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Thursday, March 31, 2022

New Mutant “XE” Omicron Variant May Be The Most Transmissible Version Of Covid Yet, According To WHO - Deadline

The CDC announced this week that the BA.2 Omicron variant, which is reportedly 30% more transmissible than the original BA.1 Omicron strain — has become dominant among new cases sequenced in the United States. That’s a startling rise for a variant that was less than 1% of all sequences as recently as January. But, just as Americans are hearing about BA.2, there’s already a newer, even more transmissible variant on the rise.

There are actually three new variants that have been given designations. According to a recently-released report from the UK Health Services Agency, the two being called XD and XF are combinations of Delta and BA.1, or so-called “Deltacron” strains, which have been talked about for months but made no significant inroads in any country.

XD is present in several European countries, but has not been detected in the UK, according to the report. XF caused a small cluster in the UK but has not been detected there since February 15. The variant of greater concern, it seems, is the one dubbed XE.

Like the other two new arrivals, XE is a recombinant strain, meaning it is made up of two previously-distinct variants. But it is not a Deltacron mix. XE is actually made up of the original Omicron (BA.1) and the newer Omicron (BA.2) which has taken over in the U.S.

The World Health Organization issued a report yesterday with some preliminary findings.

“The XE recombinant was first detected in the United Kingdom on 19 January and >600 sequences have been reported and confirmed since,” reads the WHO document. “Early-day estimates indicate a community growth rate advantage of ~10% as compared to BA.2, however this finding requires further confirmation.”

Further confirmation is getting more difficult by the day, according to WHO, which registered concern this week at what it calls “the recent significant reduction in SARS-CoV-2 testing by several Member States. Data are becoming progressively less representative, less timely, and less robust. This inhibits our collective ability to track where the virus is, how it is spreading and how it is evolving: information and analyses that remain critical to effectively end the acute phase of the pandemic.”

Last week’s briefing from the UK Health Services Agency reinforces some of the WHO report’s assertions and urges caution about jumping to conclusions. One difference between the two documents is that the WHO data and analysis seems to be more recent.

From the UK HSA briefing:

XE shows evidence of community transmission within England, although it is currently less >1% of total sequenced cases. Early growth rates for XE were not significantly different from BA.2, but using the most recent data up to 16 March 2022, XE has a growth rate 9.8% above that of BA.2. As this estimate has not remained consistent as new data have been added, it cannot yet be interpreted as an estimate of growth advantage for the recombinant. Numbers were too small for the XE recombinant to be analysed by region.

To be clear, XE only accounts for a tiny fraction of cases worldwide. That may change, given that XE is thought to be about 10% more transmissible than the already more-transmissible BA.2. That means it may be roughly 43% more transmissible than the original Omicron that savaged the globe last winter.

But a new wave of infections from the now-dominant BA.2 has not materialized, even as restrictions have been eased. So hopefully the trend with XE, should it out-compete BA.2, will be similar. Only time — and good surveillance — will tell.

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Diabetes risk rises after COVID, massive study finds - Nature Journal

Health workers move a COVID-19 patient to a ward of Dr. Ernesto Che Guevara hospital in Marica, Brazil.

People who were hospitalized with COVID-19 are at risk of a diabetes diagnosis.Credit: Bruna Prado/AP/Shutterstock

People who get COVID-19 have a greater risk of developing diabetes up to a year later, even after a mild SARS-CoV-2 infection, compared with those who never had the disease, a massive study1 of almost 200,000 people shows.

The research, published in The Lancet Diabetes & Endocrinology earlier this month, is one of a growing number of studies2 showing that COVID-19 can increase a person’s risk of diabetes, months after infection.

“When this whole pandemic recedes, we’re going to be left with the legacy of this pandemic — a legacy of chronic disease” for which health-care systems are unprepared, says study co-author Ziyad Al-Aly, chief researcher for the Veterans Affairs (VA) St Louis Healthcare System in Missouri.

Risks amplified

Al-Aly and Yan Xie, an epidemiologist also at the VA St Louis Healthcare System, looked at the medical records of more than 180,000 people who had survived for longer than a month after catching COVID-19. They compared these with records from two groups, each of which comprised around four million people without SARS-CoV-2 infection who had used the VA health-care system, either before or during the pandemic. The pair previously used a similar method to show that COVID-19 increases the risk of kidney disease3, heart failure and stroke4.

The latest analysis found that people who had had COVID-19 were about 40% more likely to develop diabetes up to a year later than were veterans in the control groups. That meant that for every 1,000 people studied in each group, roughly 13 more individuals in the COVID-19 group were diagnosed with diabetes. Almost all cases detected were type 2 diabetes, in which the body becomes resistant to or doesn’t produce enough insulin.

The chance of developing diabetes rose with increasing severity of COVID-19. People who were hospitalized or admitted to intensive care had roughly triple the risk compared with control individuals who did not have COVID-19.

Even people who had mild infections and no previous risk factors for diabetes had increased odds of developing the chronic condition, says Al-Aly. Of the people with COVID-19 who avoided hospitalization, an extra 8 people out of every 1,000 studied had developed diabetes a year later compared with people who were not infected. People with a high body-mass index, a measure of obesity — and a considerable risk factor for type 2 diabetes — had more than double the risk of developing diabetes after a SARS-CoV-2 infection.

Global burden

Given the extraordinary number of COVID-19 cases globally — 480 million confirmed cases and counting — the modest increase in diabetes risk could correspond to a drastic rise in the number of people diagnosed with the disease worldwide, if the observed trends hold true, says Jonathan Shaw, an epidemiologist at the Baker Heart and Diabetes Institute in Melbourne, Australia.

But the findings might not translate to other groups of people. The US veterans in the study were mostly older, white men, many of whom had elevated blood pressure and were overweight, putting them at high risk of developing diabetes, says Gideon Meyerowitz-Katz, an epidemiologist studying diabetes at the University of Wollongong in Australia. But that risk is much lower in younger people, he says, and higher in some other ethnic groups.

And it’s possible that some people in the control group had undetected mild or asymptomatic COVID-19 but were never tested, potentially skewing the data, Al-Aly adds.

Other factors might also be contributing to the apparent rise in diabetes among people who recovered from COVID-19, says Shaw. Existing cases of diabetes might have gone undetected until people sought medical care for COVID-19.

