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

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

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

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

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

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

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

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

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

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

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

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

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

The Road goes ever on and on ... Day 268 (768)

Happy Earth Day! If you can't plant a tree, at least say hello to one and thank it for its role in keeping us all oxygenated. Try to avoid single-use plastic anything; those recycling triangles don't mean that an item will definitely get recycled even if it's placed in a recycle bin.

It's been a hard morning on the news-finding front, quite possibly the hardest I've yet encountered. If you think it might be because the pandemic is weakening, you might want to think again. Omicron variants BA.4 and BA.5 have been discovered in South Africa, and they appear to be just as transmissible as other varaints on their Omicron family tree. As proof that an Omicron variant has the potential to evade immunity from a natural infection, a fully vaccinated, 31-year-old healthcare worker in Spain tested positive for covid twice within a three-week period. She tested positive right before Christmas 2021 and again in January 2022. It was not the case that she was just testing positive for much longer than most people do; whole genome sequencing showed that she had been infected by two different variants. In December, she was infected with Delta; in January, Omicron. 

One problem with the airplane mask mandate was that it was being haphazardly enforced. Masks came off for meals and/or drinks and often did not make it back on when the eating or drinking was done. Or the mask made it up far enough to cover the mouth while the nose was free-range. A University of Minnesota epidemiologist said that a mask mandate with as many exceptions as the airline one is like a submarine closing three of its five doors. 

In terms of mask mandates and other public health measures, the following quote jumped out at me: "A central lesson of public health is that people have a limited capacity to change their routine." It's probably human nature, in the if-it-ain't-broke-don't-fix-it vein. If something suddenly does not work, it could be a one-off event. I didn't get the usual kibble after pressing the bar this time, but if I press the bar again ... and again ...

And in China, Shanghai says that it will ease controls on truck drivers. Locking down drivers has hurt delivery of food supplies in particular and trade in general. Hong Kong is ending a two-year ban on non-residents flying in. They must be vaccinated and test negative first. The relaxed measures begin on May 1. They have not said "no" to zero-covid, though, so things could get even more interesting. 

The Road goes ever on and on ... Day 231 (731)

I've mentioned before my respect for Eric Topol previously of the Cleveland Clinic and now at Scripps. How do you think I felt when I read this opening line from a column by Topol published in today's Guardian: "When it comes to Covid, the United States specializes in denialism." First, we denied that the novel coronavirus could transmit from human to human. Then we denied that the virus was airborne. Finally, we denied that boosters were needed longer than we should have. 

Global cases seemed to bottom out in early March but are now rising again. The UK and Europe have seen five covid surges; each time, a surge in the US follows a few weeks later. Case rates are rising in over half of the EU nations. What happens across the pond doesn't stay over the pond. The UK and Europe are now seeing a sixth surge, and we don't seem to be all that concerned. I also follow a local emergency medicine doctor, and his take is, "Well folks, I think we’re going to have an issue here with the #BA2variant. I’ve been watching the trends in Europe and some early signs that cases are rising here."

The BA.2 variant (some call it a subvariant) seems to go in a cycle of being touted then pooh-poohed. We might want to keep a sharp eye on it as it currently accounts for over 30 percent of our new cases. Maybe if it had its own Greek letter, we would take it more seriously. We seem to know that it is more transmissible that Omicron, but I've heard both sides to the question of whether it is more serious. 

In terms of rising numbers of cases, Dr. Fauci says his counterparts in the UK cute three factors. First, BA.2 is, as mentioned, more transmissible. Second, society is reopening and people are mingling indoors without wearing masks. Finally, immunity is waning. Pfizer has asked the FDA to authorize a second booster for people over the age of 65. I've read different opinions on just how necessary that booster would be. In the US, 65 percent of people over the age of 65 have gotten the initial two vaccinations and a third, booster one. In many European and Asian countries, that percent is over 90. 

Expanding from people over the age of 65 to everyone, the US as a nation is doing a dismal job with vaccinations. We rank 65th in the world in terms of the percent of population being "fully" vaccinated with two doses; 64 percent have gotten those. We rank 70th in terms of three shots, one being a booster; only 29 percent have gotten all three. The argument is being made that so few people over the age of 65 would get the second booster that it wouldn't really do much good. I'd get another booster if they offered me one. 

On the world stage, the war in Ukraine continues. There was an earthquake of magnitude 7.3 off the coast of Japan, after which tsunami warnings were posted. And on a smaller scale, we are evidently looking at the appearance of Asian jumping earthworms that, unlike non-jumping earthworms, hurt the soil's ability to retain water. Oh, yeah, we aren't out of the pandemic woods yet either.

