and those with underlying conditions. It is meant to be dispensed by pharmacies and taken at home. 

How long will masks be with us? When might we be able to stop wearing them?  The CDC recommends masks for everyone where community transmission is "substantial or high." Right now, 85 percent of US counties meet this criterion of 50 new cases weekly per 100,000 residents. That suggests masks aren't going anywhere anytime soon. From an infectious disease modeler at the University of Cambridge: "I think mask-wearing is, in many ways, one of the interventions you probably want to relax last. Mask-wearing is very, very low cost in comparison to most other interventions." Many experts say that it will be easier to ease mask requirements in 2022. They also note that some people may wear masks indefinitely (raising my hand here and saying, "Me! Me!"), especially in cold and flu seasons. 

Vaccine mandates. Boosters. Masks. All are just details. I have to agree with a UCLA epidemiologist: "Cases are starting to rise again, and we have not yet conquered this virus. We may be tired of Covid and Covid restrictions and public health measures, but this virus is certainly not done with us yet."

The Road goes ever on and on ... Day 79 (579)

Back to the teeny-weeny keyboard. The new laptop, a Chromebook I will use for any and most if not all web things, arrives on Monday. In the meantime, I'll try not to swear loudly enough for you to hear me.

I got a cortisone injection in my arthritic right thumb this morning. I got there early, so there was time for a bit of a chat with my hand doc. (Doesn't everyone have a hand dog they've seen countless times over the last almost-20 years?) She told me of the troubles they had had with fully vaccinated staff members--nurses, therapists, etc.--being out with breakthrough infections. She got Moderna and said she hoped to be first in line whenever boosters are finally available. I again find it sad that the US only counts breakthrough infections as happening at all unless they result in hospitalization or death. I guess having to isolate oneself and miss work or other obligations isn't worth noting in terms of its impact on the world.

Russia promised to export roughly one billion doses of its Sputnik V vaccine but so far has only distributed about 4.8 percent. According to a Virginia Commonwealth University professor specializing in global heath, Russia was for a while the "only game in town." Now, the window of opportunity "to really stake a claim as the savior" in the pandemic is gone. Complicating matters is that, unlike other vaccines, the first and second shots of Sputnik V are different and not interchangeable. Sputnik V is a viral vector vaccine that uses a harmless virus to carry genetic material that will stimulate the immune system. Working with biological ingredients means there are lots of places in the manufacturing process at which things could go wrong. WHO and the European Medicines Agency have yet to approve Sputnik V.

The FDA advisory panel is recommending a second shot of the Johnson & Johnson vaccine at least two months after the first shot. Consideration may also be given to allowing the use of Pfizer or Moderna as a booster. A University of Pennsylvania immunologist holds that "At the end of the day, folks having the Johnson & Johnson should probably get an mRNA booster." No other country has yet recommended a Johnson & Johnson booster.

Italy is setting a high bar on vaccine mandates. Workers will have to show proof of vaccination, a negative rapid swab test, or recent recovery from covid before returning to offices, schools, hospitals, or anywhere else. Workers unable to produce any of these will be placed on unpaid leave and could face fines of up to $1,760. Italy was the first democracy to quarantine towns and apply national lockdowns; it is also the first to do something this drastic. Over 80 percent of people over the age of 12 have been fully vaccinated. The government says that the measure is already helping. Over 500,000 previously unvaccinated people have gotten vaccinated since the policy was announced, more than had been expected. 

Chicago's largest police union issued a directive for officers to ignore the city-wide mandate to report their vaccination status. The city is treating it as an illegal strike; the governor has offered to send in the National Guard if too many police stop working. The city's mandate requires city employees who remain unvaccinated and refuse semiweekly testing to be placed on unpaid leave unless they have been granted medical or religious exemptions.

New Zealand is using some interesting strategies to try to get the last 20 percent of its eligible population vaccinated. People getting vaccinated can enter an Air New Zealand jumbo jet through the first class door and get vaccinated in the arm of their choosing. They then move to economy class for snacks and in-flight entertainment if desired and pass the 30-minute post-vaccine observation period. The plane stays on the ground. Papatoetoe supermarket is giving one hot roast chicken per shot. KFC is offering a family-sized bucket of KFC or a boxful of "popcorn chicken" nuggets. Finally, vaccination buses are waiting outside some McDonald's drive-through lanes.

Finally, a bit of positive news. Enrollment in bachelor's, master's, and doctoral programs in nursing in the US increased 5.6 percent in 2020 while nurses retire or leave citing burnout as the cause. The University of Michigan got about 1,800 applications for 150 slots compared with about 1,200 the year before. Young people are seeing the global emergency as both a challenge and an opportunity.

The Road goes ever on and on ... Day 75 (575)

We're but three weeks away from Halloween and trick-or-treating. Will it be safe this year? Dr. Fauci thinks so, noting, "I think that particularly if you're vaccinated, you can get out there." This seems a bit off-center since children under 12--the mass of trick-or-treaters--are unvaccinated. Even were the FDA to approve doses for kids ages five to 11 right now, kids could not get fully vaccinated before Halloween if they follow the same two doses some weeks apart followed by two weeks of letting the vaccine do its thing that adults have followed.

Dr. Fauci went on to mention the holidays that follow Halloween. "It's a good time to reflect on why it's important to get vaccinated. But go out there and enjoy Halloween as well as the other holidays that will be coming up...we have to be careful that we don't prematurely declare victory." He did caution against indoor Halloween parties. The US seven-day average number of new cases dropped to 93,814 on Sunday. Dr. Fauci would still like to see fewer than 10,000 per day. Some experts would like to see airlines institute vaccine requirements before holiday travel takes place. A winter surge is definitely not out of the question.

Merck has asked the FDA for emergency use authorization for molnupiravir as a treatment for covid. It is the first antiviral pill treatment proposed for covid and is said to be "relatively inexpensive." Note the "relatively" there; treatment would cost about $700 per patient. That's one-third the price of monoclonal antibody treatments, though. The US government has placed an advance order for enough pills for 1.7 million Americans. Australia, Malaysia. Singapore, and South Korea have also placed advance orders.

