The Road goes ever on and on ... Day 276 (776)

I just hit "publish" for yesterday's post. Our router is having intermittent problems keeping a connection, and I was apparently not connected when I hit "publish" and shut my laptop last night. It was a long day.

Assuming that the FDA and CDC authorize vaccine(s) for children ages four or five and under, how many parents will take their children to get vaccinated? Under 30 percent of children ages five through 11 are fully vaccinated ("fully vaccinated" means two doses; boosters have yet to be authorized for children), along with under 60 percent of children ages 12 through 17. Fewer than 30 percent of the youngest kids? Let's go with 25 percent at most. 

One of the things I find most interesting about the early-childhood vaccines is that both Pfizer and Moderna say their vaccines work fine in kids from six months to two years and not as well in the rest of the under-fives. Why the vaccines don't work as well in that "in-the-middle" age group intrigues me. Does some sort of biological developing go on then or slow down then that contributes to the effect? Your guess is as good as mine; I hope the new data to be submitted to the FDA in the next little while explains this better.

Cases and hospitalizations are rising in 47 states. It's the first widespread increase since January's Omicron surge. Just a month ago, cases were relatively flat nationwide. That has definitely changed; the good side is that those cases so far are mostly mild. Over 30 states and territories have seen hospitalization rates rise over the past two weeks. In much of the Northeast, the rate has risen by 40 percent or more. That said, hospitalizations are still at one of the lowest points of the pandemic. 

The US is seeing fewer than 400 deaths per day, the lowest daily average since before Omicron, and down 20 percent in the last two weeks. Interestingly, over 42 percent of the deaths in January and February were in vaccinated people, most of whom had not yet gotten a booster. The elderly remain the most at-risk group, accounting for a third of deaths from Delta and two-thirds of the deaths from Omicron. My Mom is still the only resident of her assisted living facility whom I see wearing a mask. She is also one of the only 10 residents and staff members who expressed interest in getting a second booster shot that has yet to be given. I somewhat see the residents without masks and not interested in boosters as being more ready to pass than My Mom. I can't believe it's a devil-may-care, let-the-chips-fall-where-they-will sort of attitude. I think that if it were, I would see more or any, actually, residents smiling. 

The Sons are running a 100K race today, crewed by The Professor. My Brother arrives tomorrow for a visit that will include Mother's Day. I think I'll go do the last bit of straightening up for his visit and then stop to savor the silent solitude. 

The Road goes ever on and on ... Day 275 (775)

Just a few quick notes from a day I did not expect to have. I can't say it was a bad day, just one that felt--still feels--very, very long.

The FDA has said that they should make their decision on early-childhood vaccines sometime in June. It sounds as though they will rule or announce a decision on Pfizer and Moderna together. Some pundits say that is good; others disagree. I just hope the protection lasts longer than in the first studies done. It's one thing to tell an adult to get a shot twice a year (or more often); they will or they won't. But making, well, taking a young child for a shot that often just won't work. 

The Bay Area Rapid Transit in the San Francisco area has reinstated its mask mandate until at least July 18. Bay Area residents in general have been open to wearing masks. People tend to take (and wear) one when offered one.   

The Road goes ever on and on ... Day 274 (774)

A reader commented that my recent mention of Safelite's having replaced my windshield left them with the Safelite jingle as a earworm. Apologies. I've had my own earworm today, Itsy Bitsy Teenie Weenie Yellow Polka Dot Bikini. My apologies if I just shared that one with you.

Dr. Fauci is walking back his comments about the US's being out of the "full-blown explosive pandemic phase," offering, "I want to clarify one thing. I probably should have said the acute component of the pandemic phase. And I understand how that can lead to some misinterpretation." We may be in a different phase, he said, but "By no means does that mean the pandemic is over." He also said that the future may see the need for intermittent vaccinations, possibly every year. I recently had a conversation with someone who said she would gladly get one shot a year just as she does with influenza. More often than that, she said, she probably would skip.

A story popped up last night about South Africa's possibly facing a fifth wave, this one from BA.4 and BA.5. The full extent of such a surge is not yet clear, but cases in one province are doubling every 4.8 days. An infectious disease physician from Mass General Hospital warns, "I would say that the data that's coming out of South Africa by the hour really is alarming ... From a weather report standpoint, we are watching closely, but it does have a bit of a flavor of, here we go again." It's not clear if herd immunity is even possible any longer.

Beijing is closing all city schools indefinitely. No announcement was made regarding virtual learning or studying for exams. Students currently make up over 30 percent of total covid cases. Clusters have been linked to six schools and two kindergartens. The government is trying to avoid the large-scale measures being used in Shanghai and only locking down the districts in which cases are identified. The goal is to test every resident three times this week. Two down, and one to go. Staying internationally, Denmark has stopped its covid vaccination program, the first country in the world to do so. Authorities say that they expect to need to restart it in the fall.