The Road goes ever on and on ... Day 121 (621)

Before we get to the disturbing news of the new variant that will not be named Nu but Omicron, Dollar Tree will next year start charging $1.25 for most items. But don't worry. We might be locked down again and not able to go to Dollar 'n a Quarter Tree for a while. 

Virtually all the coronavirus news out there today concerns Omicron, designated a variant of concern by WHO less than 72 hours after its discovery was announced. For comparison, Delta was around for two months before "interest" was changed to "concern." Omicron has been described as "potentially the worst so far identified" having what has been called a "very unusual constellation of mutations," over 30 in the spike protein alone. It shares similarities with the Lambda and Beta variants which are linked to innate evasion of immunity. It may also be more transmissible. On a more positive note, it is easily detected on a PCR test, and it appears easier to compare one genetic strain to another.

Various countries, including the US, have already begun to restrict arrivals from countries known to have cases of Omicron including South Africa, Eswatini, Zimbabwe, Namibia, and Botswana. Israel identified Omicron in an arrival from Malawi. The Israeli prime minister reports that they "are close to an emergency situation." Actually, Israel may be more ready to deal with Omicron tha many other countries, having held a "war games" style drill earlier this month preparing for an "Omega" variant. Hong Kong identified one case as having arrived from Africa and another case as the person across the hall from him in government quarantine. Suspicion is that the new arrival did not wear a mask when opening the door, and the hallway neighbor inhaled virus particles.

I am particularly nervous about the Omicron case identified in Belgium, the first such case in Europe. The person arrived from Egypt on November 11. Eleven days later, on the 22nd, he began to show symptoms and was tested. He had not been vaccinated. My concern is that how long he might have been contagious before showing symptoms is not known. Once we learn more about Omicron, we might know for how many days someone is contagious before they become symptomatic themselves. I would expect that this person was shedding virus on some of those 11 days, meaning that there will be more positive cases coming. 

South Africa is also concerned about more cases on the way. Officials say it is "only a matter of time" before the virus spreads across the country as schools close and families travel. Omicron has mostly been seen in young people in South Africa, the group with the lowest vaccination rate, not helping answer the question of how well the vaccines currently in use would react against it.

About Omicron the head of Germany's Robert Kock Institute says, "We are in fact very worried." And so am I, obviously, though my worrying doesn't carry the public weight of his. I have already decided that if Omicron makes it into the US (which it probably has done already), I'll forfeit the $25 I've paid to go to a quilt show in Hampton, Virginia in February. Actually, I guess the organizers could cancel the in-person event and hold a virtual one as they did last year. I've thought all along that the pandemic is not even close to being over. That does not mean, however, that I am pleased Mother Nature may be agreeing with me. No one is safe until everyone is safe, so let's get at it!

The Road goes ever on and on ... Day 33 (533)

Where to start? I wish I could add "the ridiculous or the sublime?" but that likely won't work here, at least not today. If you continue to worry about the Delta variant, you might want to skip that in May South African scientists detected a new coronavirus variant that may have increased transmissibility. At least it contains multiple mutations associated with increased transmissibility. It has not been established if the increased transmissibility is because it's more contagious or because it is able to overcome immunity from vaccination or past infection. An infectious disease specialist and one of the authors of a paper about the new variant offers that "this pandemic is far from over" and "this virus is still exploring ways to potentially get better at infecting us." For some reason, that last comment has me picturing the coronavirus spike protein dressed as infamous villain Snidely Whiplash.

The EU has removed the US and five other countries from the "safe list" of countries whose residents can travel to the EU with no additional requirements such as quarantine and testing. It will be up to individual counties whether to follow this. To be on the "safe list" requires having fewer than 75 new covid cases daily per 100,000 people over the previous 14 days. The US has been well above that figure. It also does not help the US that it still has not opened its borders to Europeans, and they're not thrilled about the lack of reciprocity.

The daily average for hospitalized covid patients in the US in now over 100,000, higher than in any previous surge except last winter's when most Americans were not yet eligible to be vaccinated. Hospitalizations nationwide have increased by almost 500 percent in the past two months. Florida has 16,457 hospitalized covid patients, the most of any state. Texas is second on what is not a good list on which to be. Oxygen supplies are running low for some hospitals. One Florida doctor said he was seeing younger and younger patients die, all of whom were unvaccinated. The article in which he was noted did not specify if these younger patients were so young as to not yet be eligible for vaccination.