The FDA will also be discussing Moderna and Johnson & Johnson boosters this week, Moderna on Thursday and Johnson& Johnson on Friday. They will also hear a presentation on Friday on the effectiveness of mixing different brands of vaccines. Meanwhile, Pfizer will fully vaccinate all eligible people in Toledo, Brazil to monitor a "real-life scenario" of how long Pfizer immunity lasts. It's a big week on the vaccine front.

A French study of 22.6 million people over the age of 50 suggests that vaccinated people are nine times less at risk of being hospitalized or dying from covid than unvaccinated people. Similar findings have been reported in the US, UK, and Israel. Hong Kong says it will only loosen restrictions if vaccination rates rise. Currently, all incoming travelers including residents returning from abroad must quarantine for 21 days. 

Sydney, Australia is starting to reopen after over 100 days of lockdown. They had said reopening could begin when over 70 percent of the New South Wales population had been fully vaccinated, and that percent is now at 73.5. Over 90 percent have gotten at least one dose. For now hairdressers, gyms, cafes, and bars may reopen. Additional restrictions will be removed when 80 percent full vaccination is reached. Right now, New South Wales just reported 496 new cases in 24 hours and eight deaths. The powers that be are cautioning that those rates will rise as Sydney reopens. The current covid surge has yet to peak in Melbourne.

 

The Road goes ever on and on ... Day 71 (571)

I'm working a late (until 7:00 pm) shift of voting today and would prefer not to be writing after that, so here goes. Let's start with vaccines. As of September, 41.5 percent of the world's population had received at least one dose of a vaccine, but only 1.9 percent of people in low-income countries had. The creator of the Oxford vaccine warns that the "ever evolving" virus "continues to circulate unchecked," and no country in the world is truly safe. Some experts are unhappy that the new emphasis on boosters and child doses is detracting from getting the whole world vaccinated. 

As for boosters, more Americans are currently getting boosters than are getting first-time vaccinations. Vaccine hesitancy and opposition to mask or vaccine mandates are roiling local governments and hurting the nation's overall recovery. The issue of vaccine mandates is not going to get any better should the FDA authorize pediatric doses of vaccine, opening the door to a new class of at-school mandates. Pfizer has formally asked for approval of their vaccine for children ages five to 11. A meeting on the subject is tentatively scheduled for October 26 meaning that the ruling could come between Halloween and Thanksgiving. Pfizer's proposal is that children get one-third of the adult dose, something that would require diluting the vaccine or using different vials or syringes. 

Twenty medical centers in Alaska are now rationing care. One in 84 Alaskans was diagnosed with covid in the last week of September, and Monday's report was 2,290 cases and one death in three days. Hospitals are looking for beds in other states; some patients have been medevaced to Seattle. Alaska is the largest state geographically and is geographically larger than the next three largest state combined. Those states would be California, Montana, and Texas. Because of this enormity, Alaskans travel on average 150 miles each way for medical care. 

North Korea has started to accept medical supplies from WHO. No cases of covid have been reported, though, and the country has turned down several offers of vaccines. WHO is sending health kits, medicines, and other supplies that would help at primary care centers. France will start charging unvaccinated people between $25 and $50 for a covid test. Tests will remain free for vaccinated people and minors as will tests ordered by a physician. The hope is that this will increase vaccination rates. Germany is implementing a similar system.

Here's a final thought to ponder. Covid has already killed more people in 2021 than it did in 2020. Let's not think we're out of the woods just yet.

The Road goes ever on and on ... Day 57 (557)

Feel-good story for today is right here. It at least put a big smile on my face. It also helps that last night's computer woes were likely weather-related, because it's so good so far this morning. Of course, I'm saving this draft to finish later and who knows what the tech gremlins may be up to then. Note: Tech gremlins appear to be taking the day off.

How has per-capita covid changed in the last two weeks? Cases in Alaska, Montana, and Wisconsin are up more than 20 percent; Montana is up 36 percent. Cases in Tennessee, South Carolina, Georgia, and Florida are down over 20 percent; Tennessee is down 39 percent. New infections relative to population are worse in 27 states and better in 23. Like quirky things? Covid has followed something of a two-month cycle: Cases stay up for two weeks and then start to decline. Delta started in July, just over two months ago, and is now going down in places. 

As Florida seems to be declining in their number of cases, the governor has named a new surgeon general who is opposed to both mask and vaccine mandates. In fact, his take on vaccines is that "There is nothing special about them compared to any other preventive measure." He was trained at Harvard of all places. How does he think Florida should deal with the pandemic? "Florida will completely reject fear. Fear is done." Dare I note that last week, one in every 400 Florida residents alive in March 2020 has died from covid. Only cancer and heart disease claimed more lives. 

If you shook your head and said, "Huh?" at the comment about rejecting fear, I have another eye-raising covid comment coming up. England is revising its travel rules. Travelers fully vaccinated with the AstraZeneca, Pfizer, Moderna, or Janssen vaccines in the US, Australia, New Zealand, South Korea, or an EU country will be exempt from quarantine as long as they arrive from a a green- or amber-list country. (Amber is the middle level in the green-amber-red hierarchy of countries England uses to denote riskiness.) People fully vaccinated with the same vaccines in Africa, Latin America, or other countries including India will have to quarantine for 10 days. Only after that will they be considered fully vaccinated. Critics of this plan say that it will promote vaccine hesitancy by suggesting that something is wrong with the vaccine and that is why where you get it is important. Here's what a government spokesperson had to say: "Our top priority remains protecting public health, and reopening travel in a safe and sustainable way, which is why vaccine certification from all countries must meet the minimum criteria taking into account public health and wider considerations." I don't know about you, but my written comment to that was "HUH??"

I did not know and actually find it strange that New Zealand has one of the highest per-capita distributions of KFC and McDonald's outlets in the world. The government is currently in talks with representatives of KFC, Pizza Hut, and Taco Bell about giving vaccinations to customers as they wait in line. Instead of fries, it will be, "Would you like Pfizer with that order?"