Moderna has asked the FDA to authorize its vaccine for children under the age of six. Data submission should be complete by May 9. At this point, Moderna is only approved for adults; however, the company has also requested that their vaccine be authorized for the six to 11 and 12 to 17 groups. The FDA may consider all three age groups at the same time. 

POTUS still plans to attend the White House Correspondents' dinner. He will not eat and he may wear a mask when not speaking. Everyone attending must show proof of vaccination as well as a negative test within the preceding 24 hours. It is not clear, though, if the same requirements will hold for the servers. Superspreader? You tell me.

The Road goes ever on and on ... Day 273 (773)

Are we there yet, Mom? Dr. Fauci said that the US is "out of the full-blown explosive pandemic phase" and moving into a transitional phase. The coronavirus and covid will always be here in some form on some scale. The White House covid coordinator notes that stopping infections is "not even a policy goal. The goal of our policy should be: obviously, minimize infections whenever possible, but to make sure people don't get seriously ill." I include that quote because it is so convoluted. He should have just said that we will never be able to stop infections and need instead to work to minimize them. The EU says that it is moving out of an emergency phase but still focusing on vaccination, pandemic surveillance, and testing in anticipation of a fall surge. As for the world as a whole, there's still a pandemic going on.

The CDC says that 60 percent of Americans including 75 percent of children had been infected with the coronavirus by February. If this sounds good, keep in mind that natural antibodies do not guarantee protection. The director of the Center for Health Security at Johns Hopkins University advises, "Betting that you are in the 60 percent is a big gamble. For anyone who's not been vaccinated and boosted, I would take this new data as a direct message to get that done or expect that the virus is likely to catch up to you if it hasn't already."

Pfizer has requested FDA authorization for a (first) booster to be given to children ages five through 11. It appears that the FDA might be willing to consider both Moderna and Pfizer vaccines for children ages six months through four years. I wonder what the vaccine hesitancy rate is going to be for that age group. Probably higher than for the five through 11 one, I'd say. 

The Vice President has tested positive pretty much just as her husband is leaving isolation. The Veep will stay away from the White House until she tests negative and was, fortunately, not in close contact with POTUS in the days before she tested positive. This has raised the question of whether POTUS and FLOTUS should attend the White House Correspondents' Dinner. They're expecting some 2,600 people to be there, a total that does not include Dr. Fauci. He declined the invitation "because of my individual assessment of my personal risk." (Does anyone in Washington speak clearly any more?)

Remember the early days of the pandemic, the days of murder hornets and other plaques? The answer to those is mousepox. Researchers are using computer power to study which animal viruses might jump to humans. They program a computer to take in all the information about viruses and how they mutate, spread. etc. They then add information about thousands of animal viruses and wait for the computer to highlight the riskiest viruses. Mousepox tops every list so far. Mousepox was discovered in 1930 and kills mice with "ruthless efficiency." About 250 human diseases have arisen when animal viruses jumped to humans. The best known examples are probably HIV (from chimpanzees) and covid (from bats).

The Road goes ever on and on ... Day 272 (772)

Right before the pandemic started, the first item on my list of big things to take care of was to check with Safelite about getting the windshield on my car repaired or replaced. It had some dings, three of which were spidering. Bam! Pandemic! I finally got around to going to Safelite today. The replacement was supposed to take an hour, but my dinged windshield put up a fight and fought leaving what it thought was its proper place. The time I set aside to write was spent reading at Safelite instead. I hate wimping out so soon after another such day, but that's life for you, or, at least for me. I can say, though, that looking through a clean, dingless windshield while driving home was pretty sweet.

The Road goes ever on and on ... Day 271 (771)

It seems that locking down Shanghai, where there were over 19,000 new covid cases and 51 deaths yesterday, is one thing. Areas of Beijing are being locked down after the discovery of only 70 cases there. Having seen the food shortages in Shanghai, many residents of Beijing are stockpiling non-perishable food. Beijing is testing some residents and workers three times this week. Two other Chinese cities are being locked down, one on the border of North Korea.

The pandemic has changed our lifestyles to the point that builders are redesigning homes to meet those changes. Rooms are becoming smaller to function as offices, playrooms, gyms, and the like. Bathrooms are getting bigger to account for the increased use they're seeing. Houses in general are becoming more like office space. A countertop island in a kitchen or between a kitchen and another room can function as a conference table. Family members meet there then go to their own spaces for other purposes.