From hospitalizations to deaths. Deaths in 14 states increased by more than 50 percent in one week. Deaths went up by more than 10 percent in 28 more. A projection from the University of Washington suggests we could see 1,400 daily by mid-September. 

Demand for ivermectin continues to rise. It started as a veterinary drug in the late 1970s, and the discovery of its effectiveness combating certain parasitic diseases in people won the Nobel Prize for medicine in 2015. The ivermectin sold for animals can be a much higher concentration than that intended for humans. Calls to state poison control centers have jumped fivefold since July. Mississippi says that 70 percent of recent calls to its state poison control center come from people who have ingested ivermectin from feed supply stores.

The View from the Hermitage, Day 489

The Tokyo Olympics are, for better or worse, still on, with about 15,000 athletes and staff having arrived. One person staying in the Olympic Village has already tested positive. The president of the International Olympic Committee has again attempted to calm the anti-Games crowd, saying that the "risk for the other residents of Olympic Village and risk for the Japanese people is zero." He noted that these will be "the most restrictive sports event ever in the world." A Ugandan weight lifter who was in Tokyo is missing after not having shown up for a coronavirus test. In June, two people traveling with the Ugandan Olympic delegation tested positive on arrival in Tokyo. It is not clear if the missing weight lifter was one of the two. 

The US just had more than 41,000 new cases in one day, the largest number since early May. Cases are now rising in all 50 states as the Delta variant spreads. Right now, the variant may be winning the race with vaccines. 

I read the interesting tale of three unvaccinated women in Arkansas. The first figured that she would stay safe as long as she never left her house without a mask. The second had a chronic pulmonary disease and was worried that the vaccine could give her covid. The third was of the "I never get sick" school of thought. Do you see what is coming? All three got covid. The first spent 10 days on supplemental oxygen via a nasal cannula. All three did recover, after which none of them changed their mind and got vaccinated. The National Guard colonel running the state's vaccination effort figures that one third of the population will not be vaccinated period full stop. They just won't. That third will include some health care workers; 40 percent have yet to be vaccinated. Delta patients appear to need a higher level of care than patients with the original virus did. A larger share of those now becoming infected need hospitalization than in the fall, even though those patients are, on average, younger. The average age of a current covid patient in Arkansas is 54, down from 63, but some are in their 20s and 30s.

Britain says that people coming from France will still need to quarantine due to the prevalence of the Beta variant. The current vaccines offer less protection against Beta. The UK health secretary is self-isolating after a positive test he took because he was feeling "a bit groggy" Friday. He had had both vaccine doses, which may be why his symptoms are mild. The surge in Thailand is apparently fueled by both the Alpha and the Delta variants. There is now a nationwide ban on public gatherings after a record number of cases (10,082) and deaths (141) on Saturday. The maximum penalty for violating the ban is two years in jail and/or a fine of $1,220. Vietnam continues to face its worst surge so far. Three quarters of the cases are in the south especially around Ho Chi Minh City. Vietnam has gotten nine million doses of vaccine with another three million coming from the US via Covax. Unfortunately, Vietnam has a population of 98 million, meaning that those 12 million doses will not go very far. 

Did you notice that the last paragraph mentioned three different variants--Alpha, Beta, and Delta? Delta may be becoming the dominant variant, but we can't let that distract us from what the other variants can do. 

Windsor, Ontario sits across the Detroit River from, what else, Detroit, Michigan. It seems that Detroit had doses of vaccine on the verge of expiring. Windsor needed vaccines. Canadian officials will not allow US vaccines into the country, so Windsor's mayor proposed painting a white line down the tunnel connecting the two cities. American pharmacists could stand to the right, in the US, and inject vaccine into the arms of Canadians standing to the left, in Canada. Unfortunately, the Canada Border Services Agency said that the effort could disrupt trace and have "significant security implications." In other words, Detroit will have expired vaccines and Windsor will still need vaccines.It was a good idea in theory, and I'm sorry it could not be done for real.

 

The View from the Hermitage, Day 475

Son #2 just texted that they're 50 minutes out, so let's see if I can get a short post up for today. 