African leaders are speaking to the UN General Assembly today, with Vaccine inequality predicted to be a major topic. I like a comment made by Norway's prime minister in her remarks to the Assembly: "Some countries have vaccinated their populations, and are the path to recovery. For others, the lack of vaccines and weak health systems pose a serious problem. In Africa, fewer than one in twenty people are fully vaccinated. In Europe, one in two are fully vaccinated. This inequity is clearly unfair." As a numerical example, in Congo, one in 1,000 people have gotten at least one shot. Think about that. One in two fully vaccinated in Europe, while one in 1,000 are partially vaccinated in Congo.

The US Olympic and Paralympic Committee has said that athletes and team members who want to use USOPC training facilities must be fully vaccinated by November 1, while athletes vying to represent the US in the Winter Olympics or Paralympics must show proof of vaccination. The International Olympic Committee has yet to  announce any international vaccine requirement. The status of spectators is also still undecided. 

Finally, a word or two about masks. The amount of protection they give depends on the quality of the mask and its fit. In one study, communities with mask mandates were found to have lower hospitalization rates than areas not requiring masks. Of course, masks could be all in the eye of the beholder. At a gas station in southwestern Germany, a cashier insisted that a customer put on a mask. They have been required in shops since right after the pandemic started. The man left the store and returned in an hour with a gun (illegal in Germany). The cashier again asked the man to put on a mask. The man then shot the cashier in the head. He later told police that he saw the cashier as "responsible for the situation because he was enforcing the rules."

 Maybe we should all break a rule in memory of that German cashier. I guess we could always enforce a rule, too. Personally, though, I kinda want to break one about now.

The Road goes ever on and on ... Day 26 (526)

Big coronavirus domestic news of the day is that the FDA has given full approval to the Pfizer vaccine for people ages 16 or older. The vaccine as given to ages 12-15 is still under an emergency authorization. The decision on whether the vaccine may be given to children under 12 may be months away, something I know some parents will absolutely hate hearing. The full approval strengthens the case for any vaccine mandate. The military, for instance, can now move full steam ahead and not have to deal with questions about the vaccine's safety if it had not been fully approved. New York City can require all Department of Education employees to have received at least one dose of vaccine by September 27. There is no testing alternative there; it's the vaccine or a valid medical or religious exemption. I've noted before on this blog haw much I hate the alternative of presenting a negative covid test. A person can test negative one day and positive the next. It's far from a truly valid substitute for vaccination.

School districts in Florida and Texas continue to defy the bans on mask mandate issued by their governors, sometimes in creative ways. One school district in Texas modified their dress code to make "no mask" one of the banned clothing items. At least seven districts in Florida, serving over a million students, are now requiring masks. One county put in a mask mandate after recording over 200 new cases in the first week of school. 

Locally, the county school system opened today, while Wednesday is the first day of classes in the city. (Virginia has independent cities that function the same way counties do; the county in which I live is home to one of those independent cities.) I just learned that the county schools have no plan to test staff or students in any way at any time. The city schools are working with a state program that would combine samples to test some defined group. If the combined sample is negative, no one in the group has covid. If the combined sample is positive, then each individual can be tested to determine who actually has it. I much prefer the city's reasoning. I'm not sure things will end well for the county.

Alabama reports that 85 percent of their hospitalized covid patients are unvaccinated. I find that troubling after weeks of reading that between 95 and 100 percent of people testing positive had not been vaccinated. Is Delta winning on the number of breakthrough infections? In a month, will only 75 percent of hospitalizations be unvaccinated people?

Taiwan has a 40 percent partial vaccination rate but only three percent of people are fully vaccinated. The country has had so much trouble getting vaccine from foreign manufacturers that they have started using a locally developed vaccine called Medigen. It has emergency authorization based on Phase 2 trials, but concerns have been expressed about its effectiveness and safety. Is this a case of any port in a storm? If Taiwan has the resources to purchase vaccine, I find it troubling that they cannot purchase it. Are countries such as the US, Canada, and the UK hogging the vaccine market to an extent that countries that can buy it can't get it? We've been criticized for keeping more vaccine than we need and letting countries using Covax and donated vaccine go without. Are we also keeping some countries from buying their own?

Jumping around the world, Vietnam is deploying the military to enforce the Ho Chi Minh City lockdown that started on Monday. People cannot leave homes even to purchase food. Needless to say, there was lots of panic buying over the weekend. It's been nine years since I was in Vietnam, but it seemed to me that many if not most of the people there purchased food daily. We met several people who never cooked but ate all their meals at sidewalk cafes. I wonder what they're doing right now. 

Finally, did you know that Africa has five mountain ranges with enough seasonal snow to allow skiing? There are even two rudimentary ski resorts, one of which is in Lesotho.

The Road goes ever on and on ... Day 16 (516)

The CDC today joined the FDA in authorizing a third dose of the Pfizer or Moderna vaccine for people with compromised immune systems. The authorization applies to transplant recipients, cancer patients, patients with HIV/AIDS, and other people with immune systems compromised in some way. Vaccinations are moving slowly in the US, but in the right direction. On July 29, 615,000 people were vaccinated; on August 12, 699,000 people. Our neighbor to the north, Canada, has the world's highest vaccination rate with 82 percent of the eligible population over the age of 12 having gotten at least one shot. Some 70.3 percent are fully vaccinated.

San Francisco is barring unvaccinated people from indoor spaces; the order takes effect August 20. Showing a negative test result is not enough, nor is being only partially vaccinated. The order applies to indoor dining, bars, gyms, large concerts, and theaters. It does not apply to dining outdoors, entering restaurants to pick up takeout, or to children under 12 who cannot yet be vaccinated. Cases in California are about 10 times higher than they were in mid-June despite 65 percent of eligible residents being fully vaccinated. In San Francisco itself, 78 percent of the eligible population is fully vaccinated; 96 percent of residents between the ages of 12  and 17 are fully vaccinated. The city would like to see those percentages increase. For a group of at least five people, the city will send a mobile vaccination team to a home or business. People even get a choice of the Pfizer, Moderna, or Johnson & Johnson vaccines.

