The Road goes ever on and on ... Day 229 (729)

Happy Pi Day!! Unfortunately, 1:59 slipped right by as I was baking, so I missed 3.14159. Oh well. I'll live. 

President Obama reports testing positive for covid. He tested himself in response to a scratchy throat Friday night. He's fully vaccinated and boostered, so here's hoping his case stays a mild one. So far, Michelle has tested negative.

A 136-page "road map" for moving from the current crisis to the "next normal" has recommended that a Center for Forecasting and Outbreak Analytics become part of the CDC. We really need something to help us. In November 2019, the US ranked first among 195 countries in pandemic preparedness. Even so, the US has had failures that include politicization, lack of trust, individualization of health, and widespread inequality. That list has one key reason totally unrelated to public health--lack of trust. Recent research looked at infection and fatality rates in 177 countries looking for connections to democracy, universal health care, hospital capacity, quality of healthcare, and economic inequality. No connection was found between any of those factors and outcomes. The only factor that seemed to matter was trust, in leaders and in one another. While trust does play a critical role, other improvements are still needed in data collection and sharing, vaccines and treatments, improved ventilation, and high quality masking during respiratory outbreaks. It would be helpful, as the next pandemic dawns, to be able to contain outbreaks closer to their source. 

Pfizer is collecting data on a second booster. The Netherlands is offering people who received one dose of the Johnson & Johnson vaccine followed by one booster of an mRNA vaccine a second dose of mRNA vaccine. The stated aim is to help travelers meet the restrictions of more countries. 

China has locked down the province of Jilin with a population of 24 million people. People cannot move around and very definitely cannot leave. The system of "closed management" includes three rounds of testing; people are permitted to leave home for those. Multiple officials in the province are being fired or punished. I have no details on what that "punishment" might entail.

Something positive about the coronavirus! The public health measures put in place to stop the spread of covid also stopped the spread of dengue virus. The decline in dengue started in April 2020. The estimate is that there were 720,000 fewer cases of dengue in the first year of the pandemic due to restrictions on movement. School closures also played a role. Influenza cases were also down in the winter of 2020-2021. I have not read if they were down as much in the winter about to end.

Beware the Ides of March!

The Road goes ever on and on ... Day 228 (728)

Were it not for the two articles I read this morning on a BA.2.2 variant and a recombinant variant for now called AY.4/BA.1, likely to be redesignated as XD in the near future, I might agree that the novel coronavirus we worried so much about two years ago really is on its last steps to endemicity. In taking notes for each day's entries, one of the online sources I check is The Guardian. It's out there before the daily digest emails from the AP, New York Times, CNN, etc. arrive in my inbox. This morning, I looked at a couple of articles on the war in Ukraine and a general human interest item or two on my way, I thought, to the section of articles under the heading "Coronavirus." Section after section passed, and I arrived at the site's end never having found a Coronavirus section. The New York Times is cutting to three weekly coronavirus emails, and we'll see if The Guardian's section is back tomorrow.

China certainly is not seeing the end or even any lapsing of the coronavirus. There were 1,100 new cases Friday; 1,524 on Saturday; and 3,122 on Sunday. A week ago there were just a couple hundred each day. Not too far away, cases in South Korea increased 104 percent over the past two weeks. Right in the middle of the most recent week, the presidential election took place. It was a close one, but I have yet to hear if it will or even can be contested. Both countries have extremely high vaccination rates.

Oregon and Washington both have among the lowest total cases and deaths per capita. They are also both lifting statewide mask mandates. Masks will continue to be required in nursing homes, hospitals, taxis, and public buses. School districts will be allowed to set their own rules. Here, local schools may no longer mandate students wear masks; that decision is left to parents. Kids can, though, once they get to school, remove the masks they are still required to wear on the bus. There are no in-school mask police. The local school board will discuss staff and visitor masking--which are still required--at an upcoming meeting. 

The recombinant vaccine mentioned above has also been called Deltamicron or Deltacron. It was originally thought that people with this were suffering simultaneously from Delta and Omicron, though simultaneous infections are a rarity. Now, it is thought that someone did get both, and when the two viruses invaded the same cell, they reproduced into the new variant, a hybrid that then started to spread on its own. We'll have to see how this progresses.

So far the exodus of Ukrainian refugees has not resulted in super-spreading covid or any other disease, but it likely will eventually. The relatively low Ukrainian vaccination rate--barely a third of the population--will not help. In the meantime, though, a Ukrainian physician notes that, "People are not frightened about covid any more. People are frightened of the war." As would I, were I to be Ukrainian.