I think that I mentioned a couple of days ago that the White House wants to counter coronavirus surges with "response teams." I wondered at the time just how those teams would respond. The Delta variant is more prevalent in Missouri than any other state; in the last two weeks, the daily number of cases has more than doubled, and hospitalizations are up 20 percent. The state has requested one of those surge response teams. Some team members will be federal staff who will help local health departments with testing and vaccinations. Other members will be CDC personnel who will help with data analysis and field investigations. There will also be focus on monoclonal antibody treatments and expanded media campaigns to encourage vaccination. Right now, only 39 percent of the population in Missouri is fully vaccinated. Public health experts are advising that in Missouri and elsewhere answering outbreaks with vaccines is not as helpful as testing and contact tracing. Vaccinations take from two to six weeks to be maximally effective. 

Up to 15 millions doses of the Johnson & Johnson vaccine from the Baltimore plant with manufacturing difficulties have been okayed for packaging and release. Johnson & Johnson had the goal of delivering 100 million doses by the end of June which they clearly did not meet. They're missing delivery targets in Europe, too. The new batch of 15 million doses will likely be exported; the US has more than enough vaccine already.

Despite low numbers of cases, the Delta variant is gaining ground in New York City. Most of the new cases are young adults who have not been vaccinated. Only 51 percent of adults in New York City are fully vaccinated, leaving lots of unvaccinated or partially vaccinated targets for Delta. Delta accounts for one third of new cases in France. They're debating making vaccinations mandatory for health workers. The US secretary of veterans affairs is also considering requiring workers at VA hospitals to be vaccinated. Low staff vaccination rates endanger veterans who may be more vulnerable due to age and type of illness or injury. 

POTUS is encouraging Americans to celebrate July 4 with gusto, while saying that next year will be even better. Travel rates are about where they were in 2019. At the same time, though, public health experts worry about those July 4 crowds when less than half the country is fully vaccinated. A former CDC director and other experts are afraid that if Delta continues to circulate, it could mutate into a form that could get through the wall of immunity full vaccination offers. I'm no expert, at least when it comes to coronaviruses, but I share their concern. The race really is on, and I'm not feeling too optimistic that vaccines will win. Make me wrong, world, please?

The View from the Hermitage, Day 474

I survived my first birthday day yesterday. The second is tomorrow when Son #2 and DiL= come for another pancake breakfast and unknown as yet shenanigans. They called last night and sent photos of the two new additions to their menagerie. The current total is 15: five rabbits, four tortoises, three snakes, two cats, and one parrot. Gotta love those knuckleheaded kids so much that they don't ask us to animal-sit for them.

A growing number of scientists say that WHO should not be the entity to continue to investigate the origins of the coronavirus. They've called for an independent analysis similar to what was done after Chernobyl. The WHO emergencies chief says that WHO works "by persuasion" and cannot force China to cooperate. China had to approve the members of the initial WHO investigative team, their agenda, and their report suggesting that the results were not independently verified.

More local officials in the US are worried about another wave of covid. POTUS plans to deploy "response teams" to areas with high infection rates. The US will not meet POTUS's goal of 70 percent partial vaccination but will come close, at 67 or 68 percent. The District of Columbia, two territories (Puerto Rico and Guam), and 20 states have met the 70 percent goal. Those states are Vermont, Delaware, Maryland, New Jersey, New York, Pennsylvania, Virginia, California, Oregon, Washington, Colorado, Illinois, Minnesota, and New Mexico. Fourteen states including Florida and Texas are close to 70 percent, but 16 states including nearly all the Southern ones are still below 60 percent. Mississippi sits at the bottom with only 46 percent of residents partially vaccinated. 

The covid situation in the UK is being watched by other countries around the world as it turns into a race between an advanced vaccination program and the Delta variant. A professor of infectious disease epidemiology at the University of Edinburgh describes it, "The UK is in an absolutely unique position. We have the biggest Delta outbreak in a well-vaccinated country. We are a petri dish for the world." So far the Delta variant appears to be 60 percent more transmissible and twice as likely to lead to hospitalization. Two Pfizer or AstraZeneca shots reduce the risk of hospitalization from Delta by 96 percent or 92 percent respectively. Thanks (or no) to Delta, 85 percent vaccination would be needed for herd immunity.

Indonesia is tripling the oxygen supply to hospitals for the next two weeks with the extra oxygen being diverted from industry. Delta accounts for 60 percent of new cases; it is the worst outbreak since the pandemic began. Three government hospitals as swell as emergency rooms have been converted to focus solely on treating covid patients. It does not help that Indonesia has one of the lowest testing rates in the world, administering just 47.98 tests per 1,000 people. The percent positivity is currently 20.