Vaccine mandates continue to make the news. The Department of Health and Human Services will require its health workers, including contractors and volunteers, to be vaccinated; there will be no option of submitting negative test results. Medical and religious exemptions will be allowed. Many Health and Human Services workers are already required to have flu and other vaccines. The Supreme Court will allow Indiana University to require students be vaccinated. Exemptions will be permitted on religious, ethical, and medical grounds. Exempted students muse wear masks and be tested frequently. I checked the Indiana University website in search of an explanation of the "ethical" grounds. There, it listed "ethical objection" with no explanation. I will have to give thought to just what that might involve. Closer to home, the local county is requiring public school teachers and staff to be vaccinated or be tested regularly. 

Some brief numerical factoids: Over the past week, the national average for cases is 125,800, up 78 percent from two weeks ago. Deaths rose by 92 percent to an average of 616 per day. There were 68,800 patients hospitalized each day, up 82 % from two weeks ago. Florida, Mississippi, and Oregon reported more cases in the last week than in any other seven-day period. Texas and Florida accounted for almost 40 percent of new hospitalizations last week. 

It turns out that the prevalence of covid among migrants at the border is the same as for the US overall. In other words, the surge in covid cases can't be linked to migrants. It looks as if we owe it all to the Delta variant despite what some politicians are saying.

So much lately seems like "been there, done that" moments. Part of me would like to get angry about that, but most of me want to shrug and say, "Meh." It is what it is and will be what it will be. I've made it this far and can keep on keeping on.

The View from the Hermitage, Day 493

"The pandemic is a test, and the world is failing."

Thus spoke WHO's director general after he praised the Olympics as "a celebration of hope"  while also advising that we must not forget reality. "By the time the Olympic fame is extinguished on the eighth of August, more than 100,000 more people will perish. The pandemic is a test, and the world is failing."

I just checked and it appears the Olympics are still on. The host cities always lose money, but Tokyo can't afford to lose more than they already have. The host city for 2032 was announced this week; Brisbane, Australia, the only city to put in a 2032 bid, will follow Los Angeles in 2028 and Paris in 2024. That only one city bid on 2032 says a lot. The Games may be getting too big, too much for one city or even one country to handle. 

Half of Australia's population, some 13 million people, is under lockdown due to covid. The states of South Australia, Victoria, and New South Wales are imposing or extending lockdowns. Only 11 percent of Australians are fully vaccinated with another 29 percent having received at least one dose. Australia has been fighting covid with a strategy of swift local lockdowns, but that may not work given the transmissibility of the Delta variant. The prime minister said that a million doses of vaccine had been given in the last seven days, the first time that had happened. He went on to say that if that pace continues, all Australians who want a vaccine will be able to get one by the end of the year. The descriptor "who want a vaccine" is what worries me. That sounds too similar to what is going on here right now. If you want a vaccine, you can get one. If you don't, no worries.

Pfizer has struck a deal with a South African vaccine manufacturer to handle the final stage of manufacturing for vaccine shipped exclusively to African nations. "Final stage" means that the company will only handle distributions and the fill-finish final stage. That's when the vaccine is put into vials. A Pfizer plant in Europe will make the vaccine and ship it to the facility in Cape Town. The Director of Global Health Policy and Politics Initiative at Georgetown University calls this "deeply disappointing." He is worried that not enough vaccine will be sent to the African plant especially if wealthy countries decide to do booster shots. Pfizer has pledged to provide two billion doses to low- and middle-income countries by the end of 2022, but only a small fraction has already been sent.  

A yet-to-be-peer-reviewed study says that the Johnson & Johnson vaccine is much less effective against the Delta and Lambda variants. This is consistent with observations that one dose of AstraZeneca shows only 33 percent efficacy against Delta. The AstraZeneca and Johnson & Johnson vaccines have similar architectures. As noted, the Johnson & Johnson study has not yet undergone peer review. The result came from a lab experiment with blood samples and not from real world cases. There are people who got the single-dose Johnson & Johnson vaccine and who have been asking for boosters of Pfizer or Moderna, the mRNA vaccines.

US covid fatalities are up by almost 48 percent over the past week to an average of 239 per day. The infection rate has gone up 198 percent over the past two weeks. If that sounds bad, the infection rate in Mississippi over the same period increased 308 percent. It went up 376 percent for Louisiana and 387 percent for Oklahoma. Meanwhile, vaccinations are down to 521,000 per day keeping us pretty well locked in with slightly less than half the population fully vaccinated. Some experts are suggesting that the US needs to go back to widespread mask use. I'm no expert, but am certainly more comfortable out in the world wearing a mask than not wearing one.

The View from the Hermitage, Day 488

The CDC director advises that we are approaching "a pandemic of the unvaccinated ... If you are not vaccinated, you are at risk." In the last week, 10 percent of counties moved into a "high-transmission risk" zone; another seven percent became at "substantial risk." The CDC director again: increasing risk "is giving us all a reason to double down and get more people vaccinated." That is so easy to say but not so easy to do. I admit to being surprised at the size of the vaccine hesitancy or resistance. If herd immunity really exists, we aren't going to get there. I'm back to being square in the "we're fucked" camp.

WHO has warned that the surges in many parts of the world increase the likelihood of new, potentially dangerous variants. The chair of the WHO Emergency Covid-19 Committee notes, "The pandemic is nowhere near finished." Indeed, Africa's death toll this week was up 40 percent over last week. Namibia and Tunisia now report more deaths per capita than any other country. Hospitals are nearly full and with dwindling oxygen supplies and a lack of medical workers. The US has said it will send 25 million Johnson & Johnson doses in coming weeks but that is so very far from enough. There is a strong possibility, too, that supplies will still be short a year from now. A commissioner with Africa Covid-19 Response says, "The blame squarely lies with the rich countries. A vaccine delayed is a vaccine denied."