Elusive causes

Early in the pandemic, researchers raised concerns based on anecdotal reports in young people and children that SARS-CoV-2, like other viruses, might damage cells in the pancreas that produce insulin, triggering type 1 diabetes.

But data on a link between SARS-CoV-2 infection and newly diagnosed cases of type 1 diabetes remain mixed. Several studies57 have found no evidence that the disease is causing the uptick in cases of type 1 diabetes in younger adults or children. And a laboratory study published in February also challenged the idea that SARS-COV-2 destroys insulin-producing pancreatic cells8.

A lingering question is whether the metabolic changes observed in people who had COVID-19 persist after one year. More research is needed to clarify long-term trends in new-onset diabetes at a population level and to tease apart what might be causing them, says Shaw.

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First human challenge study of Covid-19 yields valuable insights about how we get sick - CNN

(CNN)It takes just a tiny virus-laden droplet -- about the width of a human blood cell -- to infect someone with Covid-19.

That's just one of the findings from research that deliberately infected healthy volunteers with the SARS-CoV-2 virus. The findings were published Thursday in the journal Nature Medicine.
Challenge studies can be controversial because they involve intentionally giving someone a virus or other pathogen in order to study its effects on the human body. Even with safeguards in place, there's an element of risk, particularly when studying a new virus.
But they are also hugely valuable for understanding the course of an infection.
"Really, there's no other type of study where you can do that, because normally, patients only come to your attention if they have developed symptoms, and so you miss all of those preceding days when the infection is brewing," said lead study author Dr. Christopher Chiu, an infectious disease physician and immunologist at Imperial College London.

Volunteers were carefully screened

The study began in March 2021. The 36 volunteers were between the ages of 18 and 30. They were allowed to participate only if they didn't have any risk factors for severe Covid-19, such as being overweight, having reduced kidney or liver function, or having any heart, lung or blood problems. They also signed an extensive informed consent form to participate.
To further minimize the risks, researchers conducted the study in phases. The first 10 infected volunteers got the antiviral drug remdesivir to reduce their chances of progressing to severe disease. Researchers also had monoclonal antibodies at the ready in case anyone took a turn for the worse. Ultimately, the remdesivir proved unnecessary, and researchers never had to give anyone antibodies.
The volunteers got a tiny drop of fluid containing the originally detected strain of the virus through a long, thin tube inserted into their nose.
They were medically monitored 24 hours a day and stayed for two weeks in rooms at London's Royal Free Hospital that had special air flow to keep the virus from escaping.

Half were infected

A total of 18 participants became infected, two of whom never developed symptoms. Among the people who got sick, their illnesses were mild. They had stuffy noses, congestion, sneezing and sore throats.
Most of the study participants who caught Covid-19 -- 83% -- lost their sense of smell, at least to a degree. Nine couldn't smell at all.
This now-well-known symptom got better for most people, but six months after the study ended, there's one person whose sense of smell isn't back to normal but is improving.
That's a concern because another recent study found that this loss of smell was tied to changes in the brain.
Chiu says the researchers gave the participants cognitive tests to check their short-term memory and reaction time. They're still looking at that data, but he thinks those tests "will really be informative."
None of the study volunteers developed lung involvement in their infections. Chiu thinks this is because they were young and healthy and inoculated with tiny amounts of virus.
Beyond the loss of smell, no other symptoms persisted.

A closer look at infection as it moves through the body

Under these carefully controlled conditions, researchers were able to learn a lot about the virus and how it moves through the body:
  • Tiny amounts of virus, about 10 microns -- the amount in a single droplet someone sneezes or coughs -- can make someone sick.
  • Covid-19 has a very short incubation period. It takes about two days after infection for a person to start shedding virus.
  • People shed high amounts of virus before they show symptoms (confirming something epidemiologists had figured out).
  • On average, the young, healthy study volunteers shed virus for 6½ days, but some shed virus for 12 days.
  • Infected people can shed high levels of virus without any symptoms.
  • About 40 hours after the virus was introduced, it could be detected in the back of the throat.
  • It took about 58 hours for virus to show up on swabs from the nose, where it eventually grew to much higher levels.
  • Lateral flow tests, the rapid at-home kind, work really well for detecting when a person is contagious. The study found that these kinds of tests could diagnose infection before 70% to 80% of viable virus had been generated.
Chiu says his study emphasizes a lot of what we already know about Covid-19 infections, not least of which is why it's so important to cover both your mouth and nose when sick to help protect others.

More challenge studies planned

This challenge study was so successful that Chiu plans to do it again, this time with vaccinated people infected with the Delta variant to study their immune response.
He says his team also plans to continue studying the people who didn't get sick.
"That's what's really interesting," he said. About half of the study participants never got sick and never developed antibodies, despite getting exactly the same dose of the virus.
Everyone was screened for antibodies to closely related viruses, like the original SARS virus. So it wasn't cross-protection that kept them safe; it was something else.
"There are lots of other things that help protect us," Chiu said. "There are barriers in the nose. There are different kinds of proteins and things which are very ancient, primordial, protective systems, and they are likely to have been contributing to them not being infected, and we're really interested in trying to understand what those are."
Understanding what other factors may be at play could help us provide more generalized protection to people in case of a future pandemic.
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Dr. Kathryn Edwards, a pediatric infectious disease specialist at Vanderbilt University who wrote an editorial published alongside the study, said the research offers important information about infection and contagion with the SARS-CoV-2 virus.
Blood and tissue samples collected for the study will continue to be analyzed for years to come, she said. "I think those are all in the freezer, so to speak, and are being dissected. So I think that should be very powerful."
In the end, she thinks the study has put many of the fears about human challenge studies to rest and paved the way for others.
"We won't be doing challenge studies in babies, and we won't be doing it in, you know, 75-year-old people with chronic lung disease," she said. But in young, healthy people, "I think these are studies that will be helpful."

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Ivermectin worthless against COVID in largest clinical trial to date - Ars Technica

A box of Ivermectina medicine manufactured by Vitamedic in Brazil.
Enlarge / A box of Ivermectina medicine manufactured by Vitamedic in Brazil.

The largest clinical trial to date on the use of the antiparasitic drug ivermectin against COVID-19 concluded that the drug is completely ineffective at treating the pandemic disease, according to results published in The New England Journal of Medicine on Wednesday.