The Road goes ever on and on ... Day 227 (727)

Since March 2, 2020, the New York Times has been issuing a daily coronavirus briefing. At the time the briefing began, there had been only 100 cases in the US, but over 90,000 globally. Of those, 80,000 were in China. Most of the 3,000 deaths had also been in China. The CDC was advising avoiding all nonessential travel to Italy, China, Iran, South Korea, and Japan. This morning's email announced that the briefing would be moving to a Monday-Wednesday-Friday schedule unless there is "big virus news you need to know about" and that this was part of moving to the "next phase of the pandemic." I was reminded of the Virginia governor's pandemic press conferences that started being held on every weekday, then Monday-Wednesday-Friday, then Tuesday-Thursday, then as needed. The times, they are a-changin'.

Two mayors have been fired in northeastern China, and Shanghai has closed its school system and moved to online instruction. China is moving from a "zero covid" mindset to a "dynamic zero" strategy. Under the new strategy, local outbreaks are tolerated with local officials depended on to control the current outbreak and curtail new cases. The two mayors who were fired obviously did not do this well enough. There are currently cases in 21 of China's 30 provinces.

Queen Elizabeth will skip next week's Commonwealth Day ceremony. That would have been her first major public event in weeks. She did have her first post-covid, in-person meeting this week, with Canada's Justin Trudeau. Prince Charles will represent the Queen at the ceremony, accompanied by his wife. The Duke and Duchess of Cambridge (aka William and Kate) will also attend. 

A new checklist of what we know about the BA.2 subvariant suggests it may not be as critical as some thought. What we know includes that it is not really new but has been around at least as long as the BA.1 Omicron variant has. BA.2 does seem to be easier to catch, but it does not seem to be more severe than the original Omicron. BA.2 is not surging in the US and likely will not surge here. Finally, its "stealth" identity is outdated. It can now be identified relatively easily. I want to believe all that, but I'm still waiting for the next covid shoe to drop.

Hong Kong has one of the world's highest fatality rates right now. With morgues full, bodies have been bagged and left in wards with live patients. There is no room at the inn. I am not at all sure how I would feel knowing that the beds next to me were occupied by dead rather than alive bodies. On the other hand, were I sick enough to be in the hospital, I might not be aware enough to realize that. 

The Road goes ever on and on ... Day 226 (726)

Happy Second Anniversary, Novel Coronavirus Pandemic! The traditional second anniversary gift is cotton. The modern one is, interestingly, china. Some sources say that WHO was slow to declare the pandemic. WHO counters that it declared the pandemic because so many countries were not taking seriously its earlier declaration of a public health emergency. On the day WHO declared the pandemic, there were over 120,000 cases in 114 countries, and there had been around 4,300 deaths globally. There were 1,263 cases identified in the US, along with 37 deaths. On the second anniversary, the "official" death toll is six million; looking at "excess deaths," though, suggests that 18 million is a better estimate.

As for an end to the pandemic, WHO has not specified any target thresholds. Pandemics generally don't end uniformly but end region by region. Considering past pandemics does reveal some recurring themes. A pandemic does not end suddenly; the end is a process not a product, and can take more time than might be thought. As Omicron lessens in the Western world, cases are still going up in areas of Asia. There is not just one end. The medical end occurs as the disease recedes. The end to a government's preventive measures marks the political end. Finally, there is a social or psychological end, marking when people move on from the pandemic's effect on them and their habits. 

WHO may have been slow to declare the pandemic's start, but it now cautions that many countries are treating the pandemic as over and letting down their guard too soon. As one public health expert put it, "This virus has fooled us every time." Still, only two percent of Americans now live in counties where the CDC still recommends universal indoor masking. Will there be a new variant to change that statistic? Quite possibly. Will we see it coming? We should hope so. I have drawn back from the matter-of-fact statement that we're fucked, which is not to say we can't take a step backwards. 

Let's leave the last word from the same official who declared the start two years ago, the WHO director:

 "The pandemic is far from over, and it will not be over anywhere until it's over everywhere."

The Road goes ever on and on ... Day 225 (725)

California is somewhat formally moving from pandemicity to endemicity as state mandates are lifted or loosened. A legislative movement is underway to add covid to the list of vaccines required for children to enter school.  Coupled with this is a movement to close the personal belief exemption for covid vaccination. It sounds as if it would stay in place for other vaccinations such as measles.