England's mask mandate will end as of Monday, and it is not clear what reactions there will be. The prime minister says, "The pandemic is not over. We cannot just simply revert instantly from Monday the 19th of July to life as it was before covid." The government "expects and recommends" that masks be worn by workers and customers in crowded, enclosed spaces such as shops. London's mayor says that masks are still required on the public transit system there, and the National Health Service will still require masks in hospitals. Scotland and Wales set their own requirements health-wise, and masks will still be required there. 

Believe it or not, the Olympics are still on! The president of the International Olympic Committee insists there is no risk of the Games spreading infections, saying organizers will do all they can to ensure no risk for the Japanese people. There are currently 30 confirmed cases among Olympics-related personnel. Tokyo's case count is climbing. There were 1,271 new cases Friday, continuing the largest surge in six months. The average number of daily cases has risen 63 percent in the past two weeks. Only 20 percent of the population of 126 million have been fully vaccinated. One of the leading Japanese newspapers says that the covid bubble "has already burst" and that organizers' plans to separate Olympics-related people from the general population "are failing miserably." A former chairman of Japan's bar association submitted a petition with 450,000 signatures arguing that the Games should not be held. "We won't be able to save lives if the infection spreads further and the medical system collapses. Now is the time to cancel the Games with courage."

A couple of covid quickies: The University of California will now require all students and staff to be vaccinated for the fall semester. They previously said that vaccinations would be required only when the FDA had given the vaccines full authorization rather than emergency. I guess the swiftly rising case rates persuaded them otherwise. Canada may admit travelers from all countries by early September  and might admit vaccinated Americans to enter as early as mid-August.

The use of cash is falling, and most of the use that remains may be of the under-the-table variety. It seems that $100 bills (currently the largest denomination that exists) account for over 80 percent of the US bills in circulation and are rarely used in legitimate transactions.

The View from the Hermitage, Day 449

Case rates may be "going down" here in the US, but vaccination rates are "plummeting." Currently, fewer than one million people get vaccinated on an average day. This is a decline of two-thirds from the April peak of 3.4 million daily and a decline seen in every state. Twelve states including Utah, Oklahoma, Montana, North Dakota, South Dakota, and West Virginia have seen vaccinations fall below 15 daily per 10,000 residents. Last week, Alabama had just four per 10,000. There are 13 states, mostly on each coast, that have passed the 70 percent level POTUS would like to see by July 4. Fifteen more states plus the District of Columbia are likely to meet it. Tennessee and five other states currently at 50 percent or lower are unlikely to make it. Hitting the 70 percent goal requires 4.2 million people per week, not the 2.4 million nationally seen last week.

Countries across the world have started incentive programs to increase vaccinations. Hong Kong will be giving away 20 cash prizes of $12,890 as well as a one-bedroom apartment worth $1.4 million. The lottery is open only to vaccinated residents. Registration opens June 15 for the September 8 drawings. Airport authorities will give away 60,000 tickets to city and airport employees who are fully vaccinated. Civil servants and some private citizens will get one day off from work for each dose they get. One town in the Philippines is raffling off a plot of land with a home. Interestingly, some of the vaccination incentive programs in the US are making people less likely to be vaccinated. The incentives make them more suspicious of the vaccines.

For evidence that masks worked (and still work), 11 percent of people who reported wearing a mask at all times tested positive for covid. Thirteen percent of people reporting that they sometimes but not always wore a mask tested positive. For people reporting they wore masks occasionally but not often, the percent was 18. Finally, 23 percent of people who reported never wearing a mask tested positive for covid. That's twice as many as in the always group.

Taking a quick trip around the world, Malaysia is using drones to detect people with fevers in public places. The drones can detect temperatures from as high as 20 meters above the ground. In Uganda, there was a 131 percent increase in the number of cases last week over the week before. Four African nations have yet to start vaccinating citizens--Tanzania, Burundi, Chad, and Eritrea.Norway has been giving doses with a 12-week interval but is shortening that to nine weeks. And Ontario will lessen its covid restrictions three days ahead of schedule. 

More than 100 current or former heads of state are among 230 leaders calling on the G7 to pay two-thirds of the $66 billion needed to vaccinate low-income countries. The WHO head refers to the current situation as a two-track pandemic. In six months, high-income countries have given 44 percent of the world's doses, while low-income countries have given just 0.4 percent. 

Alpha is still the dominant variant in the US and apparently disables the first line of defense giving the virus more time to multiply. Alpha has 23 mutations, nine of which alter the spike protein. One helps the virus bind more tightly into cells. Lung cells under Alpha make a lot less interferon, a protein that switches on several immune defenses. Alpha-infected cells also make some 80 times more copies of a gene called Orf9b. Orf9b makes a viral protein that dampens the full immune response. Beta and Delta also drive down interferon but in different ways.

The coffee maker is set to start at 3:51 tomorrow morning, which is about the time the alarm will go off. The Professor and I spent an hour this afternoon helping get furniture moved, plexiglass shields and marking carrels set up, and otherwise getting thing ready for tomorrow's primary election. How many people will come to vote is a toss-up. We had one single-party June primary with 65 voters in the 13 hours we were open. Several thousand people voted mail-in absentee ballots or came to early in-person voting, but I don't know how many of those might have been from this precinct. If I don't post anything tomorrow, don't think you've missed anything.

The View from the Hermitage, Day 429

The weather is always a safe subject, so let's start there. That by no means signifies that this post will be at all unsafe; it just jumped to mind as an opening line. I keep the weather app on my iPhone set for five places: where I live (Charlottesville, Virginia), where my brother lives (Bangor, Maine), where my brother-in-law lives (Tisdale, Saskatchewan), where Son #2 and DiL= live (Richmond, Virginia), and where their cabin is (Ruther Glen, Virginia). Imagine my surprise last night when, looking for what our overnight low temperature would be, I discovered that it was in the 80sF in Tisdale, Saskatchewan. It's 88F there now even as I type this. But don't get used to it too much, Tisdalians. There's a 50 percent chance of snow on Friday.