The double-blind, randomized, placebo-controlled clinical trial was primarily designed to test if ivermectin could reduce the need for hospitalization among 1,358 COVID-19 patients at high risk of severe disease. Ivermectin did not, according to the international team of researchers behind the trial, dubbed TOGETHER. "We did not find a significantly or clinically meaningful lower risk of medical admission to a hospital or prolonged emergency department observation with ivermectin," the researchers reported.

The folks with TOGETHER also found that the drug failed to reduce all other secondary outcomes of COVID-19, including the time to recovery, time to viral clearance on PCR test, time spent in the hospital, the need for mechanical ventilation, the duration of mechanical ventilation, death, or the time to death. "We found no important effects of treatment with ivermectin on the secondary outcomes," the researchers wrote.

Seriously, y’all

The findings align with some smaller trials and current medical consensus that ivermectin has not proven effective at treating COVID-19. Yet ivermectin—a drug typically used by humans to treat gastrointestinal parasites and river blindness and commonly used in veterinary medicine for deworming horses, cows, cats, and dogs—has become a wildly popular COVID-19 treatment.

Ivermectin's popularity is fueled by misinformation, Republican politics, and dubious data. An early study using cells in petri dishes suggested that ivermectin has antiviral properties at very high concentrations and could inhibit the pandemic coronavirus, SARS-CoV-2. But the result of trials and other clinical studies have been mixed at best. Some small studies—many of which are of poor quality—have claimed that ivermectin has benefits against COVID-19. A few meta-analyses, including those questionable studies, have also provided a veneer of efficacy.

This has led to fierce debates about ivermectin online as well as skyrocketing use. In December 2020, ivermectin prescribing in the US increased 964 percent over prepandemic prescription levels. This giant increase was estimated to cost health insurers more than $129 million annualized. Not everyone desperate to take the drug was received a prescription, so some turned to veterinary formulations. This caused spikes in poisonings and led the Food and Drug Administration to release an unusual warning: "You are not a horse. You are not a cow. Seriously, y'all. Stop it."

The researchers behind the new trial say their data should finally put ivermectin's use against COVID-19 to rest—though they're not expecting that to be the case.

"The overall number of events that occurred in our trial is larger than the number of all the combined events in these meta-analyses," the TOGETHER researchers noted. "The results of this trial will, therefore, reduce the effect size of the meta-analyses that have indicated any benefits." But, they go on, "Given the public interest in ivermectin and the support of its use by paramedical groups, we suspect that there will be additional criticism that our administration regimen was inadequate."

Trial design

The trial took place across 12 public health clinics in Brazil from March 23, 2021, to August 6, 2021, enrolling 1,359 COVID-19 patients in total. Of those, 679 were randomly assigned to get ivermectin, and 679 were randomly assigned a placebo. All of the enrolled patients were ages 18 or older, tested positive for COVID-19 on a rapid test, and had onset of COVID-19 symptoms within seven days. All had at least one condition that put them at higher risk of severe COVID-19, such as being older than age 50 or having diabetes, high blood pressure, cancer, or lung disease. All of the patients were monitored for 28 days, with contact on days 1, 2, 3, 4, 5, 7, 10, 14, and 28 from the time of their randomization. The people in the ivermectin group received a dose of 400 micrograms per kilogram for the first three days.

The researchers noted they initially planned to give patients a smaller dose of ivermectin for only one day. But after receiving "feedback from advocacy groups," they extended the experimental treatment to three days at a relatively high dose. They also checked to ensure that the patients in the trial didn't have a history of ivermectin use, given its popularity in Brazil.

The trial's main goal was to see if taking ivermectin early in an infection could reduce the risk of hospitalization in high-risk patients. However, Brazil had periods when hospitals were overwhelmed with patients, turning some sufferers away. As such, the researchers also counted visits to emergency departments when a patient was kept for observation for six or more hours due to worsening COVID-19 symptoms, which was considered a proxy for hospitalization if hospital capacity was not limited.

Overall, the researchers saw no significant difference in the number of hospitalizations or prolonged emergency department visits between the ivermectin and placebo groups. Exactly 100 participants (15 percent) in the ivermectin group had that outcome, while 111 (16 percent) of the placebo group did. The finding didn’t change when the researchers narrowed their analysis to exclude a handful of people who went to the hospital within 24 hours of starting the trial and people who didn't report 100 percent compliance with their ivermectin or placebo regimens. The researchers also saw no benefits among the secondary outcomes. And in a subgroup analysis, they saw no benefit in patients who happened to start ivermectin within three days from the onset of symptoms instead of seven days.

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WHO Outlines Strategy to End Global COVID-19 Emergency in 2022 - The Epoch Times

The World Health Organization on Wednesday unveiled an updated plan for COVID-19 that, if implemented “rapidly and consistently” this year, will allow the world to end the emergency phase of the pandemic.

The plan—the WHO’s third on COVID-19—includes three potential scenarios for how the virus might evolve in the next 12 months: a base case, a best case, and a worst case. Key objectives include reducing COVID-19 infections, and effectively diagnosing and treating COVID-19 cases to reduce deaths.

WHO Director-General Tedros Adhanom Ghebreyesus said in the plan’s foreword that the world now stands at “a pivotal and dangerous moment in the fight against COVID-19.”

“Although it is impossible to predict precisely how the SARS-CoV-2 virus will evolve, we know that new variants will arise as transmission continues and, in many cases, intensify,” he wrote. “And yet, we can look to the future with a sense of hope that we can end the COVID-19 pandemic as a global emergency through our actions.”

The world now has “the tools to plan for and respond to every eventuality,” he said.

The director-general said during a press briefing that, based on current research, the most likely scenario is that the SARS-CoV-2 virus continues to evolve, but the severity of COVID-19 disease reduces over time as immunity increases due to vaccination and infection.

In the WHO’s base case planning scenario, which serves as the WHO’s working model, the virus continues to evolve, but causes less severe outbreaks due to sustained and sufficient immunity against severe disease and death. There will likely be periodic spikes in transmission as immunity wanes. Booster shots might be needed periodically for those most at risk. The virus would likely fall into a seasonal pattern, with peaks in colder months—similar to influenza.

The WHO’s best case scenario envisions future variants as being “significantly less severe,” while protection from severe disease would be maintained without the need for periodic boosting or significant changes to current vaccines.

The worst case scenario sees the emergence of a more virulent and highly transmissible variant against which vaccines are less effective, and/or immunity against severe disease and death wanes rapidly, particularly in the most vulnerable groups. This would require significant changes to current vaccines and full redeployment and/or broader boosting for those most at risk.