Welcome to World Immunization Week! That's all immunizations, not just the ones against the coronavirus. Southeast Asia and the Mediterranean regions are the hardest hit in terms of children missing out on basic vaccinations. Vaccine hesitancy is a spectrum, from rockhard resistance to questioning. This spectrum has, though, become more polarizing and political during the pandemic. A fact about this polarization that I found just fascinating is that in the US, right-leaning voters are less likely to be vaccinated, while in the UK, Tory voters are more likely to be vaccinated. While personal beliefs don't dictate attitude toward vaccinations, those beliefs can serve to harden hesitancy into refusal. 

Health experts put forward steps that can improve vaccine uptake. First are presumptive recommendations. These would include a doctor's saying it's time for a child's vaccination as opposed to asking whether the parent wants to schedule an appointment for a shot. Don't ask, but tell, factually and politely. In motivational interviewing, doctors open a dialog, inviting parents to voice concerns or ask questions. WHO offers the 3Cs of vaccine hesitancy: convenience, complacency, and confidence. All have a definite impact on why a person believes what they do. And sometimes it just comes down to asking people why they are not getting vaccinated or getting their children vaccinated. Orthodox Jewish communities in London initially had low covid vaccination rates not because people opposed or were afraid of the vaccines. They simply did not want to haul children on public transit to vaccination sites across town. When vaccination sites were set up in or near those communities, vaccination rates were no longer an issue.

I read an article today saying that one complication of people returning to the office was the increase in transit crime. The number of incidents may not have gone up, but the rate has risen because fewer people have been using public transit. I openly admit that I spent most of the last two years driving myself only to medical appointments or to visit My Mom. I had to ask The Professor whether it was my imagination that there were more bad drivers out there now. There is one stop light on our way to or from town through which I used to see a car or two cross on red because they were accelerating and almost in to the intersection when the light turned red. I recently saw four cars run the red light full on. That would be four cars (two per lane) crossing on a full read light after the cars that were accelerating to get through as the light was changing. I have had more cases of people cutting in front of me than I can remember having in the years before the pandemic. Are people in more of a hurry now? Do they think if they drive fast enough they can drive out of the pandemic? I hate to tell them, but that's not gonna happen no matter how much they want it to. And The Professor said he could not disagree with my statement about there being more bad drivers now than two years ago.

The Road goes ever on and on ... Day 270 (770)

The different responses of the two Chinas to covid have been interesting. The restrictions in Shanghai have tightened. Some districts that had met the conditions set for the loosening of restrictions have now been told that won't happen. When they say "zero-covid," they mean it. The goal in the People's Republic of China is to eradicate the coronavirus. Busloads of people have been taken to quarantine centers including some outside of the city, centers said to be akin to prisons. Families are being split and sent to different centers. Still, they say there have only been 36 deaths in the past week.

Taiwan, meanwhile, will not go into lockdown as 99 percent of the cases there are asymptomatic or mildly symptomatic. Their vaccination rate is higher than that in the PR of China, with 80 percent of the population double-vaccinated and 60 percent having gotten a first booster. They say they are gradually moving into a "new Taiwan  model" and learning to live with the virus. The premier explains, "We will gradually deal with it and won't be like Shanghai and go into lockdown, but we won't immediately stop wearing face masks and not take anti-pandemic measures." 

Vaccination rates are stalling in most low-income countries. Some public health experts think the momentum may never be re-acquired. WHO's goal was to fully vaccinate 70 percent of the population in every country by June 2022, a goal that will fall well short. Only a few of the 82 poorest countries have hit the 70 percent goal including Bangladesh, Bhutan, Cambodia, and Nepal. Many countries have less than 20 percent of the population fully vaccinated. Only two-thirds of the richest countries have hit the 70 percent goal, not including the US. We remain stuck at 66 percent. The vaccination situation does not look good when one considers possible future variants. 

As readers might have guessed, I'm somewhat paranoid about masking and trying to limit my possible exposure to covid. Today I read a new reason to remain so. An article in the Lancet reports that one year after hospitalization with covid for a cohort of over 2,300 patients, only one in four had fully recovered. I don't like those odds and would hate to add some new members to my family of underlying conditions.

Moving on to the social side of the coronavirus, a survey conducted by the National Literacy Trust showed that early learning suffered as parents talked and read less to children in 2021. A full one-fourth said that they did not chat with their child every day compared with only 10 percent in 2019. Only 53 percent said they read to their child daily compared with 66 percent in 2019. Finally, 72 percent of parents played with their child daily in 2021 compared to 76 percent in 2019. I have to admit that playing with a child might be seen as easier than chatting with or reading to a child, but that's no reason not to do those other two things. Interaction with children dropped even as time spent with children rose. The experts say that children experience frustration at not being able to communicate, which is where the chatting, reading, and playing really matter. Some speech-language therapists currently have waiting lists nine months long. 

The coronavirus gets you coming and going. If it can't hurt you medically, then how about socially.