The CDC's new mask guidelines rely on an honor system. The local university has a very famous one that often does not work as intended. The mayor of Kansas City, Missouri says that the honor system isn't working there either. Localities can, however, keep local mask mandates even in the wake of a state's stopping theirs. Maryland has ended its statewide mask mandate, but Baltimore City is keeping their local one in place until at least 65 percent of the adult residents have gotten at least one shot of vaccine. As Dr. Fauci clarifies it, the guidance is "not a mandate to take masks off."

POTUS is taking a bit of heat over whether the donation of 80 million doses of vaccine to developing countries is enough. Some 11 billion doses will be needed to vaccinate 70 percent of the global population, but so far only 1.7 billion have been produced. If booster shots are needed, 11 billion won't be enough. Covax will soon finish delivering 65 million doses but should have delivered at least 170 million by now. The fact that the US has a glut of vaccine along with the problem of convincing vaccine-hesitant or -resistant people to get it is not seen in our favor. There are some who argue that along with donating doses of vaccine, the US needs to work on a plan to scale up production world-wide. The US cannot produce those 11 billion doses on its own. 

Storing some of that vaccine got a boost easier. The Pfizer vaccine has been through to require a storage temperature between -70 and -80C until a "few days" before use. For those few days, it can be stored in a standard medical refrigerator. The European Medicines Agency now says that the Pfizer vaccine can be stored in a standard medical refrigerator for five days to one month, at a temperature of 2 to 8C. This makes it much more practical to use is a wider variety of settings. 

The local paper used to have a sports columnist who would often start a section of his column with "Scatter-shooting around the ACC..." Well, scatter-shooting around the world, India just set a new record for deaths in one day, 4,329. Germany has put the residents of two tower blocks in Western Germany in quarantine after discovery of the Indian variant there. In the first week of April, Nepal was counting fewer than 200 covid-19 cases daily. The daily averages for the past week are 183 deaths and 8,600 new cases. European countries are continuing to reopen at various paces, but the growing presence of the Indian variant in the UK could throw a monkey wrench into those plans. Finally, Japanese opposition to the Olympics is now at 83 percent. A top medical group, the Tokyo Medical Practitioners Association, also wants the Games cancelled.

I may have to start adding a political thread or two. I almost miss the absurdity of the XPot days. The news is certainly not as entertaining as it was in the fall. I don't think I want to get back to discussing the January 6 Capitol insurrection. Discussing the Party of XPot's treatment of Liz Cheney might double my blood pressure medicine, though I am seeing my doc for a physical next week. Matt Gaetz? That does get pretty bizarre, and the mainstream media so far has stayed away from the possibility that the young Cuban-American man living with Gaetz might be his son from a relationship with an underage young woman. I think I'll give that topic some thought. 

The View from the Hermitage, Day 422

An up-and-down day. Up in terms of getting what was supposed to be a June 1 appointment about the arthritis in my right thumb moved to this afternoon. The injection was done with help from a real-time x-ray, which I could see along with the physician assistant. There is definitely no gap between the bone at the base of my thumb and the bone in the body of my hand, but the PA said it was not the worst she's seen. It was interesting when, as part of the injection, she pulled on the thumb to create a gap between the two bones. I made it almost two years between cortisone injections in some part of my body. I had the more recent one in June 2019, into my right wrist. 

A second up is that the three-year warranty on Twiggy, my newest laptop, doesn't run out until September. As for the down, I took Twiggy to a local computer shop last Monday to see about the camera that wasn't working. The camera was apparently the tip of the iceberg. I was still there when they were checking the camera and other things started going haywire. They're now trying to clone the system and copy all the "data" so that I can contact the vendor (Lenovo) and send it in. They folks here say it does not seem at all repairable, and I should expect to get a new computer in return. That's why they're trying to clone the system, so that I won't have to rebuild things from the ground up. I thank the deities for the cloud storage in which I'd backed up pretty much everything stored on the laptop itself.

As for the covid front, the FDA has said that the Pfizer vaccine is okay to give to kids between 12 and 15 years old. There's an up and down to that news as well. The up is that the kids in that age range who get vaccinated will count toward that mythical goal of herd immunity. The down is that parents are currently split evenly on whether they will let their kids be vaccinated. There are some 17 million kids in that age range, and the medical folks note that a "different level of sensitivity" will be needed when dealing with their parents. State, counties, and school districts are already working on plans to offer vaccines at schools as well as at pediatricians' offices, day camps, parks, and beaches. The hope with pediatricians' offices is that the docs there are experienced at discussing vaccination issues with parents as well as with making vaccinations as pain-free as possible. In terms of schools, the issue is that the end of the school year is imminent. One was around this might be what Columbus, Ohio is planning--a mobile vaccination unit similar to an ice cream truck.

Erie County, New York, home to Buffalo, is offering a similar inducement for adults. The "shot and a chaser" promotion offers a free beer mug plus a coupon for a free beer when someone over 21 gets a Moderna shot. A second free beer comes with the second shot.

Yesterday, I noted that the Prime Minister of Japan was passing the question of whether to stage the Olympics off to the President of the International Olympic Committee. That would be the same IOC President who has cancelled a planned visit to Tokyo due to the coronavirus surge in progress there. It's potentially too dangerous for him but not for thousands of athletes, coaches, support personnel, media, and Japanese volunteers needed to stage the Games? Go figure. 

The effects of the covid situation in India will impact the global economy. Indian ships and waterways are critical for worldwide supply chains. India also normally produces over 60 percent of all vaccines globally but is now only dealing with domestic needs. (And I can't blame them for that, not even one little bit.) While covid cases in Delhi and Mumbai may be levelling off, rural areas are being hit even harder. Nearly 200 patients have died recently due to a lack of oxygen. Families are also being hit hard by cremation costs' rising from $27 to around $200, too much for most rural families. Besides India, cases and deaths are rising throughout the region, including Cambodia, Malaysia, and Thailand. Neplay is so short of oxygen cannisters that it's asking Everest climbers to bring back the empties they usually discard en route. About 3,500 cannisters have been used so far.