To help end the emergency phase of the pandemic, WHO called on countries to continue or increase their virus surveillance capabilities to allow for early warning signs of significant changes in the virus. It also called for improved detection of long COVID, to track and reduce long-term disability after the pandemic has ended.

Countries also must continue to do diagnostic testing for the novel coronavirus, which helps identify leading strains causing infections and guide community-level decision making. Countries also must track virus evolution within animal populations, according to the WHO.

“We have global systems to better understand the virus as it changes, and we have the vaccines, diagnostic tools, treatments, and other public health and social measures to end the acute phase of the COVID-19 pandemic,” the director-general said.

“Focus, vigilance, and commitment now will end the emergency of the pandemic and lay the foundations for a more effective response to the future threats that will undoubtedly emerge. But the pandemic remains far from over,” he added.

Reuters contributed to this report.

Isabel van Brugen

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Isabel van Brugen is an award-winning journalist and currently a news reporter at The Epoch Times. She holds a master's in newspaper journalism from City, University of London.

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What an expert says you should consider before getting a 2nd Covid-19 booster - CNN

(CNN)On Tuesday, the US Food and Drug Administration expanded its authorization of the Pfizer/BioNTech and Moderna Covid-19 vaccines. Now, adults ages 50 and older are able to get a second booster if at least four months have passed since their first one.

Within hours, the US Centers for Disease Control and Prevention came out with a statement that says it will also allow second boosters as well as guidance for people who initially received the Johnson & Johnson vaccine. These individuals who subsequently got a booster are now eligible for a second booster shot, too.
All these developments come in the wake of the CDC's updated analysis showing that the highly transmissible BA.2 subvariant is the dominant strain in the United States.
Now that more people can receive an additional vaccine dose, should they get it? What are factors they might want to consider? Is there any downside to getting more shots? And does it make sense to wait until a big event such as international travel or a large wedding to get that booster?
To help us with these questions, I spoke with CNN Medical Analyst Dr. Leana Wen, an emergency physician and professor of health policy and management at the George Washington University Milken Institute School of Public Health. She is also author of "Lifelines: A Doctor's Journey in the Fight for Public Health."
CNN: Who is now eligible to receive an additional booster dose?
Dr. Leana Wen: Prior to the announcements this week by the FDA and CDC, people with moderate or severe immunocompromise were already eligible for an additional booster dose. Now, a much larger group is eligible.
This includes two subsets of people. First, people 50 and over who received three prior doses of either Pfizer or Moderna, and who are at least four months out from their last vaccine dose, are eligible for another mRNA booster -- either Pfizer or Moderna.
Second, all adults -- regardless of age -- who received an initial Johnson & Johnson vaccine and then a booster at least four months ago are now able to receive a second booster dose with an mRNA vaccine, again either Pfizer or Moderna.
CNN: Now that a lot more people can get a second booster, should they?
Wen: First, I want to emphasize the importance of getting the first booster dose. According to the CDC, about half of Americans eligible for that first booster have not yet received it. That includes an astonishing 1 in 3 people 65 and older.
There is ample data that shows how important the initial booster is, especially against the Omicron subvariants, including the now-dominant BA.2 strain. During a time when BA.1 was the main variant, the effectiveness of two doses of the vaccine against severe disease dropped to 79%, according to a CDC study. The effectiveness of three doses remained high, at 94%.
The data around the second booster is less clear. Much of the research comes from Israel, where fourth doses have been widely available since the end of January. One study there of adults over 60 found that those who had a fourth Covid-19 vaccine had 78% lower risk of death during the Omicron surge compared with those who had a third shot at least four months earlier. However, the number of deaths was low in both groups.
Another Israeli study, published in the New England Journal of Medicine, found that while a fourth shot increased antibodies, it didn't boost protection much, and those who became infected were mildly symptomatic regardless of whether they had three or four shots. Complicating it all is that it's unclear how long the enhanced protection from the fourth dose will last.
All this says to me that the question of whether people should receive a fourth dose is not straightforward to answer. This cannot be a blanket recommendation to everyone, but rather nuanced guidance that's tailored to each person's individual medical circumstance.
CNN: What are factors people should consider in deciding whether to get the second booster shot?
Wen: First, consider your medical risk factors. If you are elderly and have multiple medical conditions, you are more likely to become severely ill due to Covid-19. Certainly, if you are moderately or severely immunocompromised, that should tip the scales in favor of getting the additional booster dose now.
On the other hand, if you are generally healthy, you are still very well-protected from severe illness due to the protection from the vaccine and the initial booster dose. It's not as urgent to get the booster, and there may also be an advantage to waiting.
CNN: Why might someone decide to wait on the booster?
Wen: Right now, the level of Covid-19 in the US is pretty low. Experts have been keeping a close eye on BA.2 in case it causes another surge, but the current transmission rate in most parts of the country is the lowest it has been in months. Because the enhanced protective effect of the second booster may not last long, it might be better to wait until there are clear signs of a surge before getting it.
In addition, there are studies underway to develop an Omicron-specific booster. If you haven't received any booster at all, I wouldn't recommend waiting for that variant-specific booster, but if you already received one, and especially if you are not particularly vulnerable, it may be reasonable to hold off for now.
Another group of people who are probably better off waiting is those who were recently infected with Omicron. It's unlikely that those individuals who were vaccinated and infected will be reinfected so soon. Especially if they are generally healthy individuals, I'd also advise them to wait a little longer before getting the additional booster.
CNN: Is there any known downside to getting the fourth dose?
Wen: Analyses of extensive Israeli data have not identified new safety concerns from the fourth dose. Hypothetically, there is the concern that if someone gets constant boosters, their immune system may not fire up as well if they got exposed to Covid-19, but this is not proven. The main downside would be the issue of timing -- is now the best time to get the fourth dose, or is it better to hold off? That will depend on each person's medical risk factors as well as their tolerance of risk, and specifically how important it is to them to keep avoiding the coronavirus.
CNN: Some people might want to wait until a big event like international travel or a large wedding to get that extra shot. Is that a good plan?
Wen: Not really. If you have not yet had your initial booster, get it now, because that first booster is important to maintain strong protection against severe disease. Don't wait on that first booster. I think it's hard to time a second booster around an event, and it would make more sense to time it around an expected surge.
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That said, I can understand why people would want to be better protected for big events. Remember that there are other tools at our disposal to do so. If you want to be extra cautious, requiring vaccines and then testing all guests prior to getting together indoors will substantially reduce risk.
Know where you could access treatment in case you do get infected. And let's not forget masks -- a high-quality mask (N95 or equivalent) protects you even if others around you are not masking. Boosters are one very important tool that can complement these other tools to help us reduce our individual risk.