There is concern that Africa could become "the continent of covid" as it is on the verge of exceeding the worst week ever in the pandemic. Just over one percent of Africa's 1.3 billion people has been fiully vaccinated. Every European country has more than 25 percent of its population fully vaccinated, and some are over 45 percent. Africa is mostly relying on Covax, and it is not clear just how many Covax doses have actually gotten to Africa. Some European countries including France and Denmark have separately sent hundreds of thousands of doses to African countries.

Portugal is reinstating curfews in 19 municipalities with "very elevated risk" of covid and 26 with "elevated risk." Lisbon and other popular tourist spots are among the municipalities cited. Curfew will run from 11:00 pm to 5:00 am. Only 34 percent of people are fully vaccinated, and "fully" is what protects against Delta. In Portugal and Britain, most new cases are in people under 30, pointing to the need of vaccinating younger adults. 

Finally, in a "how can this get even crazier" moment, British residents who were vaccinated with AstraZeneca vaccine produced by the Serum Institute of India can not automatically skip the EU quarantine that those vaccinated with AstraZeneca vaccine produced in the UK can. Approval from the European Medicines Agency for the Indian-made AstraZeneca has not been requested. Until that happens and approval is granted, the EU will not recognize it as a vaccine worthy of its recipients skipping quarantine. 

The View from the Hermitage, Day 467

Israel is reimposing a mask mandate in light of a covid surge driven by the Delta variant. Half of the new cases are people who had been vaccinated. That's the bad news. The good news is that the infections of vaccinated people are much milder than those of unvaccinated people. Delta is also driving the latest surge in Africa; it's now been detected in 13 countries. Cases have been consistently rising since May. WHO says the current wave could be the region's worst yet. According to the director of the African CDC, this third wave has been "extremely brutal." In Uganda, 99 percent of the cases are from Delta; in Zambia, 77 percent.

Delta could cause more problems here in the US. More than one in 10 people who got a first dose of Pfizer or Moderna have missed their second dose. This makes them much more vulnerable to Delta. Delta appears to be behind the outbreak in Sydney. There have been 22 new cases, bringing the total to 65, making this the largest outbreak in six months. There are likely to be more new cases. Nine hundred or so clients visited a hair salon while several employees there were infectious. Raising even more concerns about Delta, many of the confirmed infections appear to have occurred after only seconds of contact. There was also a child's birthday party where at least 17 guests had tested positive as of Thursday night. The rest of the guests are expected to be infected along with household contacts of almost everyone who was there. 

The UK reported 15,810 new covid cases today, cases having risen by almost 50 percent in one week. As of June 16, 83 cases of Delta Plus had been identified in the US compared with 41 in the UK and 40 in India where Delta Plus is considered a variant of concern. Delta Plus cases have also been identified in Canada, Japan, Nepal, Poland, Portugal, Russia, Switzerland, and Turkey.

The Chinese vaccines have been getting some very bad press of late. Since the pandemic began, 401 doctors in Indonesia have died. At least 20 of them were fully vaccinated with Sinovac. Some countries in the Middle East are giving residents a third dose of one of the Chinese vaccines. Personally, I'd ask for a different vaccine.

There's a new quirk with the Olympics. Word is that some of the British Olympians are vaccine-hesitant. Well over 90 percent of the British athletes will be fully vaccinated by July 23, but there will still be holdouts. I wonder if there will be additional restrictions for unvaccinated athletes in terms of how much they can circulate.

Meanwhile, back in the US, nearly all covid deaths occurring now are among the unvaccinated. This cannot be stressed enough: the vaccines we have in the US work. Period. Full stop. Louisiana is turning to a lottery in hopes of getting more people to be vaccinated. The vaccination rate in Louisiana is lower than every state but Mississippi. Six of the bottom eight states in vaccination rate are southern. Besides Mississippi and Louisiana, there are Alabama, Arkansas, Georgia, and Tennessee. One reason they think a lottery will work in Louisiana is that their research suggests that independent of political affiliation, the people not yet vaccinated are the people most likely to buy lottery tickets. To me, not getting vaccinated is the same as buying a lottery ticket. The odds are better in the vaccination lottery, but the covid prize sucks more than the cash one would.

The View from the Hermitage, Day 460

In one report I read this morning, someone said that a "variant" could also be called a "scariant." That's somewhat true given my worry over Delta and what variants might be yet to come. While Delta appears to be worse than most other variants, it does not appear to be particularly hard on kids who cannot yet be vaccinated. Delta now accounts for 90 percent of all England's cases; the WHO cautions that Delta is becoming globally dominant. It's been noted that for now vaccines are the way out of variants, though we need to enjoy that while we can. While current vaccines can for the most part handle Delta, there may be a variant coming that they can't. 