An Axios survey done May 7 to 10 asked whether proof of covid vaccination should be required for certain events. Here are the results for "yes" responses.

     International air travel                    64%

     Domestic air travel                         63

     Vacation (hotel, resort, cruise)       61

     Sporting event                                57

     Salons, barbers, spas                      49

     Indoor restaurant dining                 49

     Non-grocery retail                          44

For the first time since the start of the pandemic, fewer than half of Americans (43 percent) saw returning to "normal" pre-pandemic lives as risky. It was not clear if the going out to eat was indoors or out, but 54  percent of Americans say they have gone out to eat. Finally, Democrats are still much more likely than Republicans to say that they're wearing masks. 

The View from the Hermitage, Day 421

Yesterday, I mentioned the pandemic around the world being like something watched on a split screen. The vaccination picture here in the US is starting to seem like that, too. I read in one source that over half of US adults have gotten at least one dose of vaccine, and this is good. In another source I read that only 34 percent of the US population is fully vaccinated, and this is not good. It's not clear to me if we're winning or losing. The seven-day average number of new cases in the US has decreased by about 80 percent since the January 2021 peak, and that definitely is good. 

More and more experts are saying it is unlikely the US will ever achieve the herd immunity once touted as the end-all and be-all. We could end up with regional herd immunity, during which communities or states could impose short-term restrictions accordingly. I do not see that ending well. Someone doesn't want to wear a mask in a restaurant, so they do a quick road trip 40 or 50 miles to another city that does not have such a mask mandate. Right now, the vaccination rollout is in a race against the covid variants. Can enough people be vaccinated that variants have fewer opportunities to develop? If not, the covid rate could go back up again. In the immediate future, summer may contribute to a situational herd immunity because of increased ultraviolet light, but we all know from Game of Thrones that winter is coming. 

The situation in India remains much the same, not at all good. The WHO has classified the Indian B.1.617 variant a "variant of global concern." Dozens of bodies are now washing up on the banks of the Ganges River. They are believed to be bodies of covid victims for whom there was no crematory space. US physicians and healthcare workers have created a Doctors in Diaspora group to connect with healthcare providers and patients in India. More and more Indian medical experts are condemning the Indian government's response and calling for nationwide restrictions. Some estimates point to India's suffering more than one million deaths by August; the current death toll is approaching 250,000. The Institute for Health Metrics and Evaluation at the University of Washington has a model that suggests the real death toll is currently at 642,000. And frequent talking head Dr. Ashish K. Jha, dean of Brown University's School of Public Health says it is likely that between two and five million people are infected every day and that the "true" daily death toll is closer to 25,000. He says these calculations are based on the number of cremations taking place. 

The situation in India continues to spill over to its neighbors. Cases in Nepal are up by 1,200 percent over the past several weeks, and the percent positivity remains at 47. The shortage of oxygen has reached critical levels. Oxygen manufacturers claim they told the government a month ago that shortages were imminent if a second covid wave started, but the government took no action. China, meanwhile, is setting up a "separation line" on the summit of Mt. Everest to prevent or at least slow the spread of infection from climbers summiting from Nepal. 

Coronavirus continues to surge in Japan. Prime Minister Yoshihide Suga says that it is up to the International Olympic Committee whether to hold or cancel the Tokyo Games in July. In Romania, vaccinations are being offered at Bran Castle, said to be the inspiration for Count Dracula. Along with a vaccination comes a free trip to the "torture chamber." One young woman in Tuscany got more vaccinated than she bargained for and was mistakenly immunized with a whole vial of the Pfizer vaccine, that is, six regular doses. She was kept under medical supervision for 24 hours and will be followed up regularly. She reported a headache and fatigue but noted that she was "still alive."

Continuing the to mask or not to mask debate, Dr. Fauci suggests that people used to wearing masks now may opt to wear them during seasonal spikes in viruses such as influenza. The flu count has been well under normal this year, in large part due to the mitigation measures imposed due to covid. Masks do get a lot of support in some settings, though. Retail workers say they no longer have to keep a neutral face when dealing with unfriendly customers. Masks are also great for people with social anxiety. A Los Angeles screenwriter says a mask gives "emotional freedom" and that "it's almost like taking away the male gaze. There's freedom in taking that power back."

The US Social Security Administration has released its 2020 list of the most popular baby names. There isn't much change from 2019. The top 10 male names, in descending order, are Liam, Noah, Oliver, Elijah, William, James, Benjamin, Lucas, Henry, and Alexander. For females, the top 10 are Olivia, Emma, Ava, Charlotte, Sophia, Amelia, Isabella, Mia, Evelyn, and Harper. You can see the popularity of your or anyone else's name at https://www.ssa.gov/oact/babynames/. The Professor, The Sons, and my DiL= all have names that rated to some extent in the last 20 years. My name? "Jean is not in the top 1,000 names for any year of birth beginning with 2000." I can take that in two ways, and for now choose the way that makes me more of a unique individual.

Fallout from the work-from-home nature of the coronavirus has revealed some interesting migration changes for software and IT workers. The following areas are gaining such workers: Miami-Ft. Lauderdale, Houston, Dallas-Ft. Worth, Philadelphia, Los Angeles, Atlanta, and Denver. The following areas are losing them: Chicago; Austin; Washington, DC-Baltimore; Boston; Seattle; New York City; and the San Francisco Bay Area. Being able to work remotely does have the benefit of meaning one can work from wherever one wants to live.  

 

The View from the Hermitage, Day 419

The pandemic is becoming something like a program shown on a split screen. Infections and deaths are falling in the world's richest nations while rising in the poorest. WHO says there were more cases reported in the last two weeks than in the entire first six months of the pandemic, with South Asia being hit the hardest. I wonder if Africa will be next. For comparison, here's the percent rise in new cases over seven weeks.