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Covid-19: Latest News and Live Updates - The New York Times

Kenny Holston for The New York Times

Senate Democrats and Republicans neared agreement on Thursday to slash an emergency coronavirus response package to $10 billion from $15.6 billion, as they worked to break a logjam over a stalled package of federal money urgently requested by President Biden for vaccines, therapeutics and preparation against future variants.

The day after Mr. Biden pleaded with Congress to approve the money, senators were discussing removing as much as $5 billion in aid for the global vaccination effort as they scrambled to resolve disputes over how to finance the package. Republicans have refused to devote any new funding to the federal pandemic response effort, arguing that unspent money that has already been approved should be used, but the two parties have been unable to agree on which programs should be tapped.

Without consensus on that question, it was not clear that they would have the votes to move forward in the evenly divided Senate, where 60 votes — including at least 10 Republicans — would be needed.

The package now under consideration would be less than half the White House’s original $22.5 billion request.

Senator Mitt Romney, Republican of Utah, said that any votes would likely be delayed until next week before Congress leaves for a two-week April recess, as lawmakers toiled to hammer out a deal, write the bill and get a cost assessment from the nonpartisan Congressional Budget Office. He and Senator Chuck Schumer of New York, the majority leader, have been leading talks, along with other senior senators.

Under the emerging deal, Mr. Romney, said, most of the $10 billion would be repurposed from the $1.9 trillion pandemic law Democrats muscled through without Republican support last March. But direct funds for state and local governments would likely not be touched, after Democrats balked at this money at being clawed back. Mr. Romney said negotiators had discussed taking back some funding from a program that allowed states to give grants to local businesses.

Other potential funding sources, multiple senators said, included transportation money, agricultural programs and some money for live venues, like theaters, that had to close during the pandemic.

“I generally tried to not let perfect be the enemy of better,” said Senator Kevin Cramer, Republican of North Dakota. “But again, we don’t have enough specific flesh on the bone.”

Efforts to tuck the emergency pandemic aid into a $1.5 trillion spending package President Biden signed into law earlier this month collapsed when rank-and-file Democrats and governors objected to claiming $7 billion that was supposed to go to state governments to help finance the package. Mr. Biden has warned that without another round of aid from Congress, his administration would be forced to scale back the nation’s pandemic response, jeopardizing its ability to be prepared for another variant or wave of infections.

Senator Mitch McConnell, Republican of Kentucky and the minority leader, said it was still unclear whether an agreement would be possible.

“It’s kind of a work in progress,” Mr. McConnell said at an event with Punchbowl News, saying the package would likely be have been “skinnied down” to $10 billion.

“That has the potential to take out the international vaccine part, which I think is terribly unfortunate,” he added. “But that’s where we are at the moment — whether that’s going to completely come together is not clear.”

Mr. Romney said it was unclear whether some of the global aid would remain in the package. Senator Chris Coons, Democrat of Delaware and one of the negotiators, told reporters “my hope is that we will find a path toward adding more for the international side.”

But leaders in both parties signaled optimism that a final agreement could be reached.

“The gap has been narrowed greatly, and we’re intent on working with Republicans to cross the finish line, because this is vital for our country,” said Senator Chuck Schumer of New York, the majority leader.

But it also remained unclear whether progressives in the House would agree to a deal that was a fraction of what Mr. Biden had initially said was necessary and lacked the global vaccination funds.

“This is shameful — we have to get the money,” Speaker Nancy Pelosi of California said at her weekly news conference. She added, “Everyone knows that none of us are safe until all of us are safe.”

Multiple House Democrats, including Representative Tom Malinowski of New Jersey, suggested they would not support a package that did not have the international aid. Vaccination rates continue to lag in low-income countries while they are vastly higher in high- and upper-middle-income countries.

“I’d rather stop the next Covid variant in Africa or Asia than have to fight it again in New Jersey,” Mr. Malinowski wrote on Twitter, adding that he “would not be able to support a bill that effectively ends our global pandemic prevention efforts.”

With lawmakers set to leave Washington next Friday for a recess, senators were facing a time crunch for action. Democrats are also planning to hold a vote next week to confirm Judge Ketanji Brown Jackson to the Supreme Court

Catie Edmondson contributed reporting.

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Wednesday, March 30, 2022

CDC Recommends Additional Boosters for Certain Individuals | CDC Online Newsroom - cdc.gov

Data continue to show the importance of vaccination and booster doses to protect individuals both from infection and severe outcomes of COVID-19. For adults and adolescents eligible for a first booster dose, these shots are safe and provide substantial benefit. During the recent Omicron surge, those who were boosted were 21-times less likely to die from COVID-19 compared to those who were unvaccinated, and 7-times less likely to be hospitalized. CDC continues to recommend that all eligible adults, adolescents, and children 5 and older be up to date on their COVID-19 vaccines, which includes getting an initial booster when eligible.

Following FDA’s regulatory actionexternal icon today, CDC is updating its recommendations to allow certain immunocompromised individuals and people over the age of 50 who received an initial booster dose at least 4 months ago to be eligible for another mRNA booster to increase their protection against severe disease from COVID-19. Separately and in addition, based on newly published data, adults who received a primary vaccine and booster dose of Johnson & Johnson’s Janssen COVID-19 vaccine at least 4 months ago may now receive a second booster dose using an mRNA COVID-19 vaccine.

These updated recommendations acknowledge the increased risk of severe disease in certain populations including those who are elderly or over the age of 50 with multiple underlying conditions, along with the currently available data on vaccine and booster effectiveness.

The following is attributable to Dr. Rochelle P. Walensky:

“Today, CDC expanded eligibility for an additional booster dose for certain individuals who may be at higher risk of severe outcomes from COVID-19. Boosters are safe, and people over the age of 50 can now get an additional booster 4 months after their prior dose to increase their protection further. This is especially important for those 65 and older and those 50 and older with underlying medical conditions that increase their risk for severe disease from COVID-19 as they are the most likely to benefit from receiving an additional booster dose at this time. CDC, in collaboration with FDA and our public health partners, will continue to evaluate the need for additional booster doses for all Americans.”