On the vaccine front, Johnson & Johnson has pretty much fallen flat. It accounts for less than four percent of all vaccine doses given, and millions of doses may expire before they can be given. Johnson & Johnson did have the appeal of being a one-shot stop on the vaccine trail, but that appeal faded in the wake of a rare but serious blood-clotting disorder. Pausing US injections for 10 days in April was one more mark against it. Now, the press coverage of the possible contamination of millions of doses of Johnson & Johnson has pretty much sealed the deal against it. 

Europeans are still barred from entering the US for nonessential travel even if they've been fully vaccinated. On the flip side, the EU has added the US to the list of countries considered safe enough for those Americans not fully vaccinated to enter Europe after producing results of a negative PCR test for active infection. Individual countries are, however, allowed to admit or exclude nationalities as they deem fit, meaning an American might be able to go to Country A but not to its next-door neighbor Country B.

The Olympics are still on though new guidance has been given that says intimacy between athletes could lead to fines, disqualifications, or deportation. Athletes must "avoid unnecessary forms of physical contact." So where does that leave the 160,000 condoms Japanese organizers have on hand? Condoms have been something of an Olympic Village tradition since the Seoul Games in 1988 to help take care of the unofficial Olympic sport of bed-hopping. The Japanese organizers are now saying that the condoms were not meant to be used but were instead intended to be taken home by athlete and used to raise awareness or HIV and AIDS. The French are likely glad the condoms were not meant to be used given that the Games require that condoms be thicker and latex-based which some French have described as "offering an inferior experience."

South America is in trouble. Paraguay has the world's highest daily proportion of covid-19 deaths, 18.09 per million people. The next six countries in a ranking of deaths per million are also South American countries, Suriname, Argentina, Uruguay, Colombia, Brazil, and Peru. Peru, ranked seventh, has 9.12 deaths per million. For comparison, India has 2.71 deaths per million; India, 2.71; South Africa, 2.2; the US, 1.01; and the UK, 0.14.

New findings help strengthen the case for a natural origin for the coronavirus. The lab leak theory for now rests on unverified reports of respiratory illness in three of 600 staffers at the Wuhan Institute of Virology in November 2019. The WHO team looking into the origin of the coronavirus found that two-thirds of the earliest confirmed cases had some connection with the Huanan seafood wholesale market in Wuhan. It should be noted that the origin question is not a binary choice of lab versus market. The virus could have come from a farmed animal rather than a wild one, with the virus going from livestock to humans who attended the market rather than coming from some wild animal sold at the market. 

The Postal Service did not get the initial Juneteenth off unless there is no delivery planned for tomorrow, the actual Juneteenth. Potential Tropical Cyclone THREE has not yet earned its "Claudette," but at least it has not yet ruined the weekend for those living along the Gulf of Mexico. It is supposed to be 90 degrees Fahrenheit here each of the next three days, meaning I'll try to get anything that needs to be done outdoors done early. Here's hoping the temperature where you are this weekend is a tolerable one and it only rains if you need the water. 

The View from the Hermitage, Day 456

I was asked last night just how long I'm going to continue inhabiting "the Hermitage." I responded with something about when the end of the pandemic was officially declared. Technically, I do leave the Hermitage now, but only for very specific purposes that can't be done remotely, and when I do I take all form of precautions. I helped put on the election, wearing a mask and keeping as much distance as possible, handing out ballots at my arm's length plus that of the voter. I'm having my second hair appointment tomorrow and will be wearing a mask as will, I expect, my stylist. A quick run to the grocery store for some ingredient I need? Not gonna happen. I'll substitute--The Joy of Cooking has a great list of substitutions--or make something else. So when will I stop viewing the world from the Hermitage? I honestly don't know. For now, I want to keep going. The fat lady hasn't even warmed up yet. 

Quickie factoid: The Washington Post's final tally of XPot's false or misleading claims was ... suspense builds ... 30,573. If you want to know how many that comes to for each day, you're on your own. I'm not gonna go there.

It's been clear that covid-19 wreaks havoc on the respiratory system and also the heart, brain, and kidneys among other organs. Could it also cause diabetes by attacking insulin-producing cells? Some evidence suggests it might. Covid-19, the virus that keeps on giving, especially when you see the new symptoms brought by the Delta variant.