105%     Nepal

  82        Sri Lanka

  69        Maldives

  32        Costa Rica

  26        Honduras

  15        Malaysia

  11        Egypt

  10        India 

 -10        US

 -12        UK

 -12        Argentina

 -16        Italy

 -27        France

 -32        Australia

 -51        Israel

Argentina is a bit of an odd duck in that despite the fact that cases are falling, the country still registered 26,320 new cases on May 6.

The campaign to vaccinate the world continues but is not going well. The virus is spreading more rapidly than ever, and the longer it spreads, the more chances it will have to mutate. India is no longer providing vaccines to Covax; it is having trouble making enough for its own use. More scientists now say that the goal should not be herd immunity but to make the novel coronavirus more like its relatives that cause the common cold. Initial common cold infections give partial immunity so that subsequent infections become milder. This seems a more reachable goal than herd immunity.

On Saturday, India set another new record, this one for the 4,187 deaths reported. The founder of a volunteer organization that runs cremation grounds in eastern New Delhi said that they used to get six to eight bodies each day. Now, they are getting around 100 each day. By 8:30 one morning, he had already gotten 22 calls about picking up bodies. 

Cases from India continue to spill over to neighboring countries. Nepal reported over 9,100 cases Friday compared to a daily average of fewer than 100 only one month ago. Ascents of Mt. Everest have begun in earnest after 12 Sherpa guides finished affixing rope to the summit. In the process the team's leader, Kami Rita Sherpa, set a record for the most times summitting Everest--25.

New York City wants to park vaccination vans at tourist sites such as Times Square, the Statue of Liberty, and the Brooklyn Bridge with the aim of vaccinating tourists who did not get vaccinated at home before traveling to New York City. Mayor Bill de Blasio tweeted, "New York City is open for business, one shot at a time." For those not seeking vaccination  because of a fear of needles, the following advice has been offered: (1) Seek professional help. Note: This covers matters other than a fear of needles. (2) Tell whoever is giving the vaccination about your fear before you get the shot. They may be able to reassure you and will hopefully also make it as painless as possible. (3) Distract yourself. Got some music on your phone, or a soothing video? Think of the cruise you'll be able to take. (4) Focus on the benefits. Overcoming your fear benefits not just yourself, not just your family, but everyone. You've read it here before but no one is safe until everyone is safe.

Finally, want, as do several families I can think of, to get back to cruising? If you're on a Norwegian Cruise Lines voyage, you may not be sailing out of Florida. Norwegian wants to require that all passengers and crew members be fully vaccinated, and Florida will prohibit businesses from requiring that patrons be vaccinated. Don't let that fear of needles keep you off the water!

The View from the Hermitage, Day 418

I always though, as you may have as well, that the pandemic case and death tolls were underestimates. But on what scale? A new analysis by the University of Washington's Institute for Health Metrics and Evaluation suggests the true covid-19 death toll could be double the official count. Some countries only count deaths that take place in hospitals or in patients with confirmed cases. Some countries have a narrow definition or what they count as a covid-19 case. The IHME analysis suggests that the global death toll should be 6.9 million. Here's their "total" deaths versus reported deaths for the 10 countries leading the pack in terms of numbers of deaths. 

                           Total Deaths           Reported Deaths

 1. US                    905,289                    574,043

 2. India                 645,396                    221,181

 3. Mexico             617,217                    217,694

 4. Brazil               595,903                    408,680

 5. Russia             593,610                    109,334

 6. UK                   209,661                    150,519

 7. Italy                 175,832                    121,257

 8. Iran                  174,127                    72, 906

 9. Egypt               170,041                    13,529

10. South Africa   160,452                     54,390

We'll never really know how many people died from the now-not-so-novel coronavirus. We never really knew how many people died from the influenza pandemic a century ago. Looking at the numbers above, I wonder how much effect the larger numbers vs. the smaller ones would have on how we perceive the seriousness of the pandemic. Would people have viewed the mitigation measures more positively if presented with the numbers in the first column vs. the second?

India continues to rack up records, reporting 414,188 new cases on Friday. Brazil has now seen over 15 million total cases; in response, the government has ordered an extra 100 million doses of the Pfizer vaccine. Any prediction of the difference those doses might make should take into consideration what is happening in the Seychelles. It's the world's most vaccinated country, with more than 60 percent of the population fully vaccinated. It currently has its largest number of coronavirus cases per capita and is reinstating some of its earlier restrictions such as school closures and limited hours for shops and restaurants. It's seeing just over 100 new cases daily in a country with a total population under 100,000. 

Looking at a group of 1,068 active cases, about 65 percent were residents who were either completely unvaccinated or who had gotten only one dose. The Seychelles used both Sinopharm and the AstraZeneca vaccine, which appear to be less effective against symptomatic covid-19. The WHO estimated the efficacy of the Sinopharm vaccine at just over 78 percent for adults under 60, while US trials suggest 79 percent efficacy for the AstraZeneca vaccine. There is one more factor to consider: Increases came after tourists began to return beginning on March 15, with no quarantines nor vaccinations required, just a negative PCR test less than 72 hours before travel. (You know how I feel about tests--negative today does not mean tomorrow won't be positive.) Only 10 percent of the positive cases were found to be among tourists, though.

Some sources are saying that about 185 million Americans could be fully vaccinated by September, some 88 percent of the adult population. (I do not know how the researchers handled the vaccine-hesitant and vaccine-resistant.) It is not clear, though, if 88 percent will be enough and in time to fight predicted winter surges as variants become more prominent.

Other interesting but non-coronavirus-related snippets include that Wyoming, which produces 40 percent of the coal used nationally, is preparing to sue states that opt to power themselves with clean energy rather than Wyoming coal. A woman in California moved to a certain area for the "wealth of wildlife" there and now is dealing with 15 condors sitting around her house and deck doing what comes naturally to birds. There are only about 160 condors in California, so no harmful action can be taken to scare them away. And across the Pacific, a petition with the title "Cancel the Tokyo Olympics to protect our lives" gathered 200,000 signatures in two days.