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March 30, 2022 at 02:50AM
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Covid creeps closer to Biden as restrictions fall - The Washington Post

Over the last two weeks, the coronavirus has crept ever closer to Biden, disrupting White House operations just as the country and the administration have been relaxing strict safeguards against covid-19. The cluster of cases highlights the continued threat posed by the virus, complicating White House efforts to signal that the country has turned the corner on the pandemic.

After years of modeling strict precautions, including campaigning for months from his basement in Wilmington, Del., before vaccines were available, Biden is now at a higher risk of being infected, experts say, with all the personal and political consequences that would entail — though as with other vaccinated people, an infection could be less severe.

The BA.2 “stealth” omicron variant is expected to soon become the dominant strain. Here is what you need to know about a possible new wave of infections. (Video: Brian Monroe, John Farrell/The Washington Post, Photo: The Washington Post)

“There’s very little doubt that the president could contract covid-19,” said Lawrence Gostin, faculty director of the O’Neill Institute for National & Global Health Law at Georgetown Law, who is in regular touch with Biden’s covid-prevention team.

The 79-year-old Biden’s vaccination status could help the president avoid serious infection, he said. “But even that is in doubt, given his age and obvious frailty,” Gostin added. “I would be far more worried about the president’s health than it appears from recent White House protocols.”

The White House dropped its mask mandate in the beginning of the month, following relaxed guidance from the Centers for Disease Control and Protection and the end of Washington’s mandatory indoor mask requirement.

Biden does at times persist in wearing a mask behind closed doors, according to one White House aide who spoke on the condition of anonymity to reveal presidential habits. During Biden’s meetings, aides still stand far away from him, and anyone meeting with any of the four principals are tested for the virus ahead of time, according to a different White House official who was not authorized to speak publicly.

In disclosing their diagnoses, both Psaki and Jean-Pierre said they had “socially distanced” meetings with Biden the previous day. Employees who test positive must test negative before returning to the White House, the official said.

When he met with union leaders at the Hotel Du Pont in Wilmington this month, the president was not wearing a mask, according to a person who was there and photographs of the event. Delaware dropped its mask mandate in February, and the union officials all had coronavirus tests before meeting with Biden, attendees said.

In upcoming weeks Biden is expected to amp up his domestic travel, a priority he outlined in January that has been delayed several times largely due to world events. Those plans will by design put him in contact with more people.

“There’s no question the risk has increased,” said Celine Gounder, an infectious-disease specialist at New York University who served on Biden’s covid advisory board during the presidential transition.

She said that if Biden takes precautions, including wearing a mask in the West Wing and interacting with people who are tested frequently, he should remain fairly safe. “It is still very unlikely he would have serious issues,” Gounder said. “He’s very healthy.”

Biden’s age puts him at risk for a more difficult case of covid, should he get it. But he does not have Type 2 diabetes, nor is he immunocompromised, two big risk factors.

The complex mix of factors facing Biden in some ways matches the pressures confronting his administration more broadly — the political need to signal that the United States is moving beyond the pandemic for good, offset by the undeniable persistence of at least some risk.

That balancing act could come to a head for Biden when the country observes its 1 millionth death from covid, a grim milestone that is expected within weeks. The president will need to balance an observance of tragedy, a message of victory and a plea for caution.

The White House, reflecting the diminished sense of emergency, has pared back the previously daily covid calls among top officials and has reduced the frequency of public briefings on the topic.

For now, the administration’s top priority on coronavirus is pushing for congressional approval of a $22 billion package that includes additional vaccine doses and preparations for another potential surge.

During his State of the Union address at the beginning of the month — delivered to a crowded and mostly unmasked House chamber — Biden hit a newly upbeat tone on the virus.

“Because of the progress we’ve made, because of your resilience and the tools we have, tonight I can say we are moving forward safely, back to more normal routines,” Biden said.

A distinctive element of the pandemic’s current phase is infections that are more frequent but less severe, at least for those who’ve been vaccinated and boosted, as Biden has. Outside the White House, several top Democrats have announced recently they’ve been hit by covid, using the occasion to tout the benefits of the vaccine.

Former president Barack Obama came down with a case March 13. “I’ve had a scratchy throat for a couple days, but am feeling fine otherwise,” he wrote in a social media post, adding that it could have been far worse if he were not vaccinated.

Former Democratic presidential candidate Hillary Clinton announced her case a week later, describing “some mild cold symptoms.” She, too, credited the vaccines for preventing more dire symptoms.

Those cases contrast sharply with President Donald Trump’s coronavirus infection in fall 2020, which he contracted after openly flouting health precautions and mocking people who took them. Trump became ill before vaccines were available and had to be hospitalized.

For Democrats, high-profile cases contracted by leaders of the party that made covid prevention central to its brand can feel discordant, even if they capture the reality that the disease is becoming more common and less lethal for those who are vaccinated and boosted.

As it eases into the next phase, the White House has restarted some of the typical events and traditions that were suspended for much of Biden’s first year in office.

In February, when several hundred supporters crowded into the East Room of the White House for a Black History Month event that Biden attended, most wore masks in keeping with the White House rules at the time.

But this month, Biden appeared at a gala for the Ireland Funds in Washington, an indoor event that included a meal and unmasked crowds. That’s where the president spoke with Martin, the Irish leader, who had to abruptly leave the dinner after learning about his positive result.

The White House noted that the interaction with Martin was shorter than 15 minutes, which is part of the CDC’s definition of a “close contact.” At the same gala, the Irish leader sat next to House Speaker Nancy Pelosi (D-Calif.), who is 82. Both she and Biden later tested negative for the coronavirus.

The White House pledged last July to publicly disclose any instances of coronavirus-positive individuals who come in “close contact” with Biden, Vice President Harris or their spouses.

Emhoff, who tested positive for March 15, remains the only one of the four principals in the Biden White House to contract the virus. That evening, Harris skipped a White House event celebrating Women’s History Month out what a Harris spokeswoman called “an abundance of caution.”

Meanwhile, Americans who travel to Poland are advised to wear a “well fitting mask” in public indoor settings, according to the CDC website. But Biden was photographed maskless at an indoor venue in Poland as he shared a slice of pizza to boost the morale of U.S. troops who surrounded him — and also didn’t wear face coverings.