That variant scares me more every day. It now accounts for 10 percent of cases in the US, a proportion that could double every two weeks. Delta is now the dominant strain in the UK and driving new cases in people aged 12 to 20. According to the CDC, Delta offers a "potential reduction" in vaccine effectiveness and a "potential reduction" in the effectiveness of some treatments. It is not unreasonable to think that Delta could become the dominant strain here if it takes hold in areas with low vaccination rates. Even if 64.4 percent of Americans have gotten at least one dose of vaccine, one dose offers only partial protection.

Delta could also become the dominant strain worldwide, having been detected in 74 different countries so far. It has more severe symptoms than other strains including stomach pain, nausea, vomiting, loss of appetite, hearing loss, and joint pain. In Guangzhou, China 12 percent of patients became severely or critically ill within three to four days of symptom onset. The symptom that intrigues me is hearing loss. I wonder if inflammation is at the root, but would it be affecting the auditory nerves or some other part of the ear? I'm now pretty much profoundly deaf in my right ear with no known cause. Being curious about my own hearing loss makes me wonder what might be at work with Delta.

Cases are down in the US overall but rising in many states with lower-than-average vaccination rates. Eight states--Alabama, Arkansas, Hawaii, Missouri, Nevada, Texas, Utah, and Wyoming--have seen their seven-day rolling average number of cases rise from what they were two weeks ago. All those states but Hawaii have vaccination rates lower than the US average. The 10 states with the fewest new cases per capita over two weeks all have fully vaccinated rates above the national average. This includes the three most vaccinated states, Vermont, Massachusetts, and Connecticut.

Novavax says that its vaccine is 90 percent effective against variants, on par with Pfizer and Moderna. It has 100 percent efficacy in preventing severe disease. Novavax may or may not seek Emergency Use Authorization from the FDA until late September, though it is applying now in Britain, the EU, India, and South Korea. Some scientists say that the US has enough vaccines in play right now but that the Novavax could be the vaccine to use for booster shots when those come to pass.

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 387

Globally, North Korea has pulled out of the Olympics in Tokyo, citing coronavirus concerns. I think that they officially claim not to have had any cases, but if you believe that, well, that's up to you. As for Japan, it appears to be entering a fourth wave in large part to variants that are more infectious and may be somewhat vaccine-resistant. To complicate matters, vaccines are not yet widely available in Japan. Moving to the Middle East, only pilgrims who have been immunized--two doses or one dose at least 14 days prior--or who have recovered from covid will be allowed to enter Mecca on an umrah pilgrimage. Such a pilgrimage is not mandatory and can be done at any time, unlike the hajj. The restriction begins at the start of Ramadan, which is next Monday. One also needs to be immunized or recovered to enter the Prophet's mosque in the holy city of Medina. 

A senior official from the European Medicines Agency says that it is "clear" there is a link between the AstraZeneca vaccine and the rare form of blood clotting being seen, but he does not know a specific cause. The EMA later said that it hd not yet reached a conclusion, the review is ongoing, and they will release the results tomorrow or the next day. Starting in two weeks, there will be quarantine-free travel between Australia and New Zealand. What economic effect this might have is not clear. It is thought that the first travelers will not be tourists spending money but people visiting relatives. England will start easing lockdown next week, allowing pubs, shops, hairdressers, and gyms to reopen. Finally, covid-19 is spreading faster in India right now than it did at any time in 2020.

Turning from coronavirus to foreign affairs, Vladimir Putin has signed a law that would let him run for two more terms as president, extending his rule until 2036. He will turn 69 this year, so he would be in his eighties then. He is currently in his fourth term which ends in 2024. He was president from 2000 to 2008 and returned in 2012. XPot must be oh so jealous and wonder why he could not get similar rules passed here.

A crowd of 38,328 people, many not wearing masks, watched the Texas Rangers lose to the Toronto Blue Jays yesterday. It was the highest publicly documented attendance at an event during the pandemic. Super-spreader? That remains to be seen. 

The UK variant has now been identified in all 50 states. The states with the largest increases in cases are states with a strong variant presence. The recent increase in covid hospital admissions is because of adults under 50. No longer are the elderly occupying the majority of hospital covid beds. It seems that the Multisystem Inflammatory Syndrome in Children or MIS-C can emerge several weeks after a child gets the virus. Many children who developed MIS-C were asymptomatic when they were infected or had very mild cases. MIS-C appears to occur when patients' bodies have produced a maximum level of antibodies. 