In terms of California's move, covid does appear to be slowing its onslaught. Cases per 100,000 people over the past two weeks rose in only two states, Washington and Connecticut, and the largest rise, in Washington, was only five. The biggest decline was Kentucky's forty. West Virginia, Maine, and New Hampshire also saw significant drops. Probably more telling, daily deaths fell by 24 percent in the past two weeks. Death is even more of a lagging measurement than hospitalization, so a drop in deaths is possibly one of the truest signs the Omicron surge is ending. I'm trying not to think about the BA.2 variant as I type that. 

The TSA is extending the mask mandate for airplanes and other public transportation through April 18. The mandate applies both to public transportation and to public transportation hubs such as airports or bus stations. The CDC is consulting with other federal agencies about how long to keep this mask mandate in effect. Meanwhile, Ontario is dropping its universal mask mandate as of March 21, though authorities emphasize that this does not mean the risk is gone. 

Omicron is still peaking in parts of East and Southeast Asia. Hong Kong has the highest fatality rate in the world right now. Lots of countries are loosening their entrance requirements and seeking to welcome the tourists they have not seen for two years.

I did not emerge into the real, peopled world last night, passing on the quilting guild chapter meeting The Professor thought I should attend. Not having slept well the night before, I ended up sleeping all the way home from sewing-machine-dropoff and lunch in Richmond and still felt too tired to venture out. I have never liked driving at night--my eyeglasses don't fix my double vision as well in the dark as they do in the daylight--and did not want to drive in the dark while exhausted. As for venturing out, I did to work with early voting for two elections and two election days, so those should count for something. 

The Road goes ever on and on ... Day 224 (724)

Hawaii has become the final state to drop its face-covering mandate. The mask mandate there ends as of March 25.

How's that for today's post? The Professor and I are headed to Richmond to drop Xena the Warrior Bernina off at a sewing machine mechanic for repairs to the bobbin assembly. Then we'll go to Son #2's house for take-out lunch. By the time we get home, The Family Dog will need attention as might a few other home thingies. I'll be back tomorrow, gods willin' and the creek don't rise.

The Road goes ever on and on ... Day 223 (723)

Today is International Women's Day, a day I did not know existed until 2009 when we arrived in Vietnam just in time for it. I had no idea why random people were handing me flowers. Perhaps at that point it had yet to touch on American culture. The US, sadly but not surprisingly, ranks 20th on The Economist's list of the Best Places to Be a Working Woman. The UK ranks 17th, while Canada comes in at 10th. Again not surprisingly, four of the top five countries are Norse. Sweden leads the list followed by Iceland, Finland, Norway, and Portugal.

Since I led with rankings, I might as well follow up with some covid rankings. California leads the 50 states in the number of covid deaths, 82,026; Vermont brings up the bottom with 546. Recognizing that the population of California versus that of Vermont makes those numbers somewhat irrelevant, deaths per 100,000 people is a better scale. Mississippi leads that list with 391; Vermont again brings up the bottom with 87. From states to countries, Peru leads the list of deaths per 100,000 people with 641.71: New Zealand rests at the bottom with 1.08. The US sits at 17th with 282.85. Vaccinations by country? We could certainly do better there. The world average is 54 percent fully vaccinated. Portugal is the most vaccinated with 91.46 percent fully vaccinated. The US ranks 21st with 65.59 percent. I don't think we'd be competitive if it were a competition. 

The risk of covid to kids is now about the same as the risk of influenza. We have no problem telling parents to get their children flu shots; why can't we treat covid the same way? Florida is on the verge of recommending that healthy children not be vaccinated against covid. The new state surgeon general has "expressed skepticism about the vaccines' effectiveness." What should I expect in a state in which the governor hosts a 90-minute discussion on "The Curtain Close on Covid Theater"? Hawaii is now the only state not lifting a statewide indoor mask mandate. Only a third of US school districts still require masks. 

A professor of preventive medicine and health policy at Vanderbilt University notes five distinct peaks in the US beginning with April 2020 as the pandemic began to take hold. A second peak occurred in August 2020 with a third in January 2021 after the winter holidays. There was a Delta peak in September 2021 followed by an Omicron one in January 2022. The professor notes that the on again-off again nature of the pandemic "has led to a lot of the confusion and grumpiness." You gotta love someone mentioning grumpiness in that way. I'm still pondering whether the introvert I am would be more or less grumpy had the pandemic not given me a perfect excuse to cocoon for an extended period of time.