“Avoid travel to Poland,” the CDC’s website advises. “Even if you are up to date with your COVID-19 vaccines, you may still be at risk for getting and spreading COVID-19.”

During this trip to Europe, Biden’s principal press secretary, Jean-Pierre, contracted the virus. She did not appear at Monday’s press briefing, which she had been scheduled to handle in Psaki’s absence.

Gounder, who is also a senior fellow and editor at large for public health at Kaiser Health News, said that boosting Biden every three to four months, even if that’s not recommended for the general population, might be advisable. “Presidential medicine is its own category,” she said. “It’s not what we do for VIPs or the public.”

Tyler Pager contributed to this report.

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Into the wild: Animals the latest frontier in COVID fight - The Associated Press - en Español

By LAURA UNGAR

March 30, 2022 GMT

GRAND PORTAGE, Minn. (AP) — To administer this COVID test, Todd Kautz had to lie on his belly in the snow and worm his upper body into the narrow den of a hibernating black bear. Training a light on its snout, Kautz carefully slipped a long cotton swab into the bear’s nostrils five times.

For postdoctoral researcher Kautz and a team of other wildlife experts, tracking the coronavirus means freezing temperatures, icy roads, trudging through deep snow and getting uncomfortably close to potentially dangerous wildlife.

They’re testing bears, moose, deer and wolves on a Native American reservation in the remote north woods about 5 miles from Canada. Like researchers around the world, they are trying to figure out how, how much and where wildlife is spreading the virus.

Scientists are concerned that the virus could evolve within animal populations – potentially spawning dangerous viral mutants that could jump back to people, spread among us and reignite what for now seems to some people like a waning crisis.

The coronavirus pandemic has served as a stark and tragic example of how closely animal health and human health are linked. While the origins of the virus have not been proven, many scientists say it likely jumped from bats to humans, either directly or through another species that was being sold live in Wuhan, China.

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And now the virus has been confirmed in wildlife in at least 24 U.S. states, including Minnesota. Recently, an early Canadian study showed someone in nearby Ontario likely contracted a highly mutated strain from a deer.

“If the virus can establish itself in a wild animal reservoir, it will always be out there with the threat to spill back into the human population,” said University of Minnesota researcher Matthew Aliota, who is working with the Grand Portage Reservation team.

E.J. Isaac, a fish and wildlife biologist for the reservation that’s home to the Grand Portage Ojibwe, said he expects the stakes to get even higher with the start of spring, as bears wake from hibernation and deer and wolves roam to different regions.

“If we consider that there are many species and they’re all intermingling to some extent, their patterns and their movements can exponentially increase the amount of transmission that could occur,” he said.

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INTO THE WILD

Their research is meant to ward off such unwelcome surprises. But it carries its own set of risks.

Seth Moore, who directs the reservation biology and environment department, recently almost got bitten by a wolf.

And they sometimes team with a crew from the Texas-based company Heliwild to capture animals from the air. One chilly late-winter afternoon, the men climbed into a small helicopter with no side doors that lifted above the treetops. Flying low, they quickly spotted a deer in a forest clearing. They targeted the animal from the air with a net gun and dropped Moore off.

Wind whipped at his face as he worked in deep snow to quickly swab the deer’s nose for COVID, put on a tracking collar and collect blood and other biological samples for different research.

The men capture moose in much the same way, using tranquilizer darts instead of nets. They trap wolves and deer either from the air or on the ground, and trap bears on the ground.

They knew of the young male bear they recently tested because they had already been tracking it. To get to the den, they had to take snowmobiles to the bottom of a hill then hike a narrow, winding path in snow shoes.

When Kautz crawled part-way into the den, a colleague held his feet to pull him out quickly if necessary. The team also gave the animal a drug to keep it sleeping and another later to counteract the effects of the first.

To minimize the risk of exposing animals to COVID, the men are fully vaccinated and boosted and get tested frequently.

The day after testing the bear, Isaac packed their samples to send to Aliota’s lab in Saint Paul. The veterinary and biomedical researcher hopes to learn not just which animals are getting infected but also whether certain animals are acting as “bridge species” to bring it to others. Testing may later be expanded to red foxes and racoons.

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It’s also possible the virus hasn’t reached this remote location – yet. Since it’s already circulating in the wilderness of Minnesota and nearby states, Aliota said it’s only a matter of time.

LOOKING FOR MUTANTS

Close contact between humans and animals has allowed the virus to overcome built-in barriers to spread between species.

To infect any living thing, the virus must get into its cells, which isn’t always easy. Virology expert David O’Connor likens the process to opening a “lock” with the virus’ spike protein “key.”

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“Different species have different-looking locks, and some of those locks are not going to be pickable by the key,” the University of Wisconsin-Madison scientist said.

But other locks are similar enough for the virus to enter an animal’s cells and make copies of itself. As it does, it can randomly mutate and still have a key that fits in the human lock. That allows it to leap back to humans through close contact with live animals, scientists believe.

Although spillback is rare, it only takes one person to bring a mutated virus into the realm of humans.

Some think the highly mutated omicron variant emerged from an animal rather than an immune-compromised human, as many believe. Virologist Marc Johnson of the University of Missouri is one of them, and now sees animals as “a potential source of pi,” the Greek letter that may be used to designate the next dangerous coronavirus variant.

Johnson and his colleagues found strange coronavirus lineages in New York City sewage with mutations rarely seen elsewhere, which he believes came from animals, perhaps rodents.

What scientists are most concerned about is that current or future variants could establish themselves and multiply widely within a reservoir species.

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One possibility: white-tailed deer. Scientists found the coronavirus in a third of deer sampled in Iowa between September 2020 and January 2021. Others found COVID-19 antibodies in a third of deer tested in Illinois, Michigan, New York and Pennsylvania. Infected deer generally have no symptoms. Testing in many other wild species has been limited or absent.

“It’s possible that the virus is already perhaps circulating in multiple animals,” said virology expert Suresh Kuchipudi of Pennsylvania State University, an author of the Iowa deer study. If unmonitored, the virus could leave people “completely blindsided,” he said.

CAN IT BE STOPPED?

Ultimately, experts say the only way to stop viruses from jumping back and forth between animals and humans — extending this pandemic or sparking a new one — is to tackle big problems like habitat destruction and illegal wildlife sales.