A survey of American parents reported that 74 percent were concerned about a fourth wave. Other results included that 71 percent had already gotten vaccinated or intended to as soon as possible; however, only 52 percent said that they were likely to get their child vaccinated as soon as the child was eligible. I was not surprised to see that Republicans were most reluctant to have their children vaccinated. I was a bit surprised to see that only 28 percent of parents reported that they had worked from home or remotely in the last week. I know that states have been relaxing restrictions, but I thought more people would still be working remotely. 

In terms of remote work, 26 percent of workers plan to look for a job at a different company once the pandemic has subsided. Concern over career growth was the motivator for 80 percent of those workers, while 75 percent said that the pandemic made them rethink their job skills. Most workers said that they would like to work remotely at least part of the time after offices reopen, but nearly half of remote workers said they would be nervous about job security if they stayed remote while other workers went back to the office. 

Remember the toilet paper and cleaner shortages at the pandemic's dawn? Restaurants have been dealing with a national ketchup shortage. Covid-19 upended the condiment world order as takwout boosted the demand for ketchup and other condiment packets. Many managers are using generic versions, pouring bulk ketchup into individual cups. Costco has become quite popular. 

I found the cake pan and this morning baked a chocolate cake with coffee buttercream icing. Dinner will be The Professor's choice, Mongolian beef. And perhaps tomorrow I shall discuss the two days and counting it is taking me to go through photography equipment and documentation while pondering which camera no longer with us took the 55mm filters that don't fit any of the current cameras in the family.

The View from the Hermitage, Day 317

We've gone past 100 million (100,000,000) cases of covid-19 worldwide since February 29, 2020; more than 2 million (2,000,000) of those people died. Given testing limitations, those estimates are decidedly on the low side. The US is the big winner (or loser?) in terms of case level, followed by India, Brazil, and Russia. There are now multiple variants of the virus that may be more transmissible and/or more lethal. Each country has their own plan for dealing with the virus.

Americans complaining about the coronavirus mitigation measures here should be glad they don't live in many European countries. There has been rioting in various cities in the Netherlands for three nights in a row despite a 9:00 pm to 4:30 am curfew (and Virginians don't like a curfew that doesn't begin until midnight). Bars and restaurants have been closed since October. Schools and nonessential businesses have been closed since mid-December. There are advantages to not having a parallel to the tenth amendment to our Constitution:

The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people.

There may be some loophole that would let our national government impose a national curfew, lockdown, or other mitigation measure. Given that they're still figuring out how to implement Mr. Biden's executive order about wearing masks on interstate transportation, that loophole may be tricky.

As one might expect, remote island nations have been more successful at controlling the virus, though New Zealand may keep their borders closed for the rest of 2021. Island nations such as the UK in proximity to the European Union have a harder time restricting entry from outside. 

Scientists are preparing to upgrade the vaccines currently in use to address the viral variants. Moderna is developing a booster shot they hope will not be needed. Dr. Fauci has noted that the new variants don't respond well to the monoclonal antibodies that have been used as treatment for covid. He is especially concerned about the South African variant, noting that it is "different and more ominous than the one in the UK." There is also some evidence that the variant from Brazil could lead to reinfection because antibodies might not recognize it. The CDC predicts that the UK variant may become the dominant strain in the US in March. It will be the dominant strain in Denmark even sooner, in mid-February. 

Beginning next week, The Professor will only need to have a covid test once weekly rather than the twice he's had to for the last three weeks. Fortunately, all the tests have been negative. If he ever gets a positive result, things will get dicey since I probably will have been exposed before he got the test result. I'm not sure living separately in the same house will work then, though I would hate temporarily relocating to Son #1's house and leaving The Professor here on his own not to mention possibly exposing Son #1. I think I'll put that on my list of things to discuss sooner rather than later. 

In other news, Xpot has rebranded himself as occupying the "Office of the Former President" with seemingly official stationery and other office accoutrements. I'm getting pessimistic about the whole second impeachment thing. Republican Senators are lining up to say that it is unconstitutional to try someone after they have left office. I wonder if they would feel the same way had the rioters actually taken prisoners not even considering that they wanted to kill some of those people. We may well be back to the shooting someone in the middle of Fifth Avenue and still getting votes. It almost turns my stomach.

If you need to distract yourself, check this article out. It is not the biography one would expect of the new Director of National Intelligence and might take your mind off the fact that we're still on the way to being fucked.