“We are encroaching on animal habitats like we have never before in history,” Aliota said. “Spillover events from wild animals into humans are, unfortunately I think, going to increase in both frequency and scope.”

To combat that threat, three international organizations — the United Nations Food and Agriculture Organization, the World Organization for Animal Health and the World Health Organization — are urging countries to make COVID surveillance in animals a priority.

In Grand Portage, Aliota’s collaborators continue to do their part by testing as many animals as they can catch.

With icy Lake Superior sparkling through the evergreens, Isaac slipped his hand beneath the netting of a deer trap. A colleague straddling the animal lifted its head off the snowy ground so that Isaac could swab its nostrils.

The young buck briefly lurched its head forward, but kept still long enough for Isaac to get what he needed.

“Nicely done,” his colleague said as Isaac put the sample into a vial.

When they were finished, they gently lifted the trap to let the deer go. It bounded into the vast forest without looking back, disappearing into the snowy shadows.

___

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.

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Tuesday, March 29, 2022

Covid Live Updates: News on Omicron, Boosters, and Cases - The New York Times

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It has long been clear that Black Americans have experienced high rates of coronavirus infection, hospitalization and death throughout the pandemic.

But those factors are now leading experts to sound the alarm about what will may come next: a prevalence of long Covid in the Black community and a lack of access to treatment.

Long Covid — with chronic symptoms like fatigue, cognitive problems and others that linger for months after an acute Covid-19 infection has cleared up — has perplexed researchers, and many are working hard to find a treatment for people experiencing it. But health experts warn that crucial data is missing: Black Americans have not been sufficiently included in long-Covid trials, treatment programs and registries, according to the authors of a new report released on Tuesday.

“We expect there are going to be greater barriers to access the resources and services available for long Covid,” said one of the authors, Dr. Marcella Nunez-Smith, who is the director of Yale University’s health equity office and a former chair of President Biden’s health equity task force.

“The pandemic isn’t over, it isn’t over for anyone,” Dr. Nunez-Smith said. “But the reality is, it’s certainly not over in Black America.”

The report, called the State of Black America and Covid-19, outlines how disinvestment in health care in Black communities contributed to Black people contracting Covid at higher rates than white people. Black people were then more likely to face serious illness or death as a result.

The Black Coalition Against Covid, the Yale School of Medicine and the Morehouse School of Medicine were authors of the report, which also offers recommendations to policy leaders.

In the first three months of the pandemic, the average weekly case rate per 100,000 Black Americans was 36.2, compared with 12.5 for white Americans, the authors write. The Black hospitalization rate was 12.6 per 100,000 people, compared with 4 per 100,000 for white people, and the death rate was also higher: 3.6 per 100,000 compared with 1.8 per 100,000.

“The severity of Covid-19 among Black Americans was the predictable result of structural and societal realities, not differences in genetic predisposition,” the report says.

Black Americans were overrepresented in essential-worker positions, which increased the risk of exposure to the virus, the authors write. And they were also more likely than white Americans to live in multigenerational homes or crowded spaces, be incarcerated, or live in densely populated areas.

Many Black Americans who contracted the coronavirus experienced serious illness because of pre-existing conditions like obesity, hypertension and chronic kidney disease, which themselves were often the result of “differential access to high-quality care and health promoting resources,” the report says.

The authorization of the first coronavirus vaccines was seen by many experts as a light at the end of the tunnel, but new disparities emerged, driven by both vaccine hesitancy and limited access to the shots.

Though the gap in vaccinations has since narrowed — 80 percent of Black Americans were fully vaccinated as of January, compared with 83 percent of white Americans, the report says — disparities persist.

“We understand that there remains unfinished work yet to do to save and protect our communities from the Covid-19 pandemic,” wrote Dr. Reed Tuckson, who in April 2020 co-founded the Black Coalition Against Covid.

And when it comes to unfinished work, long Covid is top of mind.

“So much of even getting a long Covid diagnosis is tied to having had a positive test right at the beginning,” said Dr. Nunez-Smith, adding that early on in the pandemic, many Black Americans “weren’t able to secure a test and in some cases, were denied testing.”

She emphasized the importance of investing adequate resources into studying long Covid. “Like everything else, without intentionality, we’re not going to get to equity there,” she said.

Correction: 

March 29, 2022

An earlier version of this item described incorrectly the average rate of weekly cases, hospitalizations and deaths from Covid among Black Americans in the first three months of the pandemic. They were rates per 100,000 people, not percentages. An earlier version also included outdated figures provided by the Black Coalition Against Covid that the organization revised after publication.

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March 30, 2022 at 07:41AM
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Covid Live Updates: News on Omicron, Boosters, and Cases - The New York Times
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Omicron BA.2 Variant Now Dominant In U.S.; New Cases Of More Transmissible Covid Hitting Northeast Hard - Deadline

The more transmissible strain of Omicron, BA.2, is now the dominant Covid variant in the United States. In just the last week, it has risen from 35% of all new cases genetically sequenced to 55%, per CDC data. That’s a remarkable 80% jump in just seven days.

In the swath of the Northeast that includes Pennsylvania, New York, New Jersey, Vermont, New Hampshire, Connecticut, Massachusetts, Rhode Island and Maine and has a population of about 55 million people, BA.2 now accounts for more than 70% of all new cases. That’s up from just over 50% the week before and 38% the week before that.

BA.2 omicron

A late January report from the Statens Serum Institut, which operates under the auspices of the Danish Ministry of Health, found that “BA.2 may be approx. 30% more transmissible than BA.1 (the original Omicron).” Some analyses since then have claimed the variant’s transmissibility advantage is even higher.

The good news is that the Omicron strains are much less virulent than Delta, but as the U.S. saw in early February of this year, Omicron’s increased transmissibility can still create a wave of deaths equal to or surpassing that of Delta by the sheer number of infections alone.

So far, that is not happening, with only minor jumps in the number of cases reported in parts of the Northeast and no significant jumps in hospitalizations.

One state where cases have risen alongside BA.2 is Florida. Covid numbers from data hub Helix.com indicate that, by mid-March, Omicron BA.2 accounted for 66% of all new cases in the state. The 7-day average of new cases in the state have risen from about 2300 on March 23 to about 4200 on March 28, per CDC data. But hospitalizations have actually dropped, so whether or not BA.2 will have a substantial impact on the local healthcare system remains to be seen, as hospitalizations generally lag cases by 2 weeks.

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